Journal of Reproduction & Infertility
Year:2005 | Volume:6 | Issue:4 (24)|Papers Count:18

Introduction: Each year health and lives of millions of people are endangered by the termination of unwanted pregnancies. Unsafe induced abortions happen very often all over the world,  especially in developing countries which many lead to death and disability of women in their fertility years. The highest incidence of unsafe induced abortions are reported from developing countries, especially those that impose tighter legal restrictions. These important problems which inflict women, need to be addressed by a comprehensive study on different aspects of abortion in such societies as Iran, which is confronting about 80,000 abortions each year. On of the objectives of this study was familiarization with the problem of abortion in the Iranian society where religious, legal and cultural prohibitions have lead to an increase in unsafe induced abortions. Other objectives of this study were to evaluate the causes of this increase, to assess the  need for educative information on different aspects of unsafe abortions, to familiarize the legislative authorities with the present condition of the country and to make preparations for a change in views and also to cultivate the social grounds to reduce the increasing rate of such abortions.Methods: This study was based on literature and documentation  reviews.Results and Discussion: Considering the young age of the Iranian population, changes in the views of Iraian women on the family size, late marriages, absence of parents at home in most of the day time, committing unsafe abortions due to the pressures exerted by restrictive legislations, endangering physical, sexual and psychosocial health of men and women and the increased treatment expenses and their effect on the health care budget, require great steps to be taken to make changes in legislative policies by applying WHO’s views on the concept of health to hopefully witness a pronounced reduction in unsafe abortions. It seems that there are the possibilities to achieve legal solutions by considering the comprehensive aspects of abortion and taking divagate of the uncertainties and absence of a unified jurisprudential view on the time of soul inspiration and by relying on the robust law of "hardship", prescription of abortion in some instarces can come true.

In his paper, the author tries to deal with one of the most controversial ethical problems of the modern time from a moral point of view; abortion. Is abortion moral? and can it be justified in any situation? Or it cannot be justified in any case? There are four main ethical approaches to abortion: First,a conservative approach, second, a liberal, third, a moderate, and fourth, a feministic one. None of these approaches seem to be able to justify various kinds of abortion. We need to deal with every case separately and try to assess its morality. Accepting this view, the author tries to face abortion due to rape and he argues that this kind of abortion may rest its reasons on four principles: Autonomy, justice principles, self-defense, and the responsibility of society toward the pregnant woman as a victim of violence and rape. According to these principles, if a woman is raped and becomes pregnant, it is her personal choice to continue her pregnancy or abort it. Then the author goes into some jurisprudential details from an Islamic perspective and tries to defend his position by citing some famous Islamic legal decisions, or "Fatwa"s.

There is no clear mention of abortion in the moral teachings of the New Testament. Yet, from the very early times of Christianity, Christian sects and scholars have paid attention to this problem. The Roman Catholic Church believes that the fetus is a full human being, with a right to live, from the moment of conception; therefore this church has condemned all direct acts of abortion. Didache, a late first-century or early second-century manual of Christianity teachings, decrees that: “You shall not kill the embryo by abortion and shall not cause the newborn to perish.” In another Christian document, abortion is regarded as an abominable crime. Although some Christian scholars put forward the idea that abortion would be possible if the fetus has not developed a soul. The Roman Catholic Church in the nineteenth century rejected this idea formally, and decreed that abortion of any fetus is prohibited, and the person who performs it is condemnable to the canonical penalty of excommunication. One of the most important challenges to this idea of Catholic Church is that a pregnancy may put the mother’s life at risk of death. According to this teaching, even in such cases, abortion is not allowed. Catholics in response to this problem have suggested the rule of "double effect", to save the life of the mother. For example, if a pregnant woman has uterine cancer or pregnancy in the fallopian tube, physicians may undertake procedures to save her life. In terms of the rule of double effect, the pregnant woman and her physician don’t intend the fetus’ death, and removing the cancerous uterus is a legitimate medical treatment for uterine cancer, even though it will result in her fetus’ death. By contrast, many Protestants, Orthodox and other theologians, especially in recent times, view the fetus as a potential human being, which lays significant claims to the pregnant woman and others. Yet, abortion can sometimes be justified (e.g., when the life of the mother is at risk). Some feminist theologians, that give another interpretation of the relation between the pregnant woman and her fetus, allow abortion if the pregnancy endangers the mother’s life.

