Mar 30 2012
Lying for the State
Quacks lie. In some ways, that’s what separates us from them. Real doctors are stuck with the messy truth: with bad news, with uncertain outcomes. It’s this reliance on the truth which gives us much of our credibility.
Laws forcing doctors to lie to patients take me back to reading Kundera in the 80s; the hovering fear that everyday actions might bring the authorities to your door. These feelings affect every portion of your life, whether you are a patient or a doctor. Lying in service of the state is pervasively oppressive. Laws requiring doctors to lie have become a popular tactic in the abortion wars.
Let’s look at Texas’s law, it’s requirements, and internal contradictions.
Sec. 171.012. VOLUNTARY AND INFORMED CONSENT.
(a) Consent to an abortion is voluntary and informed only if:
(1) the physician who is to perform the abortion informs the pregnant woman on whom the abortion is to be performed of:
(A) the physician’s name;
(B) the particular medical risks associated with the particular abortion procedure to be employed, including, when medically accurate:
(i) the risks of infection and hemorrhage;
(ii) the potential danger to a subsequent pregnancy and of infertility; and
(iii) the possibility of increased risk of breast cancer following an induced abortion and the natural protective effect of a completed pregnancy in avoiding breast cancer;
(C) the probable gestational age of the unborn child at the time the abortion is to be performed; and
(D) the medical risks associated with carrying the child to term;
We have encountered a problem. Informed consent is a medical term d’art that protects both the patient and the doctor. To the extent possible, a doctor must communicate risks and benefits of a proposed procedure in a way the patient can understand and acknowledge. These risks and benefits are not set in statutes but found in the medical literature. Statistics such as complication rates of various procedures are usually easy to find and to cite.
The statute does not use the medical definition of informed consent but it’s own concoction. It throws in “…when medically accurate…” but then insists that the doctor state information that is counterfactual (that is, a lie). In this section, the most glaring lie is that abortion is associated with breast cancer. It most certainly is not. And where are the “benefits” in “risks and benefits”? It is implied that there are none.
What about the next section?
(2) the physician who is to perform the abortion or the physician’s agent informs the pregnant woman that:
(A) medical assistance benefits may be available for prenatal care, childbirth, and neonatal care;
(B) the father is liable for assistance in the support of the child without regard to whether the father has offered to pay for the abortion; and
(C) public and private agencies provide pregnancy prevention counseling and medical referrals for obtaining pregnancy prevention medications or devices, including emergency contraception for victims of rape or incest;
The above section is slightly murkier. It looks superficially to be innocent enough, perhaps even compassionate. This makes the lie even more dangerous. The section infantalizes the woman seeking an abortion, assuming that she needs this information to make her choice. Likely, she’s already made her choice. It’s not up to a doctor to give information that is clearly designed to topple the patients autonomy. It’s also only somewhat factual. ”Medical assistance may be available…” (emphasis mine). I’m sure that’s very comforting, a real promise of assistance (sarcasm mine). I’m sure that the state can hunt down the father and find a way to make him pay child support (additional sarcasm), assuming the patient feels this is wise, safe, and desired (although the patient’s desires aren’t taken into account here). And then there are “referrals” to agencies that provide pregnancy counseling (often thinly-veiled anti-abortion offices) and to “emergency contraception” for rape and incest. If they are seeking an abortion, it’s a bit late for Plan B. And why only for rape and incest? According to the law, the crime must be reported in order to avoid some of this law’s consequences. This is problematic in ways that would take another full post.
This section assumes that it is economics or assault driving the patient to choose an abortion, that it is not a well thought-out choice by an adult who wishes control over her own body. It makes the woman invisible, except for her womb.
The following section goes on to delineate exactly how the doctor is to perform the state-mandated rape of the patient with an ultrasound probe*. This violation of trust between the physician and patient is too obvious to mention, but mention it I will. It’s bad enough to demand we lie, but to demand we commit rape is, it would seem, obviously bad.
The statute also requires the doctor to give the patient a booklet full of misinformation about abortion with trumped up descriptions of risks, and no discussion of benefits.
The statue does a lot of bad things I haven’t listed, as do similar statues being passed in other states. The point here is not that statues that essentially outlaw abortion, infantalize and shame women, and require forcible penetration are bad. Any sensible person knows this.
The other consequence is the complete destruction of the doctor-patient relationship. If the state can compel a doctor to lie to a patient in one circumstance, it can in any circumstance, and patients will no longer be able to believe anything a doctor says. They would be fools to trust us.
When the state can demand that we violate our basic responsibility to our patient—that of delivering the truth—we are no better than quacks, and deserve no better than quacks.
Here is the ultrasound part of the statue for your revulsion:
(A) the physician who is to perform the abortion or an agent of the physician who is also a sonographer certified by a national registry of medical sonographers performs a sonogram on the pregnant woman on whom the abortion is to be performed;
(B) the physician who is to perform the abortion displays the sonogram images in a quality consistent with current medical practice in a manner that the pregnant woman may view them;
(C) the physician who is to perform the abortion provides, in a manner understandable to a layperson, a verbal explanation of the results of the sonogram images, including a medical description of the dimensions of the embryo or fetus, the presence of cardiac activity, and the presence of external members and internal organs; and
(D) the physician who is to perform the abortion or an agent of the physician who is also a sonographer certified by a national registry of medical sonographers makes audible the heart auscultation for the pregnant woman to hear, if present, in a quality consistent with current medical practice and provides, in a manner understandable to a layperson, a simultaneous verbal explanation of the heart auscultation;
(5) before receiving a sonogram under Subdivision (4)(A) and before the abortion is performed and before any sedative or anesthesia is administered, the pregnant woman completes and certifies with her signature an election form that states as follows:
“ABORTION AND SONOGRAM ELECTION(1) THE INFORMATION AND PRINTED MATERIALS DESCRIBED BY SECTIONS 171.012(a)(1)-(3), TEXAS HEALTH AND SAFETY CODE, HAVE BEEN PROVIDED AND EXPLAINED TO ME.
(2) I UNDERSTAND THE NATURE AND CONSEQUENCES OF AN ABORTION.
(3) TEXAS LAW REQUIRES THAT I RECEIVE A SONOGRAM PRIOR TO RECEIVING AN ABORTION.
(4) I UNDERSTAND THAT I HAVE THE OPTION TO VIEW THE SONOGRAM IMAGES.
(5) I UNDERSTAND THAT I HAVE THE OPTION TO HEAR THE HEARTBEAT.
(6) I UNDERSTAND THAT I AM REQUIRED BY LAW TO HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
___ I AM PREGNANT AS A RESULT OF A SEXUAL ASSAULT, INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL CODE THAT HAS BEEN REPORTED TO LAW ENFORCEMENT AUTHORITIES OR THAT HAS NOT BEEN REPORTED BECAUSE I REASONABLY BELIEVE THAT DOING SO WOULD PUT ME AT RISK OF RETALIATION RESULTING IN SERIOUS BODILY INJURY.
___ I AM A MINOR AND OBTAINING AN ABORTION IN ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER CHAPTER 33, TEXAS FAMILY CODE.
___ MY FETUS HAS AN IRREVERSIBLE MEDICAL CONDITION OR ABNORMALITY, AS IDENTIFIED BY RELIABLE DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY MEDICAL FILE.
(7) I AM MAKING THIS ELECTION OF MY OWN FREE WILL AND WITHOUT COERCION.
(8) FOR A WOMAN WHO LIVES 100 MILES OR MORE FROM THE NEAREST ABORTION PROVIDER THAT IS A FACILITY LICENSED UNDER CHAPTER 245 OR A FACILITY THAT PERFORMS MORE THAN 50 ABORTIONS IN ANY 12-MONTH PERIOD ONLY:
I CERTIFY THAT, BECAUSE I CURRENTLY LIVE 100 MILES OR MORE FROM THE NEAREST ABORTION PROVIDER THAT IS A FACILITY LICENSED UNDER CHAPTER 245 OR A FACILITY THAT PERFORMS MORE THAN 50 ABORTIONS IN ANY 12-MONTH PERIOD, I WAIVE THE REQUIREMENT TO WAIT 24 HOURS AFTER THE SONOGRAM IS PERFORMED BEFORE RECEIVING THE ABORTION PROCEDURE. MY PLACE OF RESIDENCE IS:__________.
____________________
____________________
SIGNATURE DATE”;
165 Responses to “Lying for the State”
I got into an argument with a couple of people about these laws. Their basic premise was that an ultrasound is routinely done during pregnancy, so what’s the big deal with the law?
My initial response was that transvaginal ultrasounds are not so routinely done, usually it is transabdominal.
“Ok, so what’s the big deal still? Isn’t this just a benign medical procedure that is still reasonably common and won’t cause any harm to the mother or fetus?”
“That’s not the point,” I said. This legislates away medical decision making. It forces a doctor to do a medical procedure that may not be indicated. And even if it is indicated, a patient still has the right to refuse it! However, this law removes that right and removes patient autonomy.
And really, the ultimate point is that the state should never be legislating medical protocol. There are no absolutes in medicine and thus either someone will have their autonomy violated or the law will be broken at some point. Period. And in cases where that would never happen, (“in cases where a patient has completely lost function of his or her phrenic nerve, the physician is required to insert an endotracheal or other definitive airway and attach the patient to a ventilator set as medicall necessary”) the law is utterly superfluous and completely pointless.
So why legislate such a thing? It has absolutely no other purpose than to shame a woman out of having an abortion.
And that was all before I read the actual wording of the law and it is even more despicable than I imagined.
As this physician says, sadly under the veil of anonymity because of fear of a bad reputation from it, we are our patient’s advocates. First, last, always. And we must never forget that.
Roe v. Wade was decided in 1973 – 40 years ago. That there are still people trying to relitigate that decision is astounding. What strikes me as most disingenuous is that I rarely – if ever – hear those voices that are crying in anguish over the murder of the unborn also lobbying to reform adoption laws, bringing foster children into their homes, mentoring at-risk youth through programs like Big Brothers. I’m not saying that it doesn’t happen – only that the decibel level advocating for children without homes is decidedly lower than that advocating against abortion.
@windriven – you’ve got that exactly right. I always make a point to ask these people point-blank how many homeless and unadopted children they’ve taken in. How much do they donate to organizations in support? And do they also support WIC and other programs that provide child support. Of course at this point they turn beet red and shut up. Because of course the majority are just fetus lovers and morality slangers, and are unwilling to do the hard work of helping children after they’re born.
I occasionally wonder if it is time to start mailing coat hangers to legislators again, for those of you old enough to remember those days.
I’ll admit that I’m a little hazy. What are the benefits of an abortion other than getting rid of the baby? And isn’t that covered in the section where they are required to describe the potential medical risks of the pregnancy?
As regards the “pro-life people only care about fetuses”, I’d have more respect for the argument if it weren’t always phrased as a “I said this to one person and they didn’t have an answer, and I think it applies to everyone in that group”.
That’s not much different from the various CAM people who claim to have met doctors who are in it only for profit, and therefore they all are. Personally, as someone pro-life, I do donate to organizations that help abandoned and orphaned children. I donate to funds that help pay for the costs of raising children in the case that a single mother decides to keep their child. Just like the other side’s arguments, this is just anecdotal evidence since I’m just one data point, but I am one data point.
Minor thing, you have a lot of references to “statues” near the end.
@windriven, you clearly don’t know enough people actively involved in the pro-life movement.
I don’t agree with the law in totality, especially with the t/v ultrasound. I believe that any such discussion about assistance, counseling, etc. should be an administrative issue that doesn’t need to be handled by the physician. All clinics have administrative staff and counselors. However, knowing that many women make these decisions for financial reasons and/or because they’re being compelled by the family or babby-daddy, I have a hard time seeing how exposure/emphasis of the alternatives are a BAD thing, especially for the woman only reluctantly has an abortion.
My mother was one of them, and it has had a lasting negative effect on her life and relationships.
I missed the part of the law where they explain the risks of a medically unnecessary ultrasound procedure and where to get assistance suing the state of Texas in case of injury.
In my mind, I like to think that Obama is posturing. When he gets reelected (I’m making this assertion based entirely on my lack of desire to even think about one of the current GOP candidates running the show), I really like to think that he will clean house, going from state to state and taking on anything that is anti-human rights or just plain not in the best interest of Americans as a free society. It just blows my mind how a single group of people can talk about preserving the constitution and keeping the government out of business can, at the same time, do everything they can have the government (at the state level) deny women and homosexuals some fairly basic human rights. I’m well aware that my Obama fantasy is just that, a fantasy. How sad is it that I can’t even imagine the possibility of someone being elected that took each issue one at a time and evaluated it in a rational, logical way? The concept of someone being president that makes decisions based on reality and not ideology doesn’t even seem remotely possible. To keep from rambling more, I’ll simply digress for now. I’m sure I’m not the only one that gets disillusioned from time to time over it all. Even in the midst of the overall, big picture being so messed up……Texas? Wow! Even though I know there are some very smart and awesome people in Texas, with what goes on with the politics in that state….I sincerely can’t imagine a scenario that could get me to move and live there. It’s like the septic tank of the US for irrational leadership and just plain crazy. Rick Perry and Alex Jones actually live in the same state? Does anyone really want to go anywhere near that state? At least if the crazy is all herded together, they are easier to avoid.
I must admit that the term “state-mandated rape” makes me uneasy, because it strikes me as intentionally emotionally loaded rhetoric that sheds far more heat than light on the medical and informed consent issues involved. The reason is that there are actual real medical indications for doing a transvaginal ultrasound before performing an abortion. (There was an excellent post elsewhere enumerating those indications; I’ll have to see if I can find it again.) The issue, besides the state trying to destroy a woman’s autonomy, is that the state is mandating an invasive medical procedure that is usually (but not always) medically unnecessary.
As for the state-mandated misinformation that doctors are ordered to provide women seeking abortions, I see no difference between this and what I have referred to as “misinformed consent,” in which, for example, antivaccinationists vastly exaggerate the risks of vaccination (and even make up risks that don’t exist, such as the risk of vaccine-induced autism) while downplaying its benefits. I have to wonder whether a physician’s duty to his patient demands that, while obeying the letter of the law, he undermine the law any way he can, such as by telling the patient that the contents of the state-mandated “information” are not supported by science. For instance, as a breast cancer specialist, I could easily follow the letter of the law while undermining its spirit by saying something like:
Or, I would just not mention breast cancer at all. Then, if challenged, I would justify my omission by saying that it’s not medically accurate to attribute an increased risk of breast cancer after abortion. If further challenged, I would then provide the challenger the copious evidence from the peer-reviewed medical literature and position statements from major women’s health societies that back up my assessment, all sitting on my hard drive and in files in my office, ready for just such a challenge.
@duggan
If you explicitly list risks you must Also lit benefits. We do that for all procedures. For an abortion a potential statement would be “the benefits of this procedure are the successful termination of your pregnancy per your wishes.” if you want to get pedantic you could go into all of the dangers of pregnancy and childbirth avoided.
I don’t think any doctor would have asked the question you did so thank u..
@davidG
I agree that rape is an intentionally loaded term but it is also accurate.
The NH Legislature is attempting to pass a similar bill in NH. It has already passed the House. It is called, apparently without a shred of irony, “The Women’s Right to Know Act.”
I have blogged about it at http://www.patientspatienceandpaces.blogspot.com/2012/03/dear-nh-senate-please-stay-out-of-my.html
Since it falls under the FBI and UN definition of rape, can a doctor be charged with rape?
One benefit of abortion is that it prevents the many health risks and complications associated with pregnancy. Abortion is safer than full-term pregnancy.
You mention that the statute infantilizes women. It also infantilizes and insults doctors, implying that state coercion is required to get them to do their job of providing informed consent.
@nybgrus,
“So why legislate such a thing? It has absolutely no other purpose than to shame a woman out of having an abortion.”
Well stated. Why single out abortion? They don’t apply the same standard to other elective procedures such as breast augmentation and facelifts. They don’t even apply it to another hot button issue: neonatal circumcision. They didn’t propose a law requiring auto mechanics to explain what they are doing, to show customers the damaged parts, and to offer options like rebuilt parts instead of new ones.
“the ultimate point is that the state should never be legislating medical protocol”
Oh but they do it all the time. We do also sorts of things because the law / core measure has not caught up the current best practice.
