Defunding UNFPA: a moral analysis: is there evidence of coercion in China's family planning program?

ETHICAL DECISIONS TAKEN IN Washington, DC, sometimes have global consequences. Never was this more true than with respect to a decision taken by Secretary of State Colin Powell on July 21, 2002, to halt $34 million in US funding for the United Nations Population Fund (UNFPA). I became involved in this issue when, in early September 2003, I served as a member of a nine-person delegation of US religious leaders and ethicists that traveled to China to meet with those associated with the UNVPA program there. [See page 25.]

A QUESTIONABLE PREMISE

Our trip was faced with some novel moral questions that we hoped to answer by careful reflection and by information gathering during our travel to China. At the heart of the debate were reports of coercive practices, including forced abortions and sterilizations resulting from the Chinese policy of controlling birth rates. These reports and pressure from antiabortion forces in the US contributed to the passage in the US Congress in 1985 of the Kemp-Kasten Amendment. This measure, which has been repassed in substantially unchanged form every year since, forbids funding for "any organization or program which, as determined by the President of the United States, supports or participates in the management of a program of coercive abortion or involuntary sterilization."

The Kemp-Kasten Amendment reflects a moral objection to coerced abortion and sterilization. Although one could ask whether circumstances might not sometimes justify the use of coercion to accomplish vital demographic objectives-such as when an exploding population poses a grave threat to many people's lives or health--that debate was beyond our purview. We sought to determine whether the Chinese program is, in fact, coercive. To answer this question, we have to understand what coercion amounts to in a moral sense, and whether features of the Chinese program make it reasonable to conclude that it involves "coerced abortion and involuntary sterilization." If this question were to be answered in the affirmative--and we will see that it is doubtful that it can be--a further moral question had to be answered in order to justify a halt in US funding for UNFPA. When does involvement in others' deeds amount to "support or participation" in them?

First, there is the question of coercion. In moral terms, we can define coercion as the intentional infliction of significant evils (or threat to inflict evils) on another person or persons against their will in order to make them behave (against their will) in a way one desires. (1) Drawing on the work of my colleague Bernard Gert, these evils include: death, pain (physical or psychological), disability and loss of freedom or pleasure? (2) For an act or threat to be coercive, one must not only inflict or threaten to inflict these evils, but the intensity, of the evil inflicted or threatened must be significant. Modest degrees of evils involve disincentives, but they may not be coercive. For example, a motorist who is threatened with a fine for speeding is not usually regarded as being "coerced" into not speeding. On the other hand, police who point their guns at an onrushing car to induce its driver to stop are using coercion. This distinction with respect to the intensity of evils is important. Because coercion is seen as reducing one's freedom to act, the claim that one has been coerced can be an excusing consideration in both ethics and law. (3) The claim that one was coerced by threat of death, for example, can mitigate one's culpability if one is accused of being part of a criminal conspiracy. However, one who violates a moral rule or civil law for insignificant reasons, such as a threat to have a small amount of money taken, can hardly invoke "coercion" as an excusing consideration.

Even though coercion involves the infliction of significant evils (or threat to do so) against a person's will, it is not always morally wrong. It can be used in good or morally justifiable ways (the threat to use lethal force to stop a violent person is one example). However, because coercion involves the possible infliction of significant evils, its use must always be morally justified (as, for example, by showing that it is needed to prevent the occurrence of even greater evils).

NO CREDIBLE EVIDENCE OF COERCION

One very clear conclusion of our questioning and study is that the Chinese population and family planning program does not now involve coercion in the sense of using the threat of physical force (involving deprivation of life or physical freedom, the infliction of physical pain or the threat to do any of these things) to obtain program objectives. Although such threats, as well as actual physical force, were probably used during the early 1980s to compel women to terminate out-of-plan pregnancies, everyone we spoke to--from the ministerial to the village level--affirmed that this has not happened since that time. Every third party witness we exmined supported these statements. Furthermore, current Chinese law forbids such practices and backs up these enactments with criminal penalties. Although no one call say that all Chinese population program officials always obey these laws (any more than one can say that all US health service officials always obey US laws), we encountered no credible evidence of such coercive practices. It is clear to us that China has taken very active steps to prevent the use of physical coercion for population control.