The righteousness or unrighteousness of abortion is evaluated in this article. For a more précised look, this study has been performed in two separate domains: In the ancient tradition of Zoroastrianism which is a collection of the teachings of Zoroaster mixed with ancient mythical notions and perceptions and the other is the domain in which the pure teachings of Zoroaster which specifically have been passed down in Gathas or the holy songs of Zarathustra or Zoroaster. Abortion has been counted as unrighteous in the ancient traditions of Zoroastrian teachings, as this act is both a deliberate murderous act and it also pollutes the Earth with a cadaver. However, in pure Zoroaster′s teachings, there is no direct mention of the legalities of abortion such as its righteousness or unrighteousness. However, what is quite fascinating in his teachings, is a profound outlook and a very ethical view towards human beings. The comprehension and realization of Zoroaster′s position towards abortion is possible only when one looks at this issue from the common sense prevalent in his teachings. Zoroaster sees the world as a pervasive battlefield between the bad and the good and he believes that the best deeds or actions, originate from Asha, which can be interpreted as righteousness, purity or chastity and the fundamental order governing the universe. In Zoroaster′s beliefs, all creatures of the universe, including man, are the creations of Ahura Mazda and they rotate around Asha in their self and therefore deserve reverence. In this system, the starting or departure point for the mien or manner of any human that steps in to this world, is nothing but virtue and purity; and (s)he is so free and unfettered that (s)he can egress its orbit around Asha, against it celestial self, and turn to evil and wickedness or vice versa and step onto the path of Asha and renovate or rejuvenate the universe by each deed. Therefore, one can easily see that in the views of Zoroaster, abortion is the destruction of a being of derive entity in his/her self that can widen the boundaries and strength of goodness in the world. This means that, in Zoroastrianism′s outlook abortion swings between two boundaries: Either an innately celestial being has been murdered or a being, which according to his/her innate, could have become more celestial, which both acts are obscene and denounced. According to these statements, in Zoroaster′s teachings there is always a recommendation to the application of the principles of rationality in all matters, which based on this rationality one can allow abortion under some circumstances that are indicated by the achievements of science. In other words, in Zoroastrian′ s religion outlooks, whenever the contemporary science indicates an action, we should  follow that and it is not approved to evade it, by excuses such as commitment to (unwise and insensible) traditions.

In Torah, the first and most important source of Jewish laws, there is no direct mention of a willful abortion. This book only refers to the abortion of a pregnant woman’s fetus in the course of a quarrel. In similar cases one who causes this kind of abortion shall pay fines. Talmud, the second important source of Jewish laws, refers to willful abortions. According to Talmud, abortion, although prohibited, is not punishable by death penalty. In spite of prohibition of abortion in Talmud, this book sometimes permits abortion. According to Talmudic laws, abortion is permitted if the fetus endangers the mother’s life, but from the moment that the head or the greater part of its body has emerged into the world, no one can abort it; because here there are two living beings, and no one can say the life of the mother is more important than that of the fetus. Yet, when the mother’s life is endangered, she herself may destroy the fetus even if the greater part of the fetus has come out of her body, according to "self-defense" rule. Some Jewish texts maintain that abortion should be permitted if it is necessary for rescuing the mother′s life, even if there is no fatality attached to the pregnancy or the mother’s illness is not directly caused by the fetus. The permissibility of abortion in relation to a pregnancy resulting from adultery has been a matter of controversy. Many Jewish scholars have permitted abortion by a married woman made pregnant through adultery,but not by an unmarried woman who becomes pregnant, because, according to the Jewish laws, the child of the former woman is regarded as a bastard, but the child of the latter, i.e. unmarried woman′s, is not regarded so. According to Talmud, abortion is permitted, if a woman′s pregnancy results from adultery and she is condemned to death. In this case, abortion is permitted, and it is even said that it is obligatory to do it before execution process starts, except the time when delivery has started. In recent years, the question of permissibility of abortion has been raised in cases where there is the fear of malformation or of a birth defect in the fetus. The general tendency is to uphold the prohibition against abortion in such cases. Yet, some neo-Jewish jurists have adopted a lighter view and permitted abortion in some cases.