Where does the law specify a trans-vaginal ultrasound? It only states sonogram.
Why is it revulsive to have a sonogram prior to aborting the fetus? The fetus is not alive. It is not a person, so what does it matter if you see a sonogram prior to removing it? It typical of other procedures to do imaging studies prior to removing the foreign body or offending lesion. It is after all, just a tissue that needs to be removed by request of the patient.
In other news, the abortion issue really has no place on Science-Based Medicine. I do not come here for hard hitting social issues. I come here for… Science-Based Medicine and anti-quackery,
http://tinyurl.com/6ttj6hw
“Well stated. Why single out abortion? They don’t apply the same standard to other elective procedures such as breast augmentation and facelifts”
Well typcially they do show before and after pictures for these types of proceduers prior to performing the procedure.
Also typically breast augmentations are not funded using public tax dollars. When you start taking tax dollars you come under the perview of the politics of the public purse strings.
1. How can you consider the term “Rape” accurate when it is a legal term with a precise definition depending upon the jurisdiction? Under what jurisdiction would a t/v ultrasound be rape? (A non-consensual medical procedure could be a civil battery.)
2. The above cited statute does not require the physician to lie. It requires the physician to inform “the pregnant woman on whom the abortion is to be performed of: (iii) the possibility of increased risk of breast cancer following an induced abortion and the natural protective effect of a completed pregnancy in avoiding breast cancer;” If the possibility of increased risk is 0%, that is what the physician is required to advise.
This hyperbole only detracts from your argument.
Transvaginal ultrasounds are, in fact, routine in the first trimester in pregnancy. The law doesn’t specify a transvaginal US, but it assumed that when that is the appropriate type of ultrasound, it is what must be done.
It doesn’t list “and benefits” to the abortion, but it does list that the patient should be informed of the medical risks of carrying the child to term, which is where most of the benefits of the abortion would be.
@Brandt, under many laws, penetration with an object constitutes rape. A transvaginal ultrasound involves pentration with a probe, so if it were done against the patient’s consent, it may qualify as rape.
“One benefit of abortion is that it prevents the many health risks and complications associated with pregnancy. Abortion is safer than full-term pregnancy.”
Thank you Dr. Hall. The importance of this simple statement is very much overlooked by one side and not given enough repetition by the other.
I post this simple statement every time I come across an abortion debate. I read many years ago when pregnant with my first child (in a book given to me by my OB and published by the Guttmacher Institute) that a woman’s body goes through more physical changes during pregnancy and birth than during open-heart surgery. I don’t know if this is a medically significant statement, but it offers some perspective for those who seem to think it is “no big deal” to be pregnant or give birth.
I have had a number of the abdominal type of ultrasounds and one of the vaginal kind. I am not modest at all and have little illusion about the need to be poked and prodded by all sorts of medical personnel during ob/gyn care, but I was really disturbed by the vaginal ultrasound and I had it for an important reason. I cannot imagine having been forced to have it. What is most galling, is that the same people who don’t want anyone “forced” (which isn’t even true–you simply pay a penalty/tax if you don’t) to buy health insurance have no problem forcing these onerous procedures onto women.
@Lamamaloca – please cite the law under which the procedure required by statute referrenced in the main article is rape. In the alternative please provide a cite to law that supports the “straw man” that you offer “under many laws, penetration with an object constitutes rape. A transvaginal ultrasound involves pentration with a probe, so if it were done against the patient’s consent, it may qualify as rape.”
Why does everyone instanstly opt for the transvaginally sonography? As the statue states, it’s should be consistent with current medical practice, and who is to say that routine sonography of the uterus on women who are seeking abortion, should not be transabdominal (with full bladder)? As I see it, there are mane good arguments against transvaginal sonography, so gynechologists should just write up a few articles and establish some “current medical practices” on the area. And if the uterus isn’t visible transabdominaly, so be it – that is the image quality, and it is limited by our new “current medical practice”.
It reminds me of the time when a gynechologic examination was mandatory before the first prescription of birth control pills. That was removed because some teenage girls would rather risk pregnancy than have that examination.
thatguybil81: “the abortion issue really has no place on Science-Based Medicine”
While it is fairly clear where most of the people here stand on the issue of abortion, this post is not about the abortion issue. It is about whether medical procedures and statements that are not science-based and not medically indicated should be mandated by law. The Texas law is ideology-based medicine just like woo is based on ideology and being anti-vaccine is based on ideology. Science-based medicine has every right and imperative to fight this.
Legislating that doctors in effect must provide women with misinformed consent before a medical procedure is every bit as much within the purview of science-based medicine as the misinformed consent that the “health freedom” (i.e, the pro-quackery) movement tries to promote or the misinformed consent that antivaxers promote. So is the claim that abortion increases the risk of breast cancer (part of the aforementioned misinformed consent that this law mandates) well within the subject matter of this blog. That is what this issue is about, not abortion per se.
“The Texas law is ideology-based medicine”
It is a mandate mandating the minium level of informed consent required prior to performing this procedure in the state of Texas.
The Texas law may be ideology driven but it is not medicine. At least not any more then the FDA mandating what REMS guides need to be handed out to what patient, and for what drugs all in the name of “informed concent”.
I’d be careful with the “rape” language. I know you don’t mean it to be so, but it’s potentially offensive to actual rape victims. I totally agree with the objections to these laws and I also see that a woman forced into this situation could feel violated in a way. But a safe and hygienic procedure performed by a physician in an office, even with the patient basically feeling that she had no choice, is not going to be comparable to the experience of rape, especially as the latter often involves physical violence and fear of death. The comparison could probably only be suggested by someone who hasn’t been a rape victim.
@ David Gorski
Peter A. Lipson did not make a case for misinformed consent.
He asserts that the states mandates that they hand out a patient “a booklet full of misinformation” but does not show what that misinformation is.
He then goes onto to assert that the law mandates a trans-vaginal ultrasound and that this is analogus state-mandated rape. The law does not mandate a trans-vaginal ultrasound, and even if it did it would not be rape, which is a legal term with a legal definition that are not met.
He states that the statue “insists that the doctor state information that is counterfactual (that is, a lie). But does not show what part is counterfactual.
(A) the physician’s name;
How is this a lie?
(B) the particular medical risks associated with the particular abortion procedure to be employed, including, when medically accurate:
(i) the risks of infection and hemorrhage;
Is this a lie?
(ii) the potential danger to a subsequent pregnancy and of infertility;
Is this a lie?
(iii) the possibility of increased risk of breast cancer following an induced abortion and the natural protective effect of a completed pregnancy in avoiding breast cancer;
As pointed out by Brandt above, if the current literature states that there is no possibility of an increased risk, then the informing provide should state “no increased risk”
(C) the probable gestational age of the unborn child at the time the abortion is to be performed; Is this a lie?
(D) the medical risks associated with carrying the child to term;
Is this a lie?
Dr. Peter Lipson has not made a case for “misinformed consent”. He made a list of assertions using inflammatory language base on a particular political point of view. That is what has no place on Science-Based Medicine.
@DW: Wrong. Forcing me to have a transvaginal ultrasound against my will would be as bad as the rape I experienced. You are FORCING me to have something done I don’t wish to have done. Rape does not “often involve(s) physical violence and fear of death.” Mine didn’t. Many women I know who were raped were not in fear of death nor did they experience physical violence. It was still physical contact without my consent. Rape, by any definition.
I have been pregnant; I have had both transvaginal ultrasounds (to deal with an ectopic pregnancy) and abdominal ultrasounds. It is VERY rare that a provider would need to perform a transvaginal ultrasound for a TOP to determine gestational age. As a midwife, I could give you within a week or so just by physical exam. Most good physicians could also. An ultrasound is useful if there is question of either actual gestational age based on LMP to exam, or a possible non-uterine pregnancy.
And why should physicians be forced to lie to women about false risks? Any medical procedure is risky. Informed consent requires knowledge of the TRUE risks, not fake ones that the anti-choice people want to have spouted. This is about true informed consent, no matter where you stand on the abortion side. Not forcing doctors to lie about the risks and benefits, and not forcing women to have unnecessary treatments against their will.
@thatguybil81: Anwers:
He states that the statue “insists that the doctor state information that is counterfactual (that is, a lie). But does not show what part is counterfactual.
(A) the physician’s name;
How is this a lie?
That is not a lie. Most providers do give their name to the client.
(B) the particular medical risks associated with the particular abortion procedure to be employed, including, when medically accurate:
(i) the risks of infection and hemorrhage;
Is this a lie?
No. However, the risk of infection and hemorrhage are measurably less than carrying the pregnancy to term, when the termination is performed by an experienced provider in a medical setting.
(ii) the potential danger to a subsequent pregnancy and of infertility;
Is this a lie?
Yes. Studies have shown that first trimester abortions do not lead to an increased risk of infertility nor do they lead to increased problems in susequent pregnancies.
(iii) the possibility of increased risk of breast cancer following an induced abortion and the natural protective effect of a completed pregnancy in avoiding breast cancer;
As pointed out by Brandt above, if the current literature states that there is no possibility of an increased risk, then the informing provide should state “no increased risk”.
Therefore, this is another lie. Completing pregnancy is NOT protective. Breastfeeding several children over several years may be. Have an abortion does not increase this risk.
(C) the probable gestational age of the unborn child at the time the abortion is to be performed; Is this a lie?
No, but why does the provider need to tell the woman the probable age? Do they think she is clueless? That she is doing this for the fun of it? That she is too stupid to have any idea how pregnant she is? While some women are unaware of how pregnant they are, most women who come for first trimester terminations are exactly that – first trimester.
(D) the medical risks associated with carrying the child to term;
Is this a lie?
The risks of carrying a child to term are more often then not downplayed by the anti-choice people.
In any case, this is about true informed consent. And the laws are forcing physicians to hide the truth.
Oh, and just FYI – public funds, by federal law, MAY NOT be used for abortions. I do wish people would get that straight. Planned Parenthood’s books prove that, no clinic uses public (Medicaid, Medicare, whatever) funds for abortions.
Dawn, it is not up to you to make the case. It is up to the original author to make the case. My point is that he did not make that case.
“No, but why does the provider need to tell the woman the probable age?”
Why does the provider tell a cancer patient the size of a tumor? Why do they tell the patient how many and how large of gallstones they have?
“Studies have shown that first trimester abortions do not lead to an increased risk of infertility.”
Then the answer would be “there is no increased risk of infertility for your 1st trimester abortion”.
However, you understand, while in aggregate there may be no increased risk, depending on how a particular procedure goes the patient may have complications that cause an increased risk of infertility. Typical informed consent documents spell out every risk factor, potential poor outcome, and complication under the sun, be they real or theoretical. If you compare this legal minium IC to the typical IC document, you will find they are not that different.
Bill you do realize that u r both being pedantic and moving the goalposts right?
Thank you for the great post, and some great comments as well.
It is completely disingenuous when they try to use the “informed consent” argument, which is turning in to Dr. Gorski’s “misinformed consent” in about every aspect of medicine by those trying to promote their ideology under this guise.
As an aside, do any state legislatures mandate that OBs/CNMs discuss and give written information on all the risks associated with pregnancy and childbirth? I’m pregnant with my 2nd child in one of these conservative states proposing these (and other) anti-abortion laws, and have not received booklets about all possible risks associated with the pregnancies. Our legislature wants to pick and choose when to hand out “risk vs. benefits” as it suits their ideological preference.
Requiring physicians to spread misinformation completely undermines patient autonomy and should not be tolerated.
However, every effort should be made to educate patients requesting an abortion that such a procedure will ultimately result in the termination of a human life which is what, as far as I understand, the law is trying to do. Just because a fetus isn’t born does not mean it has any less right to live.
The issue of abortion is complex and of course there has to be exceptions which the law provides:
(6) I UNDERSTAND THAT I AM REQUIRED BY LAW TO HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
___ I AM PREGNANT AS A RESULT OF A SEXUAL ASSAULT, INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL CODE THAT HAS BEEN REPORTED TO LAW ENFORCEMENT AUTHORITIES OR THAT HAS NOT BEEN REPORTED BECAUSE I REASONABLY BELIEVE THAT DOING SO WOULD PUT ME AT RISK OF RETALIATION RESULTING IN SERIOUS BODILY INJURY.
___ I AM A MINOR AND OBTAINING AN ABORTION IN ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER CHAPTER 33, TEXAS FAMILY CODE.
___ MY FETUS HAS AN IRREVERSIBLE MEDICAL CONDITION OR ABNORMALITY, AS IDENTIFIED BY RELIABLE DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY MEDICAL FILE.
More of the same
Under a new law, doctors in Pennsylvania can access information about chemicals used in natural gas extraction — but they won’t be able to share it with their patients. A provision buried in a law passed last month is drawing scrutiny from the public health and environmental community, who argue that it will “gag” doctors who want to raise concerns related to oil and gas extraction with the people they treat and the general public.
http://www.theatlantic.com/health/archive/2012/03/for-pennsylvanias-doctors-a-gag-order-on-fracking-chemicals/255030/
mdstudent:
“termination of a human life”
wait a minute, a blastocycst, embryo, and fetus are not a human life. does the medical literature ever refer to these as human life?
“Just because a fetus isn’t born does not mean it has any less right to live”
abortions before 10 weeks gestation are aborting an embryo, not a fetus. your opinion is probably still the same about an embryo, but still, it’s not a fetus.
If this ends up in court, which it most likely will, the disproportionate detail of abortion risks (vs. the single line mandating unspecified risks of pregnancy and birth) can be used to show that the legislators had a motivation other than general education.
I was leaning away from calling it “rape”, but if I were a judge hearing the case eventually brought against the state, I would like to ask the defendants to offer their explanation as to why it isn’t (tangent related to the federal healthcare case: a judge’s asking of a deeply-probing question does not necessarily mean that they aren’t going to accept the answer). Saying that it is sometimes necessary or voluntary does not count. Sexual intercourse is also sometimes voluntary or necessary, but that doesn’t mean there is no such thing as rape.
Also, which part of this law addresses which type of sonogram is to be used?
@ Amy T:
Zygote, blastocyst, embryo, fetus, baby, slimy scuba thing… you can call it whatever you want. As far as I understand from embryology, cell biology, and genetics, as soon as a sperm delivers it’s payload to the ovum you have human life (albeit in its most rudimentary form). If you’re aware of another definition of human life that enjoys broad scientific support please let me know.
just because it’s a fetus doesn’t give anyone the right to tell another how to live
@ EricG:
Yes it does.
Every parent has responsibilities towards their children and as far as I’m concerned you become a parent as soon as you conceive. Let the baby live, care for it, and educate it so that at the least it has fighting chance to live a full and healthy life. This, I completely understand, is easier said than done but still, the challenges and inconveniences of parenthood should not be an excuse to rob the unborn of life.
This implied definition of “human life” is inadequate for distinguishing between a whole and sentient person and any scrap of tissue with a full set of chromosomes. Whatever the reality may be, this definition is not useful.
@ conspicuousCarl
I disagree.
Latent within the “scrap of tissue with a full set of chromosomes” is a human being. Once the wheels of embryonic development are set in motion, it would be unfair to justify stopping them because they had yet to reach an arbitrarily defined stage of “whole and sentient person”.
“Every parent has responsibilities towards their children and as far as I’m concerned you become a parent as soon as you conceive. ”
I never conceived, so according to your definition, I am not a parent and don’t have any responsibilities. In your world, it appears, only mothers can be parents. As the church lady would say. “How convenient.”
@ weing,
Obviously, men can be parents (ova don’t spontaneously self-conceive despite what “the church lady” may have been telling you). If you’ve never conceived or adopted a child or in any way become the legal guardian of a child than obviously you won’t have the same responsibilities to a child as their parents or legal guardians. How many times have you been charged with child abuse for failing to send any random kid to school?
“as soon as you conceive” can only refer to a woman. Are you changing your definition of a parent now?
@ Peter
You missed the field goal not me. If you wanted to make a case about state and federal government not regulating informed concent because of they don’t do a good job, please make that case.
Please do not state that I am being pedantic after your blantant use of inflammatory rape rhetoric.
What is your revulsion about a sonagram being performed prior the removal of the unwanted tissue?
“What is your revulsion about a sonagram being performed prior the removal of the unwanted tissue?”
