I’ve always supported a woman’s right to choose, not least because legal access to abortion once saved me from an untenable situation. I also believe that if a woman chooses to abort, her wish should supersede any opposition to it by the father. The physical, practical and emotional effects on a woman obliged to carry a child to term (and to care for it afterward) are, in my view, far more significant than they are for the father.
But what about the reverse? What about a case in which the father (in this case, my son) is adamantly opposed to having a child, but the woman (his ex-girlfriend) wants to keep the pregnancy? While it’s not relevant to the moral question, the pregnancy is shockingly unexpected given a medical issue of the father’s. And the couple’s relationship has almost no chance of success, even without a pregnancy. Given that the woman has neither a willing partner nor a job and is already responsible for a child from a previous relationship, her decision to continue with the pregnancy is viewed by most in her circle as reckless and certain to risk her already precarious mental health. Here, her right to choose to carry the child will have a profound impact on three (soon to be four) people and is likely to be very difficult for all.
Is it right to force someone to be a parent, even if in name only? Many people, me included, would say no if that person is a woman. Recent events have shown how fraught this issue is. And yet a man who does not wish to be, has never wanted to be and was told that his chances of ever being a parent were nil can find himself in a situation where his opposition carries no weight. While it’s evident that he will have financial obligations, what might his moral responsibility be? — Name Withheld
From the Ethicist:
A majority of Americans believe that when people learn they’re pregnant, they should have the right to choose whether to carry the fetus to term. Many philosophers would say that this right is grounded in, among other things, the value of bodily autonomy. But it can be a mistake to do something we have the right to do. We have the right, say, to spew hateful messages on the web — nobody should be able to stop us — but we would fairly earn reproach for doing so. It can, in short, be wrong to exercise a right.
Would it be wrong for this woman — putting aside your son’s involvement, for the moment — to have a second child? I don’t know enough to say; she could have moral objections to abortion, which would naturally supersede other considerations, though I assume you would have said so were this the case. What I can well believe is that it would be unwise for her to do so.
What happens when we take the views of the biological father into account? Often, an unwilling biological father was aware of the possibility of having a baby and may have behaved recklessly, although both women and men can fall victim to birth-control sabotage, a form of what has been called “reproductive coercion.” Yet your son apparently thought he was infertile and acted responsibly given the medical advice he had received. (In light of his medical situation, he would, if this child is born, have reason to seek a paternity test.)
Paternity has financial consequences. The law will expect a noncustodial parent to pay some amount of child support. But it can have other consequences too. Among the moral intricacies of abortion is that a mother who is forced to carry a pregnancy to term will, in the usual course of things, cherish the child that results. She can coherently wish that she had been allowed to terminate the pregnancy without wishing that this particular child did not exist. In this way, your son may feel that the child should not be born and that if the child is born, he should play a role in its life. His ex would have effectively imposed on him not just legal paternity but actual parenting.
So yes, it may be unfair to encumber your son with the legal entailments — and perhaps the emotional ones — of paternity. But none of this deprives the woman of the right to do so.
A Bonus Question
A friend of mine was recently fined for speeding. He argued that the final amount should be reduced because of his poor financial circumstances. I argued that the offense was the same regardless of income. If he had been involved in an accident in which a person died, that person would be just as dead. He countered by saying that the impact of the fine was far greater for him than for somebody who was wealthy.
Should a penalty reflect the seriousness of the offense, or should it reflect the impact on the person being punished? — Name Withheld
From the Ethicist:
The usual rationale for punishment is some combination of retribution, which is a backward-looking consideration, and deterrence, which is a forward-looking one. But whatever your exact views are, the severity of punishment is best measured by the effects on the punished. A week in prison for someone with claustrophobia seems a more serious punishment than for the rest of us. Suspending the license of someone who drives for a living is a more substantial imposition than suspending the license of someone who walks to work. And taking someone’s last hundred dollars as a fine is more serious than extracting that fine from a billionaire.
There are sound administrative reasons that penalties are seldom finely calibrated in this way; for one thing, interpersonal comparisons of suffering aren’t easily determined. But criminal fines on companies — and on some individuals — have reached stratospheric heights, and that’s partly because the prospect of requital and deterrence seemed to require it. If you’re levying fines on two people who have offended equally, you’ll want to impose on them roughly equivalent burdens, and a fine of the same amount will burden a poor person more than a rich one. There may be practical reasons that your friend won’t get his way, but his argument, unlike his driving, is irreproachable.
Readers Respond
The previous question was from a reader who was trying to determine how much to tell people about her husband’s health. She wrote: “My husband, who has struggled with his weight for decades, has decided under the recommendation of his doctor to begin taking Zepbound, an injectable specifically for weight loss. When he starts to lose weight, we know he will be congratulated and questioned by friends, co-workers and associates, as he has before when he has had significant weight loss. Are we obliged to tell people how he is losing weight? Would it be OK to be dishonest?”
In his response, the Ethicist noted: “Your husband, you indicate, has a sound medical reason for starting this treatment. It should make him healthier, and if it does, your friends ought to be happy for him. But you’re probably thinking that they’ll congratulate him on the assumption that he lost weight by sticking to a diet or an exercise regimen — by some newfound act of will — and would look askance if they knew he had done so through drugs. That response would reflect a tendency to relate obesity to some deficiency of character. Moralizing about weight management in this way is misguided and unhelpful. … The notion that people who are taking drugs like Zepbound — known as GLP-1 receptor agonists — are choosing the ‘easy way’ may also reflect a misconception about how easy it is. … Is your husband obliged to disclose that he is on Zepbound? Of course not. His medical history is indeed his business. But if questions arise, I hope that your husband considers candor. To combat moralizing about obesity, it might help if those who have decided to lose weight were frank about the strategies that have worked for them.” (Reread the full question and answer here.)
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While I agree with the Ethicist’s response, if the letter writer is not comfortable with full candor, one option would be simply to say that her husband is working with his doctor on a weight-loss program. If pressed for more, she could explain that the husband’s medical information is private. — Tom
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I agree with the Ethicist’s advice to consider candor, but for a different reason. Being open about using the injection to help with weight loss helps to normalize the process and remove whatever stigma may be associated with it. It may also encourage others to take the injections to lose weight and improve their physical and mental health. Personally, the injections have moved my attitude from despair to positivity. — Vivian
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The problem with obesity is that the lay public considers this a condition of overeating and under exercising. As an internist, I must treat obesity as a disease just like hypertension or diabetes. We are learning so much more about obesity. It involves a complex set of gut hormones that are generally dysregulated in patients with obesity. There are other reasons that the patient may lose weight rapidly, including the treatment of an underactive thyroid, undiagnosed cancer or treatment of Cushing’s disease, just to name a few conditions. So for friends and family to jump to the conclusion that this patient is on a GLP-1 medication is inappropriate. Everyone’s health is their own business. — Steven
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I used to run a post-bariatric surgery psychoeducational group and we discussed this topic regularly. If acquaintances asked how members lost weight, the suggested answer was “Hard work,” sometimes adding, “ … and good medical care.” We role-played how to change the subject afterward. No one is entitled to your personal health information. — Ann
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I have struggled with weight all my adult life and at 72, I have just started taking Ozempic. I haven’t even told my husband because I have such an acute sense of shame and failure, and if this doesn’t work I would rather not have to talk about it. When the positive comments begin, as I am sure they will (I lost 18 pounds in four weeks), I will have some vague, dismissive thing to say and change the subject. At this point I just feel like it’s nobody’s damned business. I know people mostly mean well but the topic (pardon the expression) carries too much weight. — L.