Category Archives: abortion

Under the Rug II

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The story thus far — in the last post, we learned that Americans opposed to legal abortion have wildly unrealistic notions about what might happen if abortions became illegal. That means it’s up to us in the reality biz to face some facts.

And one of the facts we need to face is that if abortion becomes illegal women who abort will very likely face legal prosecution for it — possibly even homicide charges — in spite of what the Fetus People claim.

Allegedly the recently passed South Dakota abortion ban provides only for the punishment of abortion providers, not the women who abort. From the law:

Section 2. That chapter 22-17 be amended by adding thereto a NEW SECTION to read as follows:

No person may knowingly administer to, prescribe for, or procure for, or sell to any pregnant woman any medicine, drug, or other substance with the specific intent of causing or abetting the termination of the life of an unborn human being. No person may knowingly use or employ any instrument or procedure upon a pregnant woman with the specific intent of causing or abetting the termination of the life of an unborn human being.

Any violation of this section is a Class 5 felony.

What if a woman uses or employs an instrument or procedure upon herself? Wouldn’t that be a violation?

In the last post I mentioned a couple of young women in Colombia who aborted by taking an ulcer medication. They were arrested after being treated in a hospital emergency room for bleeding. Under the SD statute as I read it, whoever sold them the ulcer medication was liable, but it’s not clear to me that the young women wouldn’t have been liable also, since they medicated themselves. Perhaps someone with a legal background could comment on that.

But here’s another wrinkle: In Monday’s Houston Chronicle, Lynn Paltrow and Charon Asetoyer argue that

If the unborn are legal persons, as numerous South Dakota laws assert, then a pregnant woman who has an abortion can be prosecuted as a murderer under already existing homicide laws.

In other words, just because the abortion law itself doesn’t provide a legal liability for the mother doesn’t mean she wouldn’t be liable under another statute.

Farfetched? Not at all.

Prosecutors all over the country have been experimenting with this approach for years. In South Carolina, Regina McKnight is serving a 12-year sentence for homicide by child abuse. Why? Because she suffered an unintentional stillbirth. The prosecutors said she caused the stillbirth by using cocaine, yet, they did not charge her with having an illegal abortion — a crime that in South Carolina has a three-year sentence. Rather, they charged and convicted her of homicide — a crime with a 20- year sentence. They obtained this conviction in spite of evidence that McKnight’s stillbirth was caused by an infection.

Thus far, South Carolina is the only state whose courts have upheld the legitimacy of such prosecutions. But in fact, women in states across the country, including South Dakota, have already been arrested as child abusers or murderers — without any new legislation authorizing such arrests. In Oklahoma, Teresa Hernandez is sitting in jail on first-degree murder charges for having suffered an unintentional stillbirth. In Utah, a woman was charged with murder based on the claim that she caused a stillbirth by refusing to have a C-section earlier in her pregnancy.

If women are now being arrested as murderers for having suffered unintentional stillbirths, one should assume that in South Dakota’s post-Roe world intentional abortions would be punished just as seriously.

Yesterday in Slate William Saletan pointed out that the South Dakota law goes to great length to define a fertilized ovum as an “unborn human being.” Be warned.

Nicholas Kristof’s New York Times column of April 7, 2004 (via Planned Parenthood of the Inland Northwest) provides a glimpse of abortion law enforcement in Portugal.

To understand what might happen in America if President Bush gets his way with the Supreme Court, consider recent events in Portugal.

Seven women were tried this year in the northern Portuguese fishing community of Aveiro for getting abortions. They were prosecuted — facing three-year prison sentences — along with 10 ”accomplices,” including husbands, boyfriends, parents and a taxi driver who had taken a pregnant woman to a clinic.

The police staked out gynecological clinics and investigated those who emerged looking as if they might have had abortions because they looked particularly pale, weak or upset. At the trial, the most intimate aspects of their gynecological history were revealed.

Think that can’t happen here? Remember a year ago, when the attorney general of Kansas subpoenaed abortion clinics for patients’ medical records? The Red State Chastity Police do not have much in the way of respect for privacy.

Kristof continues,

This was the second such mass abortion trial lately in Portugal. The previous one involved 42 defendants, including a girl who had been 16 at the time of the alleged abortion.

Both trials ended in acquittals, except for a nurse who was sentenced to eight and a half years in prison for performing abortions. …

… Portugal offers a couple of sobering lessons for Americans who, like Mr. Bush, aim to overturn Roe v. Wade.

The first is that abortion laws are very difficult to enforce in a world as mobile as ours. Some 20,000 Portuguese women still get abortions each year, mostly by crossing the border into Spain. In the U.S., where an overturn of Roe v. Wade would probably mean bans on abortion only in a patchwork of Bible Belt states, pregnant women would travel to places like New York, California and Illinois for their abortions.

The second is that if states did criminalize abortion, they would face a backlash as the public focus shifted from the fetus to the woman. ”The fundamentalists have lost the debate” in Portugal, said Helena Pinto, president of UMAR, a Portuguese abortion rights group. ”Now the debate has shifted to the rights of women. Do we want to live in a country where women can be in jail for abortion?”

“There’s a growing sense that while abortion may be wrong, criminalization is worse,” Kristof writes. Let’s hope we don’t have to learn that lesson the hard way.

Update: See also Dr. Atrios about an abortion ban advocate who refused to answer a simple question about punishment for the mother who aborts.

Under the Rug

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I want to elaborate on this post by Digby, which links to this video in which anti-abortion protesters are asked if women should be punished for having illegal abortions. The film reveals that most of the protesters had never even thought about it. One young woman had a hard time understanding the question; it clearly had never occurred to her that women would continue to get abortions if abortions were illegal. (Upon being pressed she allowed that maybe a few women would get abortions, but she didn’t think it would happen often.)