What would be the medical indication for it? In other words, why the hell do you need to do it? Maybe make some sonographers rich? Laudable goal. But still not medically indicated as it will not improve the outcome for the patient.
@ weing,
I think you missed my point but sure, I’ll change my definition. Fathers are just as much responsible for their children (born or unborn) as mothers.
Next time I’ll be more careful with my use of the word “conceive”.
@mdstudent
“Fathers are just as much responsible for their children (born or unborn) as mothers.”
You don’t really believe that do you?
Dawn: “Rape does not “often involve(s) physical violence and fear of death.” Mine didn’t.
No, I’m not wrong. Rape DOES often involve physical violence and fear of death.
I’m opposed to the law. I am not wrong that the rape terminology will be offensive to many rape victims.
A couple of additional points:
This was not meant as a comment on the morality of abortion, although my beliefs are clear. It was as mentioned above to point out that the government is making us into doctors who are no better than quacks if we must lie to keep our licenses.
The pedantry above is idiotic. This is not about who is the high school debate team champion; my point was clearly made and you may or may not agree, but asking for closer and closer details in order to puff yourself up is not an argument. An argument would be to address the basic points, not the minutiae. Whether or not you can poke a hole here or there is irrelevant, unless you can invalidate my argument in some cogent matter.
The legal definition of rape is also irrelevant. Treating a woman’s body as an object to be penetrated/punished for the purposes of the state’s ideology is by any moral definition rape.
From an ethical standpoint it’s only a little less wrong to do a less invasive ultrasound.
And while it was not my intention to incite a discussion of when life begins or the morality of abortion, the fact is it is a legal procedure with known risks and benefits. Your personal belief in its immorality is irrelevant to the discussion.
Good article. It’s hard enough to find a doctor one can trust, as Harriet Hall’s recent article and the comments on it demonstrate. Now apparently women are supposed to add to the list of criteria, “How knowledgeable and reputable are the legislators who are telling my doctor what to say to me?” How could this not be a problem?
First you said that we have “human life” as soon as sperm and egg combine. That does not make any reference to latent potential, which is what you are appealing to here. If that is your point of view, go ahead and re-word your initial statement.
Your point of view seems to rest on that supposedly-arbitrary person being latent within a piece of living tissue.
It is funny that you claim to disagree with my criticism, then add more specifics to address my criticism, and then declare to be “arbitrary” the very thing which your correction relies on.
@ ConspicuousCarl,
Dr Lipson is right to point out that it was not his intention to incite a discussion of when life begins or the morality of abortion (it’s tough not getting sidetracked on such a controversial topic).
And just to reiterate, I completely agree with the main point of the article that law-makers requiring physicians to spread misinformation (to whatever end) cannot be tolerated.
If you like we can continue our discussion by email. But I won’t post my email since it contains my real name which I don’t feel particularly comfortable posting on an open forum.
The same goes for weing.
If an egg becomes a person when it is fertilized by a sperm, should a pregnant woman count as two people for the car pool lanes? Should she have to pay for an extra passenger when she rides the ferry? Should she be allowed to bring her fetus into a theater playing an R-rated movie? Should she be prosecuted for child abuse if she goes into a bar and has a martini, thereby bringing her underage child into a restricted area and providing him or her with alcohol? Should she be prosecuted for murder if she uses a birth control method that works by preventing a fertilized egg from implanting in the uterus? It seems to me the meaning of “person” is changeable depending on the circumstances.
@mdstudent
For me, the question of when life begins is not an issue. The question is, does a fetus’ rights supersede my own? I don’t believe that a fetus has more of a right to bodily autonomy than I do. I think this is the crux of the matter for most of us in the pro-choice movement, not whether or not life begins at conception.
@Harriet Hall 10 pm
See http://bgladd.blogspot.com/2008/04/diploid-dave-et-al.html
“An argument would be to address the basic points, not the minutiae. ”
A basic point, a major premises is that this statute requires a doctor to lie to the patient. This is false. This has been pointed out above by thatguybil81. This is not pedantic or focused on the minutiae of the argument. It is the argument.
The portion of the statue your cited requires the doctor to inform the patient of “the particular medical risks associated with the particular abortion procedure to be employed, including, when medically accurate . . .” If what follows this clause is medically accurate it must be related to the patient. If not, all you are required to do is inform the patient of the “particular medical risks associated with the particular abortion procedure to be employed” nothing more, nothing less. It does not require that you lie.
Likewise section 2 requires no lying. All the statements are true. You are even free to deliver them with all the disclaimers and sarcasm you like and would still be following the letter of the law.
In fact, you can provide true informed consent based upon the most up-to-date evidence and not run afoul of the statute.
Even if earlier premises were true, “The other consequence is the complete destruction of the doctor-patient relationship.” is not logically entailed. “Complete Destruction?”
This slippery slope to what I believe to be the final conclusion of the argument is not supported:
“If the state can compel a doctor to lie to a patient in one circumstance, it can in any circumstance, and patients will no longer be able to believe anything a doctor says. ” Even if the State could compel this behavior it does not logically follow that the State can compel a doctor to lie in “any” circumstance.
All that we have here is a poorly drafted law that appears to be relatively easy to circumvent.
NOTE: I have not read the full text of the law, only the portions that you cited here.
” the possibility of increased risk of breast cancer following an induced abortion and the natural protective effect of a completed pregnancy in avoiding breast cancer;”
That statement is a lie. There is no such thing. The state is forcing the physician to tell this whopper to the patient. This is destructive of the doctor-patient relationship as the physician is ethically obliged to tell the patient the truth.
What is the medical reason for the ultrasound? How will the results of the ultrasound affect the procedure? If a test is not medically necessary, why do it?
You also are missing the point.
Thank you for this post. It’s hard to imagine this ever becoming an issue in Canada, and I sure hope it never gets there. The other recent issue that has me scratching my head is the insurance coverage in the U.S. In general, our insurance plans cover birth control but not Viagra, which is seen as a “lifestyle” drug – the opposite of what happens in the U.S. if media coverage is accurate. In 2 countries where lifestyles are so similar, it’s hard to believe things are so different where reproductive rights are concerned. Birth control is so inexpensive, I think employers are convinced it’s cheaper to pay for it than to pay for a maternity leave – which is 1 year up here!
Look, I’m about as pro-life as they come, but this deals with medicine and law, not philosophy.
Do I think that the woman should be counseled for mental health, making sure this is her “choice” and not because she feels she’s being forced into it by people or circumstance? Yes. Do I think that the doctor should be compelled to say anything other than the realistic complications from an abortion (i.e. the kinds that would be the same as a D & C for miscarriage)? No.
Abortion is predominantly a moral issue and it is completely disingenuous for either side of the debate to bully the other by abusing law… which they BOTH do, sadly. Until abortion is defined as murder under law, it operates in the realm of surgical medicine, and medicine has to deal in objective data. The data shows that pregnancy more risky for a woman’s body than pregnancy. It’s wrong to try to scare the woman with unsubstantiated “what ifs”.
Is it better off for her long-term mental health? I definitely DO NOT think so, but I’m heavily influenced by personal anecdote (my mother’s deep regret and ensuing mental health issues, joy from friends who’ve decided to keep their unplanned babies). Unless there is objective evidence to confirm what I believe, though, I don’t think that my opinion should be forced upon others operating under the umbrella of medicine.
Pro-lifers: Stick to your strong points– moral arguments. It really betrays our cause by nefariously trying to “scare” women out of abortions.
What the legislature could do is to guarantee benefits to the woman for prenatal, neonatal, and child care from birth to adulthood. I think a physician would be glad to inform any pregnant woman of such benefits.
I guess so. What is the point, since I am unable to locate it in the title or text of the post?
Exactly how does the prochoice movement “abuse the law”? I’d like to hear that. News flash – abortion is legal.
@DW Obstructing free speech, such as setting up ‘protected’ zones around clinics, and legal intimidation are just a couple ways. I’ve chosen to not bury my head in the sand about the less-than-admirable tactics from my side of the debate. I suggest you do the same.
Commit rape with a ultrasound probe, really? I am not a Doctor, but what path is taken to perform the actual abortion? This seems to be more about moral issues with the author than with the law, or SBM.
It seems the law serves not only to shame a woman out of having an abortion, but to guilt a doctor into performing it. A Win-win for the unborn.
Just think of the odds of your very existence. Abortion, what a waste. How sad some find themselves in this situation. I wonder what its like for a Doctor to perform abortions during the day, then go home at night and have dinner with their children.
Is midwifery CAM?
@ Mrs. N
Yes clearly zones around clinics where protesters aren’t allowed to interfere with patients are exactly on par with the pro life crowd’s harassing of medical personnel in their private lives and “legal” intimidation is the same as the physical threats and actual assaults on those involved in abortion services.
You have to play very fast and loose with your definition of abusive behavior to try and make any claims of equivalency between the two sides.
“It seems the law serves not only to shame a woman out of having an abortion, but to guilt a doctor into performing it.”
Don’t understand the second part. I think you meant into not performing it. Anyway. Why not be upfront about it and make abortion illegal? Better yet. Make abortion unnecessary by guaranteeing full support for the woman and child until it reaches adulthood? I think these anti-choice people don’t believe in carrots, only in sticks. Beat on the weak, shame them, and feel good about it because you have the moral high-ground.
There should be NO apologies for referring to these statutes as state-mandated rape. The common law definition of rape was, “A carnal knowledge of a women not one’s wife by force or against her will.” These laws come awfully close to that (under the common law carnal knowledge required actual penile penetration).
MerColOzcopyon,
There was a lot more to the post than just the ultrasound issue. Requiring that the doctor lie is bad enough by itself. As for what the doctors feel when they go home and eat with their kids: I cannot speak for them, but perhaps they are glad that the aborted cells won’t develop into an unwanted or uncared for child, I suspect that many doctors have seen all too many of those. Personally, I cringe more at the idea of subjecting a rape or incest victim to the law’s requirements.
It is undeniable that a new life begins at fertilisation.
The question is: when does personhood begin?
The next question is: when does this person’s rights override that of the mother?
@mdstudent:
When you’re a practicing physician, you will be forced to confront the ambiguity of definitions of “life” in the context of definitions of “death.” Modern biology holds that there is nothing fundamentally different about systems that are “alive” from ones that are not – the discredited belief system that posits such a difference is called vitalism. Therefore, “life” is by necessity somewhat arbitrarily defined, like whether Greenland is a continent or not. It’s not a scientific question, it’s a semantic question.
In any case, I think it’s important to distinguish between cellular “life” and organism-level “life.” It’s undeniable that cellular life begins at fertilization, but cellular life is not relevant in normal clinical contexts. Living cells can be harvested from patients hours after “death” as defined by any normal clinical criterion. There are also people like Henrietta Lacks, who died something like 50 years ago, but her tumor cells (HeLa cells) are still growing in laboratories worldwide. IIRC, the normal criteria for brain death involve a flat EEG, lack of brain stem reflexes, and no spontaneous breathing. We consider those people “dead,” i.e. not “living,” despite a beating heart and lots of living cells. And those criteria are probably overly conservative, as demonstrated by cases like Terri Schiavo or babies born without a telencephalon that can still breathe.
“The common law definition of rape was, ‘A carnal knowledge of a women not one’s wife by force or against her will.’”
Yes, but that’s a horrible definition, not least because it leaves out wives! Not to mention husbands! We won’t get anywhere going back to abandoned, archaic definitions. The definition of rape has certainly expanded since then, but it shouldn’t be stretched for political purposes to fit any procedure or action that someone doesn’t like or that someone is subjected to by force of the law. That just dilutes the notion of rape. Let’s not try to solve one problem by creating dozens of others. Dawn also tried to squeeze this coerced ultrasound into “rape” by calling it unwanted physical contact etc. Not every instance of unwanted physical contact is rape. Some unwanted physical contact is assault and battery, intimidation, threats, sexual harassment, bullying, or simple rudeness and obnoxiousness.
If nothing else, it’s stupid to try to pass laws (or overturn laws using techniques) that will quickly get shot down in court. Plainly a physician performing an ultrasound is not, in usual circumstances, committing a rape. Stick to the problem at hand.
Mrs. N., antiabortioners’ free speech rights have not been denied. A protected zone around a clinic recognizes that the procedure is legal and that patients arriving for their appointments shouldn’t be threatened and harassed on the way in, in an already unpleasant and distressing situation for them. That’s not “abusive.” It’s an attempt to spare the patient from abuse while she visits her medical practitioner for a perfectly medically sound and legal reason.
“Legal intimidation” is too vague to mean anything, so I don’t know what you’re complaining about there.
“Is midwifery CAM?”
Some midwifery is certainly CAM, some is not.
@ evilrobotxoxo
“When you’re a practicing physician, you will be forced to confront the ambiguity of definitions of ‘life’ in the context of definitions of ‘death.’”
I dread the day, but hopefully I’ll be ready.
Thank you for making such interesting points.
You know, it strikes me that if we’re going to be characterizing a trans-vaginal ultrasound (which, as noted above, is not actually called out in the law) as rape, what are we going to be calling the insertion of a thermometer? On the other hand, that’s bound to make pediatrician literature more exciting… “More pediatricians recommend anal rape than oral rape when taking toddler temperatures.”
@Billy Joe,
“when does this person’s rights override that of the mother?”
That’s an interesting question that is often overlooked. Does a fertilized egg have the right to take over a woman’s body without her consent, to endanger her health, take away part of her food, cause 9 months of inconvenience, cause severe pain when exiting her body, and then require her to care for it and support it for the next 18 years? This could be considered a form of parasitism and coercion.
DugganSC,
You cannot compare the two. The thermometer reading will give you information that will affect your management of the patient. It’s not done to satisfy someone’s perversion.
@ConspicuousCarl
“If this ends up in court, which it most likely will . . .”
It already has. The Texas law was challenged as unconstitutional on several grounds. A U.S. District Court in Texas agreed with the plaintiffs that the law violated physicians’ First Amendment rights by compelling the physician to make certain statements with which he or she may disagree and which may not be medically necessary in the physician’s judgment. Tex. Med. Providers Performing Abortion Servs. v. Lakey, 806 F. Supp. 2d 942 (W.D. Tex. 2011), vacated in part, remanded by, 2012 U.S. App. LEXIS 548 (5th Cir. Tex., Jan. 10, 2012).
I agree with the district court’s decision. It is a well-reasoned discussion of why the Texas legislature went beyond what is constitutionally permissible under current U.S. Supreme Court decisions. Unfortunately, the U.S. Court of Appeals for the Fifth Circuit overturned the district court’s ruling, which effectively ended the case in the defendants’ favor. However, a similar law in North Carolina was also challenged and found unconstitutional by a U.S. District Court for the same reasons as the Texas district court. Stuart v. Huff, 2011 U.S. Dist. LEXIS 123244 (M.D.N.C. Oct. 25, 2011). It is likely on appeal now, or will soon be. As it will be heard in the U.S. Court of Appeals for the Fourth Circuit, the Fifth Circuit’s opinion will not be binding. I suspect these imaginatively named “right to know” statutes will wind up in the U.S. Supreme Court. The U.S. Supreme Court, in Planned Parenthood of Southeastern Pennsylvania. v. Casey, 505 U.S. 833, 112 S. Ct. 2791(1992) has already decided that a physician could be compelled to make certain disclosures, such as fetal age, to the woman seeking an abortion, and to direct her to other information which she could choose to review, or not. However, as the district courts noted, the Texas and N.C. statutes go far beyond what the U.S. Supreme Court has sanctioned.
Really great points, Dr. Hall. This is the reason the “slippery slope” to declaring fetuses full persons is so dangerous and idiotic. If the fetus is a person, we can have women suing their fetuses. The fetus is essentially “raping” the mother on exiting the birth canal! No one else has access to my birth canal without my permission! Put those fetuses in jail … a whole new legal specialty is born … defending fetuses who are charged with terrible crimes against their mothers, everything from rape to assault and battery. Then how about infants? Charge ‘em with sexual abuse for breastfeeding … why, some toddlers just lift up their mothers’ shirts and demand access! That’s pretty egregious sexual harassment. We could charge toddlers and preschoolers with all kinds of things. How about home invasion? These little people just move in without asking, demand food, they wake you up in the middle of the night, they frequently destroy things … we’ve got at least stalking, theft, vandalism, and disturbing the peace there.