Related to this is the question of whether China's program involves "involuntary sterilization," another practice that triggers a funding ban under KempKasten. Certainly many Chinese women have opted for surgical sterilization as a birth control measure (only a very small percentage of men report having had a vasectomy). In the counties we visited, approximately 40 percent of women of childbearing age report being sterilized, although this percentage is declining in each new cohort of women as reversible means of birth control grow in popularity, partly as a result of UNFPA'S work.

Again, there are no credible reports that women are being forced into these operations. Sterilization is one birth control method available to women, but there are others. The other very popular method of birth control, also used by approximately 40 percent of women in the counties we visited, is the IUD, which offers safe, longlasting and highly effective contraception. In view of the availability of these options and the absence of evidence that sterilization is in any way being emphasized in UNFPA-associated counties, it seems unreasonable to conclude that UNFPA either supports or participates in the practice of involuntary sterilization.

SOCIAL COMPENSATION FEES

This brings us to the issue of Social Compensation Fees, which was characterized as a coercive aspect of the Chinese program in a State Department legal analysis that Powell used to justify his decision. These fees are conceptualized by the Chinese not as penalties, but as a fair reinbursement to society for the costs of an additional birth, including costs associated with state-provided perinatal services and primary education. They are established by national law, although the specific schedule of fees is usually set at the provincial level. Fees can be as high as several multiples of annual family income (two to five times), or they can be as low as one or two months' income. In Zhongwei County, which I visited with our delegation subgroup, fees ranged from 100 to 300 Yuan. In this county the range of average annual family incomes is from 800 to 2800 Yuan, with the Social Compensation Fees being applied proportionately to family income.

At first sight, a fee as high as two to five times annual income seems to be a powerful disincentive to having an out-of-plan birth. That extremely high financial penalties (involving the deprivation or threat of deprivation of freedom or ability and the infliction of psychological pain) can be regarded as coercive is supported by common sense. Nevertheless, despite the high levels of Social Compensation Fees in some Chinese counties, several considerations work together to make it questionable whether they can be regarded as coercive of abortion.

First of all, even if we regard these fees as coercive, they are primarily coercive of birth control, not abortion. In addition to reimbursing society for file social costs of all extra birth, the aim of these fees is to induce people to have smaller families, which they can do by choosing to utilize ally of the methods of birth control that are readily available to them. It is a separate moral question whether it is ever morally right to use strong social pressure to induce people to use birth control. Most Americans find this idea to be alien, although the Chinese we spoke to, with a very different history and living in a crowded country with one quarter the per capita arable land of the US, felt that it is perfectly reasonable to expect birth limitation or, failing that, to ask people to pay for the social costs of their extra children.

Since most people can easily avoid abortion by using contraception, the question of whether the Social Compensation Fees coerce abortion only arises in the small number of cases of unintended and unavoidable contraceptive failure. Faced with this quandary, are people forced by the tees to terminate a pregnancy? Several factors advanced by the Chinese that we spoke to suggest that they are not. Common to all of these are considerations that reduce the weightiness and hence significance of the penalties.

First of all, there remains to people in this situation the reasonable alternative of paying the fee. Increasingly in China, more prosperous families are electing this option and even building it into their family planning. Since raising a child, including the costs of post-primary education, can easily amount to 100,000 Yuan, several times the annual income of even a prosperous family, it is not unusual for families to expect that having a child will involve greatly added costs. The Social Compensation Fee is just another factor ill their planning.

The fees, then, have their greatest impact among the poorest families. Yet several features of the fee program mitigate their force. First of all, fees may be paid in installments, with 40 percent down and the remainder paid in three or more years. Second, the law prevents attachment of that portion of the income that each family requires for subsistence needs, and it prohibits confiscation of property. Because of these protective measures, it is not uncommon for the social compensation fees never to be collected and to be classified as "suspended." Somewhere between one half and two thirds of all fees incurred for outof-plan births may fall into this category.