In many nations where abortion is illegal, women really do face penalty of law for getting abortions. In this post from December I linked to Juan Forero, “Push to Loosen Abortion Laws in Latin America ,” The New York Times, December 3, 2005:

PAMPLONA, Colombia – In this tradition-bound Roman Catholic town one day in April, two young women did what many here consider unthinkable: pregnant and scared, they took a cheap ulcer medication known to induce abortions. When the drug left them bleeding, they were treated at a local emergency room — then promptly arrested.

Like the sweetly innocent abortion protester in the first paragraph, the people of Pamplona are in denial.

Like much of Latin America, the people here in Pamplona have, until recently, talked little of the abortions that have taken place behind the town’s tranquil, buttoned-down facade. Yet, 68 students, most of them from the University of Pamplona, sought emergency treatment at the local public hospital last year after having abortions, hospital records showed.

Several students said that they had a liberal attitude toward sex. Condoms are readily available, and the so-called morning-after pill is sold over the counter in pharmacies.

Still, sex education focuses more on anatomy than behavior, and church and university officials preach abstinence. Shamed by the thought of having children without being married, many young women try to induce abortions by taking a drug called Cytotec, which is made for ulcers but also dilates the cervix.

Pharmacies in Pamplona are barred from selling the drug, but students can purchase it in cities nearby. It was Cytotec that the two young women took in April that left them bleeding and, ultimately, under arrest. But there have been others, court records showed.

Under questioning from prosecutors, all admitted their guilt and received suspended sentences.

Insisting that abortion was rare, Pamplona’s conservative leaders thought the case was over. Instead, the episode reverberated throughout Colombia and helped to galvanize a national movement to roll back laws that make abortion illegal, even to save a mother’s life.

Latin America holds some of the world’s most stringent abortion laws, yet it still has the developing world’s highest rate of abortions — a rate that is far higher even than in Western Europe, where abortion is widely and legally available.

In fact, as I pointed out yesterday, western Europe as a region has the lowest rates of abortion in the world. In western Europe the very lowest abortion rates are in The Netherlands, Belgium, the Scandanavian countries, Iceland, Germany — the crazy liberal Nordic fringe, in other words.

Yet while Latin America has a shockingly high rate of abortions, “Pamplona’s conservative leaders” think abortion is “rare.”

Forero of the New York Times continues,

Regional health officials increasingly argue that tough laws have done little to slow abortions. The rate of abortions in Latin America is 37 per 1,000 women of childbearing age, the highest outside Eastern Europe, according to United Nations figures. Four million abortions, most of them illegal, take place in Latin America annually, the United Nations reports, and up to 5,000 women are believed to die each year from complications from abortions.

The degree of denial among people opposed to legal abortions is stunning. Some of you might remember the recent Mahablog comment exchange with “Keith,” who dredged up a “scholarly work” underwritten by Americans United for Life insisting there had been fewer than 100,000 illegal abortions a year in the U.S. before Roe v. Wade.

Since we’re dealing with clandestine activity people didn’t exactly keep records; any number anyone comes up with is a guess. However, another estimate that relied in part on the number of hospital admissions for botched abortions, concluded there were 829,000 illegal or self-induced abortions in the U.S. in 1967. In 1962 alone, nearly 1,600 women were admitted to just one New York City hospital because of complications from illegal abortions. And emergency room admissions represented only a portion of the abortions being performed at the time. Thinking about this makes even the 829,000 number seem low to me.

And given the many innovations in abortion procedure since Roe, you know that if abortion became illegal in the U.S. there’d be a thriving underground abortion industry in place before you could say Mifepristone. Which I bet could be run across the border from Canada without too much trouble.

And there are coathangers in every closet.

So how will laws prohibiting abortion be enforced, exactly?

My internet access is cutting in and out this morning, so I’m going to post this while I can and will (I hope) elaborate on the punishment angle in the next post.

Abortions and Autonomy

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William Saletan wrote a highly annoying article in Slate that argued “technology” would somehow resolve the abortion wars. I say “annoying” because it contains some misinformation — for example, he says that the gestational point of possible viability is earlier now than it was in 1973 when Roe was decided. It actually isn’t; the limit was 23 weeks in 1973, and it’s still pretty much 23 weeks now, “lifer” mythology to the contrary. Scott Lemieux has already written a good response to much of Saletan’s article; see also Amanda Marcotte.

For now, I want to pull out just one paragraph from the Saletan article to complain about. He writes of Roe v. Wade,

Politically, legally, and technologically, the 33-year-old court decision is increasingly obsolete as a framework for managing decisions about reproduction. But pro-lifers can’t launch the post-Roe era, because they’re determined to abolish its guarantee of individual autonomy, and the public won’t stand for that. Only pro-choicers can give the public what it wants: abortion reduction within a framework of autonomy.

What the hell does that mean? That pro-choicers have to be the grown-ups who find a compromise solution, because the little anti-choice children can’t?

Regarding reducing the number of abortions — it might be useful to take a look at which nations have the lowest abortion rates to see what they’re doing right. I found the chart below in this Alan Guttmacher report.

And look who has a way lower abortion rate than the U.S. — The Netherlands. Possibly the most liberal nation that ever was. I’m not sure if The Netherlands is still #1 as of most recent data (the chart dates from 1999), but on the whole the nations of western Europe have lower abortion rates than anywhere else on the planet. And the nations of eastern Europe have some of the highest rates, even though there isn’t a real big difference in abortion law between eastern and western Europe. As I argued here, there is no correlation whatsoever between abortion rate and abortion law.

The only effective way to reduce rates of abortion is to reduce rates of unintended pregnancies. Access to contraception is key. There is no getting around that. Limiting access to contraception is a sure-fire way to increase abortion rates, no matter how strict the abortion law is or how many clinics are closed down.

