September 25, 2002

8:41 PM

A bill is currently being pushed through Congress that will give health care providers, including those that are federally funded, the right to refuse to perform abortions or administer contraceptive medication for personal moral reasons. Next week: firefighters allowed to let houses burn down because they hate the color of the curtains.
posted by XQUZYPHYR (72 comments total)

I really think you're trivializing this. Do you really not see that some people consider abortion murder? How can you demand that a physician administer a procedure SHe finds more than repulsive? It's more than just the color of curtains, it's not like they only won't perform abortions on white people or pretty women.

You are always free to choose another doctor or pharmacy. That's freedom at work!

Now, if HMO's refused on "moral ground" I'd be uproarious.
posted by wolfgangnorton at 8:44 PM on September 25, 2002

Uhm...I don't think it's fair to compare a moral opposition to abortion to dislike of curtain colors.
posted by Durwood at 8:46 PM on September 25, 2002

i didn't know how the abortion story and the curtain story got mixed together, but it got confusing. firefighters caring about the color of curtains...in general, there are more firefighting men (yes, there are lots of women too) and i can't see most of them even noticing honestly. ofcourse, that is a huge generalization, you'll have to excuse me

another thing-- i can see ppl refusing to do work on people because of race... ppl do it all the time. it [having racial issues] is sick.
posted by prescribed life at 8:51 PM on September 25, 2002

what a shitty analogy.
posted by quonsar at 8:53 PM on September 25, 2002

I apologize to those in the "fair and balanced" crowd for having only the obviously left-wing ACLU link and this equally partisan NOW link for sources. If anyone has the news link to this, thanks.

That said, I hope it can be agreed to keep this open despite its political intent, simply because it's at least not about Bush (until maybe 20 posts from now) or Israel.

That "that said" said, I will be, on a personal level, blatantly partisan about this. This is a perversion of medical practice.

In regards to the above posters, to be a doctor or nurse is to agree to attend to the needs of the patient. The law, and I believe the oath doctors and nurses take. requires them to respect, among other things, a woman's legal right to do what she wants with her own reproductive abilties. This is NOT an issue of "if you don't like it, go to a different hospital." This is an issue of "if you don't like it, don't be a doctor." I will not accept the idea that medicine is a consumer good that has bargains and comparison shopping. Essential services that refuse to perform parts of their services don't have the right to be one.

Being abortion is the only reason this concept is possible; the very notion that a doctor could refuse to perform heart surgery or prescribe any other form of medication because he doesn't feel like it would have his or her license stripped from them instantly.

My guess is that the growing coalition of churches and hospitals is the basis for this: all we need is for every "St. Someone-or-Other's" to suddenly have the legal ability to refuse women the right to choose.

Or you could all miss the point completely and just debate on my anaolgy. Great.
posted by XQUZYPHYR at 8:55 PM on September 25, 2002

I would hope we can all agree that it would be morally indefensible to require a doctor who believes abortion is murder to perform abortions.

But that's a red herring because it's already the case that doctors can refuse to perform abortions on moral grounds. This is about allowing entire health care organizations to opt out. I think it makes sense to allow organizations which don't receive any federal funding to opt out. The question of whether a federally-funded health care organization can pick and choose which procedures they will allow is trickier, but I think it's open for some debate.

What I cannot defend is the idea that organizations would be allowed to refuse to even discuss options with patients. Whenever people in a position of authority are in the position of hiding information from people because of an ideological position, I think they've crossed the line into unethical behavior.
posted by Chanther at 8:56 PM on September 25, 2002

Actually, I think you guys may be missing the main point of this bill. I reiterate the important bit here:

"H.R. 4691 would allow hospitals to turn away women who need emergency abortions because they are hemorrhaging, experiencing heart failure, or suffering any one of a host of other grave complications of pregnancy. The bill would permit callous disregard for women's health despite federal and state laws that generally require hospitals to treat patients in medical emergencies."

Using Orwellian naming procedures, certain elements of our government are trying an end run around established liberties. Here is a link to the actual text of the House
Bill. Here is a link to the text of the Senate Bill. (PDF format) Here's the USC code that this bill is meant to abrogate. This google search will show you the various "right to life" groups that are fighting hard to pass this law.

Do I think the Catholic Bishops should be making American Law? Nope. Should women who are in dire need of medical attention get it? Yep.

What's so moral about letting a woman die?
posted by dejah420 at 8:57 PM on September 25, 2002

Maybe the "color of the curtains" remark was a little bit "trivializing", but I think that the point is that if you're in a public service position -- doctor, police officer, fire fighter, whatever -- your job (or, maybe better stated, duty) to provide services to people without discriminating should come before your own beliefs (be they about race, abortion, curtain color, etc.).

Obstetricians and gynecologists know when they choose to accept this line of work that abortion and birth control are going to be something that they are going to have to deal with in their daily working lives. If they don't want to have to provide those services or make those choices, then they can choose to become cardiologists or something.

By the way, when it comes to medical care, "That's freedom at work!" only applies to those who can afford to make choices about what doctor they see. This doesn't just mean choosing doctors, but finding a doctor that your insurance (if you have any) will work with, and/or finding one that's near enough for you to get to if you don't own a car, and finding a way to get to a doctor that has hours that don't completely conflict with your working schedule, etc. It's not always as simple as "just choose another doctor."
posted by dryad at 8:57 PM on September 25, 2002

Oh, and here is the Congressional sumary of the bill, which has been titled the "Abortion Non-Discrimination Act," which is a great name for a bill that specifically allows you to discriminate against the right to an abortion. Double-plus Ungood.

This bill also "Expands the definition of "health care entity" to include (in addition to physicians) other health professionals, a hospital, a provider sponsored organization, a health maintenance organization, a health insurance plan, and any other kind of health care facility, organization, or plan.

Essentially, this means that a hospital hiring a doctor specifically to fill their women's services position could not be turned down because of his refusal to perform women's services. Please explain how that make any fucking sense whatsoever.

