A STUDY OF THE ETHICS OF INDUCED

ABORTION IN KOREA
Young-Rhan Um

Key words: abortion; moral concerns; women’s perspective

The purposes of this study were to investigate the ethical aspects of induced abortion
from the viewpoint of Korean women, and to compare and contrast their ethical con-
siderations and values with the views of western ethical scholars. The two extremes of
ethical arguments about induced abortion are pro-life and pro-choice. However, the
Korean women who participated in this study showed that conflicting ethical values were
raised between the principle of caring and the sanctity of life or the principle of respect
for the person, not between the right of self-determination and the sanctity of life. The
results of the study suggest that it would be better to include the viewpoints of women
in any ethical discussion on abortion in order for ethicists and health professionals to
understand more fully the dimensions of moral clinical problems and be in a better
position to discuss them in a practical manner.

Introduction
In Korea, according to informal statistics, about 1 million abortions are performed
each year. Some studies have reported that more than 60% of married women
have experienced induced abortion because of their failure to use contraceptives.
Because the incidence of teenage pregnancy has increased, teachers and nurses
have recently begun to educate young students about human sexuality and con-
traception. Nearly all induced abortions are illegal in Korea because they are
permitted by law only when medically indicated, or when pregnancy occurs as
a result of rape or incest. Therefore, there is a growing consensus among legal
theorists and women’s groups that the law should be amended and extended to
permit intentional abortion as a lifestyle choice.1–3
Until now, the issue of induced abortion has been discussed only in terms of
the law or the population policy in Korea. It has seldom been debated with regard
to ethics. When the newly formed Republic of Korea established its laws in 1948,
induced abortion was made a crime because it was regarded as a kind of mur-
der. However, the formulation of this law was heavily influenced by population
policy because the birth rate was considered to be too low.2 By the 1960s, the issue

Address for correspondence: Professor Young-Rhan Um, Nursing Department, Soonchunhyang

University, College of Medicine, Chonan 330-090, Republic of Korea.

Nursing Ethics 1999 6 (6) 0969-7330(99)NE309OA © 1999 Arnold

 Ethics of induced abortion in Korea 507
of abortion was again raised, both socially and legally, as a result of changing
demographics caused by the ‘baby boom’ that occurred at the end of the Korean
War in 1953.
Although, historically, abortion has been used in different cultures as a kind of
crude method of birth control, in ethical terms it has been prohibited since the
Hippocratic era. In addition, since the nineteenth century most governments have
banned abortion. It is only in the twentieth century that the topic of induced abor-
tion has been discussed with respect to a woman’s right to control her own body.
However, induced abortion is a complicated topic that involves different and
sometimes conflicting issues, for example, protecting fetal life, respecting
women’s rights, and preserving social harmony. In the Korean nursing profes-
sion, induced abortion is regarded as a problem between the doctor and the
woman, so it is generally thought that nurses need not concern themselves with
this matter. Most nurses have, however, experienced the dilemma of having to
participate in induced abortions. The Korean nurses’ code of ethics, which was
revised in 1995, describes how a nurse should act in order to protect human life,
dignity and health. The purpose of this study was therefore as follows:
• To investigate ethical considerations concerned with induced abortion from the
viewpoint of Korean women;
• To compare and contrast the ethical considerations and values of Korean
women with the views of western ethics scholars.

Method
Sample
Research interviews were conducted with a nonrandom convenience sample of
35 women who had had induced abortions, of whom 18 volunteered to partici-
pate. This number was considered to be sufficient for the purposes of the study.
The interviewing process was concluded after the eighteenth woman, because by
then a strong pattern of similar moral conflicts had already been detected. It was
considered that to continue the interviews would be superfluous.

Interview
Questionnaire
A questionnaire based on the literature about abortion was compiled and use was
made of the new casuistry method that had been introduced by Jonsen and
Toulmin.4 The questionnaire was modified and completed after interviewing three
additional women. The questions contained elements about demographic details
and obstetric history, and also other aspects related to the induced abortion, for
example:
• Reason for the abortion;
• Who the decision maker was;
• Economic and social conditions;
• Physical and psychological state before and after the abortion.

