by hilzoy
In a comment on another thread, Phil asked what I thought of this op-ed on stem cell funding, by Sen. Sam Brownback. What follows is the op-ed, with my comments.
"Last year I met a courageous young woman, Jacki Rabon of Illinois, who was paralyzed in a car accident at age 16. Today, thanks to an ethical adult stem cell treatment that she received in Portugal, Jacki is regaining feeling in her legs and can walk with the aid of braces and a walker."
Jacki Rabon's story is tragic. As of June 20, 2006, some sensation had returned to her hips, and she could walk with leg braces on parallel bars and with a walker. Her goal for the end of the year was to be able to walk with the leg braces and crutches. I've tried to find out what has happened to her since then, without success. I hope she is walking now.
"This week, the Senate will debate a bill that would provide taxpayer funding for a different type of stem cell research from the type that is helping Jacki and scores of other patients. The Senate will vote on whether to fund embryonic stem cell research, which requires the destruction of human embryos. We all started as an embryo, and biologically, the human embryo is no less human than you or I.Two issues are at stake:
First, should we treat the young human as a person or as a piece of property? Will the federal government maintain high ethical standards in research, or will we sanction the destruction of young human lives to further speculative research that might or might not eventually help patients?"
Naturally, the whole question is whether a five day old blastocyst should be treated as a human person or not. If not, then the government can continue to maintain "high ethical standards in research" while funding research on embryonic stem cells. Nothing Brownback says here provides any sort of argument on this central point. And as I've said before, pointing out that a blastocyst is both human (as opposed to bovine, equine, feline, etc.) and alive does not settle the matter. The same is true of living human cells in culture, and no one thinks that using living human cells for research is unethical. Nor does this change when we add in the requirement that the living human entity in question be an individual. People who are brain dead are still alive, and are kept alive after they would normally die when they are organ donors. If you think that this is OK -- that using organs from humans who are brain dead, but whose blood is still circulating, is not ghoulishly carving up living persons to steal their organs -- then you cannot think that the fact that a blastocyst is (a) living, (b) human, and (c) an individual organism, not a mere cell or tissue sample, settles the matter.
"Second, should we fund the research that holds the most promise to bring treatments to patients soonest, or should we fund speculative and unethical research, the benefits of which are unclear and may never come?"
There is absolutely no need to choose between these two options. We can and should fund both.
"For the sake of the patients, we should fund adult stem cell research to the exclusion of unethical embryonic stem cell research. Jacki should not have to travel to Portugal, at great personal expense, for a treatment with her own adult stem cells. And she is not the only patient who has had no choice but to travel around the world for an adult stem cell treatment."
I cannot imagine why we should fund only adult stem cell research, but not embryonic stem cell research, "for the sake of the patients." Surely, if all we're concerned about is the patients, we should fund any promising line of research. The only reasons not to fund one would be either lack of money or the fact that it shows no promise whatsoever. Neither is true here.
The fact that Jacki Rabon had to go to Portugal for her treatment has nothing whatsoever to do with research funding. It has to do with the fact that her treatment is experimental, and at the time she had it, it had not been approved by the FDA. I have no idea why that was true, or if it has been approved since then. Possible reasons for its not being approved include everything from no one having applied for FDA approval to there not being adequate evidence that it works. (At the time Jacki Rabon sought treatment, the person who provided it had not "published any of his results in a peer-reviewed scientific journal, although the first article is expected this year in the Journal of Spinal Cord Medicine." Moreover, the treatment's results are described as follows (note: this block-quoted passage does not come from Brownback's article):
"All of Lima's approximately 80 patients - half of them Americans - who have undergone the surgery in Portugal since summer 2002 have reported some gains in sensation, and about 5 percent say they have better feeling in their bladders and bowels, Hinderer said. But no one is walking without braces, and it's not clear if the improvements were related to the surgery."
If Brownback has a problem with the FDA's procedures, he should take it up with them. But Jacki Rabon's travels have precisely nothing to do with funding for stem cell research. Anyways, back to Brownback's op-ed:
"We know of 72 peer-reviewed adult stem cell treatments and applications for a wide range of diseases and injuries."