On preview: thank you, Dryad. In response to Chanther, my point is that I do not "agree that it would be morally indefensible to require a doctor who believes abortion is murder to perform abortions." I agree that it would be morally indefensible to federally fund an essential public service that refuses to perform abortions en masse. If a doctor doesn't want to do it, it should be the hospital's obligations as a public service to use part of their federal funds to get a doctor in the area who is willing to do it, or provide the patient access to another hospital that does.
posted by XQUZYPHYR at 9:06 PM on September 25, 2002

This just makes me feel all the more determined to get the best possible grades and get into medical school. I would love to be the doctor that women knew they could turn to if they needed an abortion, since I believe that it is her decision to have that procedure. Do I favor abortion in general? No, but I do favor a woman's ability and right to make her own decision in the matter.
Also, I agree that the comparison to the color of curtains is not a good one. It would be more like a firefighter not saving someone from a burning building because they felt that the people in the house should not have lit the candle in the first place. No, that's not quite the right analogy either, but I can't think of that much of a better one at the moment.
On preview, what others have said about institutions denying help in medical emergencies or just in general is, in my opinion, not the way to run a medical establishment especially if it is run with public funds. also, what XQUZYPHYR said about the hiring policies of said medical establishments hiring doctors for women's services who will actually perform these services makes a lot of sense.
here's a link to an article on cnn's site about the bill.
posted by zorrine at 9:10 PM on September 25, 2002

When I wrote "I would hope we can all agree that it would be morally indefensible to require a doctor who believes abortion is murder to perform abortions," I didn't think it would be controversial. Clearly, reading XQUZYPHYR's response and other comments, I was incorrect in that assumption.

Even though I am pro-choice, I am not comfortable with the idea that doctors should be forced to perform abortions if their religious convictions lead them to the conclusion that it's murder. I am also not comfortable with the idea that the entire discipline of OB/GYN should be closed to someone who is anti-abortion.

On the other hand, I fully support the right of a hospital or other healthcare organization to only hire someone who is willing to perform the full range of procedures offered by the organization. I think it's legitimate for a hospital to refuse to hire a doctor who will not perform abortions, if abortion services would fall under that doctor's range of responsibilities. A doctor has a right to make his own moral choices, but there also may be consequences of those choices in terms of limiting one's employment options.
posted by Chanther at 9:12 PM on September 25, 2002

There are quite a few of us out here who would rather NOT go to a doc who also performs abortions.

I always get enraged at the pro-choice crowd when they talk about abortion for the "health of the mother". It is obvious they know-or choose to know-zip about modern obstetrics. There are almost NO scenarios which require killing the baby in order to save the mother. There are a few that would require delivering the baby at an early gestational age-which the baby may or may not survive depending on many factors. (an example would be eclampsia.) To my mind that is different from setting out to destroy a fetal child.

The only thing I can think of that comes close to the "endangering the mother" scenario is an ectopic pregnancy, which could not be brought anywhere near term no matter what anyway.

Isn't it ironic that people who bang the drum loudly about "right to choose" do not wish to give health care providers a choice?
posted by konolia at 9:24 PM on September 25, 2002

Look people, if you've got plaid curtains, then really...
posted by fuq at 9:24 PM on September 25, 2002

konolia: why would you want to go to a doctor who specifically does not perform abortions? would that make them a better doctor? also, more specifically, i am willing to give health care providers a choice, but i am also worried that the organizations hiring these health care providers will not think about the choice of the patient when hiring. as XQUZYPHYR has already stated, it is the responsibility of a publicly funded health care facility to make sure that all options are provided for as it is a legal operation.
posted by zorrine at 9:32 PM on September 25, 2002

konolia, a 1988 survey performed by the anti-abortion Alan Guttmacher Institute reports that "health of the mother" and "damage to the fetus" each make up around 3% each of reasons for abortions annually. Considering over one million abortions are performed annually, how is over 60,000 people frivilous? (Granted, the massive amounts of funding into abortion research and availability our government has provided over the last decade might have dropped those numbers. Har har.)

But what do I know, I'm one of the pro-choice crowd who obviously chooses to know nothing about modern obstetrics, only to be re-educated after seeing the links to all the credible statistical information you provided to state your highly supported and evidence-laden claim. Really.
posted by XQUZYPHYR at 9:46 PM on September 25, 2002

Funny about how the federal government is anti-abortion, but pro-death penalty.

And how the federal government is more concerned about the unborn than it is for adult worker's safety, what with the Bush budget proposal to rollback OSHA funding.

It's a government that's not even really concerned about living children, judging by its actions toward child care funding and pre-school education.

Wouldn't one want to see a specialist anyway? I wouldn't trust a GP to perform an abortion, nor would I expect a brain surgeon to be performing them.

If there's such a thing as a "general surgeon," then I expect them to do general procedures -- and if abortion were a general procedure, then they should be doing it. It's in their job description. If they don't want to do it, don't take the job.

One normally doesn't get to be picky about which parts of the job description one's going to perform...
posted by five fresh fish at 9:47 PM on September 25, 2002

Dryad, in the good ol' US of A being a doctor does not mean you are a public servant. That is why most doctors are involved in private practices.

That said, emergency medicine is a completely different story (guess I should have read the article better), and should be formalized (imo) and not subjective to the doctor's beliefs.

And as for my "that's freedom at work" comment, that was made partly tongue-in-cheek, since I find our health care system obscenely deficient.
posted by wolfgangnorton at 9:53 PM on September 25, 2002

Did anybody watch this debate today? I did, all of it. I was even one of those crazy CSPAN callers (never thought that would happen to me).

Abortion is a legal, medical procedure. If your morals don't allow you to perform it, but it is a requirement of your job, you should be fired. If I were a secretary and also a diehard animal rights person and I refused to work in an office with leather chairs do you think that the office should change it's decor or do you think I should get another job?

That being said, this was strictly election year fodder presented by the far right wing to please their lobbyists and the Christian Coalition. This bill is dead on arrival in the senate. The bill never even went to committee for mark-up. It had one hearing and the Republican Majority put it on the floor because it can. It is meant to enflame the far right and the far left and cause petty argument and give the Republicans material for their Election Ads.