In the course of our conversations with Chinese at all levels, we repeatedly asked whether they regarded the Social Compensation Fees as coercive of abortion. In many instances, they could not even understand our question. In their minds, "coercive" was a term associated with wrongful practices, whereas almost all of the people we spoke to, including ordinary villagers, stated that they felt the lees were fair and justified. One report shows that 93 percent of households in Yuzhong County, against which the Social Corn pensation Fee was levied regarded the fee as necessary. (4) When i clarified that a practice could be coercive and yet morally justified, as is the draft in instances of national self-defense, they understood the question better, but still did not regard these fees as coercive. This was because most people responded to the fees by using birth control, and the few who faced an out-of plan pregnancy still had a reasonable range of options. They did not see themselves as faced with significant evils if they chose to continue a pregnancy.

Finally, it was also probably a factor in their response that the Chinese generally view abortion as a far less significant moral issue than do many Americans. With very different cultural traditions, the Chi nese tend to see abortion as one birth control option among others. Because of this, they were genuinely perplexed that their family planning program should be seen as using the threat of evils as a way of forcing people against their will into desperate choices.

For all these reasons, I conclude that the Social Compensation Fees, although undoubtedly functioning as an incentive to birth limitation and disincentive to out-of-plan births, are not reasonably de scribed as coercing people into abortion in China. If this is correct, then the Bush administration had no moral grounds for invoking the Kemp-Kasten Amendment to end its funding of UNFPA.

SUPPORT AND PARTICIPATION

While the Chinese citizens that we and other assessment teams spoke with overwhelmingly believe that the Social Compensation Fees are not coercive of abortion, many Americans who oppose abortion might disagree and believe that the Bush administration was right to end its support for UNFPA. The rationale is that UNFPA'S involvement in China makes it somehow complicit in China's population program. That, in the words of KempKasten, UNFPA "supports or participates in" the coercive program that China's critics allege exists. Is this correct?

First of all, what does it mean to say that a person or organization "supports or participates in" a coercive program? The word "supports" can be used in at least two ways. It can mean that one shares the goals and objectives of a program or it can mean that, without sharing its goals, one provides aid and assistance to a program and helps sustain it. The phrase "participates in" has an even wider range of meanings. I "participate in" something when I take part or have a role in it. But such participation can he direct and essential to a program's operation, or it can be very indirect and remote, a minor aspect of a complex activity. It can also be witting or unwitting. I directly and wittingly "participate in" illegal drug dealing if I choose to run an underground drug lab. I directly but unwittingly participate in drug dealing if, unawares, I carry through customs a suitcase in which drugs have been secreted. I wittingly, but very indirectly "participate in" drug dealing if I work as a pilot for a commercial airline that drug smugglers are known to use. I indirectly and unwittingly "participate" in drug dealing if I innocently choose to patronize that same airline. This four-fold scheme (witting/direct; unwitting/direct; witting/indirect; unwitting/indirect) suggests we must exercise moral judgment determining the degree of culpability associated with various types of participation in wrongdoing. There are forms of participation, such as knowingly managing a drug lab, that everyone regards as morally culpable; and there are forms of participation that are either unwitting or so remote from direct involvement that they are not regarded as blameworthy. In such cases (the airline pilot or innocent passenger are examples) we even hesitate to label those involved as "participants" in the wrongful scheme.

Does UNFPA "support" the alleged practice of coercive abortion in China? In the first sense of "support," as sharing the goals and objectives of such a practice, it you clearly does not. As an arm of the UN, UNFPA is firmly committed to the goals of the 1994 International Conference on Population and Development, which include voluntary family planning. These same ICPD principles also bar UNFPA from involvement in the provision of abortion services. (While UNFPA is permitted to assist in the training of medical professionals to handle medical problems caused by abortions, it does not include abortion training or the provision of abortion services among its activities.) Does UNFPA then support these alleged practices in the second sense: helping to sustain them by the provision of goods or other resources?

The State Department legal analysis that informed Secretary Powell's defunding decision also contends that UNFPA'S provision of computers to country programs assists program staff in keeping track of out-of-plan births and, hence, in imposing the fees which the analysis judged to be coercive of abortion. However, several things that our delegation learned in China contradict this reasoning. For one, we learned that UNFPA undertakes periodic monitoring of the use of its donated computer equipment to ensure that it is used only for program purposes related to ICPD goals. For another, the Chinese do not need computers to efficiently manage the fee program, which they have done for years using written records. (In one family planning clinic we visited, I was surprised to see an abacus placed alongside the most modern birth control equipment and drugs. This is a reminder that the Chinese have thousands of years of experience in running a large, bureaucratic empire.)