Oh, goody: it's David Prentice's list of 72 illnesses treated with adult stem cells again. And that means I have to link to the evisceration of it in Science (Washington Post summary here.) I don't think the Science piece is accessible without a subscription; the take-home point is that while (when the piece was written) Prentice was claiming that adult stem cells had been approved for 65 diseases, the actual number was -- prepare yourselves -- nine. Excerpt (again, this is from the Science piece, not Brownback):
"The references Prentice cites as the basis for his list include various case reports, a meeting abstract, a newspaper article, and anecdotal testimony before a Congressional committee. A review of those references reveals that Prentice not only misrepresents existing adult stem cell treatments, but also frequently distorts the nature and content of the references he cites (5).For example, to support the inclusion of Parkinson's disease on his list, Prentice cites congressional testimony by a patient (6) and a physician (7), a meeting abstract by the same physician (8), and two publications that have nothing to do with stem cell therapy for Parkinson's (9, 10). In fact, there is currently no FDA-approved adult stem cell treatment--and no cure of any kind--for Parkinson's disease.
For spinal cord injury, Prentice cites personal opinions expressed in Congressional testimony by one physician and two patients (11). There is currently no FDA-approved adult stem cell treatment or cure for spinal cord injury.
The reference Prentice cites for testicular cancer on his list does not report patient response to adult stem cell therapy (12); it simply evaluates different methods of adult stem cell isolation.
The reference Prentice cites on non-Hodgkin's lymphoma does not assess the treatment value of adult stem cell transplantation (13); rather, it describes culture conditions for the laboratory growth of stem cells from lymphoma patients.
Prentice's listing of Sandhoff disease, a rare disease that affects the central nervous system, is based on a layperson's statement in a newspaper article (14). There is currently no cure of any kind for Sandhoff disease."
My personal favorite part of Prentice's list is item 40, Alopecia Universalis. This is a form of hair loss. According to the supporting materials to the Science piece, the study Prentice cites in support of the claim that adult stem cells can cure this disease is a report of one (1) patient who got a bone marrow transplant for leukemia, after which his alopecia got better. Leave aside the fact that this is just a report from one patient, and consider what a bone marrow transplant is like. It's a hellacious operation involving killing your bone marrow and injecting someone else's. According to Wikipedia, it has a 10% mortality rate. You have to stay in the hospital for 4-6 weeks, followed by 2-3 months of "attentive follow-up care". Using this as a cure for hair loss would be like having someone else's legs transplanted onto your body in order to get rid of your unsightly spider veins.
This is the source for Brownback's assertions about 72 diseases.
"Yet embryonic stem cell research has not yielded any treatments or applications to date."
Nope, there haven't. Stem cells were first isolated in 1998. Coming up with therapies takes a lot of work: you need to learn to manipulate and culture the cells, do a whole bunch of basic science, do animal studies on possible avenues for therapies, and only when you've really got good evidence that something is likely to work in humans can you get permission to begin the first human trials, which are required in order to get FDA approval for a therapy. This is a very long process, and for good reasons: before a therapy is approved for humans, you really want it to have been thoroughly tested. There would not be any therapies eight years after the cells were first cultured even if stem cell scientists hadn't been forced to work with one hand tied behind their back, owing to restrictions on federal funding. Which, of course, they have.
"Patients should have the peace of mind that their treatment did not come at the expense of another's destruction, and they should not have to travel around the world to seek help. I urge my Senate colleagues to reject the Stem Cell Research Enhancement Act and taxpayer funding for human embryonic stem cell research."
Those patients who believe that a five day old blastocyst is a human person who should not be destroyed can obtain peace of mind through the simple expedient of not using any therapies involving embryonic stem cells. Those who do not believe this can use such therapies without jeopardizing their peace of mind. Similarly, it would be wrong to say, based on the existence of orthodox Jews in our country, that "People should have the peace of mind that they are not in some way using the Sabbath labor of others, and thus we should pass a national ban on doing any work on Saturdays." Those citizens who believe that no work should be done on Saturdays can protect their peace of mind by not doing any, and by not relying on other people's Sabbath labor; but the rest of us should not be compelled to abide by religious beliefs that we do not share.
And, as before, the relevance of Jacki Rabon's trip to Portugal is completely unclear to me.
There you go, Phil! At ObWi, we live to serve ;)
"To quote Heinlein who was quoting West Point rules"
I don't recognize the reference, but I don't claim to have every word of Heinlein memorized, so that's irrelevant; however, I'm inclined to suspect he'd have been referring to Annapolis, the Naval Academy in Maryland, which he went to extreme efforts to get nominated to, and then graduated from, rather than West Point, the Army Academy, in New York.