If you don't want an abortion then you really shouldn't have one. Governments only role in legal medical procedures is to make it safe and see that the laws are enforced.
posted by bas67 at 9:57 PM on September 25, 2002

konolia: pregnancy/childbirth carries serious health risks, is potentially fatal, emotionally traumatic and causes permanent physical changes (any credible sources you can cite which say differently would be much appreciated). Someone who doesn't wish to undertake these risks shouldn't be forced to. I used to be a nurse, I'd like to think I know a bit more than "zip" about modern obstetrics.

I understand that some people feel abortion is murder, and that being a health care provider doesn't preclude that, but it makes me uncomfortable to think that someone could be denied access to a legal procedure simply because some doctor feels they have the right to force their personal morality onto someone in a vulnerable situation. If you're not prepared to perform abortions, then work in an area which won't require it of you.
posted by biscotti at 10:06 PM on September 25, 2002

What's even more funny is how the Christian right believe babies and children at tender and innocent ages go to their Christian rightwing heaven by default if they are killed early on in the line of American duty. Never will you hear it spoken about though. The abortion issue, obviously is a ploy to get poor and middleclass havenots onto the plank of support for everything else their their anti-democratic, corporate shill representatives do to them with the poisoning of their minds, planet and ability to ever take back what rights they sold to have abortion be the #1 rightwing underclass issue. It's the shell game being played somewhere behind the populist achilles heel.
posted by crasspastor at 10:10 PM on September 25, 2002

One normally doesn't get to be picky about which parts of the job description one's going to perform...

my cleaning service doesn't do windows. for that matter, neither does my sys admin... are we honestly saying that we want all doctors who are opposed to abortion out of the industry? that no group which opposes abortion should be allowed to run a free clinic?
posted by hob at 10:11 PM on September 25, 2002

I think the issue here that the legislation may be legitimately trying to protect is the health care institutions' right to free exercise of religion. If performing abortion is against your religious beliefs and you are forced by the government to perform abortions, that seems to me to be a pretty major violation of the spirit, if not the letter, of the first amendment. Obviously, hospitals are not individuals, but it seems to me that a religiously affiliated private hospital should be given some leeway here, since it does exist solely at the behest of the particular churches' members.

I suppose it's true that there is technically no first amendment violation because the government is simply making performance of abortion a precondition for receipt of public funds. However, in practice, no hospital in this country, public, private, non-profit, for-profit could survive without the money it gets from federal programs like Medicaid and Medicare. So, in practice, you are basically telling Catholic hospitals that they have to choose between abrogating their deepest-held beliefs (not to mention violating the Hippocratic Oath as they would understand it) or shut down. This hardly seems reasonable in a country that is supposed to protect the rights of religious groups to freely exercise their faiths.
posted by boltman at 10:13 PM on September 25, 2002

In regards to the above posters, to be a doctor or nurse is to agree to attend to the needs of the patient.

In the majority of obstetric and gynecological cases, the baby IS the patient the doctor or nurse to whom they are attending. While the pregnant mother is obviously looked after, they don't perform sonograms, amniocentesis scans, and so on for the mother's sake. It's to make sure the baby is healthy.

What I infer from this conversation:
- If the mother wants the pregnancy, it's a baby, and it's good and proper to look after the health of the child.
- If the mother doesn't want the pregnancy, it's little more than a lump of cells, and no one should interfere with your state-given right to vacuum it out of your uterus.

The way I see it, don't blame a healthcare professional if they're interested in protecting an organism you're determined to exterminate.

The Hippocratic Oath: "Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God."

Also, for the other side of the fence, "The Hippocratic Oath Today: Meaningless Relic or Invaluable Moral Guide?"
posted by Danelope at 10:16 PM on September 25, 2002

Kind of off topic, but I noticed this from Danelope's link:

"I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy."
--Original Hippocratic Oath

Interesting.
posted by boltman at 10:25 PM on September 25, 2002

Every couple months or so some abortion circumvention law heads for congress. I think the last one was involved stopping minors from leaving the state with a relative to get an abortion. The anti-abortionist crowd knows they will never, ever abolish abortion, but can make it a pain in the ass to get the procedure done. The real world effect in doing this means more desperate people finding underqualified physicians to do this or going the horrible DIY approach.

I don't care what a doctor's personal ethics are, if she's providing emergency care or is part of the local medical monopoly then she has no right to turn those in need away. I'd love to see a blacklist of doctors willing to violate their Hippocratic Oath because of their religious beliefs. Let's come clean about this and put all the names on a searchable list. Some good old transparency is a good thing. Lets see how many people decide to go with a GP who takes this position. Afterall, healthcare in the US is a privilege and a business, not a right.

I think crasspastor is right. Few in congress really give a shit about the abortion issue, but the right knows it can get some 'free' votes from the religious right by playing along. No surprise these kind of bills always get voted yea or nay by party affiliation.
posted by skallas at 10:26 PM on September 25, 2002

There is also the HMO issue. This bill will allow them to refuse to perform the procedure (not because of any moral reason but for the same reason they don't cover birth control pills -- it is costly and abortion can be problematic) and also it can prevent doctors or nurses from giving needed information and referrals to women in need of reproductive services. That is time consuming and everyone knows that if you work for an HMO you are on the clock. With this bill (that will go no where) the insurance companies would be allowed to instruct their doctors that way and would have no repercussions. I don't know if the insurance companies had a hand in this bill but I bet they wouldn't mind if it passed.
posted by bas67 at 10:26 PM on September 25, 2002

...the baby IS the patient...

Not really a logical argument. Both the mother and the child are patients. They may not perform sonograms etc. directly for the mother's sake, but that's simply because they can't assess the baby any other way, and because there'd be no point in doing them on the mother, since they don't tell you anything about her. There are numerous *other* tests performed to ensure that the mother is doing well (blood and urine tests, vital signs etc.).

don't blame a healthcare professional if they're interested in protecting an organism you're determined to exterminate.