@mdstudent:
evilroboto made an excellent point there that you should very seriously consider. Additionally:
Latent within every ova and every sperm is also the potential for a human being. Is menstruation and masturbation the same as preventing the implantation of a blastocyst via the Plan B bill? How about if the Plan B changes the mucous and cervical environment such that the sperm simply can’t reach the each in time? What if the blastocyst implants and the pill still induces the shedding of the endometrial lining? Where do we draw the line here? When you get into pedantic discussions about a “full set of chromosomes” having the potential for human life as the basis of your argument you are immediately in an extraordinarly precarious position.
You were taught (I hope) in medical school that on the order of 40-50% of all “sperm meets egg” encounters end in spontaneous abortion? And most, but not all, are from chromosomal abberancies? Therefore a reasonable number of such spontaneous abortions are of otherwise viable blastocysts. So perhaps your statement need be “latent within the “scrap of tissue with a full set of chromosomes” is an 80-90% chance of being a human being”?
And what about those scraps of tissue with a full set of chromosomes that aren’t able to become a person (aka a hydatiform mole)? Where does your argument take us there?
And of course, what about those that don’t have a full set of chromosomes but are none the less still able to and do become born? Does a Turner’s baby not count as a person because she has only 45 chromosomes? Or a Down’s, Edward’s, or Patau because they each have 47? Or what about an Angelman’s or Prader-Willi that contain the full set, but because of methylation don’t have the ability to express it all and thus have, in effect, a less than full chromosome count?
Do you see how arguing on such pedantic levels as “I believe the moment sperm meets egg is the beginning of life” is simply an untenable and non-productive avenue to pursue?
@mdstudent: you won’t be ready, but you’ll make it anyway
Inserting of thermometers in pediatrics … strikes me as exactly the right comparison. It’s a good example of a procedure that certainly involves physical contact and is very often done against the very loudly expressed displeasure of the person on the receiving end. But it would be crazy to call it rape. The transvaginal ultrasound isn’t rape either. The issues are simply all mixed up. Abortion politics need to be dealt with as abortion politics … not by dragging other crimes and misdemeanors into it, which will just make a terrible legal mess.
I’m not even sure “lying for the state” is a helpful framework. Although doctors can claim some legal issues here, I think the reproductive rights of the mother should be kept front and center. That is the real battleground and always has been, regarding abortion. The issues feminists defined a long time ago regarding abortion are still correct: it is about a woman’s right to control her body: her absolute right to determine whether to carry a pregnancy to term. No other individual has a right, and certainly no state has a right, to overrule the mother’s decision for any reason whatsoever.
Women’s right to complete bodily and reproductive integrity needs to be asserted ever more forcefully in the present political climate, with prereptilian creatures like Rick Santorum questioning even a woman’s right to prevent a pregnancy in the first place (i.e., contraception).
“Is menstruation and masturbation the same as preventing the implantation of a blastocyst via the Plan B bill?”
Keep in mind that in the current political climate such a question is not at all absurd, where a candidate like Rick Santorum, with his medieval theology, is actually something resembling a viable presidential candidate. I don’t think he’s got anything against menstruation, but in his theology, masturbation is indeed not allowed.
The point is will it change management? A temp can indeed change management and there is genuine informed consent coupled with medical necessary to boot. Having said that I would also be against legislation demanding that physicians always get a temp on every patient presenting for pharyngitis since, while almost universally done and generally non-invasive, it may not really be necessary and removes the autonomy of the patient to refuse the thermometer and still get treated. The point here is that if a person comes in with throat pain and clear signs of bacterial pharyngitis, but refuses the thermometer (for whatever reason! that is the point of autonomy) I, as the physician, can still reasonably treat the patient! But with this law, if a woman comes in and wants an abortion, but refuses the ultrasound (TV or not! and once again, for whatever reason!) I will now no longer be able to treat my patient, even in cases where prior to the law I reasonably could. And that is the problem with the law, and the point that Dr. Lipson was trying to make.
The further point is that it only takes ONE case to make it an unjust law. Only one patient need to be coerced into a procedure she does not want or need. And if you are dangling antibiotics in front of your patient and saying “You can only have them if you let me take a temp” regardless of whether it is oral or anal (i.e. TV or trans-ab) matters not. You have used the position of power to remove your patient’s autonomy and thus restrict their options for treatment. Period. The buck stops there. Nobody would dream of arguing this for antibiotics and pharyngitis because it is asinine and not ideology is violated there. But when it comes to abortions all sorts of contortionist linguisitics are brought to bear because some people find it morally abhorrent to them. And not to get off on too much of a political rant, but very oftenly and especially in the public political arena, those same people are all for the death penalty and for sending over troops to foreign lands to kill each other. Their insanely pedantic worship of the sanctity of life of a “scrap of tissue with a full set of chromosomes” simply does not extend beyond the womb. And for those to whom it does (as was mentioned above) then that is great and I respect you. It still does not give you (or anyone else) the right to remove autonomy from others because of your own personal moral cogitations.
Furthermore, I won’t go through and cite all the comments to the effect above, but “why is it necessary for a doctor to tell the patient the size of a tumor before removing it” is a plainly stupid argument.
We tell patients the size of the tumor because it changes their prognosis, it changes their management, and could materially affect how aggresively they pursue treatment (and what kinds) depending on the outcome of that measurement.
The informing a woman of the gestational age of the embryo or fetus to TV or really any ultrasonographic accuracy does NOT change her prognosis, treatment, or materially affect her decision. A 4 week abortion is materially indifferent from a 10 week abortion. Any other information the ultrasound can tell you would also be immaterial.
It only becomes useful in certain cases of surgical (vs medical) abortion and in case extra-uterine pregnancy is suspected. Beyond that, it has no utility in the management of the case.
@ thatguybill:
So we should now legislate everything that a doctor should say isn’t reality?? In what world does that make sense?
Should we have a law that every physician should “disclose the risk of autism before administering vaccines” and then have them say “the law says I have to tell you about this risk, which is zero?” Really? That is your argument in defense of this legislation?
That is the whole point – the law is defended and promulgated on such pedantic and asinine notions as yours. The intent of the law is clear – to legislate hurdles for abortion that are unreasonable and clearly intended to find a way to legally decrease abortion rates because of ideology.
“well, the doctor can just say the truth – that it is zero% risk” Then why should the doctor say anything at all? You also have a zero% risk of going blind from masturbation. Should we make a law that all doctors should inform pre-adolescent male patients of the risks of going blind from masturbation? No? Really? Why not? It is just as useful as informing women about to undergo abortion of the risks of breast cancer associated with their autonomous decision.
The rhetoric of this comment thread has degraded to pure asininery (yes, I invented a word so it could get through the filters) because issue is abortion. Just change “abortion” and “ultrasound” and “risks of breast cancer” to “pharyngitis” and “temperature” and “risks of autism” and see if you can still make the same type of arguments.
@dw:
Indeed. it is a very serious problem that said individuals (Romney famously) do not appreciate.
and I just thought of one more, based on mdstudent and Dr. Hall’s comments:
What about the scenario in which the fetus poses a direct and real threat to the mother’s life?
Say in a case of ecclampsia – the only therapy is delivery. Failure to do so could end the mother’s life. Yet, in cases of early ecclampsia the fetus may have a very low chance of survival if delivered. Holding on an extra week at that point would vastly improve the fetus’ chance of life, while simultaneously decreasing the mother’s.
Who wins? Whose odds to we cut in favor of?
What if the woman wants to continue the pregnancy for as long as she possibly can knowing the risks to herself because she wants to improve her fetus’ chance of life as much as possible?
Who gets to make that decision then?
Is it the pregnant woman in all cases? Doesn’t that speak to the level of autonomy of each entity in question here?
DW,
Of course there’s problems with the common law definition of rape, that’s why it was codified in every State.
Rape was, under the common law, “A carnal knowledge of a women not one’s wife by force or against her will.”
As you point out, it leaves out men and wifes. So we edit it thus:
“A carnal knowledge of a person by force or against his/her will.”
But now we have the problem of “carnal knowledge,” which means only penile penetration. So in New Hampshire, that was changed to “sexual penetration,” which is in turn defined in part: “any intrusion, however slight, of any part of the actor’s body, or any object manipulated by the actor into genital or anal openings of the victim’s body.” So now we can further edit the common law thus:
“Any object manipulated by the actor into genital openings of the victim’s body against her will.”
Which leaves open the question as to whether or not a woman who was raped, or who is under a great deal of stress for a variety of reasons, or who is pregnant as a result of incest, etc., whether that woman is really consenting when The State of Texas demands that an object be shoved up her vagina so that she can be shamed for her decision – what is required to be done with the images can very fairly be described as designed to shame.
So I stand by what I said, that people shouldn’t back away from referring to this as rape, even though it isn’t technically correct. But if you insist, I don’t really mind much referring to it as State-Mandated-Shoving-An-Object-Into-A-Woman’s-Vagina-For-The-Purpose-Of-Causing-Shame Law. Perhaps your objections will be satisfied by that high degree of accuracy.
And I again remind readers that there were plenty of other reasons to dislike this law.
@nybgrus:
You’re not the only person who pounces on that argument as if it will shatter the scales of the eyes of the opponent, but it’s an old one, and one which is as well settled as any argument involving the lives of two people and having to choose.
Honestly, that’s a non-starter in terms of arguments for most people in the pro-life movement. In such a case, you have a medical issue where two people will die or one person will die, and only one is able to communicate for consent. Thus, it falls into standard medical ethics.
@gretemike:
Yeah, the use of the word “rape” really made few people discuss the article on its own merits. Just goes to show that sensationalism cuts both ways. Heck, if someone were able to make a case of “rape” because the ultrasound involves an insertion of instruments or they can’t get the abortion done, how are these clinics going to justify inserting the rest of the equipment to do the abortion? This, of course, being apart from the fact acknowledged by these clinics themselves that they already do ultrasounds before and either to confirm the location and existence of the baby. I think this is one of those cases where the author’s pen got a little too smart in choice of words, resulting in having to defend the article’s content on what it says rather than what was intended, i.e. getting people riled up.
It really is not a close call. Shoving something into a woman’s vagina against her will so as to shame and humiliate her is rape.
This type of law is bad on so many levels. To me, it is a clear violation of human rights mandated by a state actor, which makes it a Crime Against Humanity under the Rome Statute.
http://www.icrc.org/ihl.nsf/FULL/585?OpenDocument
[start quotes from Rome Statute]
Article 7
Crimes against humanity
1.For the purpose of this Statute, “crime against humanity” means any of the following acts when committed as part of a widespread or systematic attack directed against any civilian population, with knowledge of the attack:
(e) Imprisonment or other severe deprivation of physical liberty in violation of fundamental rules of international law;
(f) Torture;
(g) Rape, sexual slavery, enforced prostitution, forced pregnancy, enforced sterilization, or any other form of sexual violence of comparable gravity;
(h) Persecution against any identifiable group or collectivity on political, racial, national, ethnic, cultural, religious, gender as defined in paragraph 3, or other grounds that are universally recognized as impermissible under international law, in connection with any act referred to in this paragraph or any crime within the jurisdiction of the Court;
2. For the purpose of paragraph 1:
(a) “Attack directed against any civilian population” means a course of conduct involving the multiple commission of acts referred to in paragraph 1 against any civilian population, pursuant to or in furtherance of a State or organizational policy to commit such attack;
(e) “Torture” means the intentional infliction of severe pain or suffering, whether physical or mental, upon a person in the custody or under the control of the accused; except that torture shall not include pain or suffering arising only from, inherent in or incidental to, lawful sanctions;
(g) “Persecution” means the intentional and severe deprivation of fundamental rights contrary to international law by reason of the identity of the group or collectivity;
Article 25
Individual criminal responsibility
1.The Court shall have jurisdiction over natural persons pursuant to this Statute.
2.A person who commits a crime within the jurisdiction of the Court shall be individually responsible and liable for punishment in accordance with this Statute.
3.In accordance with this Statute, a person shall be criminally responsible and liable for punishment for a crime within the jurisdiction of the Court if that person:
(a) Commits such a crime, whether as an individual, jointly with another or through another person, regardless of whether that other person is criminally responsible;
(b) Orders, solicits or induces the commission of such a crime which in fact occurs or is attempted;
(c) For the purpose of facilitating the commission of such a crime, aids, abets or otherwise assists in its commission or its attempted commission, including providing the means for its commission;
(f) Attempts to commit such a crime by taking action that commences its execution by means of a substantial step, but the crime does not occur because of circumstances independent of the person’s intentions. However, a person who abandons the effort to commit the crime or otherwise prevents the completion of the crime shall not be liable for punishment under this Statute for the attempt to commit that crime if that person completely and voluntarily gave up the criminal purpose.
Article 29
Non-applicability of statute of limitations
The crimes within the jurisdiction of the Court shall not be subject to any statute of limitations.
Article 33
Superior orders and prescription of law
1.The fact that a crime within the jurisdiction of the Court has been committed by a person pursuant to an order of a Government or of a superior, whether military or civilian, shall not relieve that person of criminal responsibility unless:
(a) The person was under a legal obligation to obey orders of the Government or the superior in question;
(b) The person did not know that the order was unlawful; and
(c) The order was not manifestly unlawful.
2.For the purposes of this article, orders to commit genocide or crimes against humanity are manifestly unlawful.
[end quotes from Rome Statue]
These laws compel physicians to commit a clear violation of the Declaration of Helsinki.
http://www.wma.net/en/30publications/10policies/b3/index.html
4. The Declaration of Geneva of the WMA binds the physician with the words, “The health of my patient will be my first consideration,” and the International Code of Medical Ethics declares that, “A physician shall act in the patient’s best interest when providing medical care.”
That compulsion to violate the Declaration of Helsinki makes physicians victims of Crimes Against Humanity too.
From the Universal Declaration of Human Rights
https://www.un.org/en/documents/udhr/
Article 5.
No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.
Article 29.
(1) Everyone has duties to the community in which alone the free and full development of his personality is possible.
(2) In the exercise of his rights and freedoms, everyone shall be subject only to such limitations as are determined by law solely for the purpose of securing due recognition and respect for the rights and freedoms of others and of meeting the just requirements of morality, public order and the general welfare in a democratic society.
(3) These rights and freedoms may in no case be exercised contrary to the purposes and principles of the United Nations.
To me, these are not close calls. The laws have a clear purpose, to shame and humiliate women seeking abortion and to compel physicians to be complicit in that shame and humiliation. Shaming and humiliating an identifiable group is not an acceptable purpose of any law. Such laws are manifestly unlawful. Compelling anyone to act in ways that shame and humiliate an identifiable group is also manifestly unlawful. Punishing or sanctioning anyone for a refusal to shame and humiliate an identifiable group is also manifestly unlawful.
Not to beat a dead horse – but to those who continue to defend the use of the term “rape” in this context, I would like to introduce you to your compatriots who insist that abortion is “murder”, or as I refer to them, individuals who lack the critical thinking skills to construct a decent argument and must resort to incendiary pseudo-reasoning. I hope that you are happy together.
” This, of course, being apart from the fact acknowledged by these clinics themselves that they already do ultrasounds before and either to confirm the location and existence of the baby. ”
Are you sure that is correct? It’s not my specialty, but I was not aware that an ultrasound was standard operating procedure in these cases. If it is, then why bother mandating it? If the physician feels it is medically indicated, that is between the physician and the patient to decide.
If I was in need of an Abortion, and after reading all this, I think I would be looking for CAM, ie. a coat hanger right about now:((
Gretemike, the argument was always ridiculous, so getting ever so slightly more accurate doesn’t help. It’s not that there is no resemblance or relationship between the coerced ultrasound and rape, but they are two different things. Rape is not a procedure in a doctor’s office. Even if the events occurring appear superficially the same, what is going on is not the same thing. The doctor isn’t raping anyone, the doctor is performing a well-known medical procedure. The patient understands what it is for, its medical purpose. She is not being physically restrained, the doctor does not have a weapon, the doctor did not grab her unexpectedly, the doctor is not telling her he will kill her if she doesn’t lie still. The doctor isn’t doing it to humiliate her or control her or terrify her … but to get images of the fetus. Do I really need to go on? The whole argument is disingenuous.
DW wrote that “the doctor isn’t doing [the ultrasound] to humiliate her . . . but to get images of the fetus.”