Somewhere there are probably lots of lovely social-psychological research studies, complete with p values and N squares, that show which values in a society might also lower abortion rates. Without those, however — if we look at The Netherlands and some of these other countries that are successful at reducing abortions we might form hypotheses. We might speculate that openness about sexuality is an abortion-reducing factor. People who are open about their sexuality are more likely to be prepared for it. This includes providing young people with factual information on contraception.

Hmm, so let’s see — who has been struggling for years to provide access to contraception and sex ed to young people? And who has been working against access to contraception and sex ed to young people (beyond “don’t do it”). Hmmm … Could it be that liberalism reduces abortion rates?

As Saletan points out, there have been some improvements in birth control methodology since 1973. But all the improvements in the world won’t help if the technology is banned, or if the local druggists won’t fill prescriptions, and young people become sexually active before they understand exactly how the baby gets into the cabbage patch.

Thus, I get a little tense when moralizers like Saletan wag their fingers and say you liberals are going to have to find a solution. I believe we already have. And I also believe there is no way to compromise with the anti-choice trogs and also lower abortion rates. So if that’s our assignment, we are doomed to fail.

Saletan says that we liberals must figure out how to achieve abortion reduction within a framework of autonomy. Seems to me the data indicate that’s the only way to achieve abortion reduction — within a framework of autonomy. Abortion reduction within a framework of authoritarianism and patriarchy ain’t happening anywhere, unless you count places like Ireland in which women who choose to abort are only a ferry ride away from British abortion providers.

Frankly, the only way to bring about the desired result –abortion reduction within a framework of autonomy– is to reduce the power of the trogs so that liberal reproduction policies might flourish throughout the land, unimpeded.

In recent years there’s been a lot of overheated rhetoric, much of it from Saletan, about how liberals can recapture the moral argument to abortion. But I think there’s an easier way. Just run the Bill Napoli virgin rant in television and radio ads, followed by a catchy closing line — something like “This guy wants to regulate your personal life. Is this OK with you?” Anyone who still cares about personal autonomy will get the hint.

Oh, the Humanity

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Once upon a time — early 1970s, pre-Roe, I believe — I remember reading a newspaper column written by a fellow who had been opposed to legal abortion. I say had, because he had changed his mind. What changed his mind was a tragedy — his beloved granddaughter, a college student, had been raped.

The young woman didn’t become pregnant. But the episode had made the man think — what if she had. Before Roe, several states banned abortions even for rape victims. For the first time, he reflected on what a pregnancy from rape might do not only to his granddaughter, but to his entire family. Could the family accept such a child? Could he? How would it feel to give a grandchild away? Not just a hypothetical grandchild, but his real, breathing, flesh-and-blood grandchild?

And he considered, for the first, time, how such a pregnancy would prolong and deepen the trauma his granddaughter had already suffered. All his hopes for her — that she would finish college, that she would marry happily and have children — depended on her recovery from the trauma. How could a compassionate and just society not do whatever it took to help her? Yes, babies are precious, but so was his granddaughter!

As I remember it, the man remained uncomfortable with abortion. But he thought on, and he thought about teenagers with poor impulse control, and couples with as many children as they could afford already, and a thousand other circumstances in which people — real people — might choose to seek abortion. Suddenly, for him a woman who sought an abortion was no longer just a hypothesis or an archetype — Careless Woman, Selfish Woman, Woman in a Vacuum. Now he understood these women were real individuals with parents, siblings, husbands, children, and grandparents who loved them.

Today I thought about the man who cared about his granddaughter when I read two posts by Digby — “The Sodomized Virgin Exception” and, um, this other post. What comes through loudly and clearly in both posts is that the anti-abortion rights position is based on an assumption that women aren’t real people — especially women who get abortions. Oh, they’re human in a scientific sense, but they aren’t people. They are archetypes who live in the heads of the anti-abortion righters — Careless Woman, Selfish Woman, Woman in a Vacuum. The same people who imagine embryos can think and feel emotions — and therefore deserve protection — must believe a pregnant woman is just a major appliance.

There are copious anecdotes from abortion providers who say that often the same people protesting outside the clinic one week are patients (or parents of patients) the next week. These people assume that their situations are unique and should be the one exception. They often want the abortion staff to know they aren’t like those other women who get abortions. This inspired the bitter joke that the legitimate reasons for abortion are “rape, incest, and me.” Such people recognize their own humanity (or their daughter’s), but those other women who get abortions are just archetypes who don’t deserve respect or considertion.

I’ve long believed that whether one is pro-choice or anti-choice does not depend on whether one thinks embryos are human beings. It depends on whether one recognizes that women are human beings. Not archetypes, but real, individual human beings. Including women who get abortions.

See also: Amanda M., Echidne and the Wege.

The Mississippi Correlation

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Speaking of South Dakota, I was just wondering if it complied with the Mississippi Correlation. The MC states that where a state’s legislature is obsessed with banning abortions, that state will have a higher than average infant mortality rate.

Yep. It does.

“The good news is that deaths from Sudden Infant Death Syndrome continued to drop. There were eight deaths in 2004, down from 21 in 1995,” said Doneen Hollingsworth, Secretary of Health. “But unfortunately, the infant mortality rate did increase to its highest level since 1999.” …

.. There were 93 infant deaths in South Dakota in 2004, or a rate of 8.2 per 1,000 live births. That’s well above the United States rate of 6.6 infant deaths per 1,000 live births for the same year (provisional data).

If you are interested in looking at comparative data on infant mortality rate in the U.S., here’s a report (PDF) from the Center for Disease Control you might like. If anyone can find a similar report more recent than 2002, please add a link in the comments.