Abortion is legal, one might reasonably expect any given OB/GYN to perform them, especially in an emergency. If you're not prepared to perform them, why not choose another specialty so that you may not wind up in the position of refusing healthcare to someone based on your opinion? I don't know that I have a real problem with there being "abortion-free clinics" or somesuch, mind you, but still it leaves a bad taste.
posted by biscotti at 10:30 PM on September 25, 2002

boltman, that part of the oath was evidently marginalized back in its time too. From Roe v. Wade:

Although the Oath is not mentioned in any of the principal briefs in this case or in Doe v. Bolton, post, p. 179, it represents the apex of the development of strict ethical concepts in medicine, and its influence endures to this day. Why did not the authority of Hippocrates dissuade abortion practice in his time and that of Rome? The late Dr. Edelstein provides us with a theory:(16) The Oath was not uncontested even in Hippocrates' day; only the Pythagorean school of philosophers frowned upon the related act of suicide. Most Greek thinkers, on the other hand, commended abortion, at least prior to viability. See Plato, Republic, V, 461; Aristotle, Politics, VII, 1335b 25. For the Pythagoreans, however, it was a matter of dogma. For them the embryo was animate from the moment of conception, and abortion meant destruction of a living being. The abortion clause of the Oath, therefore, "echoes Pythagorean doctrines," [p132] and "[i]n no other stratum of Greek opinion were such views held or proposed in the same spirit of uncompromising austerity."

Dr. Edelstein then concludes that the Oath originated in a group representing only a small segment of Greek opinion and that it certainly was not accepted by all ancient physicians. He points out that medical writings down to Galen (A. D. 130-200) "give evidence of the violation of almost every one of its injunctions."(18) But with the end of antiquity a decided change took place. Resistance against suicide and against abortion became common. The Oath came to be popular. The emerging teachings of Christianity were in agreement with the Pythagorean ethic. The Oath "became the nucleus of all medical ethics" and "was applauded as the embodiment of truth." Thus, suggests Dr. Edelstein, it is "a Pythagorean manifesto and not the expression of an absolute standard of medical conduct."

posted by skallas at 10:34 PM on September 25, 2002

Hah! I've been waiting for this since the DAY ASHCROFT WAS APPOINTED! Hilarious!
posted by zekinskia at 10:38 PM on September 25, 2002

I see a lot of posts here assuming you have to be religious (or Christian) to consider abortion murder.

I'm not religious -- at best you'd be able to call me agnostic. I do believe, though, that abortion is murder. I base this on personal experiences (which I won't detail here) and a scientific belief that babies growing inside a mother will develop into humans, and, IMHO, this equates with murder.

It seems the pro-choice side likes to use religious extermism as a label for pro-lifers. It's wrong, demeaning, and insulting to those of us who are not religious, and at best, inconsiderate to those who are religious.

Were I a doctor, I would refuse any abortions, excepting those done for serious emergency reasons. And, even before this bill, I'd put my job on the line before I take a life because a stupid couple can't keep it in their pants or cover it up properly.
posted by shepd at 10:49 PM on September 25, 2002

bas67, what HMOs do you know of that pay for abortions now or allow doctors to bill them specifically for providing information about abortion to a patient?
posted by boltman at 10:59 PM on September 25, 2002

"Abortion is murder but it's murder in self-defense."

-- Ivan Stang
posted by pandaharma at 11:02 PM on September 25, 2002

Okay, this is really simple: Doctors are not forced to perform abortions, they do it because it is their job. A doctor who performs abortions probably knew what line of work they were entering. I don't know who came up with that one, but just think about it people. Doctors who are religious enough to object to abortion are free to find other jobs in the medical field, like making sure a prisoner is dead after being electrocuted. That's freedom at work.

that being said, bas67 has hit it right on the head - this is a republican election season ploy (since they can't talk about their wonderful genius ideas about the economy.)

Here's some logic for you: Being a part-time bartender it has long been stressed to me that I am not allowed to deny a pregnant woman service. If a obviously pregnant woman toddles her way up to my bar and asks for a jack and coke I have to give a jack and coke. If I deny her, I could be sued for discrimination. This is a federal law I have to follow and I have no choice in the matter. (This actually happens.) But if I were a doctor, under this bill, I could deny an abortion because of my own moral views. Hmmmmmmmm....
posted by elwoodwiles at 11:07 PM on September 25, 2002

re we honestly saying that we want all doctors who are opposed to abortion out of the industry? that no group which opposes abortion should be allowed to run a free clinic?

...

Yes. YES!

This argument is logically identical to the argument that civil unions should be rescinded in Vermont because they violate the moral beliefs of some of the clerks who have to grant the licenses. If you don't feel yourself capable of performing the tasks your job requires of you, quit. Or wait until you're fired. If you demand that other people's established legal rights be revoked because of your own opinions, you deserve nothing but professional scorn and censure by your colleagues and superiors.

We aren't prepared to let Jehovah's Witnesses work in pharmacology, so we shouldn't be prepared to let pro-lifers work in gynecology. They are by definition unqualified for the job.
posted by Epenthesis at 11:10 PM on September 25, 2002

I believe our friend's analogy is an apt one. Physicians must leave their personal moral judgments behind when treating patients, and indeed are required to do so on a daily basis.

While the pregnant mother is obviously looked after, they don't perform sonograms, amniocentesis scans, and so on for the mother's sake. It's to make sure the baby is healthy.

Sonograms are done for the benefit of both mother and child. They can detect such worrisome conditons as placenta previa, which if undiagnosed may definitely affect the health of mom. As was previously noted in the thread, good prenatal care benefits both baby and mother.

I do believe, though, that abortion is murder. I base this on personal experiences (which I won't detail here) and a scientific belief that babies growing inside a mother will develop into humans, and, IMHO, this equates with murder.

I hate to alarm you, but over the next few years you are going to be faced with the disconcerting realization that epithelial cells scraped out of your cheek with a toothbrush have the same capacity for development into a human as any present day zygote. You might want to think now about whether you'll cry "murder" at those of us who practice rigorous dental hygiene, and whether you'll ask dentists to keep out of patient's mouths except for "serious emergency reasons."
posted by fold_and_mutilate at 11:20 PM on September 25, 2002

You're assuming one has to be dead set against the Christian right's agenda to not see abortion for what it is shepd. Abortion is far less an appealing solution than contraceptives or abstinence in financial or age related birthing-of-baby hardships. Nobody actually admires the act of aborting a baby. Indeed, you're right, it is murder. It's horrible, it sucks, it's yucky and its emotionally and physically painful. Nobody likes it. Nobody.

