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March 25, 2006
Eugenics movement in N. Korea
SEOUL (Reuters) - North Korea has no people with physical disabilities because they are killed almost as soon as they are born, a physician who defected from the communist state said on Wednesday.We've known for a long time about weirdness that is dictator Kim Jong-il. However ...Ri Kwang-chol, who fled to the South last year, told a forum of rights activists that the practice of killing newborns was widespread but denied he himself took part in it.
"There are no people with physical defects in North Korea," Ri told members of the New Right Union, which groups local activists and North Korean refugees.
He said babies born with physical disabilities were killed in infancy in hospitals or in homes and were quickly buried.
The practice is encouraged by the state, Ri said, as a way of purifying the masses and eliminating people who might be considered "different."
Will someone explain to me the difference of a few inches between this and partial-birth abortion?
Technorati: Abortion, North Korea
Posted by Darleen at March 25, 2006 10:43 AM
Comments
There isn't one. Which is why we have Princeton professors saying that we should be doing what the North Koreans are doing.
Posted by: gahrie at March 25, 2006 11:12 AM
Princeton Professors? Plural? Pshaw! Please, pal.
Will someone explain to me the difference of a few inches between this and partial-birth abortion?
I'm not sure what you mean by the term "partial birth abortion" - the term has been used by pro-lifers to refer to several different things. But for answering your question, I'll assume that you mean intact dilation & extraction (d&x) procedures.
1) A large proportion of intact d&x abortions are performed in cases where either the fetus is not viable (or has already died), or continuing the pregnancy would be a threat to the woman's health, or both. There are some real-life stories here.
2) Virtually all elective abortions in the US (including intact d&X abortions) are performed before the fetus has a working cerebral cortex. Without a cortex, a fetus has no ability to think or to feel emotions.
3) Frequently, intact d&x abortions are performed because that's the safest thing for the woman. The policy in Korea you describe has nothing to do with protecting women's health.
4) The Korean policy is Eugenics, which by definition is a choice made by governments. Allowing individual women to control their own reproduction is not eugenics.
Posted by: Ampersand at March 26, 2006 08:53 AM
Infanticide is widely practiced throughout most of Asia. In China children born deformed, and many girls are simply exposed or ignored till they die.
This sort of thing is not limited to Korea.
Horrific but not uncommon...
Posted by: Carl W. Goss at March 26, 2006 10:10 AM
Ampersand
IIRC in the Congressional hearings on D&X, not one case was presented in evidence where a woman's life was saved by D&X.
Indeed, the procedure, dialation and turning the fetus around so it can be delivered feet first, carries a significant risk of unrecoverable injury to the woman.
Small, but not unknown, are women who have D&X well past 24 weeks for no other reason that they would rather the baby be dead than be born. And there are doctors who will accomodate them, including the doctor who "invented" the procedure because too many late-term abortions done with saline had the embarrasing result of sometimes delivering a live infant.
D&X done on a stillborn or infant incapatible with life is not an ethical concern of mine. Doing it on viable, healthy fetuses is.
This is NOT a matter of "reproductive rights." It's a matter of preventing infanticide.
Posted by: Darleen at March 26, 2006 10:22 AM
Darleen, what do you mean by "a woman's life was saved"? If you mean a case where no other procedure was possible, then no, no such case exists (although why pro-life legislators find it less objectionable if a fetus is killed by being torn limb from limb inside the womb is beyond me).
If you mean a case where a woman might have died if an abortion wasn't performed, and the doctor decided that a D&X was the safest procedure, then such cases were indeed presented at the Congressional hearings, and also in the various trials resulting from the "partial birth" abortion ban.
Indeed, the procedure, dialation and turning the fetus around so it can be delivered feet first, carries a significant risk of unrecoverable injury to the woman.
Any medical procedure carries some risk. However, as far as I know, the only comparative study of D&X versus other procedures published in a legitimate peer-reviewed medical journal found that severe complications occurred more often with other procedures, despite the fact that D&X was typically performed later in pregnancy and thus would normally be expected to be more prone to complications. ("Dilation and evacuation at >20 weeks: Comparison of Operative techniques," published in 2004 in the American Journal of Obstet. & Gynecology)
Small, but not unknown, are women who have D&X well past 24 weeks for no other reason that they would rather the baby be dead than be born.
Let's say that's true (although you haven't presented any evidence). Let's also say, for the sake of argument, that such a late-term abortion would be illegitimate (although I don't think it would be). That still doesn't justify banning all intact D&X abortions.
There are drug addicts who misuse drugs that other patients legitimately need. Would you therefore ban the drug for all patients? Isn't that unfair for the patients with legitimate needs for the drug?
And there are doctors who will accomodate them, including the doctor who "invented" the procedure because too many late-term abortions done with saline had the embarrasing result of sometimes delivering a live infant.
Evidence? (Real evidence, that is, not links to pro-life sites.)
D&X done on a stillborn or infant incapatible with life is not an ethical concern of mine.
And yet I take it you supported the "partial birth" abortion ban, which would have banned D&X even in cases of fetuses incompatible with life, and even in cases of severe damage to the mother's health.
