The Inconsistency of the Ciderhouse Rule
The Ciderhouse Rules premièred when I was in high school. I know I didn’t see the film in the cinema, but I remember watching it shortly thereafter. The premise of the plot is the quest for a young doctor to come to terms with questions of abortion rights. The film tracks through a variety of elements, but the convincing argument comes near the end as our young doctor must contend with a woman suffering from a botched self-induced abortion.
The Ciderhouse Rule is that we should establish proactive measures to ensure that women have access to abortion services because women will seek the procedure anyway. Because people will go to desperate measures to access the procedure, medical doctors have an obligation to provide safe, reliable access to the procedure.
Increasingly, this particular justification of abortion strikes me as totally odd. For instance, we do not typically argue that youth violence needs a safe, reliable outlet. We do not focus on trying to convince a person engaging in cutting behaviour to cut more safely. These behaviours fall into a category of behaviour that we would like to see stop. Humans engage in all sorts of activity that is both dangerous and problematic. We don’t direct our energies into making things safer. We try to address the broader problematic.
Recently, I read about a woman so desperate for an abortion that she paid someone $150 to beat her until she miscarried. I’m struck not by the context of abortion in this story, but rather by the woman’s willingness to be beaten. This woman’s willingness to be beaten might have come principally from an emotional imbalance that lead to risky behaviours to seek validation. Was this woman not, in effect, screaming out, “I’m worthless!” with her choice of mechanisms? Might not that view of self-worth influenced what drove her towards a sexual encounter? It does not take much for me to see that the presence of a child is a symptom of a much deeper root cause.
Having a child occurs amidst an interconnected web of causal factors. Some of these causal factors are distinctly biological. But I also think these causal factors are influenced a great deal by social realities. It is much more difficult to parse the differences between young poor women unexpectedly pregnant and partnered professional women inconveniently pregnant at the “wrong time” in their career. Encouraging girls to pursue their education with a healthy self-esteem and regard for the integrity of their bodies requires a very different approach than addressing the need for financial stability in the midst of an insanely paced professional world.
It’s much easier to cite the problem with a lump of unwanted cells in a woman’s uterus and remove those cells surgically. Because if those cells just go away, then everything will be better. After all, routinised technology solves everything.
But we can also fall into a huge trap of embracing a technological solution. I cannot for the life of me understand why some people treat abortive surgeries as minor procedures. The people I’ve talked to regarding the procedural aspects of an abortion are absolutely shocked to learn that I stayed awake for my wisdom teeth extraction. They could recite danger upon danger of wisdom tooth extraction and didn’t differentiate between exposed and impacted tooth. But I think there is also something that when my doctor extracts my wisdom teeth, he has to look me in the eye. Dental surgeries are uniquely human in that regard.
Acknowledging the uniquely human dimension means that yes, doctors will need to be prepared to support women with a myriad of pregnancy implications. Some of these implications may come from self-induced procedures. Yet, acknowledging the human dimension means looking beyond the technology while serving the full person present before you.