But (cliche time), sex is going to occur in the damndest of circumstances and at the least opportune of age, therefore so will pregnancy. Ice Cube I think had a song on his first solo album where he explicitly announced that after he'd gotten a woman pregnant "He'd kick the bitch in the tummy". How's that for reality? As a woman, how perhaps, would you feel in that situation? And really that's what it all comes down to. The women.

A boy sticks his dick in, does his deed and is more or less traditionally absconded from any further responsibility, should he be a dick himself (all too many are). The female is stuck not only in the connundrum of having to live in a society where in order to fulfill her very human aspirations she must be able to compete and run with the boys, but must also deal with the personal emotional tragedy of unwanted pregnancy and/or abortion. As a society that cherishes its boys and girls equally we must allow that females also have the "way out", that boys already have built-in. To not do that would be a return to state sanctioned misogyny and an implicit slavery of women by the men who merely must endure the occasionally uncomfortable wet spot in his boxers.

Sex ed beginning at an early age is great too. But we know how the christian right feels about that. It should be automatic, it is for me. Want to have sex? Throw on the jimmyhat.
posted by crasspastor at 11:23 PM on September 25, 2002

....While the pregnant mother is obviously looked after, they don't perform sonograms, amniocentesis scans, and so on for the mother's sake. It's to make sure the baby is healthy....- boltman

Been pregnant a lot have ya? Spent all the time in the regular visits that I have in the last 7.5 months? Taken all those blood tests, visited the bathroom dozens of times for samples, drank the nasty orange stuff, sat through all the physical exams, the being stuck with huge needles, the doppler studies, the sonograms, have you?

I can guarantee you that many of the tests that were done were to assure that *I* was doing well. Unlike you, my doctors consider me something more than a container around a fetus...they seem to think the mother is pretty important too. Thank goodness.
posted by dejah420 at 11:30 PM on September 25, 2002

I feel compelled to echo shepd's remarks. While I was raised Catholic, I've not been religious for quite a long time. But I still believe that abortion is wrong.

My reasoning is quite simple: I equate a partially-formed (or fully-formed but still unviable) baby with any other helpless human which relies on outside assistance for survival. This encompasses, for example, the seriously retarded, quadriplegics, congenitally joined twins, and people living with incapacitating diseases such as serious Alzheimers. Or, perhaps even more closely applicable, people on life support awaiting scheduled organ transplants.

The primary argument I've always heard for abortion is the fact that it affects the mother both physically and mentally. I'd like to posit for a moment that whomever a disabled person or a person on life support is a dependent of is affected in very similar ways. They are required to nourish and care for the other person. There are commitments of both time and money required.

But these are much the same commitments which are required of a mother - limitations on mobility as well as financial, physical, and mental effects. We don't consider killing these people just because it would be easier on us, though.

Babies are dependent on their mothers until they can breathe and take nourishment via the mouth. If you have an organ recipient whose transplant is scheduled, it's the same situation. You know when the major obligation to that person will be fulfilled. At that point the transplantee can be expected to be much less dependent on others. And at birth, a baby will no longer be directly dependent on its mother, and can be immediately put up for adoption.

If it's okay to kill partially-formed baby which will very likely be viable within a known time period, what's wrong with killing the organ recipient deliberately if they are a burden?
posted by gkostolny at 11:31 PM on September 25, 2002

are much the same commitments which are required of a mother - limitations on mobility as well as financial, physical, and mental effects. We don't consider killing these people just because it would be easier on us, though.

Your argument fails when you shift from talking about "the mother" to talking about "us." Society is surely capable of taking care of most people who can't take care of themselves. One individual may not be.

If every person in each of the groups you identify depended on exactly one person for his or her survival, I wouldn't insist that they be kept alive either...at least, not until society is willing to relieve virtually all of that person's burden if he or she is unable or unwilling to assume it.
posted by Epenthesis at 11:50 PM on September 25, 2002

Goddamned disappearing HTML tags. I damn well quoted gkostolny's entire fourth paragraph.
posted by Epenthesis at 11:52 PM on September 25, 2002

This argument is logically identical to the argument that civil unions should be rescinded in Vermont because they violate the moral beliefs of some of the clerks who have to grant the licenses.

doctors are not civil servants. there are many professionals who will not take certain types of job, and many professional companies who will support their professionals in refusing to do so. i gave the above example of the housekeeper who does not do windows; i further give you the lawyer who does not do divorces... which does not in any way impinge on your right to obtain a divorce, through some other lawyer.

at least, not until society is willing to relieve virtually all of that person's burden if he or she is unable or unwilling to assume it.

Are you saying that it would be OK do ban abortion provided that we as a nation were willing to guarantee every child three hots and a cot?
posted by hob at 12:19 AM on September 26, 2002

Isn't that something? Yes Dr. Smith I know your one of the best damn doctors out there, but we don't care about your freedom to practice your gonna perform abortions against your will and religous beliefs. If you don't you will lose federal funding and the hundreds of patients that depend on you and federal funding will lose out becuase your unwilling to perform abortions against your will.

Why so many people here on MeFi love the state so much, I will never understand.

-Z
posted by ZupanGOD at 12:21 AM on September 26, 2002

fold_and_mutilate: You might want to think now about whether you'll cry "murder" ...

lots of interesting changes coming which will, yet again, totally redo the landscape of what we're arguing about :)

the thing is, even if you could make a human being out of dirt you have to draw a line at some point and say, "OK, beyond here it's not all right to kill this thing." we do want to keep murder illegal, right? meaning we have to be able to draw a line between living and not living, human and not human. i am simply not convinced that "at birth" is the only, or indeed the best, place for that line to be drawn.
posted by hob at 12:30 AM on September 26, 2002

Actually the state hinders a would-be Ice Cube from going "blam" and no more ZupanGOD. The state (cliche time) of and by the people is a good thing. It's when we get into special legal appropriations given to representatives of the religious right and the conglomerating effect of said corporate contributions is when the idea of a state that works to better its citizens lives begins to break down. The equalizer is The State, as it has been the rule of the land clambered to by so many immigrants (read minorities) heretofore. Minorities rights are protected in a decent and constitutionally ruled democracy. It is a minority of women who ever have abortions.

Why so many people here on MeFi love the state so much, I will never understand.