Rights, Facts, Comments and Kibble

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Every now and then I get a comment that requires so much time and research to respond to that I decide, what the hell, I might as well write a post. Well, folks, the “Chao-Chou’s Dog Has Puppies” post attracted such comments, beginning with #72:

I could only read the post and about 1/3rd of the comments before getting depressed at the lack of liberal understanding in regards to the pro-life position. Yes, the exact point that a fertilized egg becomes “Fred” is ambiguous, and the morality of destroying that fertilized egg is hazy, and that’s why we had a large myriad of nuanced laws dealing with different aspects of abortion in different parts of the country before Roe v. Wade came along and wiped all of them out and said, in effect, that as long as the baby’s head hasn’t been exposed to air, then vacuuming his or her brains out is fair game. This shouldn’t be an either/or situation, where you either have complete restriction on abortion or no real restrictions at all. Let the states decide.

I answered this comment (#73) but I want to add a bit to the answer. In particular, I want to address the “let the states decide” nonsense.

In the United States, we have these things called “rights” that all levels of government (since the 14th Amendment, anyway) must respect. For example, the 13th Amendment abolished slavery. This means Alabama can’t reinstate slavery even if 100 percent of the state legislature votes for it. And the 4th Amendment protects a “right of the people to be secure in their persons,” meaning state governments cannot dictate to a citizen (say, a pregnant woman) what medical procedures she may or may not have (for example, abortion or childbirth) without some kind of court order. The legislature cannot circumvent the 4th by writing a law that says the state can search and seize personal property whenever it wants to, for example. Such matters are off limits no matter how big a majority of the voters might want such laws passed.

I have already posted arguments (here, for example) why I think the Constitution does protect a right of privacy that includes the right of a woman to choose to have an abortion. I am not going to repeat those arguments now. If you want more arguments, head on over to Lawyers, Guns & Money. Scott Lemieux of L, G & M (whom I have met; in person he’s so intensely bright he makes me feel dim) has accumulated a substantial opus of Roe v. Wade posts. See, for example, “Roe Was Right (Part I)” and “Roe Was Right (Part II)“. If you enjoy those, you might also like “Roe Was Right (Part III).”

Now, as for the “myriad of [sic] nuanced laws” about abortion that allegedly graced the states before Roe, I refer you to this Alan Guttmacher report, “Lessons from Before Roe: Will Past be Prologue?” In a nutshell, the “nuance” was as follows: In 33 states, abortion was illegal in all circumstances. In 13 states, various provisions had been made for medical necessity. It had been legalized in 4 states.

As I wrote in my comments, “nuanced, my ass.”

As for “This shouldn’t be an either/or situation, where you either have complete restriction on abortion or no real restrictions at all,” in fact Roe v. Wade provides for a number of restrictions, including a complete ban on elective post-viability abortions.

Now, also in my response to the post above, I provided a link to this post, which refers to the Alan Guttmacher report linked above, which says,

Estimates of the number of illegal abortions in the 1950s and 1960s ranged from 200,000 to 1.2 million per year. One analysis, extrapolating from data from North Carolina, concluded that an estimated 829,000 illegal or self-induced abortions occurred in 1967.

(Now, the Guttmacher Institute is affiliated with Planned Parenthood, which I realize to some people is a partisan organization. However, both the American Medical Association and the Center for Disease Control use Guttmacher data in their reports and consider it to be as reliable as anybody else’s data.)

The commenter responded,

I did some googling, and it seems like your stats in the other post are way off. “1.2 million illegal abortions” a year before Roe v. Wade is at the extreme high-end of the possible estimates, and it includes miscarriages. I found an abstract for a paper called “An objective model for estimating criminal abortions and its implications for public policy” here:

http://www.popline.org/docs/0472/007923.html

. . . and, from what I can gather, it seems like a scholarly work that estimates that there were between “a low of 39,000 [illegal abortions] in 1950 to a high of 210,000 in 1961, or an average of 98,000 a year” and that, after Roe v. Wade, the total number of abortions increased six to eleven times, and that, strangely enough, the number of illegal abortions only dipped a little bit.

The “scholarly work” is an abstract of a paper written in 1981 by people I’ve never heard of. Without seeing the entire work I have no idea where they got their numbers, but I suspect they counted only illegal abortions that were actually documented as such at the time they were performed. Meaning, they were only counting a tiny part of the actual abortions going on at the time.

[Update: Alert reader Jeffrey Rowland discovered the “scholarly work” was sponsored by “Americans United for Life.” So much for that.]

Any number anyone comes up with is an estimate. But when you consider that that in 1962 alone, nearly 1,600 women were admitted to Harlem Hospital Center in New York City for incomplete abortions — just one hospital, and no doubt those were only a fraction of the women who aborted in the area served by the hospital — then a “high” of 210,000 abortions nationwide seems a tad low. (Women in more affluent neighborhoods got safer abortions and were less likely to turn up in hospital emergency rooms.)

As for, “strangely enough, the number of illegal abortions only dipped a little bit” — strangely enough, after Roe, the number of women who turned up in emergency rooms with complications from back-alley abortions just about stopped. And which abortions were “illegal” after Roe, pray tell? I think someone is confused.

The total number of abortions per year did go up after Roe v. Wade (although not “six to eleven times”). This is a phenomenon that seems to nearly always happen when abortions are legalized; the rate goes up for a time, and then settles back down again in a few years. (See “Sharing Responsibility: Women, Society and Abortion Worldwide [PDF] Report on unplanned pregnancy and abortion around the world” [Alan Guttmacher, June 1999] pp.28-29.) This happened in the U.S.; rates began to come down around 1990 and declined steadily through the 1990s.

The fact remains that making abortion illegal doesn’t stop abortion. We see this in nations throughout the world; there is no correlation between abortion law and abortion rate. I wrote about this at length here. And the fact remains that where abortion is illegal women will, in desperation, abort themselves or submit to back-alley abortions that are enormously dangerous. And some of them will suffer permanent injury. And some of them will die.

Finally, we get this brilliant argument:

Honestly, I have more animosity towards Roe v. Wade than I do towards abortion. And my animosity stems from the fact that it was an authoritarian, anti-democratic decision that has polarized this country in a terrible way.

