Justices, 5-4, Back a Ban on an Abortion Method

[conyat]

<p>

The AMA statement does not say that late trimester abortions generally are safest for the mother in emergency situations

.</p>

<p>This is one of the reasons that I say you argue like a member of the radical right, collegialmom. One of their common tactics is attacking a straw man; rebutting an argument no one has made to distract from the weaknesses in one’s own position. </p>

<p>This is about the fourth time you’ve attacked that particular straw man. No one has claimed that the AMA says it’s generally safer. </p>

<p>However, I think we’ve demonstrated pretty clearly that your position that it’s never safer is based on your own political ax to grind and not science.</p>

<p>Razorsharp, would you be in favor of legislation requiring a man to donate a kidney if his elderly parent or grandparent needed it to stay alive? Part of his liver? Bone marrow?</p>

<p>After all, it’s just injuring one person to save another.</p>

<p>And in case you missed it, Razorsharp, 700 people a year die from complications of childbirth and pregnancy. C-sections will not always save a woman’s life, despite what Bill O’Reilly may be broadcasting.</p>

[corranged]

<p>Razor, you seem to see “damaged health” as something like a hangnail. I’m not a doctor, but it seems to me we could be talking about paralysis from a stroke or brain damage from oxygen deprivation or severe organ damage or any number of things that could have a very significant impact on the lives of every member of the family. It also seems that in such a dangerous situation the baby, if born successfully, could likely already be dangerously unhealthy, possibly in danger of a death soon after birth. This procedure is used in desparate situations that are enormously difficult for everyone involved. These decisions should be made by a physician, the woman, and the woman’s family. I don’t think the balancing of lives should be up to the courts, and that is what they are doing.</p>

[collegialmom]

<p>This clarifies what I have been saying. It is from an article from the Journal of the American Medical Association (JAMA), 1998, written by 2 doctors. ACOG is the American College of Obstretricians and Gynecologists:</p>

<p>"Conflicting information about intact D&X and its frequency catalyzed prominent medical organizations to evaluate the procedure. In 1996, the American College of Obstetricians and Gynecologists (ACOG) convened a special committee to review it. According to the ACOG panel, intact D&X has been defined to consist of 4 elements[9] : (1) the deliberate dilation of the cervix, usually over a sequence of days; (2) instrumental conversion of the fetus to a footling breech; (3) breech extraction of the body, excepting the head; and (4) partial evacuation of the intercranial contents of a living fetus to effect vaginal delivery of a dead but otherwise intact fetus.</p>

<p>An ACOG policy statement emanating from the review declared that the select panel “could identify no circumstances under which this procedure…would be the only option to save the life or preserve the health of the woman” and that “an intact D&X, however, may be the best or most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman, and only the doctor, in consultation with the patient, based upon the woman’s particular circumstances can make this decision.”[9] However, no specific examples of circumstances under which intact D&X would be the most appropriate procedure were given.</p>

<p>Maternal Considerations.—There exist no credible studies on intact D&X that evaluate or attest to its safety. The procedure is not recognized in medical textbooks nor is it taught in medical schools or in obstetrics and gynecology residencies. Intact D&X poses serious medical risks to the mother. Patients who undergo an intact D&X are at risk for the potential complications associated with any surgical midtrimester termination, including hemorrhage, infection, and uterine perforation. However, intact D&X places these patients at increased risk of 2 additional complications. First, the risk of uterine rupture may be increased. An integral part of the D&X procedure is an internal podalic version, during which the physician instrumentally reaches into the uterus, grasps the fetus’ feet, and pulls the feet down into the cervix, thus converting the lie to a footling breech. The internal version carries risk of uterine rupture, abruption, amniotic fluid embolus, and trauma to the uterus. According to Williams Obstetrics, “there are very few, if any, indications for internal podalic version other than for delivery of a second twin.”[10]</p>

<p>The second potential complication of intact D&X is the risk of iatrogenic laceration and secondary hemorrhage. Following internal version and partial breech extraction, scissors are forced into the base of the fetal skull while it is lodged in the birth canal. This blind procedure risks maternal injury from laceration of the uterus or cervix by the scissors and could result in severe bleeding and the threat of shock or even maternal death. These risks have not been adequately quantified.</p>

<p>None of these risks are medically necessary because other procedures are available to physicians who deem it necessary to perform an abortion late in pregnancy. As ACOG policy states clearly, intact D&X is never the only procedure available. Some clinicians have considered intact D&X necessary when hydrocephalus is present. However, a hydrocephalic fetus could be aborted by first draining the excess fluid from the fetal skull through ultrasound-guided cephalocentesis. Some physicians who perform abortions have been concerned that a ban on late abortions would affect their ability to provide other abortion services. Because of the proposed changes in federal legislation, it is clear that only intact D&X would be banned."</p>