Oh, give me a break. As Dr. Gorski pointed out in his reply up near the top, that type of ultrasound is usually not necessary. So in most cases the doctor would not do the ultrasound at all but for the interference of the legislature. It is obtained in all cases (as mandated by the law) purely as a means to make the woman feel ashamed for deciding in favor of an abortion (showing her the pictures of the cute little kid). Mandating it for all abortions has no medical purpose whatsoever, and your claim to the contrary is disingenuous. And in addition, the law is mandating that the doctor say something that is not true. And that treatment is being mandated with utter disregard for whether or not the woman’s life is in danger (a real possibility in some cases, as discussed here by the doctors); whether or not the woman has been raped; whether or not horrible medical conditions may exist that the woman cannot afford (I find it ironic that the side of the political spectrum that supports this law is generally the side of the political spectrum that is opposed to universal health insurance), etc.
It’s a disgusting law that not only interferes with an intensely personal decision, but is specifically designed to make a woman feel bad for making what in some cases might be a choice that saves her life (ecclampsia).
Oh no, the rape victim is not restrained, you are correct. Instead she is taunted, humilitated and shamed. And the doctor is required to be an active participant. This is utterly intolerable.
As an aside, the rape thing didn’t originate here, but in a Doonesbury cartoon.
http://www.guardian.co.uk/world/2012/mar/11/doonesbury-strip-texas-abortion-law
[...] of states are attempting to pass laws that will require doctors to lie to their patients about the negative health aspects of abortion. There is no mention in this legislation of the lifelong negative impacts of childbearing and [...]
Lying to obtain hours of CE credits to keep your active license
In accordance with rule 61g18-16.002 (2) (a),F.A.C. continuing education requirements for active status license renewals, one (1) hour equals a minimum of fifty (50) minutes and a maximum of (60) minutes. Total hours of lecture time cannot be added up and divided into fifty (50) minute intervals to obtain 1 hour credit for each 50 minute interval. Continuing education hours are based on this rule. If the meeting is from 8:00 a.m. to 12:00 p.m. the continuing education credit would be four hours.
State boards are awarding 5 hours of CE credits for attending state board meeting that start at eight in the morning and end at or before noon. The afternoon hour of CE credit is awarded after the board in the morning has found those they compete with in business are guilty of not having enough CE hours.
art malernee dvm
fla lic 1820
Gretemike, you are missing my point utterly. I agree with absolutely everything you say about the ultrasounds. Perhaps you have not read the comment thread through. The law is an abomination. Ultrasounds for the purpose of dissuading someone from having an abortion should not happen. What I am disagreeing with is that it is rape. Get it? You don’t argue my point above – you just go back to arguing against the law. I don’t need to be convinced about the law. The point we were disputing was whether it was rape. This proposition simply mixes up categories, and pisses off rape victims. Do you get what I am saying? There are lots of things that are bad and wrong in the world that should not happen. Not all of them are rape. If my car or house is broken into, I will be very upset, feel violated etc. You wouldn’t need to convince me that we need laws against robbery and vandalism or breaking and entering. You’d need way more convincing arguments than you’ve come up with so far to convince me that I’ve been raped if my car or house is broken into. They are different things.
“Mandating it for all abortions has no medical purpose whatsoever, and your claim to the contrary is disingenuous.”
I did not make that claim.
Rape involves the coerced or otherwise non-consensual insertion of anything into a genital opening. I think we can all reasonably agree on that.
The easiest form of rape to see is the one DW keeps describing – a bunch of thugs jump out of an alley and commit the crime.
Intentionally intoxicating someone with, say, rohypnol and then having sex is also rape.
If a woman walked into a lawyer’s office and once seated he calmly pulled out a gun and pointed it at her, and stated she would be required to have sex with him or he would shoot her is also rape. Regardless of whether he actually would have shot her, hit her or hurt her in any way, yelled, or was otherwise like the “classic” rape that DW refers to.
If a police officer pulls over a woman for speeding and says he will give her the ticket unless she has sex with him, that is rape. He is using his authority and dangling carrot to coerce her into allowing her vagina to be penetrated which she otherwise would not have allowed.
So when a woman comes to a physician’s office, and is told by the state, through the doctor, that she cannot have the abortion she wants without subjecting herself to a procedure which involves the insertion of something into a genital openening we have…. rape. The authoritarian dangling of a carrot to coerce a woman into allowing her vagina to be penetrated which she otherwise would not have allowed. The procedure is not medically necessary (in this case) and without this legislation, the woman would have had access to the abortion she wanted. The fact that it is not (on the part of the state nore the doctor) intended as an act to derive sexual gratification means nothing. There are plenty of rapists for whom the act itself is not about sexual gratification but the exertion of power. For the woman, the distinction is utterly moot. It is also immaterial that it is a normal procedure that goes on normally in a doctor’s office in other circumstances. Sex is also normal and normally happens in other circumstances. In fact, the courts have demonstrated that a woman married for 20 years can still be raped by her husband.
So clearly, by every reasonable and intellectually honest definition of the term, this law will predicate the rape of at least some women (I say some, since in some cases the ultrasound will be medically necessary and/or the woman will consent freely to it anyways).
Trying to make the claim that this language cheapens the word rape and insults “actual” rape victims is a very poor argument. You could also claim that statutory rape does the same. Or date rape, where no violence was perpetrated. The counter claim that is being asserted insults those rape victims by insinuating that rape must be the product of violent thuggery to “count.”
Oh really? So if you have two adult people, who are in a situation where one or both will die, the ethical issue is settled by ignoring the one who can’t talk?
So lets say my father and I are in a car wreck. We both sustain massive injuries and are rushed to a trauma unit. Both of us have extreme liver injuries with significant hemorrhage. It turns out that we are compatible as donors. If one of us donates the viable liver tissue to the other, the doner will die and withe donee will live. So whomever is unlucky enough to be unconsious at the time of the decision making gets to be the donor? And that settles the ethical concept right there?
What about my father’s family? Do my grandparents have a say in the matter? What about my mother? If they do, then why doesn’t the father of the fetus have a say?
Sorry Duggan, but the concept is not a non-starter. It illustrates the point clearly that we would not consider a fetus as having the capacity to make decisions for itself and that the mother’s autonomy always wins out. So when it comes to an abortion, why is anything materially different? It isn’t, until you bring in theistic notions of morality on the concept.
But back to the crux of this article:
All the verbal gymnastics in the world don’t change two very simple facts.
1) The entire and unequivocal purpose of this law is to create barriers in order to make it unreasonably more difficult to obtain an otherwise legal abortion.
2) There will, as a result of this law, be at least a percentage of cases in which an unncessary medical procedure is performed that involves the insertion of a device into an otherwise non-consenting and coerced woman’s vagina. AKA rape.
Quibbling over whether it is always medically necessary, or what about this scenario, or why do we do it for tumors, or any other such bulls4!t cogitations is utterly inane and/or disingenuous. There is no reasonable way by which this law can be considered as anything other than an ideological attempt to make obtainment of legal abortions more difficult to obtain, thus acting as state level coercion to not have an abortion. The same with the 24 hour “cool-off” period. What other medical procedure requires a “cool-off” period so that the person can have forced time to reflect on their decision?
This law has absolutely nothing to do with medicine, quality of care, serving or protecting women, or any noble cause whatsoever. It has everything to do with trying to stop abortion in any way possible since overturning Roe v Wade is much more difficult.
“Trying to make the claim that this language cheapens the word rape and insults ‘actual’ rape victims is a very poor argument. You could also claim that statutory rape does the same. Or date rape, where no violence was perpetrated.”
Saying that I also “could” claim something incorrect does not work because I did not in fact claim that. I do not think that the concept of rape is being unreasonably extended in the case of statutory rape or date rape. The concept of statutory rape exists because it is generally accepted that some people (children) are too young to reasonably consent to sex. That’s got nothing whatsoever to do with the present debate. Date rape is just that, rape that occurs on a date, and there’s no reason it should be more or less of a rape than any other kind of rape. (It only has its own name because some ignorant people still believe that if a woman has let a man buy her dinner or drinks, she owes him sex, so she shouldn’t complain if he forces himself on her – she “owed” him sex. Giving it this special name makes that point; it does not assert some new category of acts that fall under “rape.” A date rape could take many forms.)
In short, both statutory rape and date rape fall quite easily within the general notion of a rape. A medical procedure generally is not going to fit the criteria.
“The counter claim that is being asserted insults those rape victims by insinuating that rape must be the product of violent thuggery to “’count’.”
I agree that it would if I had said that but I certainly did not. I’m well aware not all rapes involve “violent thuggery”; what I said was that many do, and it’s bizarre that people keep contradicting that. Plainly, many rapes involve physical violence. Check your local police blotter perhaps? Furthermore, even rapes that do not involve physical violence involve the THREAT of physical violence. (That is what happened to me, so I guess I would know whether all rapes involve physical violence or not.)
I acknowledge fully that this is the case.
You are missing the point that rape can also occur without the threat of physical violence. Rape can also occur on the threat of with holding something the person wants or needs, or by exacting some other sort of penalty. That is what you seem to be missing.
Violence, nor the threat of it, need in any way, shape, or form to come into the equation. If a starving woman comes to get food, and has all the means and legal rights to it, but is told that the only way she can get the sandwich is by allowing the insertion of something into her vagina – that is rape. If she says no, there is no violence. She can walk away without any fear of reprisal or any notion that violence may be perpetrated towards her. But it is still rape.
So when a woman comes to a physician and asks for an abortion, and has all the means and legal rights to it, but is told that the only way she can get the abortion is by allowing the (medically unnecessary) insertion of something into her vagina… well, that is rape. Even though she is otherwise free to turn around and leave without any fear of reprisal or violence.
And even if it is a transabdominal ultrasound, the principle still applies. It simply wouldn’t be called rape anymore – it would be called assault. If I, as a physician, were to perform an ultrasound on someone who hadn’t reasonably consented to it (which includes not properly informing the patient for consent), even it if it is on his arm, that would still be considered assault.
So, if a woman comes to a physician and asks for an abortion, and has all the means and legal rights to it, but is told that the only way she can get said abortion is by allowing the (medicall unnecessary) trans-abdominal ultrasound… well, that is assault. Even though she is otherwise free to turn around and leave without any fear of reprisal or violence.
Is that more clear?
Obviously in the cases where the US is medically necessary, then it does not constitute rape nor assault since informed consent is obtained and there is a medically necessary invocation of risk:benefit and the law becomes moot. But in the other cases it is not so.
So the law is either entirely moot and pointless or leads to rape/assault. Sounds like a bad law to me.
I should probably add and clarify a bit:
Inherent to that, is if I tell the patient “The is medically unnecessary and has no benefit in your case” (which would be the case in question here) then that would meet informed consent. If the patient then agrees to the procedure anyways, that would be informed consent and not constitute rape nor assault. However, that would violate medical ethics, since unnecessary procedures should not be done. By definition the benefit is zero. Therefore any risk involves, no matter how slight, makes it ethically untenable. In the case where risk is genuinely zero (say the trans-ab US) then considerations of mental harm can reasonably come into play. In cases where even that is negligible, then the simple calculus of cost and resource spending must come into play. No matter what level you slice it at, it is medicall unethical to inform a patient a procedure is completely unnecessary and then do it.
This is inherently different from an elective procedure like cosmetic surgery. The patient in question here did not come to you for an elective US just so she can see her baby (and pay for it out of pocket as is her wish). She came for an abortion and ran into the barrier of this medically unnecessary procedure she did not anticipate nor want. Who is responsible for the costs of the procedure?
I don’t think the creator of Doonesbury was trying to say that the Texas legislature was guilty of rape. He was making an analogy, and I was making the point that it is a good one. (My exact words were, “these laws come awfully close to that”). However, I can see that it is clearly a distraction and will refrain from using the word in the future in connection with this issue.
Glad to hear we are in agreement that the law is an abomination.
We have no disagreement that it is a very bad law and that the ultrasound would be coerced. You make some reasonable points about the (as I see it) *similarities* to rape. I just think it stretches the definition too far. Not every act that is coerced is a rape. Not everything that is done to a person against their wishes, even sexually, is rape. I’ve made this point repeatedly and I’m sure everyone can think of dozens of acts that involve coercion of another person of some sort, and may be against the law, yet are not rapes.
The most persuasive analogy you use is the the exchange of sex for food, or for money to survive. However, we have another term for that: prostitution. Sex for promotions or advancement at work usually falls under sexual harassment. It’s also wrong and illegal, it also involves coercion and threats of a type (at least the threat of removal of an opportunity) but sexual harassment still isn’t the same thing as rape. There’s lots of reasons people have sex that are really bad ideas, that they later wish they hadn’t done it, they felt the other person had control or power over them that they wish they had resisted, that maybe they didn’t even understand at the time, or they gave in because at the time they didn’t perceive other options. Not all of those situations are rape. Some may be, and I admit the definition is not always totally clear, but not ALL such situations are rape, and my point is we should be careful about expanding the definition beyond reason for a political cause (no matter how good the cause).
We’ve probably belabored this far enough … the real issue is HOW to address such a bad law. From the angle of this blog, obviously physicians have to stand up against the requirement to “lie for the state” and protest violations of their professional autonomy and of patients’ rights. And they have to resist being used politically, becoming tools in abortion politics. This suggestion to try to classify the procedure itself as a rape is just totally misguided. Casting around for other, unapplicable criminal categories for the problem isn’t helpful. It’s offensive to rape victims – at least some of them – but that’s not the bigger problem.
You aren’t paying attention to what I am saying. My analogy was in no way related to prostitution. The woman in question wasn’t exchanging sex for food. She had the money and legal rights to the food, and was told that additionally she would have to have sex for it. That is rape, not prostitution. Note that I clearly stated “If a starving woman comes to get food, and has all the means and legal rights to it, but is told that the only way she can get the sandwich…”
This is an important distinction, since the point here is that if not for said law coercing the woman into an US, she would otherwise have all means (either through private funds or insurance) and rights (by law) to the abortion.
Inappropriate comments, touching, or flirtation is sexual harrasment. Actual sex for a promotion is often relagted to sexual harrassment but is also reasonably rape. By law it is a form of sexual assault, which is broken into 4 categories, all of which fall under the umbrella term “rape.” Whether the plaintiff chooses to pursue legal recourse via sexual harrasment, abuse, or rape laws speaks more to the politicolegal environment and does not negate the notion that such situations can indeed be a form of rape.
Having said that, I’ll state that I agree with you for the most part and that we have indeed belabored the point sufficiently. Suffice it to say, whatever word you feel most comfortable assigning it, I think the case can easily be made that it would be a form of sexual assault in cases of TV US and regular ol’ assault in cases of trans-ab US, with the former being tantamount to rape.
Moving forward, the answer to such a bad law is to be loud in its dissent and for physicians en masse to test the law in the courts (the latter being an unsavory option, but sadly one we are heading towards).
DW, what if the state required the insertion of a probe into a woman’s vagina as a condition of registering to vote?
How about as a condition of filing for a tax refund?
How about as a condition of obtaining a marriage license or a drivers; license?
How about as a condition of getting her children into school or daycare?
How about as a condition of boarding an airplane?
How about as a condition of getting out of jury duty?
How about for pleading innocent to a traffic ticket?
How about as a condition of driving a car or walking on the street?
How about instead of stop and frisk they have stop and transvaginal ultrasonic probe?
How about as a condition of filing a restraining order or trying to get an order of protection?
How about for getting food stamps, welfare, unemployment insurance?
How about as a condition of being admitted to an emergency room?
If the state can require an invasive non-medically indicated procedure designed to shame and humiliate someone as a precondition for any procedure, they can require it for all procedures.
The entire purpose of this law is to shame and humiliate women who are trying to get an abortion. Trying to shame and humiliate someone is not a power that the US Constitution grants to government. Not to the Federal government, not to State Government, not to any local government.
I can’t say I’m totally clear on sexual harassment laws … but it seems to me that if you are told you have to have sex to get a raise or a promotion, that’s sexual harassment. If you’re told you have to have sex because otherwise you will be hurt or killed (or some related threat), or because the other person is basically blocking the door, or has you physically under his control, that’s rape.