Look at it this way — Christians probably think abortion and prostitution are about equally bad. I mean, one of the ten commandments is about adultery. However, do you see hundreds of thousands of people marching to Nevada every year to protest legalized prostitution? No. I posit that the reason why is that prostitution hasn’t been forced on the entire country, and that the only areas that have legalized it are those communities that are okay with it.

That’s exactly what people said about Brown v. Board of Education, you know. Are you old enough to remember the years in which school desegregation had the whole nation up in arms? I am. I believe it was a worse conflagration than what was caused by Roe. (See also “The Long Tentacles of Conservative Revisionism” by Scott Lemieux.) By your logic, we should have maintained Jim Crow laws because declaring them unconstitutional got so many people riled up (and hollering about “states’ rights”).

Sometimes liberty and justice get messy. Deal with it.

Update: See also August J. Pollak.

Touching Innocence

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This is a sorta kinda followup to the last post, which discussed matters of life and death, space and time, religion, law, morality, and what it is to be human. Which was a tad ambitious now that I think about it. But I request that people not add comments disagreeing with this post until you’ve read that one. This will save us both a lot of time.

Anyway, I see that some righties are upset about a British court ruling that will allow physicians to impose a “do not resuscitate” order for Baby Charlotte, a desperately ill two-year-old, against the wishes of her parents.

The rightie blogger of Stop the ACLU asks,

Is this the direction America is headed? Is this where the ACLU, and the “right to die” folks will take us?

Kim Priestap of Wizbang blames socialized medicine:

Baby Charlotte’s health is fragile normally, so she will go through health scares like this again. This will cost Britain a lot of money. Since Britain has a nationalized healthcare system, funded by taxpayer money, it’s in the state’s best interest to let her die.

What’s going on here? As a mother myself I’m very uncomfortable when government interferes with family decisions like this. I tend to think that when the family is agreed the patient should be resuscitated, the doctors should respect the decision and not involve courts. I don’t know enough about Baby Charlotte to be able to judge whether there is a compelling reason to make an exception in her case. I infer from news stories that the doctors consider her case to be hopeless and that keeping her alive is just making her suffer. And her parents see things very differently.

I argued in the last post that humans need to struggle with hard choices. When governments or other institutions swoop into our lives and make our choices for us, it makes us less human. And this is true even when we make “bad” choices (within the law, of course). Our decisions may be less important than the process we go through to make them. So in that respect I’m sympathetic to the rightie point of view.

However … the title of this post doesn’t refer to Baby Charlotte. It refers to the righties who are oh, so innocent of the facts of life and death these days.

Nearly a year ago us “culture of death” liberals took up the cause of Sun Hudson, a Texas baby whose life support was terminated against family wishes. Although their diagnoses may differ, the legal situations of Baby Sun and Baby Charlotte seem to me to be nearly identical. If anything, Sun’s case was more extreme than Charlotte’s. His mother (father unknown) wanted aggressive medical care to continue, but the law sided with physicians who decided enough had been enough. Baby Sun’s breathing tube was removed on March 15, 2005, and he died of asphyxiation within minutes.

My understanding is that Sun Hudson’s prognosis really was hopeless. But then, so was Terri Schiavo’s.

Sun Hudson died three days before Terri Schiavo’s feeding tube was removed for the last time. Some of you might recall that righties got a tad excited about the Schiavo case. However, they were mostly silent about Sun Hudson — slipped their attention, I guess. Were it not for liberal blogs I wouldn’t have heard about Sun Hudson either.

Why were righties so oblivious to the Sun Hudson case? One explanation is that the law that allowed his life to be terminated had been signed by then-Governor George W. Bush.

The federal law that President Bush signed early yesterday in an effort to prolong Terri Schiavo’s life appears to contradict a right-to-die law that he signed as Texas governor, prompting cries of hypocrisy from congressional Democrats and some bioethicists.

In 1999, then-Gov. Bush signed the Advance Directives Act, which lets a patient’s surrogate make life-ending decisions on his or her behalf. The measure also allows Texas hospitals to disconnect patients from life-sustaining systems if a physician, in consultation with a hospital bioethics committee, concludes that the patient’s condition is hopeless.

Bioethicists familiar with the Texas law said yesterday that if the Schiavo case had occurred in Texas, her husband would be the legal decision-maker and, because he and her doctors agreed that she had no hope of recovery, her feeding tube would be disconnected. [Knight Ridder]

The Sun Hudson story came out just as the VRWC media echo chamber was working overtime to promote George W. Bush as a champion of life. Faux News’s Bill O’Reilly first commented on the Sun Hudson story before he discovered the Bush angle, forcing him to flip-flop harder than a trout on a hot pier. While Terri Schiavo’s parents were depicted as noble and pure of heart, Sun Hudson’s mother became a deranged black woman who couldn’t face reality. Never fear; O’Reilly had flip-flopped back by April when he attacked the ACLU for (perhaps) being behind “infanticide for impaired babies.”

Let’s go back to the Texas Advance Directives Act of 1999, which is the law under which Sun Hudson’s life was terminated. Put very simply, the law allows a health care facility to discontinue life support against the wishes of the patient’s family. The law requires the facility to jump through a number of hoops before it can do this, which ensures there is an overwhelming medical consensus that the patient’s condition is hopeless before the plug is pulled. The family has the option of finding another medical facility willing to continue life support. But other medical facilities are unlikely to take such a patient, especially if the patient will be a drain on the budget.

In other words, if the family is wealthy enough to pay the costs of Grandma’s care and make a generous contribution to the hospital building fund, Grandma lives. If the family’s insurance is capped and they’ve already spent the second mortgage to pay her medical bills, she dies. To paraphrase (well, OK, mock) Kim Priestap of Wizbang (see above), Grandma’s care will cost hospitals a lot of money, so it’s in their best interest to let her die.

