There are no social policies without costs or unintended consequences. Even if we agree that something is bad and ought to be stopped—sexual trafficking of children, for example—it is inevitable that giving more power to the state to prevent an action carries with it all sorts of risks that exercising state power will do harm and may do more harm than good. How do we weigh the moral costs of doing the right thing?
Matthew Lee Anderson has written a marvelous essay at Canon and Culture vivisecting what he calls “moral idealism” and rightfully demonstrating how we should not allow the urge to prevent known risks of harm from hampering our efforts at positive social change, namely, ending the practice of abortion. Anderson kindly chose my own take on defunding Planned Parenthood to riff off of for the purposes of his essay and, while carefully hedging his argument to not accuse me of any crimes I haven’t committed, he seems to make some unfortunate assumptions along the way. My call to fully fund Medicaid as a counterbalance to defunding Planned Parenthood is cast in Anderson’s essay as a potential liability if it were used by someone “less careful and more progressive” than me.
I do appreciate Anderson’s thought here, because this “moral idealism” is a genuine threat to people who wish to promulgate the common good. If one is skilled in the art of problematizing, then one can find a sufficiently problematic reason to justify resting one’s hands on their hindquarters until the streets are full of blood. As Elizabeth Bruenig says, “Believing in something makes you vulnerable.” When I take CPR training, my classmates and I are taught that sometimes the force necessary to keep blood moving through a heart that has stopped is also strong enough to crack ribs. A cracked rib is painful and, if bad enough, can be deadly, but it’s better to walk out of the hospital with some broken bones than be wheeled out of one with your ribs intact.
If there is a line in the sand between the incrementalists and the idealists as Anderson alludes to (and it would appear that this is a real line that sometimes gets drawn inside the pro-life camp), I am firmly an incrementalist and would describe my proposal as such. My argument in my original article (which was expanded on in this follow-up podcast) fully acknowledged that expanding Medicaid isn’t really a tit-for-tat exchange. After all, the original push to defund Planned Parenthood would immediately reallocate those same funds to community health centers and even fully expanding Medicaid would leave some people in the lurch because no state health system has the capacity to provide the same health services overnight that Planned Parenthood has built up over decades. Furthermore, expanding Medicaid carries a cost that is several orders of magnitude higher than what is currently going to Planned Parenthood.
I am strongly convinced that Medicaid expansion is good for mothers, children, and families in a way that is holistically “pro-life”, but I am even more strongly convinced that being holistically pro-life is the only realistic way of expecting to end the moral scourge of abortion. This perspective– what Drew Dixon called “being pro-life from womb to tomb” in our podcast– is more realistic for two reasons. Anderson hinted at the first reason in his initial paragraphs, describing a space in between the laws restricting abortion and the personal connections that support mothers and children wherein much of the incremental work happens. This space, under which I think Medicaid expansion falls, is mostly about nuts-and-bolts policies weighing costs, potential benefits, risks of harm, and the like.
The second reason that “womb to tomb” is far more realistic than merely electing a Republican and donating some diapers to the local crisis pregnancy center is that our political environment has built a narrative—sometimes justifiably so—that abortion politics are about controlling sexuality and punishing poor people. Whether or not you think this narrative is justified at all is irrelevant; it’s a hurdle that no amount of thoughtful polemics about human dignity will budge. A concrete commitment to spending some money will help shift some minds, though. Anderson seems to miss the fact that Medicaid expansion is both an incremental shift towards a more holistic policy that honors families as God gave them to us and the sort of concession that gets more hands out from beneath their respective hindquarters; Planned Parenthood’s other (useful) services would still take a hit but that’s a cost we’re willing to bear for the sake of derailing abortion.
Of course, the polemics are still important and we should not stop writing good ones in defense of human life. (For the love of God and unborn children, stop writing bad ones with false statistics about breast cancer and hazy moral reasoning about sexual responsibility.) Where the polemics are most useful, I think, is in outlining the moral weights that we should assign to different social goods and harms. Anderson’s thesis that we should be willing to suffer harms in service of unraveling greater harms only works if we can appreciate the value of our values.