As for the prostitution thing, and the other bizarre scenarios raised by daedalus, I just don’t think we can take this debate much further. Those are just silly invented scenarios – nobody WOULD say a woman had to undergo such a thing to be allowed to vote … of course if that happened I would consider it rape, but the ultrasound before an abortion at least has some connection to the event, some medical pretext, so I really don’t see those bizarre scenarios as relevant. We clearly all agree the ultrasound law is terrible, for quite a few reasons.
“If the state can require an invasive non-medically indicated procedure designed to shame and humiliate someone as a precondition for any procedure, they can require it for all procedures.”
Put another way, yes, theoretically “they” could do all those things and all those things would be terrible. It’s just that not all of them would be rape.
For instance, what about the subjects of forced medical experimentation, e.g., the Tuskegee syphilis experiments? Should we call all those victims rape victims? What about all the subjects of lobotomies, bleedings, purgings, etc.? Are they all rape victims too? Were the thalidomide babies all rape victims?
It’s an interesting discussion but I’m hijacking this comment thread so I’ll stop now.
The meme did not start with Garry trudeau. It was an obvious conclusion of many on seeing these laws.
DW, rape has a specific definition, the insertion of something into a bodily orifice without the permission of the person who owns the orifice. If it is your orifice, you get to give permission or not for something to be inserted in it, and if you don’t give permission, you get to decide if it was rape.
If you listened to the comments the legislators were making about the law, they dismissed the idea that a woman would object to a probe being inserted into her vagina because she was already pregnant and had consented to having the sex that got her pregnant (they of course neglected rape and incest because that was inconvenient), so there was no reason for her to not consent to a probe being inserted into her vagina to shame and humiliate her. If she wanted an abortion and this was necessary to get an abortion, then she had consented.
Medically unnecessary is medically unnecessary. Just because some politician feels there is a nexus between a woman’s vagina and abortion and decides that having a probe inserted so as to humiliate and shame her doesn’t make it medically necessary. If the government can compel probe insertion for one medically unnecessary condition, they can compel it for any medically unnecessary condition.
There is also the issue of compelling doctors to lie to their patients. There is nothing in the Constitution that gives any government the authority to compel someone to lie.
If the government can compel one lie, they can compel any lie. This strikes at the heart of the First Amendment. If you are compelled to lie, then you don’t have freedom of speech.
I would say that this also violates the eighth amendment. They have in effect criminalized seeking an abortion and imposed the cruel and unusual punishment of having a probe inserted into the woman’s vagina to shame and humiliate her.
From a different location, outside of the USA:
Locally, prior to a termination of pregnancy, a woman is required to have a transabdominal ultrasound.
The medical purpose of the ultrasound is to establish whether she is in the first or second trimester of her pregnancy. This allows her to have the termination in the safest place, by the safest method and by the most appropriate practitioner.
There is no requirement for the physician to be present at the sonogram, no requirement for the sonographer to discuss the sonogram, no requirement for the woman to see or hear any results from the sonogram unless she herself wishes to.
Unless there are ulterior motives intended by the legislators, as appears obvious, I can see no reason why an ultrasound in Texas prior to a termination need be any different.
Daedalus, your post is full of all the reasons calling this rape would be such a bad idea legally. Don’t get me wrong, I fully understand and am sympathetic to the *comparison* to rape, the possible similar feelings of women subjected to this. If it were me I would be utterly enraged, no doubt about it.
But your “definition” of rape and is completely off and so would it be to try to suggest legally that the procedure would be done to “shame and humiliate.” That may be some of the proponents’ motives, it isn’t an unreasonable thought. But clearly the proponents would argue that this motive can’t be known and more plausible is that the motive is to show the woman the fetus, so that she then wants to keep it. I really don’t think the idea of the law is that if a woman sees she has to go through this procedure, she realizes she will feel ashamed and humiliated, so instead of having the ultrasound, she will decide not to have the abortion? That’s just not a realistic scenario. If she decides to have the baby, she’d usually undergo a whole bunch more ultrasounds! If the procedure is shameful and humiliating, it would make a lot more sense to have the abortion and get it over with.
No, the idea is that it is *when she sees the sonogram* that she will decide not to have the abortion. And I actually agree with the proponents that it doesn’t make a lot of sense to define “insertion of something into the vagina” as inherently “shaming and humiliating”; that’s just silly puritanism, and plays to old stereotypes whereby a pure woman is “shamed” by her own sexuality. Women shouldn’t want to go along with legal definitions whereby something inserted in the vagina is shaming and humiliating! Good grief, let’s not go backwards.
What’s wrong with the law is that it is clearly intended mainly as an obstacle to abortion. The medical justifications for the ultrasound are bogus. But so is a countermeasure to call the ultrasound itself rape. We need a REAL countermeasure to the law, based on women’s right to abortion without a hassle of any sort.
DW, If you do a google search on rape definition, this is the fifth link
http://articles.cnn.com/2012-01-06/justice/justice_rape-definition-revised_1_definition-oral-penetration-sexual-abuse?_s=PM:JUSTICE
Well daedalus, you may be right about the definition – I was aware that it had recently been sort of expanded this way, but I think the aim was to (to put it crudely) include all the possible orifices … so that oral penetration is just as much rape as vaginal penetration, for example. I don’t think the aim was to expand the definition to include medical procedures in which something might be inserted, somewhere.
Ideas like this – using rape laws to fight antiabortion legislation – often have a lot of unintended consequences. The law that is bad, the law that should be fought, should be fought using appropriate tools. Dragging in unrelated legal concepts can lead to a lot of completely unforeseen crazy stuff. Like we end up agreeing that it is “shaming and humiliating” to have an ultrasound. Think about the possible consequences of THAT. That kind of legislation could go a hundred really bad places that prochoice people would NOT want.
If an ultrasound was really being done against the patient’s wishes, perhaps it would be assault. I would feel a lot more comfortable with invoking existing assault laws, than with expanding “rape” to include medical procedures.
Sheesh … physicians, too, should be really wary of allowing the law to define a very common medical procedure to be considered “rape” under anything but but circumstances that are clearly criminal and unusual. Do you want to see physicians prosecuted for RAPE for adhering to an antiabortion law? I do not.
Physicians have a lot to lose, too, if procedures performed for a questionable indication can become criminalized. There is a lot of professional judgment in there, right? Physicians should fight this tooth and nail.
@ Brandt,
The pro-life side of the debate has nothing to with a lack of critical-thinking skills. I brought up certain ideas because I was prepared for a challenge and sure enough was met by alot of compelling arguments and points (namely by Dr. Hall, evilrobot, nybgrus, and Dr. Lipson) that forced me to re-evaluate my appreciation of how complex the issue actually is.
If everybody on this site always agreed on everything it wouldn’t be a very interesting place to have a discussion.
@DW,
“I think the aim was to (to put it crudely) include all the possible orifices ”
A definition of rape that included all possible orifices would imply that a mother who uses a Q-tip to clean her child’s ear canal is raping the child.
Yeah, that came up earlier with the thermometer example. It occurs to me that if “inserting something” somewhere for medical purposes, such as an ultrasound, against a person’s wishes is going to be classified as rape, then if antiabortionists get their way and get fetuses declared full persons, then we could have people suing doctors for raping their fetuses in utero.
DW you miss the part about without permission. Good and competent doctors only do things that are medically necessary and they get informed consent before they do them. Good and competent doctors have no problem with defining unnecessary transvaginal ultrasounds given without informed consent as rape. Good and competent doctors don’t do such things. That is one of the characteristics of a good and competent doctor.
That is what distinguishes a medically necessary transvaginal ultrasound administered with informed consent from an unnecessary vaginal probing imposed under duress to shame and humiliate a woman seeking an abortion.
In emergency situations, where the patient is unconscious, then consent for medically necessary interventions is presumed (in some cases).
The problem for doctors isn’t the definition of rape, it is the legislature mandating non-medically necessary interventions to shame and humiliate patients. Doctors are put in an untenable situation. They follow the law and commit rape, or they don’t follow the law and are put under legal jeopardy.
This is exactly like the situation that soldiers are put under when they are given illegal orders to commit war crimes. Follow the order and commit the war crime, or not commit the war crime and be punished for not following orders.
This law is so egregious that I don’t think there is any way a jury or any competent tribunal would sanction a doctor who refused to follow it. I know that I wouldn’t if I were on a jury.
If a woman sued for being raped under this law, I would find the legislators to be mostly liable for the damages (which I would find to be gigantic).
I agree with you that the courts have got to toss this out and/or refuse to sanction doctors who won’t follow it. I sincerely hope you’re wrong that doctors are going to end up getting charged with rape if they do follow this law.
“DW you miss the part about without permission. Good and competent doctors only do things that are medically necessary and they get informed consent before they do them.”
Arrgg. Again, I am not at all unsympathetic to what you are trying to do and I know what informed consent is. I definitely get that “without permission” such a procedure might be rape. I am, of course, assuming that the doctor would have the patient’s signed consent before performing the ultrasound. You and I may feel that it’s a terrible law that requires she jump through these hoops before getting an abortion. Nevertheless, doctors routinely require certain tests or screening before treatments of a wide variety. The patient HAS to have the required testing before the doctor will treat her. Are those patients being raped, too? This way lies madness.
It’s just not the same thing. If a doctor corners a patient, pins her to the examining table, and shoves something up her, that’s rape. If a doctor says, “The law requires that you have an ultrasound before I can refer you for abortion. If you consent, please sign here,” then the patient signs and the doctor performs the ultrasound, the doctor has not raped anyone. I’m sorry but it’s just nuts.
@ dw
the quibble appears to be in your second to last sentence. if the patients signs a release for a procedure that they do not want, that is medically unncessarry and they are unable to obtain the procedure they wish without the aforementioned procedure – there’s the issue. though i must agree, “rape” by itself is a very strong term to describe this situation.
@ all discussing this
sounds like a new term is needed.
I very much enjoyed reading this discussion, as it really forced me to think of my own definitions. I found myself persuaded in part by all sides, but found that the words used to describe the situations were critically lacking.
Here are some situations:
alley thugs + sexual force = rape (with probable inclusion of battery, assault and possibly homicide)
drugs/alcohol + sexual force = rape (quite possibly non-violent)
lack of consent = date rate (probably non-violent, more emotionally coercive)
sexual acts with a minor = statutory rape (might even be consensual to the extent that you believe a minor can make those choices)
now we get to our point at hand: we need a new term. We have slid on down the scale of force and violence and now are at a place where no violence exists, but certainly a kind of force and that of a sexual orientation but without actual sexual gratification (at least we hope). I agree that forcible Q-tip ear cleaning is unlikely to be considered rape in any case – among the other “orifice oriented” cases one could likely posit to make a counter case (nostrils, for instance).
but, let’s take it to the male equivalent. Clearly men can be raped, and in a very traditional sense. If I were to be required to (and ultimately consented to) undertake a medically unnecessary prostate exam (force, non-sexual, medically unnecessary, im sure you could invent a scenario to where it was shame oriented for its own sake), to achieve any medical ends at all (antibiotics, chemo, liver transplant etc.) I would consider that “insert new term here.”
rape is too strong for that, IMO, but it definitely has many of the same characteristics of rape and could be of a more severe magnitude that statutory and date rape, for that matter.
Any ideas? clearly a 120+ comment string largely devoted to defining rape in this case necessitates a new term that adequately address the issues without the baggage of the other word. medical force? sexually charged force? medical rape?(that sounds perhaps too intense…) SCUMP (sexually-charged, unauthorized medical procedure)?
Just saying “rape is rape – forced entry into an orifice” clearly isn’t cutting it, given our wonderful brand new example of how humans have managed to inflict force and discomfort in yet another way upon one another.
I thought my wife’s comment on these bills was quite good, “Shouldn’t we be discussing charging the authors of these laws with practicing medicine without a license?”
in proofreading-post-production…
“unnecessary prostate exam (force, non-sexual, medically unnecessary, im sure you could invent a scenario to where it was shame oriented for its own sake), ”
that was said to demonstrate equivalency to the ultrasound, not to imply that prostate exams are of that nature by default.
Eric, I too really sympathize with both sides, I see the *point* of declaring it rape but I just think it’s a very inadvisable strategy, with many unforeseen consequences.
“if the patients signs a release for a procedure that they do not want, that is medically unncessarry and they are unable to obtain the procedure they wish without the aforementioned procedure – there’s the issue. ”
But patients do sometimes agree to procedures that they don’t want; those are two different things. Patients can also change their minds, and that’s exactly the reason you get signatures. And as to whether it’s medically necessary, I fully understand that in most of these cases it is not, and to require it is wrong. But as I also pointed out, what is medically necessary in many situations is a judgment call, and can be very controversial. Surely doctors do not want to risk being charged with RAPE! for recommending something that someone else thinks is medically unnecessary. The possible tangles here are really, really thorny.
It’s an issue all right, we just can’t agree on what that issue is, I don’t think that issue is rape, I think that issue is, as usual, abortion politics.
@ dw
of course, people comply with procedures they dont want all the time. who wants a triple bypass? the consequences of non-compliance are death and/or extreme suffering in the mean time, in that case, and the benefits drastically outweigh the risks. are there any forseeable consequences to proceeding with an abortion without a transvaginal ultrasound? (based on what I take as your position, I assume you agree there are none – thats not the point i’m trying to make).
would you feel i be justified in using the term “rape” to describe being forced to submit to a prostate exam in order to obtain a vasectomy? I’m not a doctor – so its only my speculation that those are unrelated events. And, supposing there was some group with lawmaking power and a moral objection to getting a vascetomy, couldn’t this conceivably “shame” me enough to mentally traumatize and change my mind? (though, I admit there is no real comparable male event to seeing a fetus in your womb). you’ve stated that legislation of this kind is absurd, so i’m not trying to continue to imply that by you holding your position on the definition of rape, that you somehow embrace the legislation by default. don’t worry, I read you
All I’m saying is that I would be pretty freakin reluctant to get a probing of any kind if only for the purpose of some righteous lawmaker to sneer at the discomfort they’ve imposed – reluctant enough to call that something resembling rape. I’d call that a sciump (added invasive) procedure.
If a doctor lied and said “there is a new way of measuring blood pressure that I have to use that involves sticking a probe into your vagina”, and then did so, that would be rape even if the patient consented because the doctor lied about the medical necessity.
Substitute any other lie for the excuse to stick a probe in a patient’s vagina and it is still the same.
Substitute a lie mandated by the legislature and it is still the same.
There isn’t a way around it. The legislature mandating medically unnecessary probing of a woman’s vagina is the legislature mandating rape.
EricG,
There’s another situation you didn’t consider, and that is of a prison guard having entirely consensual sex with an inmate. In that situation the guard is without question guilty of a felony sexual assault. Why? Because due to the fact that the potential for abuse is so high, such a relationship is utterly forbidden in all fifty States (well, in Vermont anyway. I assume in all fifty States).
I’m not arguing that such laws apply here. It’s just interesting to compare: we are at a place where we shield female prison inmates from the mere potential of abuse (rightly so, in my view), while simultaneously subjecting female rape victims who choose abortion to state-mandated lies and shame.
@DW:
I think you are missing the finer points of informed consent:
If the doctor says “We need you to have this US before the abortion” and the patient, for whatever reason, says no or asks why the US is necessary, then the doctor is required to explain why it is medically necessary. If the patient still refuses but wants the abortion, it puts the physician in a medical dilemma…. (s)he has to weigh the risks of not getting the US with the outcomes and risks of the procedure and see how firmly the medical requirement must stand. If the only reason it must stand is because the law says so, and the woman hangs her head in defeat and accepts the US in order to get her abortion, then by definition the state has committed rape through the hands of the physician.
This is the analogous situation to the woman wanting food and having money to pay and rights to buy it, except being told she needs to have sex (or even just allow a probe inside her) in order to pay for the food. That is rape too.
Indeed. And there will be some cases where the TVUS is necessary or at least genuinely medically controversial as to its necessity. But by virtue off the law, since all cases will be captured here, there will be a subset of women for whom it is absolutely uncontroversial that they do not require it at all from a medical standpoint. There will also be a subset for whom it is a shaming and extremely onerous to get a TVUS (or even trans-ab US). Lastly, there will be a subset of the population where those two circles intersect, and there will be women for whom it is not necessary and find it shaming and onerous and are only doing it to achieve their goal of abortion…. that is the subset for whom the rape term applies quite correctly and adequately. And even if that is only one woman (it will undoubtedly be more) that is still one too many. And when the law does absolutely nothing else of utility (i.e. it does not somehow gaurantee that woman who need a TVUS and would not have gotten it will) and we can predict that certainly at least a few women will fall into those categories, it is not unreasonable to be morally outraged at something that will ultimately lead to state demanded rape.