Abortion and its laws in Islamic jurisprudence, is one of the important issues in religious domains and by the evolution and progress of sciences, this issue has entered into the realm of science and medical societies too. Islamic jurisprudence can not be passive in dealing with current demands and exigencies, and also it can not retreat from the progresses of science or does not follow or synchronize itself to science as new scientific findings become available. The emergence of new diseases and dilemmas will affect the comprehension of some essentials of jurisprudential principles, perception of different subjects and concepts and even inferences from religious texts; therefore the researchers of religious seminaries which preserve the Islamic jurisprudence, should more than ever familiarize themselves with different schools of thought and opinions and consider and reconsider important jurisprudential subjects based on new scientific achievements. The subjects which have been addressed in this article are as follow: 1. Defining fetus, 2. Developmental stages of fetus such as zygote, 3. The duration of each fetal stage, 4. The disagreement among Islamic jurisprudents on the application of the term fetus to an entity that has not yet taken the form of a human and whether one can consider the application of abortion laws to it, and 5. The stages of pregnancy in which abortion is permissible. In Imam Mohammad Gazelli′s opinion, abortion is strictly prohibited but there is disagreement on this issue among different schools of Islam and contemporary scholars. a) Hanafite school′ s point of view on abortion: In the textbooks of Hanafite jurisprudents like "Aldor al-Mokhtar” it has been stated that abortion can be performed before the inspiration of soul, that is before the end of the forth month of pregnancy; although the jurisprudents of this school have not prohibited abortion before the inspiration of soul into the body. b) Malikite school′ s point of view on abortion: They do not allow the expulsion of zygote even before the fortieth day of pregnancy and even they do not spare any room for exceptions. c) Shafi′ ite school′ s point of view: The Shafi′ite jurisprudents have two opinions on this issue: 1. An opinion which prohibits abortion after conception and even before the end of the fortieth day of pregnancy. 2. Some others, among them Abou-Isacc Marvazzi and Shebra Melsi, by referencing to Abou-Hanifa′s thesis, have exempted abortion in zygotic and blood-clot stages, have accepted legal pleas and have allowed abortion in both situations, although Imam Mohammad Gazelli even prohibits abortion of zygotes in any stage. d) Hanbalite school′ s point of view: The jurisprudents of this Islamic school do not allow abortion after the fortieth day of pregnancy. e) Zahirites school′ s point of view: The jurisprudents of this school do not allow abortion under any circumstances and do not authorize any excuses or exceptions for abortion. f) The preponderant view amongst the schools: The contemporary jurisprudence teachings master, Dr. Abdol-Karim Zeidan in “Al-Mofasal” has stated that if abortion is necessary as a medical treatment or it is a legal problem and the fetal stage is before the inspiration of soul, before the end of the fourth month of pregnancy, abortion is permissible from the Shariah or Islamic law point of view and even some believe abortion as permissible before the end of the fourth month with or without any excuses. Sheik Mohammad Shaltout, the former president of Al-Azhar University says: If it is strongly proven that the survival of the fetus after its coming to existence will face difficulties and even death, the general laws of Shariah, order us to "the least two losses". Nowadays, some of Islamic scholars permit abortion because of the mischief of the contemporary time and social problems. The views of Dr. Josef Gharzavi, the master of contemporary Islamic jurisprudence, depict that fetus is regarded as a complete human after the fourth month of pregnancy and its soul inspiration and any crime committed to it is similar to crime committed to a complete human and even the laws of Shariah allow pregnant women to break their fast in Ramadan to preserve the life of the fetus and even they delay the avenge for blood of a condemned pregnant women to death to a time after delivery or likewise the stoning of a pregnant women. The subject of soul inspiration is different from pure ani-mal life and animal life is antecedent to human life (inspiration of soul). Some contemporary Islamic jurisprudents and contemporary jurisprudence specialists have permitted abortion in situations that are exigent and imperative and they believe that fetus is in the form of pure fluid, a clot of blood or a mixture of meat loaves. Dr. Gharzavi affirms that if it is proven scientifically scientific, that the fetus in its mother′s womb has anomaly or has serious malformations and its viabi-lity in future will cause torment and problems for himself/ herself and the family, based on the rule of repelling or warding off the loss as much as possible, has permitted abortion.