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508 Y-R Um

Semistructured in-depth interview

Respondents were interviewed on the basis of the above-mentioned questionnaire.
However, the questions were more detailed and open-ended. Interviews were
recorded as memos; they could not be audiotaped because this inhibited the
women’s responsiveness and made them reluctant to talk freely about their feel-
ings and thoughts.

Constructing cases
The criteria used for constructing cases were twofold.5 Circumstantial statements
such as who, what, when, where, why, how and by what means were identified
from the interviews. Maxims were implied in these cases, these being the practi-
cal rules and values by which people lead their lives. Jonsen5 is quoted as say-
ing that maxims give moral identity to cases.

Analysing cases
• Defining ethical problems from an objective viewpoint;
• Identifying moral considerations from a personal or subjective viewpoint;
• Identifying maxims that were regarded as central to a woman’s justification
of her action.

Interpreting
The results of the analysis were interpreted by comparing and contrasting them
with the arguments of western ethics scholars on abortion.

Results
Six women described the major reason for having an abortion as being that they
did not want any more children. Two underwent abortion because they thought
that they would not be able to care properly for their existing children and fam-
ily. A further two had been worried about the possibility of a fetal abnormality.
One woman had an abortion because of a pregnancy conceived outside of mar-
riage. In four others, the procedure was on the recommendation of a physician,
because of vaginal bleeding early in the pregnancy.
Only three cases were finally selected for analysis because of the degree of eth-
ical conflict involved. These women considered the abortions to be an individual
and private matter, the result of a personal decision.

Case 1: Anxiety over caring for an existing child

This patient was aged 31 years. She had one son and one daughter, and had
undergone one abortion.
I became pregnant again three months after giving birth to my first child. I did not
want to become pregnant so soon and I was not aware that it could happen again so

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 Ethics of induced abortion in Korea 509
quickly. My first baby was often sick and had to visit the hospital frequently because
he had been born about six weeks premature. I was also often sick myself and had to
go to the hospital, too. There was nobody to help me to take care of the baby because
my husband and father-in-law were very busy working on the farm and my mother-
in-law’s health was poor owing to illness. Therefore I thought that if I had another
child, I would not be able to look after them both properly. So I wanted an abortion.
After the abortion operation, I experienced many unhappy and troubling emotions.
I worried that, because I had had an abortion, I might be punished by being unable to
have any more children in the future. In addition, I felt heartbreak and guilt whenever
I recalled the abortion. I had killed a life. It did not have a chance to live because of
my actions. I often imagine what the child would have been like if he or she had been
born. I once told my friend about my feelings, but she comforted me and reassured me
that I had done the best thing given my situation, so I was relieved.
When I came home after the abortion operation, I cried loudly. I was very sad and
felt something was missing. However, I could not talk about it with my parents-in-law
because my husband is the only son and his mother and father wanted to have many
grandsons, but I am only going to raise two children, one boy and one girl, who were
both born by caesarean section. I think the process of pregnancy and caesarean section
is too difficult for me.

Case analysis
• The defining moral problem:
– Which has priority – the responsibility of caring for the existing child, or
respect for the life of the unborn?
• Identifying ethical considerations:
– Decision maker: pregnant woman;
– Reason for abortion: anxiety over caring for the existing child and herself
because nobody could help her;
– Emotions after abortion: crying, guilty feelings.
• Identifying maxims:
– Do not kill human life;
– Responsibility for taking care of existing baby.

Case interpretation
This woman had to decide between the responsibility of taking care of her baby
and, on the other hand, respect for the life of the fetus. However, because she
thought it was better to abort the fetus than not to be able to look after her exist-
ing baby properly, the option of abortion was very compelling. Later, she felt
guilty that she had killed a life and deprived the fetus of the chance to develop
into a person. However, she tried to assuage her feelings of guilt by reasoning
that the consequences of having another baby would have been worse than hav-
ing the abortion. This shows that the woman was more influenced by consider-
ations of responsibility and care for the existing child than about the sanctity of
life of the unborn. This supports the theory of Gilligan,6 who asserted that women
regarded the moral problem as a problem of care and responsibility in relation-
ships rather than as one of rights and rules.

