堕胎权漫谈（一、二、三）
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堕胎权漫谈（一）
（2016年5月22日通讯）
今年堕胎权之争最重头的戏码，无疑是最高法院六月份即将宣判的关于德克萨斯州反堕胎法的一案。不过在万众瞩目翘首以待这一判决的同时，还有许多大大小小的斗争在上演。5月20日，俄克拉荷马州的共和党州长Mary Fallin州议会刚刚通过的。根据该法案的规定，如果施行堕胎手术并非拯救孕妇生命的绝对必要手段，则施行该手术的医生将会被判处重罪（felony），面临三年有期徒刑并吊销行医执照。
Fallin并不是堕胎权的支持者。恰恰相反，她是一位：
In 2008, as a member of Congress, she to treat fetuses as people and give them equal protection under the U.S. Constitution. Since she became governor in 2011, she has signed legislation to ban many , require , and restrict access to — laws that were to be .
她否决这个法案，只是因为法案的关键条款实在太过粗糙含混。根据自己前几次签署的法案被判违宪的教训，Fallin知道这次的法案同样毫无在法庭上通过考验的希望，只会因为打官司白白消耗州里的预算，而俄克拉荷马目前恰恰：
Sources familiar with the governor's thinking told CNN that the decision to veto the bill "weighed heavily" on the anti-abortion rights governor, but that the "hundreds of thousands of dollars in legal fees" faced by the state from a near-certain Constitutional challenge to the bill eventually led to her veto.
Oklahoma is currently facing a budget crisis, something that spokesperson Michael McNutt told CNN the governor's office was focusing on instead of the growing buzz over the governor's chances to be on the ticket in November.
当然，掌握州议会的共和党并不会善罢甘休，已有议员。
由俄克拉荷马法案将施行堕胎手术的医生定为重罪，不难联想到前段时间特朗普在堕胎问题上的「失言」。3月30日，特朗普在接受采访时声称，应该对接受堕胎手术的孕妇施加「某种形式的惩罚（some form of punishment）」。结果这番表态不但激起了堕胎权支持者的反弹，而且连（当时尚未退选的）克鲁兹和凯西克这两位持极端反堕胎权立场的对手（克鲁兹认为、凯西克在州长任内）都：
Ohio Gov. John Kasich told MSNBC, “Of course, women shouldn't be punished for having an abortion.”
And Texas Sen. Ted Cruz said Trump's comment “demonstrated that he hasn't seriously thought through the issues, and he'll say anything just to get attention.”
“On the important issue of the sanctity of life, what's far too often neglected is that being pro-life is not simply about the unborn child; it's also about the mother – and creating aculture that respects her and embraces life,” Cruz said. “Of course we shouldn't be talking about punishing women; we should affirm their dignity and the incredible gift they have to bring life into the world.”
于是几小时后，特朗普又收回了之前的表态，宣称该受惩罚的绝不是孕妇本人，而是施行堕胎手术的医生（也就是俄克拉荷马法案的立场）。
有些人怀疑特朗普之所以会在这个问题上「失言」，是因为他并不真心反堕胎权，也不了解反堕胎权派的具体主张，才会以为表态越强硬越能讨好保守派。梳理特朗普，这确实是一种可能。1989年特朗普因为设宴招待「全国堕胎权行动联盟（National Abortion Rights Action League, NARAL）」主席Robin Chandler Duke而遭到反堕胎权分子的威胁；1999年特朗普在电视采访中宣称：
“I’m very pro-choice,” Trump says.“I hate the concept of abortion. I hate it. I hate everything it stands for. I cringe when I listen to people debating the subject. But you still — I just believe in choice.”
Russert clarifies his original point: Would you ban partial-birth abortion? “No,” Trump replies.
一直到2011年特朗普考虑参选总统时，才在保守派政治行动会议（Conservative Political Action Conference）上，自己已经成为一名反堕胎权主义者。不过那一次，特朗普的参选野心，蛰伏了整整四年，才卷土重来、正式参选。
特朗普在反堕胎权上的相对新晋，可能确实导致他不太熟悉保守派的话语策略。但真要追究起来，其实他不熟悉的，也仅仅是「话语策略」而已（请参考5月10日会员通讯《共和党建制派为何对特朗普的出格言论无可奈何》）。正如，「惩罚堕胎孕妇、而不仅仅是惩罚堕胎医生」的做法，保守派早就悄悄付诸实践了，而克鲁兹、凯西克这些自命「关爱女性」的反堕胎权派对此却从来不置一词：
In Indiana last year, in prison for what the prosecutor charged was an illegal self-abortion. In Tennessee, Anna Yocca was for trying to end her pregnancy with a coat hanger. In Pennsylvania, went to jail for giving her daughter abortion pills. Have our kinder, gentler abortion opponents spoken up for any of these women?