[razorsharp]

<p>Several of the posters on this thread keep confusing health of mother with the life of mother. You that the health of the mother should be an exception and then given examples of possible death of the mother. Well, if there is a reasonable possibility of death to the mother, the law permits a partial birth abortion. That is the exception contained in the statute. Thus, your arguments are meritless.</p>

<p>An exception for the health of the mother means (at least to me) that the mother’s health would be endangered but NOT her life. So when you give examples of how the mother could die, you have not refuted my argument.</p>

<p>If you are saying that a partial birth abortion is okay for the health of the mother, you are saying it is ok to kill the child because the mother may have any health problems. </p>

<p>It is the role of the legislature to weigh these very concerns between the mother and the child because this may change over the long run as we learn more about medical procedures, etc. If you think there should be a health exception then ask your legislator to pass a bill creating one. Expecting the Supreme Court, however, to create an exception for you is not the role of the court.</p>

<p>The reality is that when there are general exceptions for the health of the mother, the result is that if you can find some doctor who will buy your story that you will be depressed following the birth, you can have your child killed. A parallel (but less significant) example, is how medical marijuana is handled. For those states with prescription marijuana statutes, why is it that all of a sudden every stoner has a medical reason for pot?</p>

[conyat]

<p>

This clarifies what I have been saying.

</p>

<p>

None of these risks [of Intact D&X] are medically necessary because other procedures are available to physicians who deem it necessary to perform an abortion late in pregnancy.

</p>

<p>This is nothing like what you’ve been saying. Where have you been saying that late-term abortion is sometimes medically necessary? </p>

<p>What you’ve been saying is the opposite–that late-term abortion is never necessary because a C-section is always safer. Further down, I’ll quote the part that proves this wrong.</p>

<p>

Intact D&X poses serious medical risks to the mother.

</p>

<p>Of course it does. But if a woman’s already not going to survive live birth or C-section–and hundreds of women a year don’t–what worse outcome can she have? You may have missed the point that the authors aren’t comparing the risks of Intact D&X to the risks of C-section; they’re comparing the risk to other forms of late term abortion.</p>

<p>And finally:</p>

<p>

an intact D&X, however, may be the best or most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman, and only the doctor, in consultation with the patient, based upon the woman’s particular circumstances can make this decision.

</p>

<p>This is exactly what people have been trying to tell you all along. And what you’ve been denying.</p>

[conyat]

<p>Razor, you haven’t answered the question as to whether you’d support legislation requiring a man to donate a kidney, bone marrow or part of his liver to an elderly dying parent. </p>

<p>By your logic, injury to one is better than death to the other. So I hope you’ll be writing your Congressperson to urge him or her to sponsor legislation to this effect.</p>

[razorsharp]

<p>

This is one of the reasons that I say you argue like a member of the radical right, collegialmom.

Conyat, it seems like you can’t make an argument without suggesting someone who disagrees with you is a radical right or a neocon. It is possible for people to have different opinions from yours but not be put into a little box with a label you have created. Frankly, I am not even sure what a neocon is but I really don’t care. All I know is that the logic of the argument is separate from political opinion.</p>

[razorsharp]

<p>

Razor, you haven’t answered the question as to whether you’d support legislation requiring a man to donate a kidney, bone marrow or part of his liver to an elderly dying parent. </p>

<p>By your logic, injury to one is better than death to the other. Where do you stand on this one?

No, I would not support such legislation. Your analogy is false. Context matters, and the two situations are materially different.</p>

[conyat]

<p>In what way are they different? In either case, someone is going to die unless someone else’s health is compromised.</p>

<p>The most salient “context” that’s different is that in my example, men are affected too.</p>

[corranged]

<p>

Well, if there is a reasonable possibility of death to the mother, the law permits a partial birth abortion.

One of the many problems is judging, in a tense situation, whether a woman will die. Who determines what level of likliness of death makes this procedure legal? How are doctors supposed to determine whether a woman is close enough to death for this to fall under the court’s guidelines? All of the possibilities I listed could damage or kill a woman. The call of which it will do is not always clear, and it is not appropriate that physicians will be forced to make a decision based on language in a court’s decision.</p>

<p>In terms of the JAMA excerpt… Evidently the courts do feel that the procedure could be of use, which is why it isn’t completely banned. They then decided when it should be used–that decision should not belong to a court.</p>

<p>More than anything else, I simply do not feel the government should be determining when any medical procedure should or should not be used. That is not their call to make.</p>

[razorsharp]

<p>

In what way are they different?