"Does it? Again, what example are you offering of the law taking away your control over your own body and forcing you to provide bone marrow, liver, kidney, or blood to save a life?"
Steve was picking up on your poor phrasing, which is what's making it necessary for you to add the clause that comes after "and" here, to save you from having made an over-strong claim.
The State puts a lot of requirements on our bodies, as regards the sort of things Steve referred to. Another would be that the state requires you not to relax your hand muscles if you're holding a child over the balcony of a twelve-story building; it requires you not to, when holding a two-hundred pound weight over someone's head, release the weight with your hand muscles. You are constrained by the State from poking your finger through someone's eye. Etc., etc., etc., ad infinitum.
What it doesn't do is put the more specific, and limited, requirements upon the internals of your body, that you actually have in mind, but wrote in such a way as to instead include all behavior of your body.
Basically, the State can and does constrain us from a gazillion positive actions we can take with our bodies -- this is constraining our bodies; what we pretty much don't let the State do is enjoin us to take positive actions, such as donate blood, give up an organ, etc.
(Though that distinction is arguable, too: for instance, we're at least theoretically both restrained from jaywalking, and enjoined to walk across streets at cross-walks; what's a constraint versus an enjoinment is sometimes a matter of POV.)
It's a relatively trivial point, and completely avoidable by simply being a bit more careful, and a bit less sweeping, in your phrasing.
Posted by: Gary Farber | April 11, 2007 at 05:57 PM
Steve: Point being, if you had put it that way, I would have agreed with you. Why you're continuing to pick a fight over something I agreed to is beyond me.
Sorry. Probably because threads that turn into abortion threads tend to get acrimonious: I apologize for picking a fight with you, and will now retire from the thread...
Posted by: Jesurgislac | April 11, 2007 at 05:58 PM
The experience in California strongly suggests that mental health exceptions in abortion statutes are inherently manipulable and subject to abuse.
The pre-Roe statistics are, quite frankly, indicative of civil disobedience. The pre-Roe California statute provided that you couldn't get an abortion, even early in the first trimester, unless "there is a substantial risk that continuance of the pregnancy would gravely impair the physical or mental health of the mother" or the pregnancy resulted from rape or incest. Clearly, there were some doctors who felt that it was ridiculous to ban first-trimester abortions, and relying on the mental health exception was the easiest way to circumvent the statute. I'm not saying that makes it right, but if I were a doctor, it's possible I'd feel the same way after the first time I sent a woman home only to have her return in a body bag following a botched DIY.
Anyway, consider that today, we're discussing the mental health exception only in the context of late-term abortions, something most doctors and medical associations are reluctant to approve in the first place. Just because doctors in California were routinely abused the mental health exception in order to approve first-trimester abortions hardly means they will be equally willing to find any excuse to approve an abortion at 30 weeks. The sort of doctor who approves a third-trimester abortion for no good reason is surely rare, and I'm not convinced such a creature even exists.
In addition, you're kind of going down the road of the typical conservative argument which says "some people cheat at welfare, so we shouldn't have welfare." Either you're disdainful of the notion that abortion could ever be necessary for mental health reasons, or else you're looking to ban abortions that ought to be performed for such reasons on the grounds that if we allow them, some people will get away with gaming the system.
Posted by: Steve | April 11, 2007 at 05:58 PM
"The pre-Roe statistics are, quite frankly, indicative of civil disobedience. The pre-Roe California statute provided that you couldn't get an abortion, even early in the first trimester, unless "there is a substantial risk that continuance of the pregnancy would gravely impair the physical or mental health of the mother" or the pregnancy resulted from rape or incest. Clearly, there were some doctors who felt that it was ridiculous to ban first-trimester abortions, and relying on the mental health exception was the easiest way to circumvent the statute."
Ahh, this works really well with Lizardbreath's argument that I should trust doctors to do the right thing without any supervision or check whatsoever. Thanks for setting my mind at ease.
Posted by: Sebastian Holsclaw | April 11, 2007 at 06:09 PM
Have you got any evidence at all that these laws are ever violated? The pro-choice conspiracy of silence didn't successfully conceal all the pre-Roe illegal abortions -- are you asserting that it's more effective now?
Posted by: LizardBreath | April 11, 2007 at 06:11 PM
Think for a moment how incredibly difficult it is to get good statistics on prisoner abuse. This is true EVEN THOUGH PRISONERS ROUTINELY SURVIVE PRISON AND ROUTINELY ARE RELEASED FROM PRISON.