This is NOT a matter of "reproductive rights." It's a matter of preventing infanticide.
This assumes there's no difference between an infant and a fetus. But that's assuming what's at issue in the abortion debate; many people don't agree with your lack of distinction.
Posted by: Ampersand at March 26, 2006 11:09 AM
Oh... Ampersand
Fetal development of the cerebral cortex is present at 20-24 weeks gestational age. Since D&X is not ever performed in the first trimester and its use is pretty confined to fifth gestational month and beyond, when it is used on a healthy fetus, it is being used on a fetus that is not much different in brain development than a newborn.
Posted by: Darleen at March 26, 2006 11:15 AM
Ampersand
One of these days I'll have to take a trip into Los Angeles and see if I can search the LA Times morgue for an interview with the "inventor" of D&X that ran in the old LA Sunday Times Magazine in the late 1980's.
To this day -- the doctor (and I believe it was Dr. James McMahon, but I can't be sure, I just deduce that from googling) was quite candid on why he came up with the procedure and that he never questioned the motivations of the women, most whose fetuses were healthy and viable, on why they wanted a 3rd trimester abortion -- that interview haunts me. He wanted to spare doctors who did late-term abortions the embarrassment of ending up with a live infant.
And you know, there ARE saline-abortion survivors around.
I'm PRO-choice. I believe a single, adult woman within the first trimester should be able to seek an abortion without government interference.
But I don't support what is infanticide.
And in regards to drugs, we don't sell drugs without ANY regulation just because most people use them responsibly.
Posted by: Darleen at March 26, 2006 11:32 AM
Addendum
Do you see the pics I have posted of my grandsons? They were born six weeks early, indeed, their mom had gone into premature labor 3 weeks earlier at 31 wks gestation and we were prepared for them being born at that point (the doctors were able to stop her labor and she spent 3 weeks in a hospital bed until a C section)
There is NO significant difference between a 34 week fetus and a full term (40 wks) newborn. Birth, per se, is a mile stone, but not a significant event in an infant's development.
Posted by: Darleen at March 26, 2006 11:49 AM
Darleen, I'm glad to hear you're pro-choice for the first trimester; but in real life, not everyone even knows they're pregnant by the 12th week. Would you really ban abortion starting in the 13th week?
Regarding the cerebral cortex, it begins developing around the 20th week, but it's not functional. In particular, it’s not possible for there to be any thought or awareness before the emergence of pyramidal cell dendritic spines on neurons, which happens relatively abruptly at about the 28th week. Pre-dendritic spines, the cerebral cortex might as well be a pile of gray slush, in terms of how well it can actually function.
Once the dendritic spines are in place, does the fetus become a person that instant? I doubt it. I think a working cerebral cortex is a necessary condition of personhood (in human beings, anyhow - maybe Vulcans are different), but I don't think it's sufficient. Once a fetus has a fully working cerebral cortex, to some extent that's like having a blank hard drive; the hardware is all in place, but the data is still to come.
I'm sorry, but I just can't accept a half-remembered article as evidence. Either you can support your statements, or you can't.
James Haskell, who is often credited with developing the intact D&X procedure, and was definitely the first doctor to describe it in print (he also named it), describes why he developed the procedure in this interview (pdf file). He says he developed it because it was easier and quicker - which, as I'm sure you know, means better for the patient.
The saline procedure is much, much more dangerous for mothers. The complication rate for saline is 1.6%-3%, whereas for D&C it's under 1% - and D&X tends to be safer than D&C. Any responsible doctor should prefer the procedure that's safer for the patient.
And in regards to drugs, we don't sell drugs without ANY regulation just because most people use them responsibly.
Late-term abortions are not unregulated; they can only legally be performed by physicians.
Besides, you're dodging my question. It's a fact that for some women, a late-term abortion is medically necessary, and their doctors think that an intact D&X is the safest procedure for them. Is it fair to deny these women D&X abortions? Please answer the question instead of dodging it.
There is NO significant difference between a 34 week fetus and a full term (40 wks) newborn.
Of course there is. The difference is a woman. Being inside a woman is not the same as being born.
Besides, no one is performing elective abortions on 34 week fetuses. Like most people who favor banning D&X abortions, you refuse to talk about the reality, which is that the typical D&X abortion is performed before the 22nd week.
If the pro-life movement (and I know you're not part of that movement) really wanted to ban elective third-trimester abortions, they could have done so years ago, with support from the Democrats and a signature from President Clinton. (In fact, such a ban was proposed by democrats and shot down by republicans). It's telling that the actual "partial birth" abortion ban passed doesn't say a word about limiting itself to late-term abortions.
Posted by: Ampersand at March 26, 2006 12:58 PM
Ampersand
Being inside the woman IS the difference?
I was speaking of the infant his/herself. If the infant is viable then being inside or outside is irrelevant. There is no reason for a convenience abortion to be allowed at that point because the right of the viable infant outweighs the convenience to the woman.