The child is being killed by another human. The elderly parent is not being killed by another person. The elderly parent is dying for reasons unrelated to the direct actions of another human. </p>

<p>Another difference is the level of foreseeable risk. When a woman become pregnant her body changes and there is long history of women and children dying in childbirth. There is no such thing as a risk free pregnancy. </p>

<p>A son or daughter has no expectation or control over whether his or her elderly parent will need a kidney. Most elderly parents don’t need kidneys or other assistance from their children. In addition, a son or daughter has no control over whether he or she is born.</p>

[razorsharp]

<p>

One of the many problems is judging, in a tense situation, whether a woman will die. Who determines what level of likliness of death makes this procedure legal? How are doctors supposed to determine whether a woman is close enough to death for this to fall under the court’s guidelines?

Again, the guidelines are not those of the Court. The court did not set guidelines and should not be involved in setting such guidelines.</p>

<p>Who determines this depends on what a reasonable doctor would consider the likeliness of death. If the government wishes to put someone in jail, the government prosecutors must prove their case beyond a reasonable doubt. That is a difficult standard to meet. If a doctor exercises his professional judgment, then there would be insufficient criminal intent to convict the doctor.</p>

<p>Here is some of the text of the statute:

A defendant accused of an offense under this section may seek a hearing before the State Medical Board on whether the physician’s conduct was necessary to save the life of the mother whose life was endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself.
The findings on that issue are admissible on that issue at the trial of the defendant. Upon a motion of the defendant, the court shall delay the beginning of the trial for not more than 30 days to permit such a hearing to take place. </p>

<p>

</p>

[corranged]

<p>It isn’t OK just because a doctor isn’t likely to ever be convicted.</p>

[razorsharp]

<p>Here is some of the text of the statue:</p>

<p>

Any physician who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus shall be fined under this title or imprisoned not more than 2 years, or both. This subsection does not apply to a partial-birth abortion that is necessary to save the life of a mother whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself.

</p>

[razorsharp]

<p>

It isn’t OK just because a doctor isn’t likely to ever be convicted.

I agree with you.</p>

[conyat]

<p>

If the government wishes to put someone in jail, the government prosecutors must prove their case beyond a reasonable doubt. That is a difficult standard to meet. If a doctor exercises his professional judgment, then there would be insufficient criminal intent to convict the doctor.

</p>

<p>Realistically, all it’s going to take is one nurse with a political ax to grind, a DA looking to make a name for himself, and 12 jurors who may or may not understand the medical evidence, and who may or may not find it acceptable for a mother to survive if her child doesn’t. </p>

<p>Remember that even very educated people like Bill O’Reilly, with vast resources at their disposal, believe the myth that “no one dies in childbirth anymore-they can just have C-sections.” Because they refuse to believe a woman’s life is ever in jeopardy, they will not accept that Intact D&X can have been the only or best means of saving it.</p>

<p>Look how easily Georgia Thompson was railroaded into jail by a political appointee prosecutor. The appeals court said the evidence was “beyond thin”; that there was nothing to indicate a crime had been committed; the prosecution was “preposterous”–yet she served about a year in jail. And that wasn’t even a hot button issue.</p>

<p>It will be very, very easy to railroad an innocent doctor to jail over this. My guess? Doctors won’t take the chance; they’ll just allow the woman to die rather than risk losing everything they’ve worked for.</p>

[mini]

<p>Let’s remember that this decision ratifies a law which has been the law of the land for some time now, and not a single case has been filed in any state in the union.</p>

[conyat]

<p><a href=“http://www.msnbc.msn.com/id/18278305/site/newsweek/[/url]”>http://www.msnbc.msn.com/id/18278305/site/newsweek/&lt;/a&gt;&lt;/p&gt;

<p>One woman tells her story.</p>

[mommusic]

<p>Thank you, conyat.</p>

<p>And re the JAMA article–it is a 1998 article based on a 1996 committee report. I can’t believe this 11-year old information is the latest medical thinking. (And according to the doctor I heard interviewed on the radio, it is not.)</p>

<p>Congress should not legislate medical care. Or men, would you like to see a female-dominated congress decide Viagra is not medically necessary? Or more seriously, decide for you on a course of prostate cancer treatment?</p>

[collegialmom]

<p>Why is Bill O’Reilly being mentioned in some of these posts? I am not a big TV watcher, so am not sure what the reference to him is about? Is he against partial birth abortion, or against all legalized abortion?</p>