The present article discusses briefly the different reasons for induced abortions and it then seeks the answer to this question by explaining the views of Sunnite jurisprudents on abortion when the continuation of pregnancy threatens the life or the health of the mother. In the author′s view, the answer to this question becomes possible after dividing the life of the fetus into two stages, before and after soul inspiration, dividing Sunnite jurisprudents into past and present and also with regard to four major Sunnite schools. In each case we should find the basic criterion and the bases on which the Sunnite jurisprudents have established their views, because this attempt may at least bring to light the decrees on abortion and the reasons for which these decrees have been issued, although they have not been directly stated. The past jurisprudents′ views on abortion have the kind of air that abortion after the inspiration of life even for rescuing the mother′s life is not permissible, as the fetus in this stage has "self" and a verse in Koran applies to it in this regard, "Do not kill the self as this has been prohibited by God". Regarding different views stated by major Sunnite jurisprudents on abortion before soul inspiration, when the mother′s life is in danger it is understood that abortion is not only lawful but also imperative as the fetus has no soul and it does not contradict the mentioned verse of Koran. In the conflict between the life of a being "the mother" and an entity that has no life, soul or self, and it is regarded as an object "the fetus", the life of the one has priority which has soul, as based on the justification for "the least losses" saving the life of the mother is the least loss sustained by the human society. But on abortion after soul inspiration, some contemporary jurisprudents believe that it is considered unlawful if it is committed in the absence of any reasons, but some say it is lawful even in cases where there are no rational excuses for them. Nevertheless both groups believe that if the continuation of pregnancy will threaten the life of the mother, a justifiable reason is met for abortion and it is not only lawful but also obligatory.

From medical point of view, abortion is the expulsion of partially formed fetus or abortion of an incomplete pregnancy by the mother or another person. In Islamic religious beliefs, fetus is regarded as two forms: fetus with soul and human life and fetus without any soul. On prohibition of abortion in the first case, there is no difference between Shiites and Sunnites, as fetus in this case has self or soul and based on all the versus and traditions of Islam, its abortion is counted as murdering a human. In the second case, some Sunnites allow its abortion but Shiites prohibit this one too, of course aside from some exceptions. This paper tries to discuss two important issues on abortion; the first one is the soul inspiration of the fetus. In this regard some medical doctors believe that there is not such a thing as lifeless fetuses and even some believe that even spermatozoids and ova have life before conception. Some others believe that fetus has movements long before its movements are detected by the mother and this is due to the tininess of the fetus and largeness of the fetal sac, but upon the growth of  the fetus its movements are perceived. It is to be said that we have to accept all the sensory issues that are proven by medicine without any question. But it should be noted that Islamic jurisprudents do not solely mean life, but human life which is made of the inspiration of life into the body. Life has different types in ancient philosophers’ opinion: Vegetative, animal and human. Vegetative life is in need of food, respiration, temperature, and … Animal life is in need of the senses and voluntary movements, aside from the previously mentioned ones. Human life has the ability of intuition in addition to the senses,  movement, etc and this capability is due to the effects of his abstract rational soul. Nowadays, scientific evidence has been added to rational and religious reasons for the existence or being of humans too. From medical point of view, there are other classifications for life and its stages, but there is not much expectation from medical science to comprehend the state of possession of soul by fetus. Science penetrates in the sensory world but has no other choice except resorting to silence in the worlds of philosophy and religion. Materialists have made a mistake for stepping out of the boundaries of science by denying the injunctions of rationality and philosophy; as there is no conflict between physical and spiritual causes, although some theologians have made mistakes on this issue too. The human soul is disengaged or isolated from matter and its appendages like time and place; but as a contingent being it is finite and has essence, contrary to the existence of God which is immaterial and has no essence. Soul does not incarnate into the body and does not have a specific place in it, nor does it mount on it. Soul is the expedient of the body and has expediential affinity to it, but the truth of this affinity is not philosophically, religiously or scientifically known. From this expedient belonging of soul to body, life is blown into the body and this inspiration of life into the body is called life. This is not the blownability of soul but blowability by soul, therefore the meaning of blownability is life. Though life appears in the fetus after 4 months of pregnancy, but its exact day and time is not known. In the second part of the paper, abortion is studied on the following premises: In the premise that there is certitude for the death of the fetus, in the premise that fetus lives on but it will end in the mother′s death or the premise that it will harm the health of the mother, the assumption that the birth of the fetus will cause severe hardship for the mother, in the case of hydatidiform mole and  abortion in the case of  illegitimacy.