Perhaps Mr. Trump “misspoke,” as he described it, because he’s a relatively recent convert to the cause, unfamiliar with the doublespeak in which forcing women to give birth is a form of love, and punishment is the last thing on the anti-abortion movement’s mind. In his blundering way, he revealed the true logic of the case against legal abortion: If it’s murder, then murder has consequences. Too bad the moment of clarity couldn’t last.
反堕胎权派之所以要用「关爱女性」来自我粉饰，顾忌的无非是女性选票，结果导致了立场上的自相矛盾、左支右绌。当然，一个「吾道一以贯之」的反堕胎权主义者，完全可以斥这种为了选票而抛弃原则的做法为怯懦，坚持认为：既然胎儿是人，那么堕胎就是杀人；既然堕胎是杀人，那么不管堕胎的医生还是孕妇，都应当受到相应的法律惩罚。对于这种一以贯之的反堕胎权主义，堕胎权的支持者应该怎样回应呢？且听下回分解。
堕胎权漫谈（二）
（2016年5月23日通讯）
昨天的通讯说到，一个彻头彻尾的反堕胎权主义者，可以秉持一种看起来无懈可击的逻辑：「胎儿是人，堕胎是杀人；如果说杀人要被禁止、被惩罚，那么堕胎同样也要被禁止、被惩罚」。
堕胎权的支持者可以沿着两种不同的思路，来反驳上面这个推理。一种是去争论「胎儿究竟算不算『人』；在什么意义上、什么情况下可以算作是『人』」。另一种是让步式的，搁置「胎儿算不算『人』」这个问题，去论述「就算胎儿是人，堕胎也不应当被禁止、被惩罚」。今天的通讯先聊聊后一种思路，下回再谈前一种。
在现实中，并不是任何情况下的「杀人」都会被禁止、被惩罚。比如刽子手依法处决死刑犯、交战时杀死未投降的敌方士兵、或者平时出于正当防卫而杀人，等等。不同人可能对什么情况下可以杀人有不同看法（比如有人反对死刑、有人反对战争），但至少大家会有一个抽象的共识：在某些特定的情况下，杀人是应当被容许的。
这就引出了堕胎权支持者的让步式的思路：即便承认胎儿是「人」、承认堕胎是杀人，堕胎也仍然属于「应当被容许的杀人」范围之内。这里关键在于：怎么论证堕胎是「应当被容许」的杀人？
在这个问题上，较早、较有名、影响较大的一个论证，是由哲学家、法学家茱迪丝·汤姆森（Judith Jarvis Thomson）在其1971年论文中提出的「小提琴手思想实验」：
You wake up in the morning and find yourself back to back in bed with an unconscious violinist. A famous unconscious violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers has canvassed all the available medical records and found that you alone have the right blood type to help. They have therefore kidnapped you, and last night the violinist's circulatory system was plugged into yours, so that your kidneys can be used to extract poisons from his blood as well as your own. The director of the hospital now tells you, "Look, we're sorry the Society of Music Lovers did this to you -- we would never have permitted it if we had known. But still, they did it, and the violinist is now plugged into you. To unplug you would be to kill him. But never mind, it's only for nine months. By then he will have recovered from his ailment, and can safely be unplugged from you." Is it morally incumbent on you to accede to this situation? No doubt it would be very nice of you if you did, a great kindness. But do you have to accede to it? What if it were not nine months, but nine years? Or longer still? What if the director of the hospital says. "Tough luck. I agree. but now you've got to stay in bed, with the violinist plugged into you, for the rest of your life. Because remember this. All persons have a right to life, and violinists are persons. Granted you have a right to decide what happens in and to your body, but a person's right to life outweighs your right to decide what happens in and to your body. So you cannot ever be unplugged from him." I imagine you would regard this as outrageous, which suggests that something really is wrong with that plausible-sounding argument I mentioned a moment ago.
