3. Assisted suicide has more gray area than abortion. Douthat writes:
Saletan's account of his own father's passing suggests a sense in which abortion is very unlike assisted suicide. It can be hard to tell exactly what counts as assisted suicide and what doesn't, because there are obvious moral gray areas with end-of-life care—places where the line between easing pain and easing passing gets blurry, places where it's unclear where reducing suffering ends and abetting suicide begins. Whereas with rare exceptions (certain versions of the morning-after pill, perhaps), abortion is much more of an either-or: You either kill the fetus/embryo or you don't, and there's rarely any doubt about what just happened.
This is an area in which the assisted-suicide analogy sheds useful light on the abortion debate. In end-of-life care, the gray area is blurry in practice but not in principle. The moral line, as Douthat notes, is clear: It's OK to ease suffering and thereby hasten death, but it's not OK to hasten death deliberately and unnecessarily.
Conceptually, we could draw a similar line in abortion ethics: It's OK to end pregnancy and thereby kill a fetus, but it's not OK to kill a fetus deliberately and unnecessarily. Strictly speaking, the woman has a right to bodily freedom, not a right to terminate life. So, for example, she can have the fetus removed from her body, but once it's removed, she can't have it killed. This is not an idle distinction. It's the line Gosnell crossed.
But the much more common parallel is the one to which Douthat alludes: morning-after pills. My bet is that the practice of preventing unwanted births will continue to shift from surgery at the fetal stage toward chemical interference with fertilization and implantation. In that respect, abortion will become grayer, like assisted suicide. And that, in turn, may persuade more people that it's too subtle to merit prohibition.
4. Legalization is legitimation. Douthat argues:
But it's possible to accept that no government can "stop" assisted suicide or abortion completely (and that no government should create the kind of deeply- invasive mechanisms required to try) without believing that either practice should therefore be legalized and legitimated. Avoiding the police-state scenario doesn't require treating self-slaughter as a protected right, and effectively licensing the Jack Kevorkians of the world to cater to anyone who wants to die badly enough to take the plunge.
To me, this equation of legalization with legitimation is a big mistake with perilous implications. A government that prohibited every illegitimate practice—adultery, greed, cruelty, lying, Anthony Weiner's sexting—would be horrific. A free society needs space in which to sort out our values. It needs to tolerate the legality of practices whose legitimacy we can thereafter debate.
When Douthat uses the phrase "protected right," I think he's suggesting that there are two categories of rights: those that pertain to practices we deem legitimate, and those that pertain to practices we deem illegitimate. He believes, if I understand him correctly, that abortion has wrongly been deemed legitimate, and therefore the right to abortion has become a "protected" right: Abortion isn't just legal; it's protected by courts from various restrictions, such as previability gestational limits. And if I thought abortion were inherently illegitimate, I'd agree with him that it shouldn't be protected in these ways. But I don't. I think the legitimacy of abortion, like the legitimacy of assisted suicide, varies from case to case. And this makes me leery not of public debate, but of presumptive government intervention.
5. Planned Parenthood represents abortion run amok. According to Douthat, one sad result of our treatment of abortion as a "protected right" is the rise of "a kind of abortion industry—in which the country's largest abortion provider doubles as a major Democratic interest group." He's talking, of course, about Planned Parenthood.