I don’t think a new term is needed. The point is that rape is a very strong word. It is also a word that accurately and adequately describes the situation. The point of using the strong word is to clearly state how disgusting this law is and why. Inventing a new word makes the point meaningless – “Oh, it’s a case of SCUMP, that’s not good, right?”
Eric, daedalus et al. – I do take your points. I see the arguments for calling it a rape. I guess I am talking more about a strategy (for fighting the law). Some of these arguments are very convoluted – a doctor lies and says I have to stick a probe in you to take your blood pressure; a law is passed requiring an ultrasound before you’re allowed to vote … well, you can invent bizarre scenarios all day to find a way to make these bizarre occurrences be “rape” and maybe you’re not always wrong – but casting the preabortion ultrasound as “rape” is still going to be a bad idea.
So daedalus says “there isn’t any way around it” but fortunately there is, because the unintended consequences and implications of calling this rape are just not worth it.
The scenarios described are too far from reality. No one is going to declare a forced prostate exam is required before a vasectomy, because there is no political motive for such a weird thing. The political motive (the antiabortion motive) is the problem here and so the solutions should address the problem. People are not focusing on the problem.
Nybgrus: “definition the state has committed rape through the hands of the physician. “ Ah – well that is slightly
different than the scenarios previously proposed. Not sure what I think about that, but it is definitely different to accuse the state of rape rather than to accuse the individual physician. We just can’t have physicians complying with laws being accused of rape. Why aren’t more of the physicians here (I’m not one) recognizing what a disaster that would be? Jeez, you take an oath, you’re law abiding, a crazy politically motivated law gets passed, and you’re accused of rape for performing an everyday medical procedure, with the patient’s signed consent? How can I be the only one who thinks, this is not something doctors should be supporting, any more than they should be supporting the law requiring the ultrasound. Get a grip!
So the point is to FIGHT THAT LAW. Not to find ways to prosecute individual physicians for following the law.
Again, I take all the points that the strong language describes the strong feelings, and I share them. I’m talking about strategy – this is a bad one.
DW, it is my opinion that the only way to fight the law is to put the law makers who passed such a thing in legal and financial jeopardy. That is why I think the best approach is to consider it to be rape and to prosecute the legislators for Crimes Against Humanity under the Rome Statute.
Goodness, but this is a rather strong discussion. I think that it’s good that everyone’s so willing to discuss the matter, although I find it disturbing, as always, how often it comes down to “You’re accusing me of saying this one thing, but I said this other thing instead. Please argue with me over what I actually said” followed by a reply saying “But by saying this thing…” ignoring that they didn’t say it. This is a contentious issue. Twisting peoples’ words so that you can cast them as the ignorant enemy doesn’t help matters.
@nygrbus:
Did I say that it was always settled in favor of the conscious person? No. I’m saying that it’s not a new medical issue. Also, while I know it was a minor comment on your part, but there are operations that require a cool-off period. Sex reassignment surgery is one of the most prominent ones. Now you may or may not agree with that cool-off period — I’ve known several people who argue that it’s the result of unreasonable bias against such surgery — but it exists. I wouldn’t be horribly surprised if other radical surgical procedures, like complete hysterectomies, similarly required a period of contemplation as to whether the patient felt it was the right step to take, but that’s not something I know about.
On a side note, if we prosecuted lawmakers for making laws they aren’t qualified to make… well, we wouldn’t have a government for long. That and, from a philosophical point of view, that raises the issue of who watches the watchmen. Ideally, we would have the people most knowledgeable about the subject making the law in an impartial manner. In an ideal world, teachers would make as much as engineers, but we don’t live in an ideal world. As it is, we can only hope that most lawmakers do consult with experts and they make laws based on what’s most right, not necessarily the cause that they most believe in. I think both sides are guilty of the latter, making laws to fit their view of the world rather than sit down and look at the evidence, especially on polarizing topics like abortion where it seems like you’re only allowed to take one extreme or the other.
Daedalus, but it would be individual doctors who would be prosecuted under such a scheme – it’s folly to imagine the legislators would somehow end up getting prosecuted.
First off, I for one think this is an interesting discussion and there has been no anger, malice, or frustration in my responses. I am interested in fleshing it out a bit and am willing to amend my view. I just haven’t seen an argument that has made me reconsider yet.
Apparently we managed to misinterpert each other and/or the post. This is not different than what I had been reading as the entire discussion all along.
I don’t think anyone here, Dr. Lipson included, intended to say that individual physicians were rapists. The point was that the law would create a situation in which a physician will almost certainly be placed in a position where they must either break the (new) law or commit a state-demanded rape. Now, the distinction as to who actually committed the rape is somewhat moot here, but interesting none the less. It harkens to the concept of an unjust military order – the soldier may be breaking a rule of engagement or fail to follow an order. In general, the military courts rule in the favor of the soldier, but only if it can be demonstrated clearly that the commanding officer’s order was indeed illegal. Otherwise, the soldier is indeed found guilty for breech of duty.
This is not a military case, and I am not a legal expert, but a similar scenario could forseeably arise, in which case establishing that the law was clearly unjust is necessary. An easy and accurate way to do so would be to demonstrate, as we have been doing here, that following the law leads to a form of rape (not something like rape, but a form of it) and thus the physician is justified in breaking the law.
The flipside would be if a physician who did not have the qualities DW assumes (incorrectly) each and every one of us do have does follow the law. Then a woman could (and should) accuse the physician of rape. Defense and exploration of the matter would hinge on the law itself and, I hope, ultimately find that it is an unjust law as well. In the meantime, the physician in question would likely have minor sanctions in light of the dilemma in which (s)he was placed. However, I actually agree that a physician in such a circumstance should be punished somehow, since it seems clear that everyone here is advocating that the law not be followed in the first place on professional ethical grounds.
So the point here is not to start racking up docs in prison for rape, but to use the fact that rape accurately describes the outcome of this law as a powerful tack for demonstrating its unjustness (is that a word? lol) from a few potential angles.
So the reason for physicians (myself included) to support the outcome of this law being called rape as opposed to something else is many fold.
First, it helps raise rapid awareness.
Second, hinging it on the notion that it is purely ideologically motivated by theistic notions of morality in regards to fetal life is a non-starter. The majority in this country, and by far the majority in legislation, support this ideological morality! The would agree and thank you for supporting their law! Calling it rape is something no one can support.
Third, it forces physicians to realize that when pressed with the decision, obeying the law is something much more significant. Calling it “SCUMP” or whatever makes it easy(er) to rationalize and be rather milquetoast about it. If a physician is thinking “Meh, just another regular’ ol’ procedure with little likelihood of direct harm, mortality, or morbidity” (s)he will have less motivation to actually stand up to the law when faced with the likely unpleasant consequences of civil disobedience.
So from my vantage point, and I would dare to say Dr. Lipson’s, that has been the point of this rhetoric.
@dugganSC:
My apologies then. I made the implicit argument and when you did not rebut it I assumed that as acquiescence to the point. No need to rehash however.
As for the cool-off period… actually there really aren’t any surgeries or procedures that require a specific “cool off” period. Not even gender re-assignment.
For gender reassignment, the standard of care is a slower transition with psychological counseling along the way to ensure the best possible outcome. That includes active gender-reassignment therapy during the period prior to final surgery. In the US, that period is partly justified and partly extended by erroneous moralistic considerations.
However, it is no different than due diligence for any other significant procedure (such as, say vasectomy) in which the physician has a duty of care the ensure that the decision is of the patient’s own volition and truly desired. This changes with each patient – a 45 year old man, happily married with 5 children asking for a vasectomy is indeed different from a 19 year old with no children asking the same.
However, there exists no such paradigm in ethical medical practice that a randomly assigned “cooling off” period is necessitated for anything other than medical need – which could, should, and does include due diligence for mental health of the patient. As such, proper (and accurate and truly informed) counseling prior to abortion is ethically demanded. However, an arbitrary 72 hours (and in many cases parental consent) after being bombarded with unnecessary sonograms is does not fall under the same principle. Neither is the “counseling” offered by many anti-abortion clinics (and health professionals) wherein lies are told, positives are downplayed, and negatives are trumped up in order to sway the patient’s decision.
The point I am trying to make is that “cooling off” periods are never a medically justified practice – not in the sense used in conjunction with abortion legislation. In the latter sense it is purely ideological with the implicit intent to give a woman every reason to feel ashamed for her decision and have a minimum time to stew over it and reneg. This is fundamentally different from proper, caring, informed medical counseling prior to the abortion itself.
I’ll add that I would not support walk-in hair cut style abortion clinics. I’m not sure if they exist or to what extent, but a place where a woman can go in and with minimal or no counseling have an abortion within an hour or two of arrival. Just like any other surgical procedure, there should be an initial consultation, with appropriate information and medically accurate pamphlets (which do include the legitimate concern of regret in a portion of women), and then scheduling of the appointment at the earliest convenience of the patient and practitioner. In the interim, the woman can freely decide to cancel her appointment.
@nygrbus:
Ah. It would seem that we may have been two of those people arguing past each other. I’ll admit that I’m often a bit quick to fly off of the handle on this subject. As crazy as it may sound, I’ve had people argue with me that abortion should be a “haircut” procedure where you walk in, get the procedure, and walk back out. As I’ve said before, it’s one of those polarizing topics… one side feels that delays give the chance for people to reconsider while another side feels that any form of delay or roadblock automatically means that someone is having their liberties infringed. The latter are the sort of people who also argue that abortion clinics shouldn’t have to follow the guidelines of sanitation that other surgical clinics do because they feel that it would be like bicycle helmet laws, used only to target one particular group (I know… bicycle helmets? But it’s been shown in several studies that minority children are almost ten times more likely to be fined for not wearing their helmet in states that have these laws). Frankly, I can somewhat see their point of view, but I feel that extremes like that throw the baby out with the bathwater, much like how many pro-lifers have gotten swept up in protesting contraception methods (although that, I also partially blame on lobbying to prevent the Pill from being listed as a more medically accurate abortifacient due to its prevention of implantation rather than conception).
Honestly, the other thing which I don’t quite get is where people go from the law stating that an ultrasound is required to it necessarily being the invasive vaginal one. A couple of people have pointed out in the comments that the law does not require the more invasive one. Much like calling the procedure “rape”, this is another area where I feel people are distorting the truth of the law in an attempt to paint the law as more monstrous than it is.
One point that has not been considered in the discussion of rape: Rape is, I think, a criminal statute. This means that it requires a district attorney to prosecute the crime and an agency, like a police force, to file a report. Can anyone imagine that happening in anti-choice states like North Dakota or Texas? Practically speaking, Doctors probably don’t have to worry about being charged with rape for doing the state’s bidding by performing unnecessary and humiliating medical procedures, or treating adult women like children. The only source of concern is if you are committed to providing good medical care, based on scientific information. In that case, you are in a lot of trouble, because you will have to choose between following your training, or being a political tool of state legislators and the religious right. And you don’t have to wait for that to happen, because it’s already here in many states. Most Doctors have opted out of providing medical care that would cause them to have political problems: witness the lack of abortion providers in this country. Why doesn’t every gynecologist provide first-term abortion as a routine office procedure? Because they are afraid of the anti-choice fringe. That’s completely understandable; anti-choicers will commit murder to further their own moral and religious agenda. Understandable…. but very sad. Because if many Doctors agreed to perform abortions, it would make it harder for individuals to be targeted by fanatics. By allowing abortion to become a marginalized procedure, performed by only a few specialty clinics, such targeting is easy.
DugganSC:
Wait a sec — are you seriously arguing that the Pill (meaning, presumably, the usual sense, products such as Ortho Tri-cyclen, Yaz, etc.) doesn’t prevent conception??? It prevents ovulation, and I have yet to see any evidence it can act as an abortifacient or even to prevent implantation. I know there’s been talk that maybe it does, but I’m unconvinced, especially given that the effectiveness of emergency contraception drops off sharply within a few days of intercourse, faster than the likely interval between intercourse and implantation.
(Note, of course, that if we’re being medically accurate, something that prevents implantation is not an abortifacient; medically speaking, pregnancy begins at implantation, so before that there is nothing to abort. There is a gray area between conception and implantation where there is the beginnings of human life but no pregnancy. Otherwise, a woman who adopted a surplus frozen embryo from a fertility clinic could find that she’s actually been pregnant since several years before deciding to become pregnant, which is obviously absurd.)
@dugganSC:
Delays for the sake of delay are one thing. Delays as a matter of proper medical conduct are different. I think we are closer to each other in thought than we may have thought, but still rather divergent. For example, if the resources are available, and the practitioner is sufficiently skilled and confident, I believe that a 20-30 minute evaluation could be sufficient to then have an abortion immediately following. I’m not an expert on the psychology involved therein, but I do agree that putting unnecessary roadblocks to any procedure is wrong. If the 19 year old was able to convince me that he really wanted that vasectomy for good reasons, I would be hard pressed to come up with anything but a personal hesitation at providing it.
That is the genuine gray area of medicine here. Arbitrarily defining a “cooling off” period makes no sense. Perhaps for most people it really does take an hour long consultation and a day to make an informed decision about abortion. For some it wouldn’t. So legislating a delay – whether it be 1 hour or 1 week – makes no sense.
Compare it to breast cancer surgery. Lets say a patient comes in with a T1N0M0, low grade DCIS. By definition this is very easily resectable by lumpectomy. Let’s further say that the woman has ample breast tissue and zero family history and is 70 years old just to make lumpectomy as much a slam dunk in medicine as you can get.
Now lets say she wants a complete bilateral mastectomy because she is deathly afraid of the cancer spreading or coming back. As a physician, it would be my duty to inform her of the medical fact that lumpectomy a much better option and furthermore that data clearly shows many women have regret from elective mastectomy because of body image issues once the fear of cancer has faded (all of this is actually medically correct, BTW).
Should I tell her she has to take a time out and wait 1 week? 1 month? before I accept her decision for mastectomy over lumpectomy? What if I happened to have OR time the next day?
I believe the correct course of action would be to extend the consultation and probe to the best of my ability and satisfy both myself and the patient that this truly is the best course of action for her. I would admonish her to think more on it and potentially use delays that are out of my hands to offer her that as time to think. But if I had the time the very next day, unless I had extremely good reason to deny her, I would be ethically bound to perform the surgery. Note that the burden of proof is on me as the physician to prove she should not have the operation – the burden is never on the patient to prove why they should.
The paralell is clear for abortions. If a woman wants the abortion I would consult, advise, and then schedule at earliest convenience with the same admonition of deliberation until the procedure. If she wanted it immediately there would be an inherent ethical and professional onus on my part to try and suss it out. But, ultimately, if I couldn’t demonstrate good reasons why to deny her the procedure and it could be done the same or next day… it should.
You are correct that the law does not explicate it must be TVUS. However it does say:
(B) the physician who is to perform the abortion displays the sonogram images in a quality consistent with current medical practice in a manner that the pregnant woman may view them
This means that in most cases it will be TVUS, since most abortions are early in the 1st trimester and the only way to visualize the conceptus is via TVUS at that time.
So you are right, that it isn’t a firm requirement of the law, however in its wording most women seeking abortion will still have TVUS required. Apparently this was a big enough issue that the wording was changed (at least in VA) such that women may have the option to opt out of TVUS, but must still get the trans-abdominal version and hear a description of the conceptus and its development, as well as wait 24 hours. That is a step in the right direction, though it would still fall under assault laws, albeit not sexual assault.
Lastly, I will echo what Calle Arcale said – you can’t be serious about the OCP can you?
Though I will moderate that by saying that indeed it has been demonstrated that in a very small amount of cases (I believe <5%) it does act by preventing implantion, but mostly it is a prevention of ovulation.
However, neither aspect could possibly make it an abortifacient.
