Here we go again, it's the so called "pro-lifer" against the pro-abortionists arguments. There will never be a common ground. It's the episode that those who are inclined to hate Janeway give for their justification. But the honest truth is the ending could have been no other way.
Tim Russ and Ethan Phillips had contracts, Kenneth Biller did not. The story could only go one way.
Let's hear it for pragmatism. There's not enough of that around!
Me, I like the episode (like Season 6's Memorial) simply for the ethical debate it stirs up; for the best of those there's no clear outcome. The debate itself is the thing -- questioning, probing, thinking.
Oh, and that makes for the best Trek episodes. Funny, that...