One point I should have included in the previous post, but wasn’t sure how to work in, was the distinction between letting die and killing. A strong pro-lifer could claim that it’s morally permissible (if not exactly laudatory) to let someone die, but not permissible to actively kill. Thus, they could claim they have no duty to sign up for organ donation, though perhaps it would be nice if they did.
However, I doubt they would take that tack in the drowning-child case: if you see a child drowning, and you could save her, but choose not to because, let’s say, it’ll get your clothes dirty and you have a social engagement, have you committed a moral infraction? If the answer is “yes,” then it seems you may still be obligated to at least give blood regularly.
That is, some minor inconvenience is no excuse for failing to aid in a way that would save another’s life.
Now, if the pro-life proponent holds the above, then it seems that he is entailed sign up for organ donation, since the inconvenience of pregnancy far outweighs that of a missed social engagement. Unless, that is, even though the pro-life advocate holds that there is a duty to aid and a duty not to kill, those duties operate by very different rules. That is, the duty to aid stops when the inconvenience is larger, but the duty not to kill does not.
But at what point, then, does the duty switch off? Suppose I could save the child but choose not to because I’m on vacation and will miss a plane home, and will have to stay at some unpleasant, but not terribly dangerous, location for a week. Is it ok to let the child die? What if saving the child means I’ll miss an opportunity that would have increased my income by 40%? That’s a huge inconvenience. Am I now allowed to let the child die? I doubt the strong pro-life advocate would say, “well, if you’re going to a job interview, you should just let the child die.” I’m guessing it would be pretty hard to come up with an inconvenience that doesn’t involve serious, physical harm to self or others that would morally permit one to let the child die.
In the case of pregnant women, states have added duties that seem to go beyond forbidding active killing, and include aiding the embryo/fetus. Some states (Tennessee, Alabama, Utah) will prosecute a mother who is drug addicted and becomes pregnant and does not stop taking drugs if those drugs might harm the infant. Mothers have been prosecuted for the deaths of children born prematurely in these states.
It seems here that we are actively asking the women to do, rather than refrain from doing, something: that is, we ask them to give up drugs. This is a serious doing, and not merely a not doing, since it takes considerable effort to overcome an addiction. If you wish to ignore the effort of quitting an addiction, one could claim that the drug-taking is an active doing, and not taking is merely not-doing. I think this is obviously wrong, but to pursue it:
Let’s reverse the drug-addiction case: Suppose a mother knows that she must take a certain vitamin, or her baby will have a 40% chance of dying shortly after birth. Would the strong pro-lifer accept that the mother has no duty to take the vitamin, because in not taking it she is not doing anything to harm the child, she is merely refraining from doing something? I doubt it.
I think there is some wiggle room for the strong pro-lifer here, but he will be put in a bad position if he adopts the strong “letting die vs. killing” distinction. He must allow the mother to neglect her health, eat far too little, and engage in behaviors that would endanger a fetus or embryo, as long as these behaviors are omissions of acts, and not acts.