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REVIEWED BY M. THERESE LYSAUGHT, PhD

"…[T]his is a book that will completely satisfy no constituency.…Whatever your view, it will be challenged here. And if you're willing, you're highly likely to learn something as a result."

So writes Melinda Henneberger, senior writer for BloombergPolitics.com and a former reporter for The Washington Post, in her foreword to Charles Camosy's Beyond the Abortion Wars. She is correct on all three points. Yet Camosy's attempt to bring clarity to the question of abortion politics in the U.S. and to move the public conversation beyond demagoguing polarization toward a constructive solution might find his most receptive audience among those who work in Catholic health care. For, as a moral theologian on faculty at Fordham University, Camosy engages the question of abortion through two lenses that are germane to this audience: moral theology and public policy.

Camosy's argument unfolds in six chapters. Chapter 1, "Shifting Abortion Politics," is the strongest. Here, he provides an illuminating historical overview of abortion's changing politics, starting with early feminists' staunch opposition and continuing through shifting platforms within both the Republican and Democrat parties from the 1970s through the early 1990s. He demonstrates, through recent polling data, that Americans as a whole are not nearly as polarized about abortion as public rhetoric would suggest and are, in fact, largely "pro-choice" in some situations and "pro-life" in others. Few Americans, it appears, want to see abortion banned entirely, but most would favor greater restrictions. His overview of these statistics as well as the plethora of legislative initiatives currently in process at the state and federal levels provides a thick description of the abortion question's landscape.

With this context mapped out, Camosy turns to moral analysis. In Chapter 2, he reviews the standard arguments on the moral status of the fetus, evaluating their strengths and weaknesses. His own conclusion is that the fetus is a person, deserving equal protection under the law. Yet this strong position does not simply determine the legislative question. Rather, it provides the starting point for a more nuanced consideration of those limited situations where both U.S. law and the Catholic tradition have considered it licit to end the life of a person.

Camosy moves through these situations in Chapter 3. He carefully outlines and engages the two key ways of conceptualizing abortion — as an act that either "aims at the death of" or "ceases to aid" the fetus. With regard to the first, he seeks to balance and preserve two important moral principles: that it is always wrong to aim at the death of an innocent person and that a woman has a right to defend herself when pregnancy threatens her life. He advances the conversation in important ways, reframing cases in which the mother's life is threatened under the category of material harm. He also seeks to glean what insight he can from claims made by some that in abortion, a woman is simply ceasing to provide physiological aid to her fetus.

A next question is: Ought these moral positions to be translated into law? Camosy turns to the issue in Chapter 4, "The Challenge of Public Policy." He draws particularly on the work of the Catholic theologian and legal scholar, M. Cathleen Kaveny. His analyses, which cannot be briefly summarized, will be of interest and use to those engaged in the work of advocacy and policy development.

In Camosy's view, the question regarding public policy also brings the moral status of women to the forefront. In Chapter 5, "Abortion and Women," he makes a compelling case that, in general, "our broader abortion practices and policies actually serve the interests of men … have had disastrous consequences for women," and overall have made women in the U.S. less free. He draws on arguments from pro-life feminists in making this case, but in doing so, he sets up the fundamental premise for a constructive proposal, namely, that any legitimate endeavor to limit abortion and advance women's freedom will entail changing our social structures to respect women, to provide them true equality under the law and economics, and to implement social and cultural supports that truly value all lives.

In his final chapter, Camosy makes a bold move for an academic theologian: He proposes a public policy initiative. In Chapter 6, "A Way Forward," he sketches the outlines for a legislative proposal he entitles the Mother and Prenatal Child Protection Act, which combines a deep commitment to the lives of the unborn with a proposal for social and economic supports for women and children. The four planks of the act include: (1) equal protection of the law for the prenatal child; (2) equal protection of the law for women during pregnancy; (3) economic support of mothers and their children during and after pregnancy; and (4) legal support for "ceasing to aid a fetus" for a proportionately serious reason. Specific initiatives under each heading are listed.

This is a brave and helpful book, and one that is quite easy to read. Camosy seeks to push toward a practical solution that reflects the positions of the American public and truly seeks to advance the common good. He provides clear and helpful counterarguments to positions on both sides of the debate while also grounding his work in the complex, conflicted and often subtly coercive realities in which many women find themselves.

As Henneberger noted, this book will completely satisfy no constituency. Although I think Camosy makes a helpful contribution to the Catholic conversation in his analyses of "aiming at death" and "ceasing to aid" in Chapter 3, some no doubt will take issue with his argument; but he lays the groundwork for further conversation among Catholic moral theologians around important technical moral questions. Equally, pro-choice feminists will likely find their arguments underrepresented in Chapter 5.

Nonetheless, this is one of the few books — and perhaps the only one — that attempts to move beyond shrill polarization and craft a careful, thoughtful, balanced and reasonable solution to a devastating moral and social issue, one that often places Catholic health care in the crosshairs. I anticipate that many who work in the Catholic health care ministry will align with Camosy's positions and therefore will appreciate the clarity his analysis brings to what is usually just a muddle.

In closing, while I laud his attention to the question of public policy, I wish to end with an oblique comment that he makes that points in an equally, if not more, pressing direction. He rightly calls out the Catholic Church for the abyss between its teaching, its political rhetoric and machination, and its actual witness, noting that:

… it is an utter scandal that local Catholic communities don't do more to support local pregnant women in difficult situations. We should be lining up to adopt babies of various races and health conditions; we should be using our free time to provide free child-care for needy women in our local communities and churches; every parish and church should offer shelter and assistance to pregnant women in difficult situations and offer programs of counseling and healing for women who have had abortions.

What a difference the Catholic Church could make with regard to the issue of abortion if it would only live the Gospel via these practical, material manifestations of the Catholic social tradition. Camosy's words could be equally directed to our Catholic health systems, which occupy such a powerful position amid so many economically troubled communities.

This is a timely book, given the potential reconfiguration of the U. S. Supreme Court and the continued legislative efforts around abortion in the United States. But it is also timely given the reconfiguration of health care delivery from a tertiary care model to population health — going forward, informed by Camosy's analyses, how might Catholic health systems provide a real witness and make a real difference with regard to maternal and child health and help move Catholic health care beyond the abortion wars?

M. THERESE LYSAUGHT is a professor and associate director at the Institute of Pastoral Studies at Loyola University Chicago, with a joint appointment in the Neiswanger Institute for Bioethics and Health Policy at Loyola's Stritch School of Medicine.