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This disagreement reflects the evolution of the national debate about "reproductive freedom." Whereas election campaigns once focused on abortion as the primary element of reproductive freedom, candidates now find themselves addressing a broader array of arguably related issues, including the use of human embryos for stem-cell research and whether such research should receive federal funding; the extension of eligibility for the State Children's Health Insurance Program (SCHIP) to unborn "children" (but not pregnant women), in keeping with a 2002 federal redefinition of "child" as "an individual under age 19, including the period from conception to birth"; and the assurance of access to family-planning services and comprehensive sex education both in the United States and abroad. Also under discussion are the Partial-Birth Abortion Ban Act and requirements for parental notification or consent for minors to obtain abortions.
Moreover, what had been a circumscribed, if ideological, debate over the Supreme Court decision in Roe v. Wade, which legalized abortion, has expanded to encompass multiple shades of political gray. Some "prolife" Republicans favor the option of abortion in cases of rape, incest, or risk to the life of the mother. Yet others, such as the Republican Majority for Choice and the Women in the Senate and House (the WISH List), espouse an agenda that is indistinguishable from that of prochoice Democrats. The Democrats for Life of America, in turn, advocate for a prolife Democratic plank and prolife Democratic candidates.
Judging by their voting records and positions articulated on the Senate floor, on the primaries trail, and on campaign Web sites, the 2008 presidential candidates differ substantially in their views about these reproductive issues (see table). Senator Obama supports a woman's right to choose to terminate her pregnancy, favors unfettered access to family-planning services and comprehensive sex education at home and abroad, and endorses federal funding for the use of human embryos for stem-cell research. Obama opposes requiring parental notification or consent for minors to obtain abortions, the extension of SCHIP eligibility to include "the period from conception to birth," and the Partial-Birth Abortion Ban Act.
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This constellation presents voters with a stark choice. Reproductive freedom is effectively on the line, given the strong likelihood that the next president will be selecting like-minded nominees to the Supreme Court. McCain's positions appear to accord with those enunciated by President George W. Bush, with the exception of the matter of human embryonic stem-cell research. Obama's convictions appear to be in keeping with the traditional values of the Democratic party. Nevertheless, there is much that remains unknowable. Leaders, after all, may evolve, and their worldviews may change. Will McCain, a 26-year veteran of the U.S. Congress, toe the conservative line on all aspects of reproductive freedom if elected, especially if he chooses not to seek a second presidential term? It would appear that McCain is at odds with the Republican party's platform not only in his support of limited human embryonic stem-cell research but also in his leaning toward exceptions to abortion restrictions in cases of rape, incest, or a threat to the life of the mother.
In Obama's 8 years in the Illinois State Senate and 4 in the U.S. Senate, he has had more limited opportunities to vote on these issues, and his positions have had less time to evolve. His future actions may therefore be less predictable than those of many past nominees. Would Obama issue an executive order, as expected, rescinding the Mexico City Policy, which currently prohibits foreign recipients of U.S. family-planning funding from providing, or even counseling clients about, abortions (except in cases of rape, incest, or a threat to the life of the mother)? Would he restore U.S. funding to the United Nations Population Fund, and would he work with Congress to ensure the federal funding of human embryonic stem-cell research? We don't know for certain.
Even if we were guaranteed full knowledge of a candidate's position on past and current controversies, the way in which a new president will handle issues that arise in the future is a matter of pure conjecture. As the life sciences continue to advance, new light is shed on early human development and the thorny question of when life begins. Insofar as the scientific horizons are unknowable, the questions of which programs or research the federal government should fund and what restrictions, if any, should be placed on emerging areas of research remain unanswerable. Practitioners of the life and health sciences who are concerned about these issues, like all Americans, will have to vote their consciences while relying on the voting records and public statements of the candidates — and, as is often the case, a hefty dose of imprecise extrapolation.
No potential conflict of interest relevant to this article was reported.
Source Information
Dr. Adashi is a professor of medical science at Brown University, Providence, RI. Dr. West is vice president and director of governance studies at the Brookings Institution, Washington, DC.
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