It is VERY RARE that a woman would go into her 2nd trimester unaware of pregnancy. And I didn't say I would ban it, just that (ala Roe v Wade) that government regulation/restriction should be allowed when the state can demonstrate a compeling interest.
I'm not dodging any question. I think D&X should be banned for all but life of woman/infant incompatible with life issues. Period.
Since D&X sometimes takes 2 - 3 days, then any emergency "health" problem can use C-section to deliver a premie alive.
I'm sorry you think I'm offering up Dr. McMahon out of bad faith. I was being quite honest that, even as I'm pro-choice, I was quite appalled by the interview and those portions have always remained with me.
Abortion is thorny because it IS an attempt to balance interests between two individuals when they come into conflict..and one of those individuals is entirely dependent on the other for 6-7 months. It is NOT an either or situation. The mother's interest is paramount until such time the infant's right to life becomes evident with viability.
btw D&X is not recommended prior to 20-22 weeks gestation. It is specific to post 24 week gestation (up to 24 weeks abortion is allowed on-demand, no reasons needed, and advertised as such in just about any Yellow Pages).
The incidence of D&X is very small compared to all abortions. And I would suspect most of them are done for tragic AND VALID reasons. I have no problem with exempting those reasons from a ban.
But shall we NOT pretend that elective late-term abortions don't take place? By the CDC's own statistics the majority of abortions done past 21 weeks gestation occur for those under 20 years old. This is NOT the demographic of females prone to either birth defects or health problems related to pregnancy.
Yes, I think both extremes of the debate are self-defeating in their "gotcha" manueverings. But I believe reasonable people of good will CAN find common ground and agree there comes a point in a normal pregnancy where both female and fetus are healthy, and that the interests of the infant, when it becomes viable, outweighs the interests of the female (when such interests are not health/life related).
Life over convenience.
Posted by: Darleen at March 26, 2006 02:08 PM
I don't accuse you of "bad faith" regarding the interview you recall reading with someone years ago whose name you're not sure of. But I do think you're capable of error.
Already, in this discussion, you've said that there were no cases presented to Congress in which D&X abortion was a life-saving procedure - but that's a mistake on your part, as I already pointed out. (See the stuff from the congressional record quoted in the judge's decision I linked to earlier, for evidence). You've implied that D&X is less safe than other procedures, but the one scientific study that exists contradicts that view. You claimed that D&X was said by its creator to be created to make sure the fetus died, but I linked to an AMA interview in which the creator (who may or may not be the same person you're thinking of, since you couldn't remember the name for certain) clearly says he created D&X because it was a faster, easier procedure. And you were mistaken about when the cerebral cortex becomes functional.
I'm sure you're honest. But you're capable of making honest errors, just like I am, so both of us should have the burden of showing the sources for our factual claims, when they're challenged.
I think D&X should be banned for all but life of woman/infant incompatible with life issues. Period.
I don't understand this view. Why ban a particular procedure? If your concern is preventing "infanticide," then how is the world better if the "infant" is killed with a different procedure?
The fact is, Democrats in the Senate proposed banning elective late term abortions more than once; and that was rejected by Republicans, who preferred banning one procedure without any reference to terms. How does that make sense? The "Partial Birth" ban won't stop a single abortion, if it works the way Republicans claim it will work; it'll just force doctors to switch a slightly more dangerous abortion procedure.
Why do you think the world is a better place if we have exactly the same number of abortions, but a slightly higher number of women getting abortions will be injured?
But shall we NOT pretend that elective late-term abortions don't take place? By the CDC's own statistics the majority of abortions done past 21 weeks gestation occur for those under 20 years old.
I agree that some elective late-term abortions take place. However, the link you provided goes to a graph that describes who gets abortions past 15 weeks gestation, not past 21 weeks gestation. (And in any case, even if the graph was as you describe, it wouldn't prove anything - too many non-controlled variables.)
Since D&X sometimes takes 2 - 3 days, then any emergency "health" problem can use C-section to deliver a premie alive.
Since I admitted that elective late-term abortions happen, can you stop doing things like putting "health" in scare quotes? There are women with real health problems, and being sarcastic about it that fact, as if they're just pretending to have health problems, is not facing the reality of what you're asking of women.
As for C-sections, they're dangerous. "A cesarean delivery usually involves twice as much blood loss and, before thirty-four weeks of pregnancy, the lower segment of the uterus is usually too thick to use a standard horizontal incision, so a vertical incision is necessary. Any uterine incision complicates future pregnancy, but a vertical incision jeopardizes both the mother's health and future pregnancies, which would also require a cesarean."
"Twice as much blood loss" is not a minor thing - ask any surgeon how much difference the amount of blood loss can make to the patient's outcome. It trivializes the issues when you dismiss the desire to avoid major elective surgery (c-section before quite late in pregnancy is major surgery) as only a matter of "convenience."
Just to help me understand what you favor in practice, did you favor or oppose the Partial Birth Abortion Ban of 2003?
Posted by: Ampersand at March 26, 2006 04:06 PM
You've already made the distinction in the comments above, but the short answer is, as they say in real estate...