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Case 2: Financial difficulties

This participant was aged 40 years. She had two sons and had undergone three
abortions.
I became pregnant again shortly after giving birth to my first child. At that time my
husband needed me to help him with his business. We were much poorer than we are
now, and there was no-one to help me to take care of my baby. I thought that if I had
another baby I would not be able to cope and take care of my first child properly. I dis-
cussed having an abortion with my husband, but his only reply was: ‘Do as you like.’
As my husband was busy, I had to go to the hospital alone to have the abortion per-
formed. Afterwards, when I came back home, I wept bitterly. Our poverty and diffi-
cult living conditions saddened and depressed me, but there was no one to talk to about
my problems. On arriving home, my husband said curtly: ‘Thanks for your trouble.’ I
told my mother and sisters about it several years later, and they commiserated with
me.
I regretted having the first abortion. I think it would have been a girl. However, I
felt sorry for my second son, who was born subsequent to the abortion, when I thought
like this, because I planned to raise only two children, and therefore he would not have
been born.
I had two more abortions after my first one because I failed to use contraceptives. I
thought the abortions were necessary as we wanted to limit the number of children to
two. Many other women have had abortions for similar reasons. I regretted not hav-
ing used contraceptive devices more carefully in order to avoid the need for abortion.
Later my husband had a vasectomy.

Case analysis
• The defining moral problem:
– Can a fetus be replaced by another baby?
• Identifying ethical considerations:
– Decision maker: pregnant woman;
– Reason for abortion: anxiety over caring for the existing child and herself
because she was poor;
– After abortion: crying, and guilty feelings towards the fetus and the next
child.
• Identifying maxims:
– Respect for persons;
– Responsibility of taking care of existing baby.

Case interpretation
This participant considered the feelings of the second son to be more important
than the fetal life when she tried to justify her actions. This could be interpreted
as her considering the fetus as a person. She thought the relationship with the
second son and respecting this person was more important than the fetal life.
However, she recognized that the fetus had the potential to be a human being
and she felt compassion for it. She also felt compassion for the second son who
was born after the abortion because of her feelings towards the aborted fetus. I
therefore think that replacement theory can be supported from the perspective of
ethicists or public population policy makers, but not from that of pregnant
women. This accords with Callahan,7 who criticized replacement theory based on

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 Ethics of induced abortion in Korea 511

the genetic uniqueness of each fetus. (Replacement theory is one of the arguments
used by proponents of abortion, which is that fetus ‘X’ can be replaced by fetus
‘Y’. Therefore there is no reason why a woman should have any scruples about
such a replacement. It is argued that there is no need for a woman to continue
an unwanted pregnancy if she could become pregnant again on another more
auspicious occasion, because the argument for the fetal potential to become a
human person applies only in ordinary situations, not in distressed cases.7)

Case 3: Abortion for birth control

This participant was aged 43 years. She had one son and two daughters, and had
undergone seven abortions.
My husband is the eldest son of the head family. There were 16 members in his fam-
ily when I married him. My husband and his family lived on a farm at that time. I
have had seven abortions because of my failure to use contraceptives since my last child
was born. I suffered severe morning sickness during every pregnancy, so I felt relieved
and lighthearted after the abortions. Because I did not want any more babies, I did not
have any special feelings or thoughts after the abortions.
I alone decided to have the abortions, and only told my husband about them after-
wards. My parents-in-law used to say, ‘Let all babies conceived be born’, so I could not
tell them about the abortions, and I could not rest after them. When my parents-in-law
learned about them, I pretended they were miscarriages.
(The head family means the eldest son’s family whose father and grandfather
were also the eldest sons; they are considered to be the direct descendants of the
original ancestor. Accordingly, the eldest son and his wife have duties and respon-
sibilities and must perform the ancestral rites of the head family. There is also a
stronger obligation to provide male heirs to continue the family bloodline. All
eldest sons and their wives have important filial duties to their parents and grand-
parents. However, recently, this system has been somewhat weakened because the
nature of the family has changed from being extended to nuclear in structure.
Traditionally, Koreans believed that each baby has its own destiny. Therefore,
they rarely considered economic factors when they had a child. However, this
tradition has changed since the 1970s owing to government population policy.)

Case analysis
• The defining moral problem:
– Can an abortion be justified as a method of birth control?
• Identifying ethical considerations:
– Decision maker: pregnant woman;
– Reason for abortion: family planning;
– Emotions after abortion: lighthearted, guilt free.
• Identifying maxims:
– Right to self-determination;
– Responsibility of care.