简而言之，汤姆森的结论是：就算胎儿有「生命权」，也并不意味着「维持胎儿生命」构成孕妇本人的义务，而需要以尊重孕妇本人的意愿——或者说「选择权」——为前提；就像不能因为重病缠身的小提琴手有「生命权」，便强迫一个不情不愿的人花费九个月的时间和自己的身体去「维持这位小提琴手的生命」一样。
就像所有的哲学论证一样，汤姆森的思想实验也引来了各方面的批评与辩护，这里不能尽述。2003年David Boonin所著一书的第四章（第133-281页）详细整理、分析了对汤姆森论证的各种反驳，感兴趣的读者可以翻阅（剧透：Boonin认为，尽管汤姆森的原始版本存在一些问题，但经过恰当修正后，就能有效回击所有的反驳）。
这里特别提一下其中一类在现实政治中很有影响力的反驳，即在「默示同意（tacit consent）」基础上发展出来的「强奸例外论」：倘若一名女性自愿地参与了一次没有采取避孕措施的性行为，就意味着她「默示同意」了接受这次性行为所带来的所有可预期后果（包括怀孕），也就「默示同意」了承担起维持胎儿生命的义务。根据这种推理，只有在遭到强奸怀孕等「非自愿」情况下，堕胎才是可以允许、也能够被「小提琴手思想实验」支持的；但是「小提琴手思想实验」并不能支持其它情况下的、更为一般性的堕胎权。借用David Boonin的总结：
The tacit consent objection turns on two claims: that because the woman’s act of intercourse is voluntary, she should be understood as having tacitly consented to something with respect to the state of affairs in which there is now a fetus developing inside of her body, and that what she should be understood as having tacitly consented to with respect to this state of affairs is, in particular, the fetus’s having a right to have the state of affairs continue for as long as this is necessary for it to remain alive. （第153-154页）
「强奸例外论」作为一种「温和」立场，一度在反堕胎权派中占据主流地位。从禁止联邦经费用于堕胎的「」，到，都包括有「除强奸、乱伦或危及孕妇生命的怀孕之外」之类条款。不过近年来随着共和党内宗教保守主义势力的愈发强硬，「反堕胎无例外」的论调在党内越来越有市场。2012年大选时，共和党时任众议员Todd Akin宣称只要是「真正的强奸（legitimate rape）」就绝不可能导致怀孕、凡是怀孕的肯定至少半推半就；另一位共和党参议院候选人Richard Mourdock宣称强奸怀孕也是上帝的意愿、不可以违背。在当时引起轩然大波，但也反映了保守派内部的潮流，以至于到了今年大选，不仅这种极端茶党代言人，就连本来有意争取中间选民的中公开宣布支持「无例外论」。
其实就实践效果看，各州反堕胎法案中所包含的「例外条款」也：本来在男权社会中，被强奸的女性就畏于社会舆论而；等到过段时间发现自己怀孕后，又要面对Akin式的怀疑目光、证明自己怀孕是因为遭遇了「真正的强奸」而不是「半推半就」的结果（讽刺的是，越是保守派掌权、从而越是反堕胎的州，这种Akin式的怀疑就越盛行）：
It's not so difficult to imagine the policy of rape exceptions devolving into a power struggle where rape survivors must prove themselves and their experiences to skeptical audiences. In fact, we're not so far away from that policy world already.
那么，堕胎权的支持者如何从理论上反击用「默示同意」和「强奸例外论」作为掩护的反堕胎权立场呢？其实汤姆森本人在论文中已经对「强奸例外论」：
In this case, of course, you were kidnapped, you didn't volunteer for the operation that plugged the violinist into your kidneys. Can those who oppose abortion on the ground I mentioned make an exception for a pregnancy due to rape? Certainly. They can say that persons have a right to life only if they didn't come into existence because of rape; or they can say that all persons have a right to life, but that some have less of a right to life than others, in particular, that those who came into existence because of rape have less. But these statements have a rather unpleasant sound. Surely the question of whether you have a right to life at all, or how much of it you have, shouldn't turn on the question of whether or not you are a product of a rape. And in fact the people who oppose abortion on the ground I mentioned do not make this distinction, and hence do not make an exception in case of rape.