To this end, I think that pro-life conservatives need to genuinely reflect on the costs we are willing to bear for the sake of protecting human life in all its forms. The simplest example we’re already practicing is that of loving people with disabilities and honoring their God-given dignity. Because potential or actual disabilities are often used as a justification for abortion, Christians have rightly rushed to the defense of the disabled and sought to promote conditions for these people and the families who care for them to flourish. This is by no means the sole reason why the Church takes up such a vigorous position, but the two are inescapably connected. The task of caring for the disabled is an expensive and time-consuming endeavor and will be more so when abortion is illegal in America, but we bear the cost gladly because we know how devastating the moral consequences of inconsistency would be otherwise.
If protecting human life by banning abortion is truly worth suffering all sorts of other harms– and I think it is, for the force of law protecting life has undoubtedly helped to prevent abortions in other advanced democracies like Ireland– then Christians should lead the way in bearing those harms. As Anderson says, “Justice in an imperfect world demands that someone lose out”; as Steve Taylor says, “Jesus is for losers”.
I don’t doubt that many conservative Christians are sincere in their belief that freer markets and less government spending will somehow lead to the the sort of financial prosperity and cultural harmony that would remove the financial and social pressures that motivate many women to contemplate abortions. I do doubt that this model actually works as most Republican budget-cutting proposals seem to think it will, wherein cutting a few million dollars here and there will somehow allow businesses to hire more workers. If this were the case, the states that are the most “business-friendly” and the least “handout-happy” in, say, the Deep South would not be the poorest and sickest in our nation.
A full defense of social welfare programs sufficient to provide for housing, food, and healthcare for the poor is beyond the scope of this essay, and I am under no illusions that this policy package would somehow eliminate the need for abortions (though it would certainly help in a significant way.) There is also a group of hardcore abortion-rights supporters to contend with who would not be moved by such a proposal that was tied to a serious abortion ban. I doubt that this minority could actually stop this proposal, but we’ll never find out unless the pro-life movement is willing to seriously debate and discuss what we are willing to give up in order to protect human life.
If either greater social welfare spending significantly reduces the demand for abortions or committing to such spending reduces the political opposition to abortion such that a serious ban could be passed, then such spending is unquestionably worthwhile. I think both are the case, but only one has to be true for this proposal to be valuable If higher taxes or a slower economic growth rate is the price that we have to pay, then we should follow Anderson’s logic all the way to the point where we believers should be enthusiastic to pay it.
The efforts of pregnancy centers, foster families, and other means of Christian charity to mothers and children are all crucial to a holistic pro-life social ethic and we should not relent on any of these things. Conservative Christians will need to step up even further in all of them in order to win the legislative and social victories ending abortion requires, just as we must keep writing good polemics. However, given the scope of the abortion problem in America and the resources we have available to us in America, the realpolitik of incrementalism demands a greater level of financial commitment and infrastructure development.
Of course, the real cost of doing the right thing expands far beyond just abortion. If significantly reducing gun violence requires that more law-abiding citizens don’t have the guns to protect themselves and are mugged more often, is saving the human lives that are ended with guns worth it? If refusing to drone-strike weddings in Yemen and Pakistan opens us up to the potential of another terrorist attack, should we not be willing to bear that risk for the sake of any unborn children in the bridal party? If Christians are to be known for being “single-issue” voters on matters of human life and dignity, how far are we willing to go to put our money where our mouths are, and possibly even do so in a way that is as wasteful but politically necessary as taxation?
Matthew Lee Anderson is right: there are no perfect social policies and eliminating potential suffering from the pursuit of justice is foolhardy. Thus, those of us who are called to suffer with the vulnerable should aggressively explore the possibilities for enacting justice on their behalf with a careful willingness to redirect any potential harms towards ourselves. If the Planned Parenthood videos have shown us that human life has no price tag, then a few costly political concessions are well worth it to end abortion.
Matthew Loftus is a physician preparing to move with his family to South Sudan, where we will practice and teach Family Medicine.