"Location, Location, Location"
Posted by: Strider at March 28, 2006 07:40 AM
What I find interesting here is that Amp claims that D and X is somehow safer than other late term abortion procedures yet provides not one wiff of evidence to back this claim up.
Amp is not being 100% accurate in how he describes the AJOG study. The study states, "Complications occurred in 19 cases (5.0%), and occurred with similar frequency in the 2 groups. We identified 62 subsequent pregnancies. There were no second-trimester miscarriages. Spontaneous preterm birth occurred in 2 of 17 (11.8%) pregnancies in the intact dilation and extraction group, compared with 2 of 45 (4.4%) in the dilation and evacuation group (P=.30)."
The link he provides to his own blog cites multiple assertions by professor of social ethics. The professor boldly asserts that a D and X is the safest option in some circumstances without providing a shred of evidence. Why would it be safer than a D and E?
It should also be noted that Martin Haskell's interview seems to indicate (at least to me) that a woman's health was not the main priority for his use of the technique - it seems more like Haskell was far more concerned with his time and how easy the abortion was on him.
The democrats who proposed the ban also included a "health" exception which we all should know by now means (according to Doe v. Bolton) whatever a woman can think of and an abortionist will agree to.
Posted by: Jivin J at March 30, 2006 11:40 AM
Amp is not being 100% accurate in how he describes the AJOG study.
I just reread the study, and I stand behind what I wrote. Did you read the study, or just the abstract?
Let's look at the substantial point at issue: I brought the study up to refute Darleen's unsupported claim that D&X is more dangerous than other abortion techniques. Even what you chose to quote from the abstract confirms that Darlene was mistaken, so you can't possibly be claiming I was mistaken about that central point. D&Xs are not more dangerous than other techniques.
Plenty of doctors have testified that there are circumstances under which they'd prefer to use a D&X because they consider it a safer method. A D&X requires many fewer passes of forceps or other surgical tools into the woman; since every single pass of an instrument increases the odds of a uterine tear, a technique that requires fewer passes is generally safer. (But it still depends on the particular doctor and patient; if the cervix isn't expanded enough, a D&X may not be possible, for example.)
Really, the burden of evidence should be on your side. There are doctors who feel that they can keep some patients safer by using D&X; shouldn't you have solid evidence before a bunch of (mostly) non-doctors in Congress intrudes into the doctor-patient relationship and overrules the doctors and the patients?
It should also be noted that Martin Haskell's interview seems to indicate (at least to me) that a woman's health was not the main priority for his use of the technique - it seems more like Haskell was far more concerned with his time and how easy the abortion was on him.
That still doesn't rescue Darlene's claim that the procedure was created just to kill fetuses. Nor does it change the fact that D&X is safer for the woman than the saline procedure Darlene compared it to.
But in any case, I think you're wrong. In a professional medical magazine, Haskell didn't bother explaining that, all else held equal, a shorter and easier procedure is better for the patient. If you're really so ignorant that you think that it makes no difference to patients how long or difficult procedures are, I can't help you. But you've once again proven that the pro-lifers who take it upon themselves to make women's health decisions for them haven't bothered to find out the first thing about the procedures they'd ban.
The democrats who proposed the ban also included a "health" exception which we all should know by now means (according to Doe v. Bolton) whatever a woman can think of and an abortionist will agree to.
Not true. One of the Democratic proposals overwhelmingly rejected by Republicans would have allowed late-term abortions only if two different doctors signed statements saying that not having an abortion would put her physical health in significant danger.
As for Doe v. Bolton, why not try to overturn it? Republicans proposed a lot of bans that they knew went against Supreme Court precedent, with the intention of challenging the precedents. But when it comes to reasonable protections for women's health, suddenly Republicans can't even dream of trying to challenge Doe v Bolton.
Basically, the Republicans had a choice in how they tried to overturn Supreme Court precedent: they could have said "let's craft a law calling for a health exception with strict standards, and we'll fight for it in the courts," or they could ahve said "let's craft a law which says that women who need an abortion for medical reasons have absolutely no standing unless they're at death's door, and we'll fight for it in the courts." And they chose the latter. How do you excuse that?
Posted by: Ampersand at March 31, 2006 02:50 AM
Ampersand
A quibble, I never said that D&X was worst than any other abortion technique. I was comparing D&X to BIRTH.
Infact, I only mentioned saline abortions as how they affect the unborn child...sometimes a child is born alive. Damn such an EMBARRASSMENT.
How does D&X compare to HAVING the child? Indeed, with 2-3 days of dialation, it IS comparable with birth in 3rd trimester abortions.
Let's face it, there has been a lot of posturing on both sides of the abortion debate that have little to do with moral concern for the fetus but with demonstrations of power.
As I attempted to say on Neil's column at Ezra's place, a fetus is ALWAYS a moral concern and the next step is where along the gestational age does that moral concern become compelling enough for the state to intervene?
MOST Americans believe that comes when the mother is a minor, the mother is married or the fetus is viable. MOST Americans don't want first trimester abortions banned.