There are two issues to be addressed here, both involving rightie inability to face reality. The first is regarding health care and how it is paid for. Just about every nation on earth affluent enough for most citizens to own a microwave has some kind of national health care system. The exception is the United States. In a recent Newsweek column, Jane Bryant Quinn (hardly a socialist) said that America’s health-care system is turning into a lottery.

The winners: the healthy and well insured, with good corporate coverage or Medicare. When they’re ill, they get—as the cliche goes—”the best health care in the world.” The losers: those who rely on shrinking public insurance, such as Medicaid (nearly 45 million of us), or go uninsured (46 million and rising).

To slip from the winners’ circle into the losers’ ranks is a cultural, emotional and financial shock. You discover a world of patchy, minimal health care that feels almost Third World. The uninsured get less primary or preventive care, find it hard to see cardiologists, surgeons and other specialists (waiting times can run up to a year), receive treatment in emergencies, but are more apt to die from chronic or other illnesses than people who pay. That’s your lot if you lose your corporate job and can’t afford a health policy of your own.

Years ago there was a joke in circulation that said a conservative is a liberal who got mugged. The new joke is that a liberal is a conservative who’s lost his health insurance.

The point is that all the evil, inhumane things going on in Other Countries That Have Socialized Medicine are happening here, too. Righties just refuse to acknowledge them. Among those Other Countries, Britain is a good “bad example” because they’ve underfunded their system for years. Meanwhile, we in the U.S. spend far more per capita than other nations (see this report in PDF format; note especially Figure 1 on page 3) but we’re getting worse results (see Table 1, page 4). By some measures we’re getting even worse results than those cheapskate Brits.

And the moral is, people whose health care system is a broken down mess shouldn’t be pointing fingers at other peoples’ health care systems.

The other issue I see here is the touching innocence of righties regarding hopelessly terminal patients. Physicians have made decisions not to aggressively treat hopeless patients, especially suffering hopeless patients, since Hippocrates. Generally they’ve done it quietly and without drawing attention to themselves, but they’ve done it. For example, since the 19th century physicians have prescribed larger and larger doses of opiates to ease the pain of dying patients, knowing that eventually the dosage will be fatal. And as far as the family ever knew, it was the cancer that killed Grandpa, not that last dose of morphine.

Just about any health care professional will confirm this. I’m sure such decisions are being made all over America even as you read this.

The reason we’re hearing about such cases these days is, IMO, multifold. First, in the past medicine wasn’t all that effective. It was easy for doctors to make a show of “doing all we can” because in truth there wasn’t a whole hell of a lot they could do. But now we can do so much more. We have medical technology that will retain life in a body even when the person that body once sustained has long since dissipated, as in Terri Schiavo’s case. The line between life and death itself has blurred.

Second, because of the technology, more and more families refuse to accept a hopeless prognosis. I understand even anencephalic babies are sometimes put on life support these days, even though those babies have no hope of survival. In earlier times, the only choice offered parents would have been whether they wanted to hold the baby while it died, or not.

And third, mass media and our “reality TV” culture make sure the more controversial decisions get global publicity. In earlier times, these matters wouldn’t have been been discussed outside the family. Today, people with less than a half-assed idea of the facts can plaster their uninformed opinions all over the Web.

As individuals, as a nation, as a society, as a species, we’ve got hard choices to make. These choices involve ourselves and our loved ones. We need to make some mature, non-politicized judgments about how to pay for health care. We must think rationally about how much of our health-care resources should be spent on futile care. We need non-hysterical discussion about if, or when, governments should intervene in family decisions. These are all complex issues. Reasonable people will disagree on many points. But we’re going to get nowhere until we’re able to face some hard realities.

Which means we’re going to get nowhere as long as righties dominate the discussion.

When Life Begins, or Not (Formerly Chao-chou’s Dog Has Puppies)

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I see that Lance Mannion has taken up the question of when “life” begins. I see that Shakespeare’s Sister mostly agrees with Lance; Jedmunds of Pandagon mostly doesn’t.

Now I want to confuse everyone by arguing that “when life begins” is the wrong question. It’s the wrong question because life doesn’t begin. Or, at least, it hasn’t begun on this planet in a very long time. However life got to Earth — between 3 and 4 billion years ago, I believe — once it established it hasn’t been observed to “begin” again. It just continues, expressing itself in countless forms. The forms come and go — in a sense — but not life itself.

It will be argued that fertilization marks the beginning of a unique individual and is, therefore, a significant moment in the life process — the point when a life begins. But let’s say a couple of weeks later the egg divides into twins or triplets. Did those individuals’ lives begin with the conception? Or, since they didn’t exist as individuals at conception, is the cell division something like an existential reboot?

Further, in the grand scheme of things, is any one moment really separable from all the other moments, the couplings, the countless episodes of cell mitosis going back to the first stromatolites and microbes and macromolecules to the beginning, which is beginningless as far as I know, considering that a stray enzyme at any point over billions of years would have resulted in you being a lungfish?

I don’t have an answer to that. I’m just sayin’ “beginnings” are way overrated.

The real question, seems to me, is when does an individual begin? Is there a clear, bright moment at which we can all agree, “yep, that’s Fred,” and be done with it?

Some argue that the product of pregnancy is a unique individual from conception because its DNA is different from its mother’s. But if unique DNA combinations are what make a unique individual, you’d have to conclude that the twins from the third paragraph are the same person, divided. And if we give you a transplanted heart, lung, and kidney, each with unique DNA combinations from their respective donors, does that make you four different people?

I don’t think science can help us with this one, people. Indeed, if you step back and look at human civilization throughout space and time, you might notice that “person” is a social construct that has been constructed in very different ways by different societies. At various times only men, or only people of a certain skin color, or only people from our tribe, or only people of a particular caste or class, were considered “persons.” We may think we have reached maximum enlightenment by considering all human beings “persons” (assuming we all do, which I question), but it’s possible our distant descendants will expand “person” to include, say, other primates, whales, dolphins, and border collies. You never know.