The study of historical development of criminal law in different countries shows that abortion has initially been regarded as a crime with severe punishment in many countries, including Australia. Abortion is an inevitable universal phenomenon, and according to statistics released in 1990, the worldwide number of attempts for abortion was estimated to be between 36 to 50 million a year, which only one third of them were carried out legally and with access to modern clinical and pharmaceutical facilities. On the basis of statistics provided by World Health Organization (WHO) in 1990, around 61000 pregnant mothers lose their lives every year due to unsafe abortions. The high percentage of maternal mortalities, particularly in the third world countries, was scrutinized and recognized as a big concern in the Population and Development Conference held in Cairo in 1994. Consequences and difficulties due to the absolute prohibition of abortion, promoted the legislative and executive bodies of many countries to more realistically allow legal abortions under particular circumstances while, still no realistic changeovers have been accorded in laws of abortion in some other countries, including Iran, and accordingly, people in these countries are suffering from the absolute prohibition of abortion. Upon reviewing the development of abortion laws in Australia, this article studies the logical flexibility of some countries over the social phenomenon of abortion and relevant reforms of laws in those countries. By analyzing the social and jurisprudential bases and resources of law, the article also reaches to a conclusion that necessitates law reform, and allows practice of legal abortion under defined circumstances in Iran.

Studying abortion from Human Rights views and making a statement about its legality or illegality, requires us to know that human rights is a part of International Law, which is based on the will of states as the members of international community, and it is materialized in international conventions and customs. International Law is a main branch of science of Law which is a tool in the hands of the civilized man to draw the different wills closer and to enact punishment for breaching the rules pertaining to Public Order. In the contemporary era, human rights which is inclined towards the inherent values of human beings and is outside the reach of the will of states and accordingly should be just codified and respected by governments, and in this respect can not be granted or even waived, with regard to the rapid changes in the international community, already is under such a great attention that has affected Law in its whole concept. The main issue in all international human rights instruments is human being and the intrinsic rights belonging to his nature, accordingly it can be deduced that humanity as a whole, is the real concern in human rights. Notwithstanding, the most fundamental right of human beings through which enjoyment of other rights is possible, is the Right to Life which is considered by all the relevant instruments. Different human rights are not based on hierarchy but each of them is complimentary or supplementary to the others, therefore submitting to this right without considering and respecting the other human rights i.e. freedom of choice, actually would end up in negating the intrinsic values of mankind which has been created by God in his figure. Abortion is a complicated issue and necessitates considering the contradicting rights inherent in human nature namely: the right of fetus, which according to medical and biological sciences bears human DNA and therefore should be considered a human being, the right to life and the right of women to choose the walks of life they choose, especially when one chooses the kind of motherhood she wishes during her life. The reason why most international human rights instruments do not carefully address this important problem is rooted in the mentioned conflicts which in a broad analysis have a restricting effect on the rights of the two parties. The black and white theories of those who approve or criticize abortion, which is based on pure metaphysics or humanism, to the benefit of either the unborn child or the mother, can not help to elucidate this problem because the mentioned inconsistency is not entrenched to the theoretical debates but is considered as the exact starting point of encountering reality and law in a particular aspect of social life. Although in our views, there is no uncertainty about the human characteristics of the fetus, hence about his right to life, we have to remember that the nature of human beings consists of opposing and at the same time evolutional elements, therefore human rights can not be studied devoid of consideration of all conflicting problems and developing issues concerning this complex nature with its earthly needs. If no steps are taken to comply with the minimum standards in the mankind’s life, he, as a result of distress or as seeking a solution to his problems, without contemplating about ethics and values, may infringe the rights of others, including his own child’s.

