ABORTION DECISIONS AND THE DUTY TO SCREEN: CLINICAL, ETHICAL, AND LEGAL IMPLICATIONS OF PREDICTIVE RISK FACTORS OF POST-ABORTION MALADJUSTMENT

Abortion defies categorization. It is a moral, religious, legal, political, health, and human rights issue. People concerned about population control, environmentalism, national security, international law, race relations, education, economics, bioengineering, sociology, and psychology — to name but a few—all approach the issue from different perspectives. The great number of ways in which this controversial subject can be viewed always ensures lively debates. However, these intellectual debates are tepid, academic exercises compared to the intense, internal battles — between conflicting beliefs, desires, uncertainties, and fears — actually faced by women who are confronted with an unintended pregnancy and the prospect of abortion. For every intellectual argument for or against abortion, there are thousands of women who have struggled with the same issues before and after their choice. Certainly there are some women for whom the decision to abort or carry to term is not a struggle. Years of pondering the “what if I became pregnant? ” question, or the overwhelming pressures of immediate circumstances that lead them to conclude they have “no choice, ” cause some women to make their decisions quickly, even immediately. Yet reports of a rapid, “easy ” decision reflect only a relative freedom from internal conflicts over the decision. It does not eliminate the fact that the abortion experience may have immense * David C. Reardon, Ph.D., is a biomedical ethicist, the director of the Elliot Institute, and a widely published researcher on the psychological and physical effects of abortion on women. This manuscript is based in part on an unpublished paper originally presented at the American Psychiatric Association Annua