The argument made by many opponents to legal abortion is that the product of pregnancy is human life, and human life is sacred; therefore, it must be protected. There’s no question that a living human embryo is both alive and human, but when you call it “sacred” you’re throwing a religious concept into the mix. And the great religions of the world do not at all agree on the question of when (or even whether) “human life” becomes “sacred.” Some say at conception, some say at “quickening,” some say at viability, some say at birth. And some will tell you that everything and nothing are equally sacred, so stop asking stupid questions.

The reason we’re even having this discussion is to settle the question of abortion as a matter of law. But as a legal matter, the question of when humans are allowed to take the lives of other humans rarely has absolutist answers. Some kind of regulation about who can kill whom is necessary for civilization, since we can’t very comfortably live together in communities without some assurance our neighbors won’t throttle us in our sleep. But there are always loopholes. Through history, in many societies (even Christian ones), a noble could kill a peasant or slave without penalty. Today governments can order wars or impose a death penalty, and legally that’s not murder.

I tend to get impatient with people who argue that laws are based on morality, and abortion is immoral, therefore it ought to be illegal. As I said in the last paragraph, there are some laws essential to human civilization. These laws regulate who can kill whom and who can own what. They make commerce possible by imposing penalties for fraud. They make complex human enterprises possible by enforcing contracts. Exactly how law has regulated these matters has changed considerably over time; the important point is that, within a given society, there are basic rules everyone is supposed to agree to so that society can function.

The realm of morality, however, is separate from the realm of legality. There are all manner of things that we might consider immoral that are not, in fact, illegal; adultery is a good example. Such acts may have harmful personal consequences, but regulating them isn’t necessary to civilization. And I don’t see what’s immoral about, say, misjudging how many coins you should put in the parking meter. That’s why I tend to see the legal versus moral question on a Venn diagram. The diagram here isn’t entirely accurate since the blue area should be bigger — law and morality intersect more often than they don’t. I’m just saying that answering the moral question of abortion (assuming we ever will) does not tell us whether an act should be legal or not. In fact, since abortion is legal (with varying restrictions) in most democratic nations today with no discernible damage to civilization itself, I’d say the abortion question falls outside the blue area of the diagram.

On the question of morality I disagree a lot with Ezra Klein when he says “confused polling on abortion is evidence that Americans have confused views on abortion.” I think people are not so much confused as limited. Our conceptions of life or humanity or individuality or the self are to a large extent conditioned into us by our culture. It’s very hard to step outside of our conditioning and take a broader view. We’re all blind men feeling an elephant — our ideas about what an elephant is depend on what particular part we happen to be feeling (an elephant is like a a tree trunk? a wall? a fan?). Following this metaphor, there are all manner of people in America today who do not feel confused at all about that elephant. They’ve got hold of its trunk, and they are certain it’s just like a snake. End of argument.

If anything, most people aren’t confused enough.

Our notions of where a fetus fits on the morality scale depend very much on the angle from which we view the question. A fetus is human. But humans are sentient, and a fetus is (so science tells us) insentient. A fetus is like a parasite, or a lower life form. A fetus is God. A fetus is a baby. A fetus is not a baby. A fetus is a potential baby. A fetus is sacred. Nothing is sacred. Everything is sacred.

How about, All of the above?

In case you’re wondering, from a Buddhist perspective it might be argued that since a “person” is an aggregate of the five skandhas (form, sensation, perception, discrimination, consciousness) and an embryo or fetus has only form, it’s not a person. On the other hand, Buddhism teaches that each of us is all of us, throughout space and time. The cells of whatever is conceived contain all life forms, from the beginningless beginning to the endless end, perfect and complete. Interfering with life’s attempts to express itself is a serious matter.

So where does that leave us? It leaves us with individuals who have to make hard choices. Struggling with hard choices is a distinctively human activity. I think it’s something we need to do to be fully human. It helps us wake up. The decisions we make may be less important than the fact that we can make decisions.

I have written in the past (such as here) why I think abortion should be legal, at least until the fetus is viable. My opinion is based mostly on the effects of abortion law in the lives of women. You might notice I don’t spin my wheels much over the question of morality, since I’ve come to see that morality depends on the state of mind in which one acts as much as the act itself. People do “good” things for selfish reasons, and “bad” things for altruistic reasons. Judge not, lest ye be judged.

So, I say, ambiguity is good for you; don’t be afraid of it. Go forth and be human and work it out for yourselves.

[Note: The title of the post refers to the first koan of The Mumonkon. If it doesn’t make any sense to you, that’s OK.]

Knock Knock

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Righties are congenitally unable to recognize and appreciate satire, but judging by the reactions to this, some lefties don’t get it, either.

Update: To those of you who, so far, aren’t getting the point: The “jokes” aren’t jokes. They aren’t supposed to be funny. Humor is not the point.

Update update: This, on the other hand, is genuinely amusing.

Two Justices Don’t Make a Society

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Anti-abortion rights forces see an end to Roe v. Wade just around the corner, writes Michelle Boorstein in today’s Washington Post.

Tens of thousands of abortion opponents held an upbeat rally on the cold, gray streets of downtown Washington yesterday and described what they see as a societal tide turning against the 33-year-old Roe v. Wade court decision that legalized the procedure.

“Societal tide”? Two justices don’t make a society. In fact, possibly the most remarkable thing about the abortion controversy is that, in spite of years of Sturm und Drang, opinions actually are not shifting. I believe we’re still pretty much where we were just after Roe v. Wade was decided.