By the means of assisted reproductive technologies (ART), such as in vitro fertilization (IVF) and intracyctoplasmic sperm injection techniques (ICSI), more than one million infants have been born throughout the world. One of the interesting happenings in infertility treatment procedures, that needs to be addressed, is the occurrence of multiple pregnancies which is usually seen following the use of ovary stimulating medications, embryo hatching and transference of a high number of embryos for higher success rates. For reducing the chances of this problem and preventing subsequent complications during pregnancy, embryo reduction is employed for two purposes: 1. Embryo reduction in triple or higher pregnancies, for the prevention of fetal and maternal complications and 2. Selective embryo reduction in cases where one or more fetuses have malformations or chromosomal defects. Embryo reduction methods: Dilatation of cervix and suction of one or more fetuses, via transvaginal route, by the help of sonography and transabdominally by the use of sonography. Although medical doctors might not be eager enough to know about embryo reduction in multiple pregnancies, but they have to know about the procedures and be prepared for medical interventions in emergencies, based on ethical and legal principles or on the request of patients. The first step, especially in infertility clinics, is reducing the chances or preventing the occurrence of these instances. Although selective reduction of embryos is ethically and legally accepted, but before any moves taken, offering infertility counseling is essential and it should include the expression of the risks of multiple pregnancies and ethical issues in embryo reduction before the transference of embryo(s) to the uterus, as lack of information on these subjects may lead to more problems afterwards. This study reviews the medical and ethical aspects of the issue and also introduces embryo reduction techniques in multiple pregnancies,in methods employing ovarian stimulating medications and in in vitro fertilization techniques. This method of embryo reduction, will reduce the risks of abortion, premature births, birth of malformed children and fetal demise,otherwise these would be the case if measures are not taken to correct the problem.

Introduction: Facing dead bodies of mothers due to criminal abortion in the dissecting hall of forensic medicine offices or in hospitals is due to the ignorance of a social reality which has not been addressed well by a decisive action for its solution or control. Unfortunately, eighty tho usand maternal deaths occur each year in the world due to criminal abortions which are accompanied by the deaths of 80000 fetuses too. The 10% illegal abortion of all abortions carried out in Iran indicates the importance of the subject for consideration. The termination of pregnancy before fetal capability for extra uterine viability without any legal justification is considered criminal abortion. Mothers or inexpert people and sometimes delinquent medical personnel, commit criminal abortion, often in unscientific ways. Most cases of criminal abortion are committed during the second or third month of pregnancy by the use of different medications or local injuries, but in the first month it is usually done by blunt traumas to the abdominal or pelvic areas.Common methods of illegal abortion: 1. Abortificant drugs: Low doses of these drugs are ineffective, but in high doses without having any direct abortificant effect, result in abortion by toxifying  the mother. 2. Local abortificants: These substances are applied in the vagina or onto the cervix and they will cause abortion by their chemical properties. 3. Instrumentation: These are the most effective methods used and are done via three methods: a) douching b) syringing c) direct instrumentation. Causes of death due to criminal abortions are: a) inhibition deaths or deaths because of overdosing, b) hemorrhagic shock, c) septicemia, d) drug or chemical poisoning, e) air emboli or f) amniotic fluid emboli.Conclusion: Familiarization of physicians and medical personnel with illegal abortions and causes of maternal deaths due to this problem and also an attempt to find a solution for its control or decrease, together with familiarization of authorities in Iran may finally lead to a solution and control of illegal abortions in the society.

Abortion is the termination of pregnancy either spontaneously or intentionally before fetus develops sufficiently to survive outside its mother’s womb. Not all zygotes, which are the result of spermatozoid and ovum fertilization, will reach implantation stages and too many pregnancies terminate inevitably because of fetal or maternal causes. The data on maternal mortality rate and complications which unwanted pregnancies face and the number of attempts for induced abortions is considerable. Although, at the first glance, it seems that abortion is a medical issue, but diverse fields have their statements according to their approaches. These statements are often expertised, judgmental and incisive but most of them are theoretical discussions and cover different beneficiaries and the mothers’ decisions, rights and health for the continuation or termination of pregnancy may be of the least concern. Even in the cases of the mothers’ or fetuses’ illnesses, the decision on maintaining the health of pregnant mothers depends on other dimensions of interest. This article, without agreeing or disagreeing with  abortion, provides information on pregnancy and abortion, and the reader is left free for the analysis and decision making.