Of course, I guess that means MOST Americans, are neither pro or anti abortion - they can equally be snarked at by the anti-side calling them immoral for killing babies and by the pro side for wanting to punish women for having sex.
Lovely.
Posted by: Darleen at March 31, 2006 05:58 AM
A quibble, I never said that D&X was worst than any other abortion technique. I was comparing D&X to BIRTH.
I apologize for misunderstanding you.
However, I'm pretty sure that D&X abortion is safer than birth, statistically. There's no evidence that D&X is less safe than other abortion techniques, and there's proportionately less maternal mortality associated with abortion than with birth.
Although of course it's up to you, I would really like it if you could explain why it's better to ban a certain abortion technique, than to ban all elective late-term abortions - which has been, in effect, the Republican party position ever since the Clinton years.
Reading through your archives, you're extremely disdainful of Democrats, but it seems to me that Democratic proposals to ban elective late-term abortion have been more consistent with your position than the "partial-birth" abortion ban is.
I don't agree that a fetus is always a moral concern. I'm sorry if that makes me seem cold, but if a fetus is unwanted, and doesn't yet have a working cerebral cortex, then I just don't see any basis for saying it's a moral concern. And even after the 28th week, just because it's a moral concern does not, in and of itself, establish the need for state intervention.
I certainly agree that most Americans are what I think of as "moderate pro-choicers," wanting abortion legal in some but not all circumstances, rather than being at my extreme (alas) or at the pro-life extreme (whew!).
Posted by: Ampersand at March 31, 2006 10:37 AM
Amp,
I read the article and the way you framed it, it seems your description wasn't 100% accurate. If you wanted to refute Darleen's point then you could have easily just said, "Here's the study which found that D and X and D and E had similiar complications rates so one isn't necessarily safer than the other." Instead, it seemed like you were trying to prove D and X is safer when there's nothing to back that up.
Sure, plenty of individuals who perform and D and X have testified and plenty of other doctors have testified refuting their scenarios. I think I remembering reading one individual (I think he was from San Franscisco) testifying about a certain scenario and then the other doctors testified how performing a D and X in that scenario would be exceptionally dangerous.
Doctor-patient relationship? Yeah, more like stranger-patient relationship. Plus, numerous experts have testified and from my perusal of the testimony I find the testimony of the non-abortionists to be much more reliable. Why is the burden on my side? D and X is a relatively new procedure (which pro-choice leaders lied about for years - doesn't exist, only a couple a years, only for the mother's health, the sedatives kill the child, etc.) which seems to have been invented to make it easier on the abortionist while D and E has been used for years.
Isn't every abortion procedure created to kill fetuses? Is there some abortion procedure which was invented to keep fetuses safe? I bet that abortionist isn't doing to well.
I'll ignore the "really ignorant" and "first thing" comments. Rather uncalled for I think. Aren't most women knocked out for the vast majority of late-term abortions? I'm sure the patient would care how long the procedure is regardless but Haskell didn't seem to factor in the patient. It seemed much more about him and what worked best for him.
What was the proposal's text? Do you have a link to it or more information on it? I can still see why prolife congressmen and women would be worried about that since many abortion facilities that perform late term abortions have two abortionists.
Regarding Doe, maybe they should try. That's a good idea.
Death's door? That's a little dramatic, no? The women could still have a range of different abortion procedures performed. It's not like D and X is some amazing technique that is the only procedure which can help women suffering from certain maladies.
Posted by: Jivin J at March 31, 2006 12:14 PM
Amp,
Out of curiousity, what about an unwanted born child (say 23-24 weeks) whose celebral cortex isn't yet functioning to the level you find revelant?
Is there a moral concern for that child in your opinion?
Posted by: Jivin J at March 31, 2006 12:23 PM
I read the article and the way you framed it, it seems your description wasn't 100% accurate.
Every word I wrote was accurate. I think you need to apologize, or you need to directly quote something I said that was factually untrue. That you keep on accusing me of lying, while being unwilling to back up your accusation with facts, is making me feel as if you're not treating me in a respectful or fair fashion. If I were a pro-lifer, I doubt you'd feel free to accuse me of lying without being able to back up the statement with an actual example of me lying.
Doctor-patient relationship? Yeah, more like stranger-patient relationship.
No, a stranger-patient relationship is the relationship between you and a woman in New Jersey who wants a D&X because she considers it a tragedy that her fetus has problems that make childbirth unviable, and she wants a technique that will leave her and her husband with a relatively intact corpse to bury and mourn. You don't know her, but you think you should be able to dictate her medical care to her, regardless of her own preferences.
Her doctor is someone she has a chance to meet and talk to, most likely at the recommendation of another doctor that she can also talk to. She can ask questions. She can decide to refuse the procedure. Yes, she doesn't know the doctor who performs the procedure well, any more than someone getting a hearing aid necessarily knows the audiologist well. But there's still a huge difference between having your medical care decided on through consultation with a doctor, and having your medical care decided on by pro-lifers who have never met you. That you don't see this difference doesn't convince me that you're approaching this issue with any appreciation for what's at stake.
Why is the burden on my side?