Most important, what UNFPA contributes to the Chinese family planning programs is only a drop in the bucket of the hundreds of millions of dollars China expends on this effort. When we spoke to high-level National Population and Family Planning Commission officials, they were offended by the idea that the US could "punish" them by ending UNFPA'S material support for their program. That support, they said, was negligible compared with their own government's.

But if this was so, why were they troubled by the attack on UNFPA? Why is UNFPA important to them? Their answers to this question were unanimous and of great importance in terms of the issue of support. UNFPA, they said, is a catalyst for change in China. They noted that many people, including powerful figures in the government, are opposed to a transition to a population program based on ICPD principles. These people fear that an exclusive reliance on voluntariness in family planning will once again unleash the demon of rapid population growth and undo the great progress in this area that they believe China has made. These "conservatives" must be given proof that demographic stability is compatible with an exclusive reliance on voluntary family planning. This is what the UNFPA pilot programs can do. Attacking these programs or diminishing their efficacy, Chinese officials said, undermines the spread of ICPD, principles and contributes to those who see strong state administrative measures as the only way of maintaining demographic stability. Taking this viewpoint seriously, we can see that far from "supporting" coercive measures in either sense of the term "support," UNFPA'S activities in China combat coercion and weaken the hold of those who favor it.

This leaves only the question of whether UNFPA can reasonably be regarded as "participating" in the allegedly coercive programs. It is true that UNFPA played a small role in helping set up the 31 pilot programs being conducted under China's National Population and Family Planning Commission auspices. UNFPA workers also maintain collegial relationships with their Chinese counterparts. In this sense, they "participate in" these programs. But this "participation" is an unavoidable aspect of their effort to establish fully voluntary programs. It is as remote from "participating" in any possibly wrongful activities as the airline pilot's performance of his own function is from smuggling illegal drugs, and it may even be less "supportive" of the allegedly wrongful practices. If maintaining collegial relationships and engaging in mutual dialogue is taken as a basis for contending that one "participates in" another's misdeeds, then it can equally be said that George W. Bush "participates in" China's alleged human rights violations by meeting with members of its Politburo or by assenting to its admission to the World Trade Organization. This reductio ad absurdum argument reminds us that one's "participation" in wrongful deeds can be so remote, so unintentional, and so inconsequential as to lead us to conclude that it is not really even "participation." This, I believe is the proper conclusion in evaluating UNFPA'S current involvement in China. It is the conclusion reached by the Clinton administration but subsequently rejected in favor of an absolutely strict interpretation of "participation" by the State Department legal analysis. On this interpretation, any contact with their Chinese colleagues makes UNFPA a participant in the Chinese program, an interpretation that could as easily preclude many of the Bush administration's organizational contacts with the Chinese government.

Clarification of the issues is unlikely to immediately affect the course of US policy on UNFPA. Powerful political forces are driving that policy. Nevertheless, sound moral reasoning and careful attention to the facts can assist public discourse about complex and controversial issues. It is to be hoped that the work of our delegation will spur renewed discussion about a policy that urgently needs to change.

NOTES

(1) Michael Bayles distinguishes between "occurrent" coercion, involving the actual application of physical force, and "dispositional" coercion, involving the threat to impose sanctions in J.R. Pennock and J.W. Chapman, (eds.), Nomos XIV: Coercion, (New York: Aldine, 1972), pp16-29.

(2) Bernard Gert, Morality: Its Nature and Justification, (New York: Oxford University Press, 1998), p90. My discussion is much influenced by Gert's essay, "Coercion and Freedom," pp3048, in Pennock and Chapman, op. cit.

(4) The New York Penal Law, 35-35 treats duress/coercion as a positive defense. Michael D. Bayles, op. cit. p16.

(5) Zhai Zhenwu, "Investigation Project of Social Compensation Fee: Findings and Suggestions," Renmin University Population and Development Studies Center, May 2003, (on file).

PROFESSOR RONALD GREEN, PH.D. is the chair of Dartmouth College's Religion Department and directs Dartmouth's Ethics Institute.

An expanded version of this article appears in the Kennedy Institute of Ethics Journal, Vol. 13, No. 4, December 2003.