How Can A Paradigm 
Affect Your Rights As A Woman?
"The abortion rate will drop and the safety of the procedure will improve, parallel to the position women occupy in a given society, and to the level of recognition of their sexual and reproductive rights."
[ International Journal of Gynecology and Obstetrics 1997 Jul;58(1):77-83.]

From earliest times the relationship between a woman and her developing embryo or fetus has been the subject of philosophic, religious, and legal wrangling.  This is one of the most important questions in the abortion debate because how this relationship is envisioned will result in both legislation and social attitudes based on that vision. With this in mind I'd like to examine the paradigms we currently use and look at the implications.  I want, furthermore to examine how those paradigms fit into what we know biologically about the relationship and discuss whether we are basing our paradigms on this biological reality or on a concept that fits a political agenda.

 This work will essentially throw some light on the flaws inherent in the current trend to sometimes view an embryo/fetus (which for simplicity I will refer to as fetus from here on) as a separate entity residing in the body of the woman.

The "Integrated Single Unit" Paradigm.

With this concept the woman and her fetus are represented as a single organism which could be referred to as the "Pregnancy Unit" as the textbook Williams Obstetrics does; or the "organism of the pregnant woman" as it is referred to on this site .

Viewing a pregnancy in this way certainly is in line with what we know about the nature of the relationship being described. British Medical researcher and Scientist, Sir Peter Medawar, as part of the study of the immune system he was conducting in 1953, drew attention to a paradox with respect to that fetal relationship.  He described the fetus as a graft on the body of the woman and as such wondered why, without drug intervention, rejection does not always take place. 

As background, grafts can be of several types.

 They may be:

  • Autologous:  referring to naturally occurring cells, tissues, organs in which the donor and recipient are the same individual and antigenically identical.  Words associated with this are autogenous, autograft, or autotransfusion isograft, a self-to-self graft.  
  • Allogeneic:   referring to naturally occurring cells, tissues, organs in which the donor and recipient are not genetically identical yet are within the same species.  Words associated are allogenic, allogeneic, allograft, and homograft.  
  • Syngeneic:  referring to naturally occurring cells, tissues, organs in which the donor has an identical genotype with the recipient.  Words associated  syngraft, isogeneic, or isogenic.  
  • Xenogeneic:  referring to naturally occurring cells, tissues, organs in which the donor and recipient belong to different (or widely separated) species.  Words associated  xenogenic, xenogenous, heterogeneic or heterologous. 

  • (The above are taken From Stedman and Dorland definitions).
There are others types of graft also but these are sufficient for our purpose.  Now since the contribution to the genetic structure of the fetus is half from the woman it is not a true autograft but a semi autograft, and since it is the same species as the host it is it is therefore properly described as an allograft but it is more like the host than most allografts because of the 50% identical genetic component. So semiallogenic is the term frequently used to describe the fetal/host graft relationship.  Medawar noted that despite the semiallogenic nature of the fetus that rejection did not take place automatically and postulated a  number of reasons for this. Without going into unnecessary detail here, let me simply say that further research has shown the maintenance of the graft relationship (and thus the pregnancy) depends on the production of hormones that will reduce the normal rejection mechanism of the immune system, and cause the host body to recognize the graft as a part of itself.

Thus the relationship between the woman and her fetus is a graft to host one and the graft is integrated into the body of the host making the combination, as in all such relationships, a single unit.

The "Dual Organism" Paradigm.

A competing vision of what the pregnant woman consists of, is that what is actually present are two separate and independent entities and that they should always be treated as such.  For this reason, using this paradigm, we find fetal specialists and medical ethicists insisting that the pregnant woman is actually two patients. This view then makes the further claim that a separate organism is produced at conception, which is "when life begins" and that organism, because it has a different DNA from the woman in whose body it resides, is not a part of her.  The human reproductive cycle is thus viewed as an instantaneous point in time rather than the  prolonged approximately 40 week developmental process it actually is. Let me point out some of the flaws in this 'dual organism' position.

Organisms come in many forms, including single celled, but since we are talking about humans at this point, we are referring to mammals, and mammals are not single celled organisms.  What we need to do is look at the markers that are necessary and sufficient to classify an entity as a mammalian organism.  These markers are identified in many biological textbooks and but for simplicity I will use the definitions found in the Oxford English Dictionary, and Websters, here.
Organism: An organized body, consisting of mutually connected and dependent parts constituted to share a common life; the material structure of an individual animal or plant. OED
And from this the biological definition of Individual is needed also:
Individual: "Biol. An organism regarded as having a separate existence...an organism detached from other organisms, composed of coherent parts, and capable of independent life."  OED
Then from Webster's Medical Dictionary Online we have:
Organism:  "An individual constituted to carry on the activities of life by means of organs separate in function but mutually dependent : a living being."  (Merriam-Webster's Medical Dictionary on line)

So what is required to describe an entity as a mammalian organism is individuality, and the capacity for independent life.  Some of the requirements for maintaining independent life in a mammalian organism would be the ability to detoxify and reoxygenate  blood; to maintain homeostasis - temperature, blood pressure and blood pH, etc., using it's own internal regulatory systems that respond to the external environment; to ingest, digest, and excrete in order to produce and convert energy to maintain systems; and more.

All of these functions are performed for the fetus by the host organism of which it is a part, and the fetus is incapable of performing them independently as long as it remains integrated into the body of the woman. We can safely draw the conclusion that the fetus does not have the markers of, or perform the self regulated life sustaining functions of, independent organism in itself but  it is a part of a larger organism
(even though the fetus gains an increasing capacity for independent performance of those functions as the pregnancy progresses - which is the purpose of gestation).

I can already hear the clamor at this point to grab dictionaries or textbooks that refer to the fetus as an organism and I'm quite aware that this is frequently done for reasons of convenience and ease in description.  It is even more frequent since the "dual organism" and "pregnant woman as two patients" has been adopted by some in both the medical and political arena.  Nonetheless this paradigm is incorrect because the fetus fails to meet the biological definition of an independent organism, and calling it an organism in a textbook won't make it one.  

A fetus is, indeed, a semiallogenic graft and as such it is a part of the host/woman into whose body the graft is integrated.

What are the implications of these paradigms?

From a legal, social, and ethical viewpoint, whichever of these paradigms become the dominant one - regardless of their accuracy or lack thereof - has enormous implications on the society accepting it.   The effects on women's rights are especially dependent on the acceptance of one over the other.

If the "integrated single unit" paradigm, which is in fact the older of the two and the more accurate,  is accepted as correct, then it means that legislation concerning abortion, particularly prior to the time when the fetus has the possibility of an independent self sustaining life,  is essentially legislation designed to control a part of a woman's body  It might very well be argued that until successful parturition, when indeed there is a separate organism "capable of carrying on the activities of life", any such legislation would be unconstitutional since it would be giving a part of a woman rights that can restrict or abridge rights she currently has. Canada, with no abortion legislation on the books, may have gotten it right.

If the "dual organism" paradigm prevails, despite its inherent flaws both in biological fact and its treatment of the pregnant woman, then regulation of the separate organism certainly has a basis to work with.  Proscribing the activities and freedoms of one person for the protection of the developing organism may be both possible legally, and socially seen as acceptable.  All of the dangers warned about in Katha Pollits Fetal Rights - Women's Wrongs are possible only if the "dual organism" paradigm is accepted.


Do you need more supporting reference material?

Eileen

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