In August 2026, Massachusetts quietly abolished every remaining time limit on abortion. Under bill H.5595, a pregnancy may now be ended at any point up to the fortieth week, solely at the discretion of a physician and the pregnant woman. The New York Times reported the fact with the usual calm. The political class responded with the usual script.
Republicans called it radical. Democrats called it healthcare. Public broadcasters and progressive outlets dutifully framed the dispute as another round in the endless war between religious conservatives and defenders of individual choice. The framing is convenient. It is also false.
What happened in Massachusetts is not merely an expansion of reproductive rights. It is the formal adoption of a biopolitical logic that treats the human being, at its most dependent stage, as manageable biological material. The fetus becomes data—flesh that can be measured, evaluated, and, if it fails the current medical standard, discarded. The woman who has carried it for nine months is recast as a temporary vessel whose decisions are guided, often decisively, by professional authority. Few patients, after all, contradict a doctor who has just diagnosed a severe disability and recommended termination. For years I have argued that moving fundamental moral questions into the neutral-sounding category of “healthcare” would eventually strip them of political and ethical weight. Massachusetts has now taken that logic to its extreme. Once the continued existence of a viable fetus is redefined as a medical service rather than a matter of public concern, the democratic state performs a quiet abdication. It transfers its protective responsibility to the medical-industrial complex and calls the transfer empowerment.
The familiar liberal phrase—“a decision between a woman and her doctor”—sounds intimate and respectful. In practice it conceals an economic reality. In a market-driven healthcare system the physician is not a disinterested moral guide. He or she is a service provider operating inside constraints of cost, liability, insurance, and institutional protocol. Remove legal boundaries and the logic of optimization fills the vacuum. Bodies are scanned, probabilities calculated, outcomes ranked. What remains is an industrial conception of the human: life assessed according to projected productivity and freedom from defect.
Criticism of this development is routinely dismissed as conservative or theocratic. That is a failure of imagination. There is a coherent progressive argument against treating disability as a problem best solved by elimination. A society that claims solidarity with the vulnerable cannot simultaneously offer their non-existence as the preferred technical solution. Jürgen Habermas, hardly a reactionary, warned that selecting future human beings according to functional specifications destroys the moral symmetry between generations. A person whose right to exist depends on meeting someone else’s quality standards is no longer an end in themselves. They become a product.
The same logic that turns the late-term fetus into disposable data quietly converts the mother into a service provider within a healthcare market. Motherhood is reframed as a temporary logistical function. If the product does not meet specifications, the process can still be terminated.
This is not liberation. It is the extension of market rationality into the one domain that was supposed to resist it. Massachusetts has not expanded freedom. It has refined a system of industrial quality control and called it care.
Image: Heart behind Bars by Regula Staempfli