Abortion and multifetal pregnancy reduction: An ethical comparison

Abstract

During recent years, multifetal pregnancy reduction has increasingly been subject to debate in Norway, and this debate reached an apex when the Legislation Department delivered the interpretation statement § 2 - Interpretation of the Abortion Act in 2016 in response to the Ministry of Health and Care Services, who had (in 2014) requested the Legislation Department to assess whether the Abortion Act allowed for multifetal pregnancy reductions of healthy fetuses. The Legislation Department concluded that the Abortion Act does regulate and permit multifetal pregnancy reductions within the framework that the law otherwise stipulates. The debate has not subsided, and in the autumn of 2018, it was further intensified in connection with the Norwegian Christian Democratic Party´s (KrF) "crossroads choice" and the signals from the Norwegian Conservative Party that they would consider reverting the Abortion Act’s section 2.3c [regulating second trimester abortions due to fetal anomalies], as well as a ban on multifetal pregnancy reduction. Many of the arguments in the multifetal pregnancy reduction debate appear very similar to the arguments pending in the general abortion debate, and an analysis of what makes multifetal pregnancy reduction significantly different from abortion is wanting. The aim of this article is, accordingly, to investigate to what extent there is a morally relevant distinction between abortion and multifetal pregnancy reduction of healthy fetuses. We take on board typical arguments from the Norwegian debate and consider them in light of the scholarly literature. We have identified the most central arguments against multifetal pregnancy reduction as the harm argument, the slippery slope argument, the intent argument, the grief argument, the regret argument (concerning long-term psychological effects for the woman), and the sorting argument. We argue that these counter-arguments do not succeed in establishing a morally relevant difference between abortion and multifetal pregnancy reduction of healthy fetuses. Our conclusion is, therefore – that despite what is often held – there is no morally significant difference between the two. Therefore, when we allow abortion, we should also allow multifetal pregnancy reductions.