Check out the archive of abortion polls at pollingreport.com. Scroll down to the ABC News/Washington Post poll asking the question, “Do you think abortion should be legal in all cases, legal in most cases, illegal in most cases, or illegal in all cases?” This table shows results going back to 1996. In June 1996, 58 percent of adults nationwide believed abortion should be legal in all or most cases; 39 percent believed it should be illegal in all or most cases. In December 2005, 57 percent believed abortion should be legal in all or most cases, and 40 percent believed it should be illegal in all or most cases. Given a 3 percent margin of error, this shows that over the past decade there has been no change at all.

If you scroll even further down, you can find a CNN/USA Today/Gallup Poll that goes back to 1975. This poll asked the question “Do you think abortions should be legal under any circumstances, legal only under certain circumstances, or illegal in all circumstances?” Let’s compare April 1975 to November 2005:

1975

Always legal — 21 percent
Sometimes legal — 54 percent
Always illegal — 22 percent

2005

Always legal — 26 percent
Sometimes legal — 56 percent
Always illegal — 16 percent

If anything, the Fetus People lost ground somewhere.

Back to Boorstein:

Demonstrators at the annual March for Life said their movement has been buoyed by two recent Supreme Court nominees — one of them confirmed — who appear open to reconsidering the 1973 decision. They talked optimistically about how technological advances are producing clearer sonograms, which could make it harder to argue that a fetus is not a person.

Life Magazine ran its famous photographs of fetii in utero in April 1966. These photos and others like them have been around for 40 years. And the dingbats are talking about better sonograms?

You’ll like this part:

And they noted yesterday’s large turnout of young people, who filled the march route along Constitution Avenue and lined the walls outside the Supreme Court in cheerleader jackets, black leather outfits with studs and T-shirts that read, “Abortion is Mean” and “Sex is good, the pill is not.” [emphasis added]

You see the problem.

In the February 9 New York Review of Books, historian Gary Wills reviews Jimmy Carter’s Our Endangered Values: America’s Moral Crisis. Here’s a snip:

On abortion, for instance, Carter argues that a “pro-life” dogmatism defeats human life and values at many turns. Carter is opposed to abortion, as what he calls a tragedy “brought about by a combination of human errors.” But the “pro-life” forces compound rather than reduce the errors. The most common abortions, and the most common reasons cited for undergoing them, are caused by economic pressure compounded by ignorance.

Yet the anti-life movement that calls itself pro-life protects ignorance by opposing family planning, sex education, and informed use of contraceptives, tactics that not only increase the likelihood of abortion but tragedies like AIDS and other sexually transmitted diseases. The rigid system of the “pro-life” movement makes poverty harsher as well, with low minimum wages, opposition to maternity leaves, and lack of health services and insurance. In combination, these policies make ideal conditions for promoting abortion, as one can see from the contrast with countries that do have sex education and medical insurance. Carter writes:

    Canadian and European young people are about equally active sexually, but, deprived of proper sex education, American girls are five times as likely to have a baby as French girls, seven times as likely to have an abortion, and seventy times as likely to have gonorrhea as girls in the Netherlands. Also, the incidence of HIV/ AIDS among American teenagers is five times that of the same age group in Germany…. It has long been known that there are fewer abortions in nations where prospective mothers have access to contraceptives, the assurance that they and their babies will have good health care, and at least enough income to meet their basic needs.

The result of a rigid fundamentalism combined with poverty and ignorance can be seen where the law forbids abortion:

    In some predominantly Roman Catholic countries where all abortions are illegal and few social services are available, such as Peru, Brazil, Chile, and Colombia, the abortion rate is fifty per thousand. According to the World Health Organization, this is the highest ratio of unsafe abortions [in the world].

A New York Times article that came out after Carter’s book appeared further confirms what he is saying: “Four million abortions, most of them illegal, take place in Latin America annually, the United Nations reports, and up to 5,000 women are believed to die each year from complications from abortions.“[*] This takes place in countries where churches and schools teach abstinence as the only form of contraception—demonstrating conclusively the ineffectiveness of that kind of program.

By contrast, in the United States, where abortion is legal and sex education is broader, the abortion rate reached a twenty-four-year low during the 1990s. Yet the ironically named “pro-life” movement would return the United States to the condition of Chile or Colombia. And not only that, the fundamentalists try to impose the anti-life program in other countries by refusing foreign aid to programs that teach family planning, safe sex, and contraceptive knowledge. They also oppose life-saving advances through the use of stem cell research. With friends like these, “life” is in thrall to death. Carter finds these results neither loving (in religious terms) nor just (in political terms).

Be sure to read the whole review; you’ll enjoy it. I’d also like to point out that Wills is a Catholic and Carter an evangelical, proving that not all religious people are whackjobs.

Back to Boorstein:

“This is the beginning of the end. We’ll look back at some point soon and won’t believe that people were ever killing babies like it was nothing,” said Ryan McAlpin, 19, who came from Chicago with a group of friends.

The Alan Guttmacher Institute provides a wealth of information on abortion and abortion law worldwide. I’ve spent considerable time there and have yet to find an example — in the past 30 or so years, anyway — of a nation criminalizing abortion in a place where it was once legal. Abortion has been decriminalized in many nations, but not the other way around. Worldwide, the societal tide is clearly with choice, not against it.

One more bit from Boorstein:

Joe Giganti, a spokesman for the action center, said more Americans are starting to question the notion that Roe is settled law. “I’d say the mood has changed significantly just in the past year,” he said. “We’re going to see the overturning of Roe .”

Back to pollingreport.com. According to a, NBC News/Wall Street Journal poll conducted in December 2005, 66 percent of adults nationwide support keeping Roe v. Wade as settled law; only 30 percent want it overturned. I’d say Joe Giganti is celebrating a little too soon.

In the long term, even if Roe v. Wade were overturned and a whole mess of states criminalized abortion the next day, the overwhelming force of public opinion would eventually set things right again to make abortion legal. That is, unless the United States isn’t converted into a fundie theocracy, in which case all bets are off. And in that case abortion law will be the least of our problems.

Update: See also feministing and Digby.