In one scenario I was the doctor and was asked if I would perform an abortion for a couple — perfectly ordinary middle-class people — who had a son and wanted a daughter to round out the family. The woman was pregnant with another boy. I said I wouldn’t do it and I thought Planned Parenthood policy should preclude such abortions but be open to referring women to providers whose values may be more in sync with the patient’s. I also suggested that institutions as well as individuals have values, and that those of us in leadership positions on reproductive rights had an obligation to let the public know what our values were – in all their complexity.

 Just because something is legal — and should be legal — does not mean it is always ethical. And sometimes the right thing to say to a woman is “I am so sorry, I cannot do what you ask.”

 Some folks were outraged. It wasn’t up to Planned Parenthood or any doctor to judge a woman’s reasons for abortion, they said.  One provider told of a couple who had come to her clinic because the baby would be born under the wrong birth sign. The clinic paused; considered that women do not have to give reasons for abortions and saw no reason to penalize this woman because she was honest and gave what many might consider a not terribly good reason to end a pregnancy. Some said the couple would not be good parents, so let’s end it before some child is born to foolish and selfish parents. I just could not agree.

Joan Walsh’s appearance on Fox’s “O’Reilly Factor” set me to thinking again about these tough questions, and whether it makes sense for the pro-choice movement to deal publicly with the ethical issues as well as the legal issues surrounding abortion. There’s always been a fear in the choice movement that if we deal with “morality” we are going to lose. Even the word morality sends chills up the spines of some choice advocates. We are somewhat more comfortable talking about “ethics,” although both words have the same meaning. Morals comes from a Latin root and is a “hot” passionate word, conjuring up religion. Ethics, from the Greek, is cooler, dispassionate, more distancing and secular. The anti-abortion forces make the moral arguments and we use the rights discourse; they talk about fetuses as babies, and we talk about women as autonomous people.

 But tough questions come up more frequently than they did in the first years after Roe, as more is known about the choices some women and couples make, and fetuses have become as visible as women. Sex selection is only one of many tough issues. Abortion when the fetus has mild disabilities – or even when the fetus has no disability — is another. What about deaf couples who do not want a hearing child? Or as Ayelet Waldman reported on DoubleX, the woman in her support group who had an abortion because her fetus’ hands were deformed.

 These things should make us pause and think hard. The thought of putting every woman through the indignity of meeting with an ethics committee, or getting a doctor to sign off on her reasons for abortion, has forced most of us to stick with the principle that women must be allowed to make their own private ethical decisions, without the state getting involved. But is it really leadership for us always to simply shrug and say: “Who knows whether that was an unethical decision for that woman?” Don’t we express moral views about every other issue under the sun, from the number of embryos it is ethical to insert into a woman’s uterus to the morality of bonuses for Wall St. executives who robbed us blind?  Expressing our views about controversial issues is how society develops norms and shared values.

 If pro-choice advocates follow the example of those opposed to abortion and present only one value — a women’s right to make this decision — as the only ethical consideration worth discussing in difficult cases, do we not become as extremist as we say they are? Is there not, in an ethical sense, an important weighing of women’s rights and needs against a respect for life, even the life of nonpersons? Is there a point in pregnancy when our respect for life might outweigh a woman’s right to make this choice? And is the fact that we have avoided it part of the reason that polls show that more people are willing to call themselves pro-life than ever before?

If so, O’Reilly’s opening salvo: “Do you feel late-term fetuses deserve any protection at all?” is a question we must answer — and I would say answer in the affirmative. We have already decided that embryos and stem cells, very early forms of life, deserve protection, and we have regulations that govern how they can be treated as research subjects. We protect animals and endangered species, even some plants. How we treat these potential forms of persons as well as how we treat other living nonpersons has come to be understood as an indicator of who we think we are as moral persons. We are pro-life to the extent that we do not want to abuse or harm living things if we can avoid it. That at least is our ideal — which we then regularly violate with war, torture, the death penalty, and the callous way in which we deny those in need healthcare, food, shelter and education.