Because we live in a free country, in which the default state for medical care is that doctors decide what is legitimate care, and patients are free to choose their care in consultation with their doctors. Since you want to move away from that default state, the burden of evidence is on you.
Isn't every abortion procedure created to kill fetuses?
Pro-choicers call this style of argument "woman? What woman?" A lot of pro-life arguments in effect pretend that the woman doesn't exist.
To answer your question: No, because (in the medical literature, if not the pro-life rhetoric) abortion techniques can be performed on either living or dead fetuses. Killing the fetus is a side effect of terminating the pregnancy in the safest way possible for the woman. For instance, in D&X (which is what we're discussing) compressing the head is necessary to protect the woman's health.
Regarding Haskall's interview, we don't - or shouldn't - decide medical questions based on what we think the inventor's intention was. We should decide them based on what's best for patients. And there's no legitimate doubt that, all else held equal, patients are better off with quicker and easier procedures; and if they're unconscious, they're better off if they don't have to kept under as long.
So I consider the question of what Haskall meant to be almost entirely without substance. In the end, there's two ways of interpreting Haskall's interview.
1) When he said that some of the D&Cs he did were very easy and quick, and the D&X technique allowed him to make this the case for 99% of patients, the unstated conclusion was "which is much better for the patient."
2) When he said that some of the D&Cs he did were very easy and quick, and the D&X technique allowed him to make this the case for 99% of patients, the unstated conclusion was "which is great because I'm in a hurry to get to the golf course."
There's really no internal evidence to support either 1 or 2. If you want to give folks the normal benefit of the doubt, you think #1 is true. If you want to demonize pro-choicers, then you think #2 is true. There's really nothing more to this disagreement than that.
I can still see why prolife congressmen and women would be worried about that since many abortion facilities that perform late term abortions have two abortionists.
So you're saying that all abortionists are liars? That's typical. Nonetheless, unless you think that abortionists are unable to rationally, it would be easy enough to write penalties for lying into the law, so that even those Evil Evil Abortionists would be motivated to tell the truth.
Tell me, do you feel concern for women who have genuine medical problems requiring a late-term abortion? I'll assume you'll say "yes, I do." So my next question is, assuming that you favor banning late-term abortions, how do you propose to protect such women's interests, legally?
What was the proposal's text?
It's as follows. There's a lot of legal stuff I've omitted, this is just the important bits; but you can read the whole thing by going to Thomas.gov and searching around for amendment 1531 in 1999. (Or you can try this link, but I don't think it'll work - Thomas doesn't usually create persistent links).
§1531. Prohibition of Post-Viability Abortions.``(a) IN GENERAL.--It shall be unlawful for a physician to intentionally abort a viable fetus unless the physician prior to performing the abortion--
``(1) certifies in writing that, in the physician's medical judgment based on the particular facts of the case before the physician, the continuation of the pregnancy would threaten the mother's life or risk grievous injury to her physical health; and
``(2) an independent physician who will not perform nor be present at the abortion and who was not previously involved in the treatment of the mother certifies in writing that, in his or her medical judgment based on the particular facts of the case, the continuation of the pregnancy would threaten the mother's life or risk grievous injury to her physical health.
``(b) NO CONSPIRACY.--No woman who has had an abortion after fetal viability may be prosecuted under this chapter for conspiring to violate this chapter or for an offense under section 2, 3, 4, or 1512 of title 18.
``(c) MEDICAL EMERGENCY EXCEPTION.--The certification requirements contained in subsection (a) shall not apply when, in the medical judgment of the physician performing the abortion based on the particular facts of the case before the physician, there exists a medical emergency. In such a case, however, after the abortion has been completed the physician who performed the abortion shall certify in writing the specific medical condition which formed the basis for determining that a medical emergency existed.
And, from later in the bill:
``(A) IN GENERAL.--The term `grievous injury' means--``(i) a severely debilitating disease or impairment specifically caused or exacerbated by the pregnancy; or
``(ii) an inability to provide necessary treatment for a life-threatening condition.
``(B) LIMITATION.--The term `grievous injury' does not include any condition that is not medically diagnosable or any condition for which termination of the pregnancy is not medically indicated.
Regarding Doe, maybe they should try. That's a good idea.
But it won't happen, because you know as well as I do that the pro-life lobby will never, ever put their weight behind such a proposal. In fact, they overwhelmingly opposed the bill I quoted above.
As for "death's door," I agree it's a little purple, but it's an accurate description of a bill which includes exceptions only to protect the life of the woman, but never her health.
Finally, regarding a 23-24 week born fetus, I think we have a moral interest in protecting her life because of the huge emotional and physical investment her parents have put into her.
But if there was a "burning building" scenario - giving me the choice between rescuing three 23 week preterms or a single two-year-old - I'd rescue the two-year-old, no question. The life of someone with a developed cortex is more valuable than the life of a being without higher brain functions.
Posted by: Ampersand at March 31, 2006 02:05 PM
A couple more points:
First, I should mention that the bill did contain an exception allowing states to pass their own laws. So it would have only applied in those states that did not pass their own post-viability abortion legislation.