Now, posit it a situation where the prisoners are never released, and never survive incarceration. Would you be comfortable with a situation where the professionals in charge (the wardens) don't have to track their treatment of the prisoners. Would you be fine with a complete lack of supervision? Why or why not?
Posted by: Sebastian Holsclaw | April 11, 2007 at 06:13 PM
"The pro-choice conspiracy of silence didn't successfully conceal all the pre-Roe illegal abortions -- are you asserting that it's more effective now?"
What exactly are you talking about? Doctors were claiming in California that 80,000 women per year were going to be so mentally ill that they would have to be institutionalized because of their pregnancies and how many were prosecuted for that? Sounds like it was pretty darn effective back then too!
Posted by: Sebastian Holsclaw | April 11, 2007 at 06:16 PM
But it's not difficult to get anecdotal evidence that prisoner abuse happens sometimes -- often enough to worry about. Accurate numbers are difficult to collect, but testimony on individual cases is all over the place.
You're worried that these laws banning elective late term abortion are routinely violated, but I haven't seen you cite to a single anecdote from someone claiming firsthand knowledge of a violation. Without some such evidence, I can't see treating lax enforcement of the law as a social issue of primary importance.
Posted by: LizardBreath | April 11, 2007 at 06:18 PM
my analogy isn't an analogy: it's a direct equation. You are arguing that a woman has no right to make decisions about her own uterus: I am asking you to provide an ethical argument that justifies this for everyone (or, if you want to restrict it just to all parents) and for all organs, not just the uterus. Why do you believe it ethical, if a father does not want to give up one of his kidneys to his child, for him to be forced to do so against his will to save his child's life?
Everyone is entitled to his or her own opinions, they are not, however, entitled to their own language. Uterus:kidney, is an analogy. So, for that matter, is donation:gestation.
What you appear to mean is that your analogy is more exact. But more exact is not always better, nor is it obvious that the similarity between donation and gestation is greater than that between gestation and nourishment. You do not lose the future use of your organs when you gestate; you do when you donate. I hope it is clear that I am talking about pregnancy in general here, not about pregnancies involving major health risk, as to which my arguments do not apply because of the self-defense issue. You made an argument for a right to abort independent of major health risk, and I have been answering that argument.
But there is no moral hazard in forcing a woman through pregnancy and childbirth against her will, and no religion that (in your view) mandates regarding a woman as a human being with full human rights, even when pregnant?
Of course there is. But the moral hazard is a different one, and so is the religious precept, and you can't necessarily assume that because the one is respected so must the other be. And please don't put words in my mouth.
Whoops, it says up there that you've gone home. Well, I'll post it anyway, for the sheer intellectual fun of the thing, which is why I wrote it in the first place anyway.
Posted by: trilobite | April 11, 2007 at 06:23 PM
Sebastian, "good statistics" is one thing, no evidence at all is another.
Posted by: trilobite | April 11, 2007 at 06:25 PM
What exactly are you talking about? Doctors were claiming in California that 80,000 women per year were going to be so mentally ill that they would have to be institutionalized because of their pregnancies and how many were prosecuted for that?
What I'm talking about is that it was an open secret. The law was violated, but people knew it was being violated; we have statistics on how often it was being violated (perhaps not perfectly accurate, but there on some level). If in 1969, someone asked "Is there any evidence that the abortion laws are ever violated in California?" the answer would have been yes.
Now, not so much. When did the abortion-rights conspiracy get so good at keeping secrets?
Posted by: LizardBreath | April 11, 2007 at 06:26 PM
"Think for a moment how incredibly difficult it is to get good statistics on prisoner abuse."
Sebastian, I observe that people keep asking you for some evidence and you keep responding that there are no reliable definitive statistics.
It should be needless to point out that this response is not responsive to the question.
You've not been asked to provide "good statistics."
Posted by: Gary Farber | April 11, 2007 at 06:27 PM
Ahh, this works really well with Lizardbreath's argument that I should trust doctors to do the right thing without any supervision or check whatsoever. Thanks for setting my mind at ease.
I'm glad I put the effort into a substantive and detailed comment just so you could blow it off with this snotty response.
As I alluded to above, the conservative thought process holds that as long as someone, somewhere, is gaming the system, that's sufficient reason to revoke everyone's privileges.
