When Is Termination of Pregnancy during the Third Trimester Morally Justifiable?

The question whether to terminate pregnancy during the third trimester involves a moral conflict. We argue that such termination is morally justifiable if two conditions are fulfilled: first, that the fetus is afflicted with a condition that is either incompatible with postnatal survival for more than a few weeks or characterized by the total or virtual absence of cognitive function; and second, that highly reliable diagnostic procedures are available for determining prenatally that the fetus fulfills either of the two parts of the first condition. At present, one entity, anencephaly, clearly fulfills both conditions. We studied 10 cases involving fetuses with sonographically diagnosed anencephaly that were aborted during the third trimester. We also examined other fetal disorders and conclude that they do not clearly fulfill our two conditions for the justifiable termination of pregnancy in the third trimester. (N Engl J Med 1984; 310:501–4.) SELECTIVE abortion because of serious fetal disease or defect is currently practiced in many hospitals during the first and second trimesters of pregnancy. However, after 24 weeks of gestation, when the probability of extrauterine survival increases, termination of pregnancy is sometimes denied, even though termination in the third trimester to "preserve the life or health of the mother" was specifically upheld in the landmark Roe v. Wade decision of the U.S. Supreme Court. 1 In this article, we argue that termination of pregnancy during the third trimester can also be morally justifiable (i.e., permissible) if two conditions are fulfilled: (1) the . . .