不过她的这个回应稍嫌粗糙——毕竟「默示同意」论者可以辩称，「强奸」和「自愿性交」的差异，影响的不是「胎儿的生命权」本身，而是「维持胎儿生命」是否构成孕妇个人的义务。
即便如此，反堕胎权主义者从「默示同意」到「强奸例外论」的推理仍然破绽重重。Boonin书中（第148-167页）对此有细致的分析，这里恕不赘述，：
Suppose that because of your unique compatibility, the violinist will die unless you undergo a series of nine painful bone marrow extractions over the next nine months, and with a clear understanding of the nature of the procedure and its potential risks, you freely volunteer to undergo the first extraction. After the second round of extraction, however, you find that the burden is considerably more than you are willing to bear on his behalf. Do you really believe that it would now be morally impermissible for you to discontinue providing aid to the violinist merely because you began providing aid voluntarily? To say that doing so would be impermissible would be to say that the violinist’s right to life does not entitle him to seven more extractions of bone marrow from you if the first two were done involuntarily, but that it does entitle him to seven more extractions from you if the first two were done voluntarily.（第165页）
自愿搭救这位小提琴手，当然是好事一桩，但如果中途转变想法不愿再帮下去，别人也没什么资格阻拦——除非一种情况：你一开始的自愿搭救导致产生某种新的排他性（并且你也知道这一点），亦即如果你一开始不搭救的话，别人是完全可以搭救的；但你一搭救之后，这位小提琴手的身体就产生了排异反应，导致之后别人再也救不得。这样的话，可能你一开始的自愿搭救确实意味着你必须一救到底。但孕妇与胎儿的关系显然不是这种情况。如果一开始不怀孕，胎儿根本就不可能存在，也就不存在「你没有怀上这个胎儿的话别人就可以怀上同一个胎儿」的可能性。换句话说，即便「自愿性交」意味着「默示同意」，这个「默示同意」的内容最多也只是「同意承担堕胎可能带来的身心痛苦」而已，并不能直接得出「同意维持胎儿生命直至其出生」。
希望以上对相关哲学讨论的粗略介绍并不让你太过厌烦，因为我之后还会接着介绍「胎儿究竟算不算人、究竟有没有生命权」这样一个恐怕更为抽象的问题。
堕胎权漫谈（三）
（2016年5月25日通讯）
上回提到，有一些堕胎权支持者，采用类似于汤姆森「小提琴手思想实验」的让步式思路，来论证即便胎儿有生命权，也不构成对女性堕胎权的限制。强硬的反堕胎权主义者当然不会轻易被这些论证说服，但是与此同时，另一些堕胎权支持者也对这种思路大为不满，认为太过于和稀泥，给了反堕胎权派钻空子的机会。
比如想象一下这样的情景：你自愿插上管子用九个月时间搭救那名得了绝症的小提琴手，半年后你改变了主意，想现在就拔掉管子，而不是耗完最后三个月。由于接受了半年的搭救，这名小提琴手的状况正在逐渐好转，即便拔掉管子，在现有的医疗技术手段下，本来也已经有了非常大的概率能够独立存活；但是这时候你发现，由于之前某些操作上的疏忽，导致你身上的管子无法在小提琴手仍然存在生命体征时拔下。换句话说，想要拔掉管子，就先要杀死（经过这半年搭救后本来已经有非常大概率能够借助现有医疗手段独立存活的）小提琴手。在这种情况下，如果你仍然坚持要拔掉管子，似乎总有那么点说不过去。
类似地，假如胎儿和小提琴手一样有生命权的话，那么随着孕期越来越接近尾声，胎儿体外独立存活的概率越来越高，胎儿生命权的份量也就越来越重，堕胎权与生命权之间的天平自然会越来越向后者倾斜。
这其实就是最高法院在一系列堕胎权判决中的思路。汤姆森论文发表之后两年，高院就在奠基性的「（）」一案中，围绕「胎儿体外存活力（fetal viability）」这个概念（「the interim point at which the fetus becomes "viable," that is, potentially able to live outside the mother's womb, albeit with artificial aid」），发展出了所谓「（trimester framework）」：第一孕期（最后一次月经起前13周内）孕妇有绝对的堕胎权，第二孕期（约第14到26-27周）各州可以出于保障孕妇健康的目的监管堕胎，第三孕期（第28周开始）胎儿已经具备了体外存活力，因此各州可以出于保障胎儿生命权的目的而禁止堕胎。
但是用「体外存活力」来为堕胎权划界，对堕胎权支持者来说是一个严重的问题：随着医学手段的发展，理论上说，胎儿体外独立存活的临界时间是能够不断提前，一直提前到刚刚受孕时的；这意味着禁止堕胎的时间也会随之提前，一直提前到刚刚受孕时。事实上，仅仅到了1992年的，高院就已经把允许各州禁止堕胎的时间，从「罗诉韦德」规定的第28周，又提前了一个多月：