Ho hum Mr. Martyr. Your state obviously ain't the state I wish to preserve.
posted by crasspastor at 12:49 AM on September 26, 2002

I think the issue here that the legislation may be legitimately trying to protect is the health care institutions' right to free exercise of religion.

Institutions don't have rights; only individuals do.
posted by rushmc at 12:57 AM on September 26, 2002

7?
?3? you want to go to a doctor who specifically does not perform abortions?

Is this a serious question? If a person is of the belief that abortion is an act of murder, why would they put themselves and their unborn child into the hands of a murderer for care? That's a big duh in my book.

With regard to the bill, I have gone on record before in favor of conscience exemptions for all healthcare providers, regardless of status, in the case of elective terminations. I do not believe that any individual should be compelled - by government or an employer - to take part in a situation which is morally repugnant to them. That said, it seems that this proposed change flies directly in the face of existing laws which prevent hospitals from refusing to treat emergent cases.

I wonder, though, how many would actually choose to do so, or have even hinted that they might? Only the most zealous within the pro-life community refuse to draw a sharp distinction between elective and non-elective abortion procedures. I've never met any normal person who claims pro-life beliefs who wouldn't agree that there are instances in which there is just no other choice, and while they (and I) would hope that other options are exhausted first, abortion should not be completely disregarded as an available remedy when pregnancy will cost a woman her life.

Is there really a legitimate reason to fear that a large number of trained medical professionals and administrators who don't draw that line, and given the green light would throw their aspiration machines into the nearest dumpster and forget that anyone in the building ever knew how to use one?
posted by Dreama at 1:52 AM on September 26, 2002

I'm somewhat stunned that so many of the first amendment types around here suddenly think that the state has the right to require that anyone who enters the OB/GYN specialty of medicine perform an act which their conscience tells them is murder. Despite my belief that abortion must remain safe and legal, I'm not comfortable putting that kind of power in the hands of the state. Now organizations - yes, I'm prepared to say they must provide abortion services if they receive federal funding.

A physician who refuses to perform abortions may limit his employment opportunities. He may end up only being able to practice medicine at small healthcare organizations which receive no federal funding and which share his views. He may have a niche market of patients for whom that is a primary consideration.

But for the government to tell him he may not practice OB/GYN, ever? I'm finding that some people have trouble supporting the first amendment when the threatened freedom isn't in line with their own personal convictions.
posted by Chanther at 4:22 AM on September 26, 2002

Chanther, this has absolutely nothing to do with the First Amendment. What does wanting to perform an abortion or not have to do with free speech? No one is telling a doctor they can't express their disapproval. Doctors give advice to patients all the time that is routinely ignored. That doesn't give them the freedom to not have to do their job if asked.

Besides, seeing how the majority of the doctors would oppose abortion for religious purposes, wouldn't the first amendment require them to keep their moral centers at home when they go off to their government-funded jobs?
posted by XQUZYPHYR at 5:18 AM on September 26, 2002

"Thank you for calling Aetna -- how may I help you?"
"I have a problem... er... you know... down there. What can I do?"
"That sounds like a sexually transmitted disease. We at Aetna are morally opposed to fornication. So we won't give you any information."
"My doctor says that I have to take acyclovir."
"Ooh. That's an anti-herpes medication. You're not covered."
"But my doctor says it's really important!"
"Sorry. You're a fornicator, and you're paying the penalty. We are not morally responsible. You can always choose another healthcare company."
"But you're the only one my job carries! You're the only one I can afford! And even if I did switch carriers, I wouldn't be covered as it's now a pre-existing condition."
"Sorry. You're out of luck, you dirty, dirty slut."
posted by ptermit at 5:24 AM on September 26, 2002

At least this will never become law, so that's something....

I find it interesting that the Republicans have taken the exact wording of an equal rights bill (also stuck in the House)--
the Employment Non-Discrimination Act...
to name the "Abortion Non-Discrimination Act" ...

Where one would prevent discrimination in hiring, the other would allow doctors and health care orgs. to discriminate against patients...
posted by amberglow at 5:39 AM on September 26, 2002

Besides, seeing how the majority of the doctors would oppose abortion for religious purposes, wouldn't the first amendment require them to keep their moral centers at home when they go off to their government-funded jobs?

Exactly. If there's anything you find that's morally reprehensible about your job, you shouldn't be doing that job in the first place. I think doctors know exactly what they're getting into, especially after 8 years of med school. If they believe abortion is murder then they should be in a medical field where they don't have to deal with it. If I found myself in the need of getting an abortion (which is highly unlikely cuz I'm a guy) I'll be damned if I couldn't get one because my doctor was riding his moral high ground. It's the woman's choice, bottom line.

By the way, a fetus is not a human being, it's a group of little congregated cells. You're not a human until you're in my phone book.
/Bill Hicks
posted by spungfoo at 5:47 AM on September 26, 2002

XQUZYPHYR, as i said above, it's not free speech that's implicated but free expression of religion. also explicitly guaranteed by the first amendment.

spunfoo, by your logic, abortion is fine up until the moment of birth. how is that meaningfully different then infanticide?
posted by boltman at 6:11 AM on September 26, 2002

er, sorry, that's free excercise of religion
posted by boltman at 6:25 AM on September 26, 2002

My only concern with this discussion is the believe that OB/GYN, as a practice, **MUST**include abortion. It would seem to me that a doctor, after learning to be an OB/GYN, could elect to have an abortion-free practice. She could even have connection, and employment, from hospitals that receive medicare/medicade funding. She could adamantly refuse to do an abortion, even in emergencies. This might even be acceptable to her employers, if there is a need for the services she will provide in that area.

HOWEVER -- It would be the obligation of the doctor to insure the health of the womb-owner (I didn't want to use "Mother", as it is too charged in this argument). If that means that other doctors in the practice CAN do abortions, or that privledges at the selected hospital allow use of local doctors that can provide the procedure, so be it. My wife had an abortion (we're both pro-life-choice) so I know it is necessary sometimes. The doctor should be able to handle this issue, even if she doesn't do the procedure herself.

