How can you “kill” something that cannot “die”?
This is arguably the most significant question in any discussion concerning the legality of abortion, and because facts matter, the following seventeen words are critical in understanding that before gestational week 25, although more accurately week 28, there is no ethical dilemma in terminating a pregnancy because nothing is being killed—or worse, to use the careless language of some, murdered.
At no stage does life magically appear in a zygote, a blastocyst, an embryo, or a foetus.
Life began on earth 3.8 billion years ago and has not been interrupted since. There is no ‘divine spark,’ no ensorcelled moment when the inanimate abruptly transforms into the animate. A foetus was never inorganic and suddenly becomes organic. The egg and the sperm are already parts of the living system—a 3.8 billion years old system driven by chemiosmosis, where the rechargeable chemical battery for life, adenosine triphosphate (ATP), is first broken down and then re-formed during respiration to release energy used to power every living reaction.
This is a fixed, unmovable fact. It is not up for debate, and from this cardinal truth it becomes immediately clear that when discussing pregnancy, and the ethical-cum-legal guidelines concerning the decision to terminate one, we are never talking about the inception of life, rather the beginning of a human organism, and the first defining feature of a living human organism—long before self-awareness, direct experience and memories shape an individual’s personality—is that a living human organism can die.
In as few words as possible, defined human life begins the moment its twin, death, also springs into existence. Without death there is no life. The former begets the latter. The latter assigns meaning to the former. One delineates the other, and the definition of human death is not in dispute. Death is the permanent loss of capacity for consciousness and all brainstem functions. Or more simply put: death is when electroencephalography (EEG) activity ceases. That’s it. That’s death, and a 2002 survey published in the journal Neurology comparing worldwide standards and regulations of death found brain death to be the universal legal and medical measure accepted across the globe. In the U.S., laws on brain death vary by state, but all states recognise that death is determined by the irreversible cessation of brain function, or as bluntly stated in the journal, Nature Reviews, Neuroscience: “Brain death means human death”—And for very good reason. Consider this simple fact: Theoretically, I can remove the heart from an adult human being, and for just as long as I keep blood flowing through the body, that person will remain being a living person because their brain is still working naturally. You cannot do the reverse of this experiment.
It follows quite naturally therefore that the onset of a defined human life is when foetal brain activity begins to exhibit regular and sustained activity, and this occurs consistently around week 25. It is an important milestone when considering the ethical lines of abortion, lines that should always err on the side of caution, but it is crucial to note that the brain’s major physical substrates—those structures essential for consciousness—are not, however, complete until week 28, after which the process to full bilateral synchronisation begins.
There is no approximation or inference here. Research into foetal brain development started in earnest in the early 1960’s, and today we have a precise picture of what is happening, when and where.
Simply put, foetal brain development is a process of continuous specification and refinement of brain areas that begins at the end of the third gestational week with the formation of the neural tube. This is not a ‘little brain,’ rather the first rung of scaffolding that marks the beginning of a construction process triggering the production of specialised ectodermal neural stem cells. These neural progenitors are produced along the neural plate, and through division can differentiate into committed neural sub-types such as neurons, astrocytes, and oligodendrocytes which then migrate around the developing brain (and central nervous system) like modular construction blocks. Upon reaching their target region, the young neurons need to then become part of information processing networks, developing axons and dendrites and synaptic terminals that allow the cells to communicate with other neurons.
At 20 weeks, the first intermittent firings in both cerebral hemispheres can be detected, but these are little more than blind test-firings. By week 24, as electroencephalographic activity nears constancy, the foetus can begin to react to aversive stimuli, but there is still no coherent information flowing down major pathways because those pathways have not yet formed. For example, two of the most essential structures for consciousness, the thalamocortical and corticothalamic pathways that transmit sensorimotor information, only begin to form 4 weeks after those first intermittent firings, at the very end of the second trimester, but are only complete by gestational week 28. After which, as noted by neuroscientist and chief scientific officer of the Allen Institute for Brain Science, Christof Koch, the electroencephalographic rhythm across both cortical hemispheres signals the onset of global neuronal integration.
And with that a complete human organism begins to exist. Despite sharing the same metabolic rate as the mother, and although it will not be until week 32 that the brain is ready to control respiration, it is at this point when the ethicist can call the foetus truly “On,” and only after something is “On” can it be turned “Off,” meeting the universally recognised definition of human death.
So, how can you “kill” something that cannot “die”?
Without a continuously functioning, synchronised brain there is no full human organism—a fact noted by Professor of Cell and Developmental Biology, James Goldenring, writing in the New England Journal of Medicine, Development of the Fetal Brain:
“When the coordinating and individuating function of a living brain is demonstrably present, the full human organism exists. Before full brain differentiation, only cells, organs, and organ systems exist, which may potentially be integrated into a full human organism if the brain develops. After brain death what is left of the organism is once again only a collection of organs, all available to us for use in transplantation, since the full human being no longer exists.”