Second, the bill did provide penalties, including loss of medical license, for doctors who broke the law.
Third, I've put the entire text of the bill on my own website, here, so you can read it without having to go through Thomas. (I don't know why I didn't think of that in the first place).
Posted by: Ampersand at March 31, 2006 02:15 PM
Amp,
I never accused you of lying. Please cite where I used the word liar, lying, lie, etc. I said you weren't being 100% accurate. You stated, "However, as far as I know, the only comparative study of D&X versus other procedures published in a legitimate peer-reviewed medical journal found that severe complications occurred more often with other procedures, despite the fact that D&X was typically performed later in pregnancy and thus would normally be expected to be more prone to complications" - this statement leaves out the fact that the rates of complications for the study were described as similar (with the D and E being less by a ridiculously small margin). You also left out the fact that women who had D and X abortions had a higher rate of preterm delivery on subsequent pregnancies.
You also stated, "Frequently, intact d&x abortions are performed because that's the safest thing for the woman" - something which you've provided no evidence for. You basically seemed to be painting a rosy picture of D and X compared to D and E yet the study doesn't necessarily back you up. My statement was more based on how a bunch of information from the study was left out in your description of it. For example, if person A was arguing for the repeal of drug laws and mentioned a study that found something which supported his case but then left out everything which didn't support his case, I'd usually label that not being 100% accurate. Now maybe your intent wasn't deceptive, heck, I have no clue - but citing a study a providing one fact from it while ignoring the other pertinent facts seems less than 100% accurate.
"Woman, what woman?" - "Fetus hanging more than halfway out of her mother, what fetus fetus hanging more than halfway out of her mother?" I recognize perfectly well that a woman is involved in abortion just as you recognize that a fetus is involved. We just disagree over whether one has the right to have the other most delivered before the other is killed.
I didn't say that all abortionists are liars. It's just seems fairly easy for a prolife congressperson to assume that if two abortionists are working under the same roof or have some kind of working relationship that they could both say it was medically necessary because they'd usually perform that type of abortion procedure.
Thanks for posting the text of the legislation. Why didn't Durbin and the others put this legislation forward as something that wasn't a replacement amendment? Aren't most D and X performed prior to viability? So this legislation wouldn't have effected them? What I really wonder about is if this legislation was introduced today, who would support it? And would it be challenged because it's definition of health differs from Doe?
Regarding my hypothetical - what if the parents don't want the child or they want the child dead. Wouldn't their huge emotional and physical investment be void if they don't want the child to live? Haven't women and men who aborted 24-week old fetuses had similiar emotional and physical investment?
Posted by: Jivin J at April 3, 2006 01:09 PM
I'd also note that a D and X is a longer procedure than a D and E. From what I've read the dilation period is usually 2 days for a D and X while the dilation period for a D and E is usually around one.
And I forgot one of your questions - yes I have genuine care for women who face medical problems during their pregnancy. But from the testimony of medical experts that I've read like Thomas Goodwin the cases where the woman and the fetus can't be treated as separate patients are extremely, extremely rare. Too often our society's solution to a problem pregnancy is abortion instead of treating the child the child as a second patient. When the court-enshrined definition of "health" has no concrete meaning then using the term "health" won't prevent a single late-term abortion. Too often proponents of D and X treat nearly every D and X as if it was some miracle procedure that is the only procedure which can be used.
Posted by: Jivin J at April 4, 2006 05:26 AM
....this statement leaves out the fact that the rates of complications for the study were described as similar....
My statement left out tons of stuff; I can't be expected to summarize every detail of the study. But what I said was accurate. Your description above leaves out that although the rate of complications were similar, every complication that required emergency surgical care happened with D&C abortions. (I guess that means you consider your own description "not 100% accurate," right? After all, you left out information that wasn't supportive of your case.)
If I had left out information that was essential or undid my point - which was that Darlene's claim that D&Xs are more dangerous was untrue - then you'd have a case. But I didn't leave out any such information.
You also stated, "Frequently, intact d&x abortions are performed because that's the safest thing for the woman" - something which you've provided no evidence for. You basically seemed to be painting a rosy picture of D and X compared to D and E yet the study doesn't necessarily back you up.
In an attempt to justify your unreasonable harping on this study, you're now vastly exaggerating how much I've relied on the study in my arguments. I didn't even mention the study in the post you're quoting from. I only used the study to rebut a single point made by Darlene.
In retrospect, I certainly wish I had given more thought to describing the study as narrowly as possible to rebut Darlene's statement - not because I said anything inaccurate, but because you're using the study to divert our discussion. But hindsight is 20/20, and at the time I was just trying to write quickly.
It's just seems fairly easy for a prolife congressperson to assume that if two abortionists are working under the same roof or have some kind of working relationship that they could both say it was medically necessary because they'd usually perform that type of abortion procedure.
Since the proposal called for fairly severe penalties for dishonesty, I don't think your argument here is viable.
Why didn't Durbin and the others put this legislation forward as something that wasn't a replacement amendment?