@nygrbus:
You’re right. Stating it as an abortifacient is as much as overstatement as claiming that the ultrasound is rape or assault. However, the legal definition of a “contraceptive” did get changed to include implantation to avoid having to indicate that it worked later than conception in some percentage of cases (as to what percent, I’ve seen varying numbers of that from as low as 1% to as high as 10%. I’ll be honest that I don’t remember the sources for those figures). I don’t know whether it got changed to avoid getting barred off of lists or if it was just to prevent the companies from having to include a disclaimer on the package indicating that it “fails to prevent conception but will prevent implantation in n% of cases” that might scare off consumers. If I were inclined to argue the point of the latter, I’d comment on how it’s similar to how the supplement manufacturers were fighting to avoid having to disclose the medical risks of overdosing on their supplements.
And yeah, we do have some similar points of view, I think. We’re on opposite sides, but willing to actually listen to the other side and not grounded on an extreme. Frankly, that does distinguish us from a lot of others out there.
@cloudskimmer:
I just want to point out that it’s always been a lunatic fringe within pro-lifers that have resorted to violence. If you’re going to hold a philosophy liable for the action of a minority of their members, you’d might as well say that all environmentalists are violent nutters because a few of them are willing to send mailbombs and smash equipment, or that all vegetarians are willing to assault meat-eaters because some members of PETA do so. As it is, most pro-lifers are so devoted to the sanctity of life that they don’t resort to violence, even in the defense of a human life. *wry grin* In some ways, I feel like it makes us the guy who sees someone getting their head kicked in and does nothing more than call 911 and lobby for better laws against assault because they abhor violence. I don’t know where that puts our moral ground.
@ mdstudent
“The pro-life side of the debate has nothing to with a lack of critical-thinking skills.” Please note that this was not stated in my previous comment. There are meritorious arguement on the “pro-life” side of the debate. I take issue with the misuse of terms to make an emotional appeal which often (but not always) indicates a lack of substance to an underlying argument, as is evident here. Jann Bellamy provided citations to cases which have questioned this statue on legal grounds, and while I have not taken the time to read them, I am fairly confident that no arguement has been made that this law requires rape.
Brandt, if you do a google search on rape definition, you will find that non-medically warranted transvaginal ultrasound can meet the definition of rape.
However, many people here are missing the point in their quest for definitions and legalities. The bottom line is that good doctors don’t want to do this because it harms people, not because it might be illegal.
If rape were legal, I would still not rape anyone because I don’t want to harm anyone by raping them.
This is really what the statute is about, defining something that harms women as “legal” and mandating it so as to harm them.
Just to expand on my last comment. The bottom line is that the legislators who passed this law don’t consider women who are seeking abortions to be human beings and deserving of human rights. They have “othered” those women and dehumanized them so that they are not human beings any more, they are simply objects, evil non-human objects.
Women seeking abortions and the medical professionals who perform them are inhuman monsters without the capacity for human feelings. They are “fair game”, and any maltreatment of them is acceptable, even praiseworthy.
In contrast, a fertilized egg is a complete human being with full human rights. Women seeking abortions and those who perform them have forfeited their human rights by their inhuman behaviors.
Some people who consider themselves pro-life won’t admit this, but this is how they feel. This is why they have no desire to promote contraception. It isn’t about preventing abortions, it is about harming women who would have sex and women who would have abortions.
@daedalus2u:
Oof… again with the generalization and demonization of pro-lifers. So wonderful to know that you understand entirely how a group of people feels and can authoritatively comment on their mental state. Except, of course, you’re wrong. The pro-lifers feel that the baby is a human being. So is the woman. Both need to be protected because we don’t judge one more human than the other. Your arguments are akin to stating that anyone who opposes the lynching of blacks doesn’t consider white people to be human.
@daedalus2u:
Sorry… that was harsher than I meant to state it. It just brought me back to growing up hearing people expound upon how they knew why black people were always criminals or why Hispanics were always lazy. It’s false knowledge on a false premise based on personal prejudices. I advise that you talk to some pro-life people, and not just the foaming-mouth ones, and find out where they’re really coming from. You may learn something from it.
And… upon rereading things with a calmer head, you indicated “some pro-lifers”. I still feel like you’re generalizing based on what you feel they believe rather than on any evidence, but I’ll also accept that you probably don’t feel that way about most people in the pro-life movement. If you do, then we’re back to my original statements. :-/
well… I for one think that this has been an interesting conversation.
I will also admit that through the course of it I am feeling a bit less robust in being able to call this a “law that demands rape” or some such robust and clear statement to that effect.
However, I still do believe that the law is overall harmful and that a subset of that harm will ultimately be cases that can reasonably be referred to as rape. And that, to me, is all one needs to know. If only 1% of all women affected by this law can be said to be raped in any sense or definition of the word, then that is the defining character of this law.
If a law led to 1% (or even 0.1 or 0.001%) of people being harmed in a way that would be reasonably called “murder” then that would be its defining characteristic for me as well.
I personally think this thread has run its course for me… so , till next time.
Best!
Oh, lastly, I should say to DugganSC – I am never grounded in anything “extreme” and am always willing to listen to other viewpoints. The exceptions being viewpoints that have already handily been demonstrated as completely false and counterproductive (creationism, religion, CAM, for example). I think abortion the patient-practitioner milieu is not one of these. I do think, however, that in a progressive society we must acknowledge the right to choose, and that the single most robust argument against choice is the inherent sanctity of human life. However, it is my opinion that the banning of all abortion relies on a theistic interpretation of said sanctity, since a blastocyst or 1st trimester fetus is hardly human life. I am actually against very late term (i.e. 3rd trimester) abortions. The middle ground is where it gets fuzzy for me, and the convenient cut off I use is the youngest age at which a fetus will be viable ex-utero. Currently this is ~24 weeks. As technology improves, that will force harder and harder decisions, though the concept that cryogenically frozen blastocysts may never develop and that doesn’t cause much bother to me seems to predict a lower limit to my own personal dilemma. But that is a discussion for another time, perhaps.
DugganSC, I have outlined my reasoning as to the mechanisms behind xenophobia.
http://daedalus2u.blogspot.com/2010/03/physiology-behind-xenophobia.html.
They are fundamentally due to feelings that the other person is “other”, not sufficiently like them to be treated as a human being.
This is why people who call themselves pro-life can be pro-death penalty, bomb clinics, torture prisoners, shoot doctors and bully gay people until they commit suicide. They can even accept that some abortions can be moral, but only their abortion is moral.
http://mypage.direct.ca/w/writer/anti-tales.html
Their position did not come from facts and logic, it came from feelings. If those feelings change, then there will be different rationalizations of those feelings.
This is why such people can have nonsensical ideas about how hormonal birth control works and have no need to rationalize how a human being can exist in the absence of a brain. They are experiencing truthy, the prioritization of their own feelings above all else, even external reality.
@daedalus2u:
All I can say is that hypocrites exist in every belief system and that generalization based on anecdotes flies in the face of what this site stands for. And… honestly, I don’t think that will do anything to change your mind about what you’ve decided to believe about the other side. I’m sorry that that’s the case. I like debating with people, but there comes a time when discussion becomes fruitless because the other person has their mind made up already.
DugganSC, in this discussion I am not talking about “all” pro-lifers, or generalizations made to all pro-lifers, I am talking about the self-proclaimed pro-lifers who are legislators and who are legislating laws that require non-medically necessary transvaginal ultrasounds prior to abortions.
Their sole interest is in making abortion more difficult and more expensive and more time consuming for women who are seeking to have one, and to shame and humiliate women who are seeking to have one.
If their interest was in reducing the number of abortions, they would in addition be pushing for greater access to effective sex education and effective contraception so that women don’t have unwanted pregnancies so that women with unwanted pregnancies do not seek to abort those unwanted pregnancies.
The legislators passing this type of legislation are not telling us the truth about what their motivations are. They proclaim they are “pro-life”, but they do not act as if they actually valued human life. If they did, they would have life-of-the-mother exclusions, but they don’t. They don’t want women who could have their lives saved by a timely abortion to have their lives saved, they want them to die without having an abortion.
The Catholic Church has even explicitly stated that it is better that both mother and fetus die than that the mother’s life be saved by having an abortion. This is not a “pro-life” position, it is an anti-abortion position. It is an anti-woman position.
The Catholic Church is also anti-contraception by essentially every effective method, even condoms. The Catholic Church is against the use of condoms even for prevention of transmission of STDs. This is not a pro-life position, it is an anti-sex position.
Anti-abortion legislators have convinced themselves that they are pro-life, even as they do actions that will kill people. They may fool themselves and their followers, but they do not fool me.
I agree with you, that discussion is fruitless with people who are unable to consider alternatives to their already made up minds. Such people occur on multiple sides of issues. Such people are characterized by an inability to address facts and logic, not necessarily by the use of anecdotes.
Anecdotes are perfectly acceptable data for some uses. If someone declares that women dying without a timely abortion is so rare that it doesn’t matter, then what they are saying that they are not pro-life because the death of that woman and her fetus doesn’t matter to them.
If people who proclaim themselves to be pro-life also say they don’t care about deaths due to illegal abortions, they are also demonstrating that they are not pro-life. If they were pro-life, they would seek harm mitigation to reduce lives lost due to illegal abortions by reducing unwanted pregnancies.
If such people were actually pro-life, they would want good data to derive their pro-life conclusions from. The legislators in these cases do not want good data based on sound science because the basis of their beliefs is not in science or in being pro-life, it is in being anti-woman.
@daedalus2u:
Ah. So your concern is with these particular legislators. I’ll understand that you don’t tar all pro-lifers with the same brush. I’ll just note that you’ve got the wrong line on the Catholic Church. The Roman Catholic Church has held grave danger to the life of the other as a sound rationale for an abortion since Humanae Vitae, “the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever”. In other words, if the intent is to save a life rather than to end one, even if ending one is an unavoidable risk of the procedure, it’s not considered to be murder. Individual members of the Church may hold stronger viewers, including people in the hierarchy, but the official position of the Church is not to sacrifice the mother for the child unless she so chooses.
As regards the church and sex… most of that is theological matters, so I doubt you’d be interested in an explanation of rationales, but I do find it a bit funny, although probably not intentional on your part, that you accuse them of doing nothing to stem pregnancy and yet you also accuse them of being anti-sex.
Sex is generally an important part of pregnancy, you see. Anyhow, the Church isn’t anti-sex. They believe that sex is a beautiful and wonderful thing, a form of prayer to God, but they believe that it belongs in a marriage. And the Church has had the position for decades now that people should not have more children than they can provide for, and provide training in how they can control their fertility by more properly understanding it. It requires a degree of education and a degree of self-control, but you can’t fault the Church for wanting to believe that its people can reach that level of competence.
Ultimately, your statements on the Catholic Church reflect pretty old theology. Admittedly, it’s not an uncommon set of beliefs, even among some of the Catholics who don’t properly educate themselves on their religion. Still, I felt that you’re the sort of person who would prefer not to be unwittingly spreading false information, so I hope you don’t mind my corrections.
Personally, I mourn for the deaths of women in illegal abortions. I still don’t think that justifies legalizing them. I also mourn the death of people involved in the drug trade, people who die while building illegal explosives in their garage, and bank robbers who get gunned down in the midst of their heist. The loss of human life is tragic, but but just because people died pursuing something illegal doesn’t mean that it’s best to make it legal. Again, I feel that your argument is based on what you project their motives to be rather than any judgment of what they are.
So yeah… we’re not going to convince each other, but I’m glad that we managed to settle a few of our differences in miscommunication and I’m glad I got a chance to set you right on the Church’s position. Incidentally, happy Easter weekend. I hope you enjoy it.
Man, you guys really know how to flog a dead horse.
The one being penetrated can be the raper. Rape in terms of abuse or violation can apply to many different scenarios. This is all rather moot.
For those who argue that the unborn are of no significance and that pro-lifers guarantee full support for the woman and child until it reaches adulthood… How about this, any woman that gets pregnant will be required to terminate unless they can prove to be fit parentally and financially.
Dr. Hall, after reading your comments, I wish I would have spent more time telling my mother how much I loved her, I didn’t realize I was such a burden. I hope I gave her some happiness.
I think you need to check your understanding of Catholic doctrine. There was a recent clear case
https://en.wikipedia.org/wiki/Excommunication_of_Margaret_McBride
and in the aftermath there have been explicit statements by high Church officials that allowing both to die is better than performing an abortion to save the mother which is never acceptable.
http://atheism.about.com/b/2012/03/23/american-bishops-order-hospitals-to-let-women-die.htm
All of the patriarchal religions are about control, control of the members by the power hierarchy. Keeping women pregnant and with small children is a good way to control them because women are hard wired to place high priority on the welfare of their infants.
It is one thing to say something vague and wonderful sounding and another to actually live up to it. I used to work in a Catholic hospital. I had a friend whose second trimester fetus died in utero – confirmed by US. The physician wanted to do an D&C to remove it, but the powers that be at the hospital (aka the Church) denied the request, stating that she would have to expel the fetal corpse herself. Completely emotionally torn apart, she was forced to leave the hospital and go find somewhere else the next day to remove her dead baby from her, because technically she wasn’t in immediate danger of death from the situation. Most likely she would have birthed the dead baby in a few days, but besides the emotional anguish the church was forcing her to absolutely unnecessarily endure, there was a chance she wouldn’t birth the corpse and become rather septic from it. At that point, with her life imminently at risk, they might have allowed it. But if you look around, you’ll find many reports where even that wasn’t accomodated.
The church is anti-sex unless it meets their specific requirements – i.e. a subservient woman receives it from her dominating man within the confines of their blessing (marriage).
Which is absolutely inane. The only way, outside of the contraceptive methods the church explicitly bans, to adequately manage family size is to abstain from sex. So how again is it that the church is not anti-sex? They severly limit it to a power hierarchy and further to acts of procreation only – no joy in it.
There is a new theology? The entire concept of theology is that it is old – that things written by the most backwards of the bronze aged goat herders are infallibly correct and never changing. No, I disagree. While not as expansive as something I may write, deadalus was pretty spot on in his indictment of the theistic position on these matters.
False and/or poor parallels. The drug trade should be legal. Why are the explosives illegal and what was the intent of their use? And bank robbers are unequivocally causing harm to others in society. The paralell does not hold up to back alley abortions.
Your latest post is a rehash of the typical, trite, and hackneyed stance that is common amongst theistic apologia. It all always boils down to, “No no… we really are this way, despite all the evidence of how things are actually done.” In other words, it is pure lip service. People like myself and daedalus are more interested in what actually happens in real life to real people, not what some pontiff claims is the official policy of the church. Because the last time I checked, the church was unequivocally against homosexuality and pederasty….
In the case of an ectopic pregnancy, the Catholic church mandates major surgery and removal of the fallopian tube, rather than the less invasive administering of methotrexate. Removal of the fallopian tube often causes fertility problems, more so than methotrexate.
If we look at the situation from the perspective of the fetus, what would the fetus prefer if it was capable of thinking and so having a preference? Since we can’t ask the fetus, what would the “reasonable fetus” want? If the fetus is going to die, why would it want its mother to die also? That makes no sense to me at all.
Why would a fetus want their mother to undergo a more costly and more invasive surgery with a worse outcome that could potentially prevent future siblings?
Many adults would sacrifice themselves to save their mother’s life. We accept that adults can sacrifice themselves to save others. In war, they are called heroes and are given medals posthumously. Why is the idea that a fetus would choose to die so as to save its mother’s life such an evil idea?
That anecdote of not allowing the removal of the dead fetus is horrible.
There is no way anyone can honestly spin that position in to one that is pro-life.
“How about this, any woman that gets pregnant will be required to terminate unless they can prove to be fit parentally and financially.”
Where the hell are you from? China? Why do you insist on making decisions for someone else?
Just because I cannot bear to be silent about this, I would like to contribute that I have been raped, I have had a (medically necessary) transvaginal ultrasound, and I would ABSOLUTELY call a non-consensual transvaginal ultrasound rape. Absolutely I do. To my mind, it is unambiguously a state-ordered rape. I, as a rape victim, am not at all offended by a non-consensual state-ordered transvaginal ultrasound being called rape, and frankly, it gives me shivers and PTSD to hear people arguing for NOT calling it rape. It does not trivialize or muddy the issue– it sheds the cold light of reality on it. State-mandated penetration of a woman’s vagina with an object for no medically-indicated reason is state-mandated rape.
I cannot bear to look at this thread anymore, but believe me, I will continue to protest and fight against this any other such legislation that comes up in my lifetime.