I am pro-abortion. Not in the sense that I think abortions are good. I don’t. In the sense that I am pro-surgery for medical conditions that can be surgically treated, or pro-pharmaceuticals for medical conditions that can be treated with drugs. I consider an unwanted fertilization to be a medical condition with significant consequences that can be treated. Now that I have gotten that out of the way I hope I can be free to state some ambivalence later about some other matters related to the anti-abortion movement.
But no ambivalence about a woman’s ability to get an abortion. Roe v. Wade was 37 years ago, but I was already a doctor by then and had seen the usual consequences of making abortion illegal. On the one hand, because I did service to people without medical care I remember the middle of the night excursions to the emergency room to meet some young woman being seen for hemorrhaging from a botched back alley abortion. Those were off hours. In the on-hours in the big city tertiary care hospital I saw plenty of legal abortions, although they were called something different (“D&Cs”) and available to women or couples with enough money. There were plenty of unwanted pregnancies in those days, even more than now, because in many places birth control was still illegal. The pill was newly available and only starting to come into widespread use. It was a different world before Roe. v. Wade and not different in a good way. If you are a woman under the age of 50-something it would be hard to imagine how different it was. That’s why when I see crap like this coming from Nebraska it makes me crazy:
Nebraska could become the first state to require doctors to screen women for possible mental and physical problems before performing abortions under a bill that received final approval from the nonpartisan Legislature on Monday.
Republican Gov. Dave Heineman’s office said Monday he will sign the bill Tuesday, along with another groundbreaking abortion measure lawmakers are expected to pass then. That bill would ban abortions after 20 weeks based on the assertion that fetuses feel pain.
The bill requires a doctor or other health professional to screen women to determine whether they were pressured into having abortions. Doctors also must assess whether women have risk factors that could lead to mental or physical problems after an abortion.
The bill is unusual, however, in spelling out what doctors must look for. They include any risk factors cited in peer-reviewed journals indexed by two major medical and scientific listing services during the year before a planned abortion. The risks could be “physical, psychological, emotional, demographic, or situational,” according to the bill. (Nate Jenkins, AP via Boston Globe)
As medical opponents noted, it’s pretty hard for a doctor to know if he or she has complied this law. There is all sorts of stuff in the literature that may or may not bear on risk factors for any surgical procedure. Most of it probably has significant flaws that make it uncertain whether something is truly a risk factor. Doctors aren’t scientists and they don’t understand the subtleties of scientific method. Nor do they spend a great deal of time reading the literature. They know the highlights, which is good, because those are the things more likely to pass through the filter of uncertain and discordant results. But there is no way they can know all the validly established risk factors in an unspecified literature (while the indexes are stipulated in the law, the search terms are not) up to the day of the patient’s treatment. This incredibly stupid and obtuse law isn’t meant to work, however. It is meant to scare doctors from treating patients in a way decided by the patient and her doctor as medically indicated. It is the grossest kind of interference in the doctor patient relationship and if we wanted a poster child for government getting between a doctor and patient, this is it.
The scare tactic will be extremely effective, given the penalty. What scares a doctor more than losing a medical license? Losing a medical license isn’t likely and isn’t a penalty prescribed by this law. The penalty is something that scares doctors even more because it happens all the time: the threat of being sued. Under this law a doctor can be sued if he or she doesn’t screen for a risk factor and something happens. The nature of the thing that happens can be “physical, psychological, emotional, demographic, or situational.” While a suit isn’t likely to succeed on its merits, this is a recipe for the kind of frivolous or mischievous politically-inspired lawsuit so decried by the right wing — unless it relates to abortion, obviously.
Now, regarding my ambivalence about the anti-abortion movement. The weird fact is that the same things that make me so pro-abortion — empathy for the patient — also forces me to identify with the intense commitment of the anti-abortion movement. I had and still have the same feeling about war, and I committed civil disobedience and was briefly jailed and was willing to go into exile over it. I never assaulted anyone or got in the face of a young soldier or called anyone names, although it is often repeated there were those that did. I saw it very, very rarely and the civil disobedience was passive and aimed at shutting down recruiting stations and draft offices or general demonstrations, not aimed at individuals. But the intense commitment was there and I recognize it in the anti-abortion movement. So I always feel some ambivalence and there is an element of recognition.
But there are differences, too, and it relates to the empathy question. I don’t know if empathy is a learned skill or a matter of natural temperament or both. But I don’t see much empathy in the anti-abortion movement. Bart Stupak, for example. He represented a very conservative district but took a tough stand against guns and a lot of NRA heat for it. The reason was personal, however. His son committed suicide with a handgun, so he knew without having to conjure it up in his mind the devastation firearms can bring. But he never was in the shoes of a scared and young woman who has to run a gauntlet of vicious taunts at an abortion clinic, so apparently he wasn’t able to imagine it. Worse, he made common cause with the far right and came close to scuttling any kind of health insurance reform and undoubtedly playing a part in producing the pallid version we wound up with. Mrs. R. is a gentle soul, but her comment on Stupak was: I wish he would be raped and get pregnant. That’s the only cure for a lack of empathy. Now his former friend have hounded him out of office and he is retiring. He’s run their vicious gauntlet and I guess he doesn’t like it.
The freedom to live a life without untreated medical conditions is now portrayed as bondage to government run health care while at the same time forcibly promoting the most intrusive kind of government interference in the doctor patient relationship imaginable is said to protect the helpless. We breezed through 1984 with hardly a notice, but it seems the idea that Freedom is Slavery is finding new life. That’s what pro-life means these days.