It is her choice what services she provides. Just as you can't make me work on an HP machine (and, if they buy one here and try to make it part of my job I'll balk at it until they back down or fire me) you shouldn't be allowed to force a private citizen to do things they find repugnant, even if they accept your money for other services they DO provide. It's not a matter of "pick another profession" for the doctor, but instead "pick a different doctor, clinic, or hospital" for the patient. That, or "pick a better condom" to attempt to avoid the issue in the first place.

That said -- Hospitals, HMOs, and whatever else that accept funds SPECIFICALLY FOR OB/GYN SERVICES from Medicade/Medicare should be required to have someone on staff that will provide services at all levels. And, if they have to pay extra to get someone willing to come in to do it, that's their choice for offering the services, and taking the money. It's that simple. If the feds want to allow groups to not provide abortions, perhaps the funding should be adjusted so an entity can elect NOT to accept it for those areas. Then, the feds could provide a local clinic with all the saved OB/GYN funding, just for those clients.

Doctors shouldn't be required, but funded groups of doctors should be expected to include among their number someone who has no problem with the job.

Is that obfuscated enough? *grin*
posted by dwivian at 6:50 AM on September 26, 2002

Dwivian, you stated in excellent fashion what I have been developing in my head reading this whole argument.
posted by pjgulliver at 7:35 AM on September 26, 2002

crasspastor writes: Actually the
state hinders a would-be Ice Cube from going "blam" and no more ZupanGOD.
The state (cliche time) of and by the people is a good thing. It's when
we get into special legal appropriations given to representatives of the
religious right and the conglomerating effect of said corporate contributions
is when the idea of a state that works to better its citizens lives begins
to break down. The equalizer is The State, as it has been the rule of the
land clambered to by so many immigrants (read minorities) heretofore. Minorities
rights are protected in a decent and constitutionally ruled democracy. It
is a minority of women who ever have abortions.



Who said anything about aboloshing the state entirely? I'm shocked
people here on Mefi are comming to the defense of the state over individual
rights in this case. I'm sure the governement appreciates the support.
<G>



-Z




posted by ZupanGOD at 7:37 AM on September 26, 2002

I'd like to posit for a moment that whomever a disabled person or a person on life support is a dependent of is affected in very similar ways. They are required to nourish and care for the other person. There are commitments of both time and money required.

The difference is that the mother is actually physically allowing for the life of the fetus. A mother of a newborn is like a person looking after someone disabled. A pregnant woman is much more incapacitated. She is the only one who can take on the duties given to her; she is responsible for the life of the fetus 24 hours a day. She cannot take a break and leave someone else to take care of it. Her actual physical body is literally made into a room for a potential being.

and that's the second part of the difference - a fetus is not capable of sensory perception, does not yet have a personality - yes, it's a unique possibility, but every time you have a period you're losing a unique possibility...

As for pythagoras's ruling against abortifacients, he also forbade his disciples to eat beans, because he believed beans had souls. And of course he was vegetarian - I do find it hard to see how someone could be against abortion and still eat animals...
posted by mdn at 7:38 AM on September 26, 2002

"Thank you for calling Aetna -- how may I help you?"

"Yes, I'd be prepared to start on Thursday... say, what types of medical coverage do you provide? Really. Just Aetna? Hmmm. What? Oh, yes, it is a problem, I'm afraid I have a moral issue with Aetna's policies..."

A doctor or company who will not provide a service which they feel to be immoral is staking their livelyhood on a moral point. If you disagree with their moral judgement, you should be at least as willing to stick up for your own ideals, right?

I do find it hard to see how someone could be against abortion and still eat animals...

An animal is not a person, and whether or not it is moral to kill and eat animals is a seperate question from whether or not it is moral to kill humans, and at what point humans become humans.
posted by hob at 8:01 AM on September 26, 2002

mdn, as you've said, and Epenthesis has above, it is true that the situations aren't identical. If they were, there wouldn't be a necessity for metaphor. Regardless, I think there are more similarities than there are differences.

As to your second contention, that a fetus is not capable of sensory perception, I would be extremely interested to know how you define "fetus". According to Merriam-Webster, a fetus is "...a developing human from usually three months after conception to birth." See m-w.com, for example.

Per that definition, and presumably per yours then, a baby cannot perceive sound, touch, pressure, etc until the moment they leave the mother's body. Is that actually what you're arguing? Because I can find you a massive amount of information demonstrating otherwise, if it's necessary beyond the obvious.
posted by gkostolny at 8:04 AM on September 26, 2002

mdn: a fetus is not capable of sensory perception

Hearing begins on the 22nd day of gestation (Anson & Donaldson, 1973: Gerber, 1977). Hearing is mostly formed by the 20th week (Eisenberg, 1969).

I can't find the study I read during my last kidlets buildout, but I remember that flashlights shined on the womb caused the fetus to move hands in front of eyes to block the light (or perhaps to play in it, who knows). Sense of touch (mothers push on elbows, and feel the baby kick back, etc) also are common.
posted by dwivian at 8:06 AM on September 26, 2002

hob: you should be at least as willing to stick up for your own ideals, right?

Yup. And, I pay full price for a particular doctor for my children, because his ethics don't allow him to join many popular insurance plans. It costs, but I believe him to be right his his position, and I will suck it up and pay for the best medical care I can get for my kids. I also wrote a polite nasty-letter to my insurance provider for holding to a policy that causes good doctors to reject their services.

His opinions that cause the problem? He believes in well-baby care rather than limiting checkups to when the baby is 105 degrees or in need of state-mandated immunizations.
posted by dwivian at 8:11 AM on September 26, 2002

This thread has turned into an abortion debate, but this law is really about more than that. It is an attempt to stem the tide of lawsuits stemming from mergers of Catholic and public hospitals across the country. When this happens, not only do the hospitals stop performing any abortions (most public hospitals that perform abortions only do so when there is a clear threat to the life of the mother), but also stop prescribing oral contraceptives, dispensing condoms, performing surgical sterilization on men and women, and do not honor any advance directives or living wills that conflict with the teachings of the church. To allow any religious organization this much say in public health is unaaceptable on so many levels that I don't know where to start.
posted by TedW at 8:34 AM on September 26, 2002

An animal is not a person, and whether or not it is moral to kill and eat animals is a seperate question from whether or not it is moral to kill humans, and at what point humans become humans.