The soundness or unsoundness of that constitutional judgment in no sense turns on whether viability occurs at approximately 28 weeks, as was usual at the time of Roe, at 23 to 24 weeks, as it sometimes does today, or at some moment even slightly earlier in pregnancy, as it may if fetal respiratory capacity can somehow be enhanced in the future.（）
而近年，更是一点一点地把禁止堕胎的时间往前推。比如密西西比和北卡罗莱纳都定在最后一次月经起第20周，其它若干州则定在受孕起第20周（约等于最后一次月经起第22周）。
除此以外，Casey案的判决相对于Roe v. Wade，在堕胎权上还有一个另外重大的倒退。Roe（以及此后1983年的、和1987年的）在评判各州反堕胎法的合宪性时，采取的是美国司法话语中最严格的「严格审视（strict scrutiny）」标准，要求州政府证明其所制定的法案旨在保障「重大利益（compelling interest）」。但是Casey推翻了City of Akron和Thornburgh两案的结论，改而采用较为宽松的「不当负担（undue burden）」标准，只要法案并没有「在目的或效果上对想把没有体外存活力的胎儿堕掉的孕妇造成实质阻碍（the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus）」，那么州政府甚至可以禁止孕妇堕掉没有体外存活力的胎儿。
这样一来，就为各保守州在何谓「不当负担」、何谓「实质阻碍」上玩弄字眼，出台更为严苛的反堕胎法，打开的方便之门。比如很多州都有所谓的「（mandatory waiting period）」，规定孕妇在和医生沟通决定堕胎之后，必须强制等待若干时间、或者至少去医院两次、或者由医生强制观看胎儿超声波图片或视频、或者听专人宣讲胎儿生命的可贵、诸如此类，才能进行药流（而且药流也必须在医院而不能在家中进行）或手术流产。上周四，路易斯安那刚刚又把24小时的强制等待时间。
与此同时，这些州也在医院进行堕胎手术的资格上做文章，比如目前正在等待高院宣判的一案，涉及的就是德克萨斯州2013年新修订的反堕胎法案针对堕胎诊所的装修、位置、与周边医院的关系等等提出几乎无法满足的标准，导致整个德州预计最终将只有不到10个地方能够提供药流或堕胎手术，想堕胎的孕妇只好要么驱车上百英里堕胎（而且由于强制等待时间的存在，必须至少去两次），要么转而寻求不那么安全的非法地下诊所帮助。在3月2日的中，德州政府宣称这些新规定不但没有对孕妇造成「不当负担」、反而是关爱女性健康的表现；但是自由派大法官们显然：
MR. KELLER: Justice Ginsburg, JA242 provides that 25 percent of Texas women of reproductive age are not within 100 miles of an ASC. But that would not include McAllen that got as applied relief, and it would not include El Paso, where the Santa Teresa, New Mexico facility is.
JUSTICE SOTOMAYOR: It includes –
JUSTICE GINSBURG: That's – that's odd that you point to the New Mexico facility. New Mexico doesn't have any surgical – ASC requirement, and it doesn't have any admitting requirement. So if your argument is right, then New Mexico is not an available way out for Texas because Texas says to protect our women, we need these things. But send them off to Mexico – New Mexico – New Mexico where they don't get it either, no admitting privileges, no ASC. And that's perfectly all right. Well, if that's all right for the – the women in the El Paso area, why isn't it right for the rest of the women in Texas?
尽管Casey案设定的「不当负担」标准存在种种问题，但是光靠汤姆森式的论证，并不能有力地从理论上说明这个标准的问题所在。就像上回所说，汤姆森式论证的一个可能推论是：「自愿性交」意味着「默示同意」，尽管其默示的内容并非「同意维持胎儿生命直至其出生」，而仅仅是「同意承担堕胎可能带来的身心痛苦」。但是在所有「堕胎可能带来的身心痛苦」之中，难道就不包括各种既有的反堕胎法案给堕胎孕妇造成的额外负担、困扰与痛苦吗？
汤姆森式的堕胎权支持者当然可以细究每一份新的反堕胎法案，争辩说其对堕胎孕妇造成了「不当」负担与「实质」阻碍，但这就意味着保守派每想出一种新的限制方法，堕胎权支持者就得再打一场旷日持久的官司（而且判决结果完全取决于哪一派有机会任命足够多的自己人担任大法官）。最一劳永逸的做法，当然还是拒绝汤姆森式的让步，直接从「胎儿算不算人、有没有生命权」这个根本问题切入。
可是到底该怎么切入？还是那句话：且听下回分解。
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