I don't know what was in Durbin's mind. But my speculation is that it would have been impossible to get this legislation a floor vote in any other way, since if it had been a piece of independent legislation the Republicans would have been able to bottle it up in committee.
Aren't most D and X performed prior to viability? So this legislation wouldn't have effected them?
Correct - although you'd never know that most D&X are performed pre-viability from most pro-life rhetoric about D&X abortions.
My point is, if the issue is protecting later-term fetuses - which certainly seems to be the case for Darlene, from what she said - then banning a particular procedure, rather than banning all elective post-viability abortions, seems like a irrational policy choice. (Assuming that the point really is protecting fetuses, rather than partisanship).
Why do you think the world is a better place if we have exactly the same number of abortions, but a slightly higher number of women won't be able to use the procedure that their doctor believes is safest for them?
You say that I'm ignoring the interests of the fetus. But how is the fetus better served by being killed with procedure A rather than procedure B?
And would it be challenged because it's definition of health differs from Doe?
My belief is that even before the recent changes in Court personell, such a challenge to Doe would have been successful. Doe was about a first-trimester abortion, remember; the Court would probably have been a lot more willing to support restrictions on post-viability abortions.
Regarding my hypothetical - what if the parents don't want the child or they want the child dead.
If they don't want the child, they can give it up for adoption. There's a widespread consensus in our society that infanticide is wrong, and in situations where there's no conflict between a fetus and a woman's right to control her own medical care, I don't see any basis for controversy over the matter. (Note that no such consensus exists for abortion.)
I'd also note that a D and X is a longer procedure than a D and E.
You're right. I should have said, the surgical portion of D&E is longer.
And I forgot one of your questions - yes I have genuine care for women who face medical problems during their pregnancy. But from the testimony of medical experts that I've read like Thomas Goodwin the cases where the woman and the fetus can't be treated as separate patients are extremely, extremely rare.
So as long as such cases are extremely rare, legislation that harms women's interests in such rare cases is acceptable? That makes no sense. People with rare conditions don't have less right to good medical care than people with common conditions.
And as for medical experts, clearly there is nothing even close to consensus among them regarding D&X. In such a case, I'd rather that doctors be free to make their own decisions. Why do you think you're qualified to decide this question for the entire medical profession? What's wrong with patients and doctors being allowed to control their own medical care, in cases in which different doctors disagree?
Return to my example of a woman with an non-viable fetus who wants a relatively intact corpse to bury. What makes you believe that you're better qualified to decide what's best for her than she and her doctor are?
Posted by: Ampersand at April 4, 2006 08:14 AM
I didn't mention the severe injuries because you already mentioned it. We both knew about it.
If you weren't trying to prove that a D and X was safer than a D and E and were just writing quickly, fine.
Fairly severe penalties? Loss of license and possibly money. What about jail time? Plus, isn't the standard of "has knowingly violated a provision of this chapter" extremely difficult to prove?
For prolife people looking at this procedure, it doesn't seem too tough for an individual willing to partially deliver a near viable child and then kill her, to sign a sheet of paper saying if they didn't grevious injury would occur. Especially when you have an abortionist like Warren Hern who's said things like, “I say every pregnancy carries a risk of death."
My guess is that Durbin and others wanted to completely scrap the PBA law or else they could have just added this as an addition.
Correct - although you'd never know that most D&X are performed pre-viability from most pro-life rhetoric about D&X abortions.
I guess that depends on what you consider most rhetoric. Do you take what NRLC says or do you take what some random prolifer, who's heard about PBA through the grapvine, says.
I wouldn't necessarily think the world is a better place. I'd say at least we have some sort of line (being inside the woman's body) between abortion and infanticide. I didn't say you're ignoring the interests of the fetus (though I don't see how your position favors the interests of fetus). I'm trying to point out how lame the "Woman, what woman?" argument dismissal seems to me. Being killed by method A rather than B certainly doesn't help the fetus but in the same manner being killed at 23 weeks vs. being killed shortly after birth also would still result in a dead child.
So in your view, society's interests matter, not necessarily the life of the child, correct? Is the actual child of any moral concern? If society's interests evolved (as they seem to be in the Netherlands regarding this issue) to accept infanticide, then would you have a problem with killing the hypothetical child?
I don't think the legislation harms a women's interests nor do I accept that a D and X is good medical care.
I think the problem in our disagreement lies largely in how we view abortionists. You seem to be of the mind (and please correct me if I'm wrong) that abortionists are usually out to do what's best for the woman. I don't share that perspective. I don't see abortionists performing D and X's as objective sources for information (probably in the same way you don't see prolife doctors).
I mean, aren't you against certain things that may take place between a woman and a kind of doctor that they both consent to? I know you're an advocate for individuals who are overweight - are there no weight loss procedures you think should be outlawed? Or what about a depressed teen who wants his doctor to help him commit suicide? I don't think there is a complete consensus on those issues.
I just can't accept that doctors are somehow removed from the law and that their practices can't or shouldn't be regulated by the government.
Posted by: Jivin J at April 5, 2006 12:44 PM