Right, but why is it wrong to kill a person? Why can't those same criteria be applied to other species? If you're going to be so sentimental as to look out for a developing fetus at the expense of a woman's life (I mean in the sense of the trajectory thereof), how can you then kill actual full grown creatures just because you feel like a hamburger?

Per that definition, and presumably per yours then, a baby cannot perceive sound, touch, pressure, etc until the moment they leave the mother's body. Is that actually what you're arguing?

A fetus doesn't have a brain stem until about 22 weeks, so isn't capable of perception of any sort until then; there's no central processing unit. Abortions are legal until I think 25 weeks ? except in emergency situations. I didn't mean to argue about third trimesters. But, it is true that a baby has to learn how to perceive things - like blind people who have operations which allow them to see, the data isn't comprehensible in the beginning. The brain has to get used to the input and figure out how to organize it so that it's useful to the organism. In this sense, the difference between in the womb and out is dramatic. That's why babies who are three months premature still celebrate their birthdays when they actually arrived, not when they were due. Coming into the world is when they really started living. The time in the womb is for getting all those organs ready to be able to learn to perceive.

Anyway, we've probably all been through this argument before. I've got some thoughts here & here if anyone's interested.
posted by mdn at 11:51 AM on September 26, 2002

Oh my god, I think I'm living in the third world or something. Isn't it enough that America barely offers medical care to it's citizens that now we have to actually threaten the lives of those who we feel are less moral than the majority? Didn't we bomb some other nameless country for that? I know this may be a troll, but some of this makes me truely angry. The idea that religion is more important in a medical decision than science is so dark ages and backwards it's sickening. How did you people manage to get internet service from the caves you live in?
posted by elwoodwiles at 12:29 PM on September 26, 2002

ps: I'll do us all a favor and ignore abortion related threads.
posted by elwoodwiles at 12:30 PM on September 26, 2002

Let me get this straight. Some pro-choice advocates -- people who passionately believe in a woman's right to do anything she wishes with her own body, even if that means eliminating an incipient human life she started there by her own actions -- wants the government to REQUIRE everyone it funds to perform actions they would never choose to because they find morally reprehensible? Pro-choice is now the right to demand others do to womans body whatever she wishes?

And federal funding is no excuse. If you're upset because a government funded program allows individuals to make some choices you find morally wrong, put the shoe on the other foot: are moral objections really enough avoid funding for a government program? If so, all federal funding for abortions should cease.

It makes far more sense to allow -- within a program funded by a citizenry with widely diverse (hell, divergent) views on the subject -- accomodation for the individual diverse views of the doctors. If it makes sense for the federal government to be funding something as controversial as abortion at all.

Requiring doctors to "support choice" is just about as good as "War is peace" and "Ketchup is a vegetable". And here I was thinking the right had the market cornered on doublespeak.
posted by namespan at 12:40 PM on September 26, 2002

The idea that religion is more important in a medical decision than science is so dark ages and backwards it's sickening

barring the relatively rare cases where the life or health of the mother is at stake, how does the decision whether or not to abort a fetus have anything to do with science?

the abortion issue poses an serious and irresolveable epistomological problem: nobody can claim empirical knowledge of the metaphysical consequences of aborting a fetus. We can argue about whether a fetus is alive, whether it has a soul, but in the end it is merely a question of faith. some have faith that the spirit (our "soul") exists seperately from the body, some have faith that we are sacks of flesh and bone and that's it. Both arguments are plausible, and there is no concievable way to prove either side right. If the soul people are right, abortion is probably something pretty close to homocide. If the flesh and bones people are right, abortion is more like putting down a dog or a cat, or maybe even a goldfish.

If we are honest with ourselves, we have to admit that we can't know for sure which side is right. We can have opinions, even deeply held beliefs, but we can't claim anything close to empirical knowledge. Since the most crucial bit of information necessary for an intelligent policy decision is missing, the question becomes, should we as a society err on the side of preventing what may or may not be homocide or should we err on the side of protecting a somewhat less important but much more verifiable interest of the pregnant woman?

To me it seems like a pretty close call, but I tend to come out on the side of protecting the fetus because of the rather grim implications of aborting millions of possibly soul-endowed fetuses every year. however, because it is a balancing test, one can imagine designing a system that allows abortions in some cases (rape, incest, health/life of the mother, etc) in a somewhat principled way.
posted by boltman at 4:08 PM on September 26, 2002

i wrote a comment above (yes, it was a dull comment), and someone came to my site and bashed me for it telling me how annoying i am. sorry to be such a burden on you people who are just too cool...whoever you are
posted by prescribed life at 7:42 PM on September 26, 2002

On a very related note from today's NYT: The Bush administration issued final rules today allowing states to define a fetus as a child eligible for government-subsidized health care...

So while congress is voting to permit doctors and health care orgs to deny services, the administration is expanding the benefits available to the unborn...
posted by amberglow at 11:59 AM on September 28, 2002

amberglow: i don't understand. do you think it is a bad thing to offer free prenatal care to low income women?
posted by boltman at 7:09 PM on September 30, 2002

it's abssolutely a good thing to help low income women, boltman--but you don't need to declare a fetus a "child" to do that....if you want to help women, do that--Bush is using a lack of health care to try to push an anti-abortion agenda...
posted by amberglow at 7:20 PM on September 30, 2002

counting the fetus as a household member is advantageous because the income eligibility criteria for Medicaid and Childrens Health Insurance are set as percentages of the Federal Poverty Level, which itself varies based on the number of people living in the household. Counting the fetus as a household member effectively raises the income limit for the entire household, making it more likely that all the children in the household (born and unborn) will be eligible for free health insurance, not just the pregnant woman. There is no other way to accomplish this in an equally targeted way, short of dumping the entire regulatory scheme governing means tests, which is just not going to happen anytime soon.

The victory for the pro-life camp is entirely symbolic, while the gains for low-income families are concrete. Not a single woman will be denied an abortion because of this rule, while thousands of kids and pregnant women will likely get free health care. Incidently, many states have have counted the fetus as a person for medicaid eligibility for years, without any legal impact on abortion rights.
posted by boltman at 9:30 PM on September 30, 2002