Case interpretation
According to the arguments of the pro-choice lobby, a woman has a right to decide
the time when she will have a baby and the number of babies to whom she will

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give birth. However, abortion is different from contraception; the latter precludes
the possibility of conception taking place, while the former stops the conceptus
already in existence from developing. Therefore, abortion is more difficult to jus-
tify based on pro-choice arguments because it is the killing of potential human
life. In this case, the woman spoke of feeling ‘relieved and lighthearted’ after her
abortions as other grounds for justifying her actions. This is interpreted from
Gilligan’s principle of care, the first and less mature stage of which is that one
should take care of oneself. However, this woman’s seven abortions cannot be
justified or understood from the point of view that women should be prudent
and responsible when entering into sexual relationships. However, this woman’s
behaviour could be justified according to the argument of convenience cited by
feminist writers such as Purdy,8 whereby a woman is sufficiently justified in
choosing an abortion simply because it makes her life more convenient.

Discussion
It seems that religious beliefs did not influence in any significant way the deci-
sions of these three women to have an abortion.
Traditionally, Korean women were considered as human vessels whose duty it
was to provide male heirs for their husband’s family. This patriarchal attitude
stemmed from the Confucian philosophy that dominated Korean thinking.
Accordingly, the participants tried to conceal their abortions, especially from their
husband’s parents. Although women in Korean society have now become freer
and can therefore choose independently to have an abortion, Confucian traditions
prevented these participants from telling their family and friends, and therefore
placed them in a very lonely and pitiful situation. They only informed their hus-
bands. This was because in Korea, all family members generally participate in
decisions about medical diagnosis or treatment, although the father, husband or
eldest son has the highest authority and the most responsibility in making the
final decision.
The woman described in Case 1 chose an abortion because the responsibility
of caring for the existing baby outweighed any other considerations and she jus-
tified her decision on this basis. In Case 2, likewise, the woman chose an abor-
tion because the responsibility of caring for the existing child was more
compelling. However, after the abortion she felt compassion for both the fetus
and the second son who was born subsequently. She did not believe that the
aborted fetus and the second son were interchangeable; each was unique.
However, she considered respect for the second son’s feelings to be more impor-
tant than respect for fetal life. The woman concerned in Case 3 had no moral con-
flicts about her decisions to have abortions. She thought they could be used as a
kind of birth control method and did not reflect on the seriousness of having
seven abortions. She described herself as being rather lighthearted afterwards
because of decreasing morning sickness.
The two extremes in ethical arguments about induced abortions are pro-life and
pro-choice. However, the Korean women participating in this study showed that
conflicting ethical values were raised between the principle of caring and the sanc-
tity of life or the principle of respect for persons, not between the right of self-

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 Ethics of induced abortion in Korea 513
determination and the sanctity of life. Therefore, Gilligan’s principle of care is
supported by the decisions made by these Korean women when choosing abor-
tion.
If the justifiability of these three women’s ethical grounds was to be evaluated
in terms of the principle of care, Case 1 is the most consistent and Case 3 the least
consistent.

Conclusion
This study shows that Korean women do not regard a fetus as a person. Although
a fetus does not have full personhood status and is unable to reason or perform
self-motivated tasks, it is an actual human life, genetically speaking, and has the
potential9 to become a mature human being. Therefore, the decision to have an
abortion is not free from moral considerations. The participants in this study also
considered a fetus as a potential human being but, as they thought the responsi-
bility of caring for existing children and their relationships with other family
members were more compelling, this bias towards abortion is heavily influenced
by social expectations. Although there is inherent moral value in their decision to
take care of existing children – according to the principle of care – there are some
serious grounds for concern. As the number of abortions increases because
women regard it as a method of birth control in the absence of other choices or
alternatives, owing to their lack of knowledge and power, the health of women
is being put at risk and the respect for human life is being eroded. If the only
sustainable basis for fertility control is the informed choice of empowered men
and women, fully conscious of their rights and dignity,10 women should be edu-
cated about reproduction and the meaning of human life in order to make freer
and fuller decisions about family planning.
This study suggests that it would be better to include the viewpoints of women
in ethical discussions in order for ethicists and health professionals to understand
more fully the dimensions of the moral clinical problems and to be in a better
position to discuss them on a practical level.

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