This computer-generated image shows the formation of a zygote after fertilization. Republican-led states such as Arkansas, Kentucky, Missouri and Oklahoma have passed laws declaring that life begins at conception.

Anatomical Travelogue/Scientific Source

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Anatomical Travelogue/Scientific Source

This computer-generated image shows the formation of a zygote after fertilization. Republican-led states such as Arkansas, Kentucky, Missouri and Oklahoma have passed laws declaring that life begins at conception.

Anatomical Travelogue/Scientific Source

As life-sustaining medical technology advanced in the late 20th century, physicians and their families faced difficult decisions with both legal and moral implications. Cardiopulmonary bypass His machine kept blood pumping, and the ventilator was able to keep the patient breathing even after the patient’s natural ability to perform these vital functions stopped.

After decades of deliberation involving physicians, bioethicists, lawyers, and theologians, in 1981, a U.S. Presidential Commission established a scientifically derived line between life and death. The brain, including the most primitive part of the brain, the brainstem, was no longer functioning, even though artificial life support could sustain other vital functions indefinitely.

Since then, the commission’s standards have served as the basis for legislation adopting brain death as the standard for legal death in most states.

now in overthrow Law vs Wade And as dozens of states rush to impose abortion restrictions, American society is embroiled in a chaotic race to define the other extreme of human existence: when exactly does human life begin? At conception, the hint of a heartbeat, the first breath, the ability to survive outside the womb with the help of modern technology?

legal and political mayhem

That we were able to devise and apply uniform clinical criteria for when we would end our lives, but not when it started, is largely due to the legal and political turmoil surrounding abortion. .

And two months after the U.S. Supreme Court ruled, Dobbs v. Jackson Women’s Health Organization, to abolish longstanding federal abortion rights, state legislators are working diligently to fill that void, and to have serious civil and criminal implications for abortion rights, contraception, and assisted reproductive technology, as well as for life. We are trying to codify the various definitions into law. law.

Mary Ziegler, law professor at the University of California, Davis, said: Several books on the history of abortion.

Unlike debates about death that delve into elaborate medical and scientific details, legislative action to determine when the components of life reach thresholds warranting government protection is generally It has ignored the opinions of mainstream medical experts.

Instead, the red states, which span much of the South and parts of the Midwest, have adopted conservative Christian doctrine-based language drafted by elected officials, although many There is little scientific basis for this.

Several Republican-led states, including Arkansas, Kentucky, Missouri, and Oklahoma, have passed laws declaring that life begins with conception. Including wrongful death lawsuits brought by disgruntled ex-partners on behalf of the estate of the embryo. (One such case is ongoing in Arizona; another has been brought to the Alabama Supreme Court.)

In Kentucky, a law banning abortion uses morally explosive terms to describe pregnancy as “a living fetal human being in the body, through the fetal embryonic and fetal stages from fertilization to full pregnancy and birth.” The reproductive state of human females with

Several other states, including Georgia, have adopted measures that equate life to the time around 6 weeks of gestation when cardiac activity during embryonic development can be detected by ultrasound. Many such laws erroneously characterize the flickering electrical impulses detectable at that stage as heartbeats. For example, the Georgia Department of Revenue recently announced that “a fetus with a detectable human heartbeat” can be claimed as a dependent.

Defining the role of government in life and death

1973 ruling of the Supreme Court Law vs Wade The Constitution that established the constitutional right to abortion did not define the moment life begins. A memorandum written by Justice Harry Blackman said that while the Constitution does not provide a definition of “person”, it extends protections to those born or naturalized in the United States when life begins. and concluded that it is not up to the states to adopt one theory of life.

Instead, egg created a framework intended to balance the right of pregnant women to make decisions about their bodies with the public interest of protecting potential human life. generally recognized a woman’s right to abortion until she was about 24 weeks pregnant and a medical professional determined that the fetus could survive outside the womb.

Dare to turn over egg In June, the Supreme Court’s conservative majority cited legal arguments that shaped another controversial end-of-life issue.legal standards adopted by Dobbs That there is no right to abortion in the federal constitution and that states can decide on their own is the same rationale that the Supreme Court used in 1997 to say that terminally ill patients have no constitutional right to medically assisted death. . that decision, Washington vs Glucksburgis mentioned 15 times in the majority opinion. Dobbs and consent of Justice Clarence Thomas.

In many cases, the same groups that have led the fight to outlaw abortion also challenge medical assistance laws.even after that Dobbs, so-called right-to-die laws are far less common than the laws that codified abortion rights in states. Doctors are still prohibited from administering drugs.

James Bopp, General Counsel for the National Life Rights Commission, which has played a central role in efforts to ban abortion, believes that both abortion and medically-assisted death, which he calls physician-assisted suicide, endanger society. said there is.

“Every human life has an inherent value and is sacred,” Bopp said. “Government has a duty to protect their lives.”

Both problems cause serious social problems. Can the government keep patients on life support against their wishes, or force women to give birth? or prohibit out-of-state patients from coming to seek medically assisted death? And who decides, especially if the answer imposes idiosyncratic religious views?

a philosophical conundrum

From determining a person’s death, to organ donation to inheritance, the implied rights held by a legally recognized fertilized egg are potentially vast, as are the legal implications. Are death certificates issued for each lost pregnancy? Are miscarriages investigated? When are social security numbers issued? How are census tallies and congressional districts determined?

Medical experts and bioethicists warn that both the beginning and the end of life are complex biological processes, not defined by a single identifiable moment, making them unsuitable for political arena. doing.

“Unfortunately, biological events are not events, they are processes,” said David Magnus, director of the Stanford Center for Biomedical Ethics.

And ask the doctor, “What is life?” or “What is death?” Magnus said. But it cannot answer the question, “When does a person begin and when does it end?” Because they are metaphysical issues. “

Ben Sarby, a doctoral candidate in the Department of Philosophy at Duke University who studies medical ethics, echoed that view by detailing the pile paradox, a thought experiment in which grains of sand are stacked one on top of the other. The philosophical conundrum is: At what point do these grains of sand become something more, a heap?

“It would be hard to draw the line that this counts as a person and this doesn’t count as a person,” he said. “Many things count as life. Sperm counts as life.” A person in a persistent vegetative state also counts as life, but does that constitute a person we should protect?”

While the debate over court abortion decisions is pervasive, the 1981 federal law resulting from the findings of a presidential commission, the Uniform Death Determination Act, is also being revisited. Earlier this year, the Uniform Law Commission, a nonpartisan group of legal experts drafting legislation for adoption in multiple states, began work to revisit the definition of death.

This group will consider making the medical criteria for brain death clearer in light of advances in our understanding of brain function. They will also consider addressing a lingering issue that has been raised in recent years, as families and religious groups engage in a bitter legal battle over the termination of artificial life support for patients with no EEG activity.

Bopp sits on the advisory board for this effort, along with the National Life Rights Commission, along with a range of physicians, philosophers and medical ethicists. The concept of ‘personality’, which permeates the anti-abortion movement’s broader push for fetal rights, is expected to become an underlying topic, albeit a mirror image. When will life form cease to be human?

Magnus, who is also a member of the Advisory Board, has no doubt that the Board will reach consensus, a sober resolution rooted in science. What is less clear is whether, in today’s political environment, that updated definition retains the same clout that is the enduring legal standard accepted statewide.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. This is an editorially independent operating program. KFFMore (Kaiser Family Foundation).