Yes, there was widespread disobedience of the onerous abortion laws in the years before Roe. And for you, this proves that even if we have restrictions that are far more reasonable, restrictions that virtually every doctor and medical assocation would be on board with, there would still be widespread disobedience. Rosa Parks violated the Jim Crow laws, she'll probably violate other, more reasonable laws as well. As I explained in detail above, I'm not impressed by that argument.
Posted by: Steve | April 11, 2007 at 06:28 PM
"But it's not difficult to get anecdotal evidence that prisoner abuse happens sometimes -- often enough to worry about."
That is because the prisoners themselves make allegations. The fetuses are dead. If a prisoner ends up dead, there is at least a pro forma investigation. When the fetus ends up dead, we don't even attempt to require that the doctor justify himself.
Posted by: Sebastian Holsclaw | April 11, 2007 at 06:38 PM
Would you be comfortable with a situation where the professionals in charge (the wardens) don't have to track their treatment of the prisoners.
But of course, most jurisdictions do require abortion reporting. Of course the reporting isn't perfect, but much of that is due to the fact that reporting in general tends to suck, not because there's a vast conspiracy to hide the truth.
link
Of course, to the extent anyone is out to deliberately misreport, it might have something to do with the fact that abortion providers do get shot in this country, and women who have abortions do get harassed for it. You can't just ignore these very real concerns and lament the fate of the poor, ignored reporting requirements.
Posted by: Steve | April 11, 2007 at 06:39 PM
Isn't it interesting that a thread supposedly to discuss whether or not it's ethical to do scientific research on 5-day-old blastocysts that will never become humans because they will never be transplanted into a human uterus, Joe Thomas very promptly brought up the issue of abortion and now we're discussing 26w+ fetuses?
You're right that I derailed the conversation; that derailment was unintentional. Though I certainly think the issues are not unrelated, I admit that the shift in focus has clearly obscured Hilzoy's original intent. In the interests of returning the thread to that topic (or at least not leading it further down the rhetorical black hole), I'll bow out.
And, as I'm reviewing to post this, I realize that Jes has done the same. Good move, I think (not because your opinion was not valuable, but for the exact reason that you cite).
Posted by: Joe Thomas | April 11, 2007 at 06:40 PM
Third trimester abortions are major surgery that take place in hospitals. With nurses, and multiple doctors, and charts. And there's still no evidence to point to. Again, that's a hell of a conspiracy.
Posted by: LizardBreath | April 11, 2007 at 06:42 PM
Gary, yes, tnxs, Sanctorum was the guy I ment.
Women should not be forced to go through prenancy and childbirth against her will, but babies should be protected when they are persons in their own right. Stating that abortions that late are rare, but still saying that it is only the women who should decide feels like saying that infanticide is rare so it should not be made illegal.
Abortion in third trimester means actively ending the life of the fetus before it is born. It still needs to be born, it does not dissolve back into the body or something. You are also not talking about inducing labour, so that the mother can *stop* "being an incubator" because the child will be out of her body. The women has the right to her body, but does the viable fetus have rights too? Or only after it leaves the body and has breathed? When does the fetus start to have rights?
We have a lawsuit (I've not read an outcome yet) against a father who heard from his wife that she wanted a divorce and that the baby she was carrying (38 weeks) wasn't his. He got angry and deliberately stabbed a few times with a knife into her belly. The baby died, and he is now accused of killing an unborn child...
Posted by: dutchmarbel | April 11, 2007 at 06:55 PM
Good thing for our conspiracy that nurses tend not to be religious types, or consider life important. Especially OB/Gyn nurses. They just hate babies, that's why they choose that specialty.
FWIW, I don't think the thread was so much derailed, as just developed -- Hilzoy nailed Brownback's demagoguery, and if anybody thinks a 5-day embryo is a person, no amount of argument will ever dissuade them, so there wasn't much to say directly on point. Fortunately, so far very little of the country thinks so.
Posted by: trilobite | April 11, 2007 at 06:56 PM
"The law was violated, but people knew it was being violated; we have statistics on how often it was being violated (perhaps not perfectly accurate, but there on some level)."
Not perfectly accurate? Please give me an good statistic plus or minus 40% of the total number. I'm asking you to document at plus or minus 32,000 out of a total of 80,000 per year. The only reason I don't ask for it with an even easier interval is that at 50% you could choose any number at all from 1-80,000 and you'd have it.
And that was back when the doctors had to document it. Now they doctor doesn't have to document it.
According to Luhra Tivis Warren (Operation Rescue member but former medical secretary to famous late-term abortion doctor Tiller):
Posted by: Sebastian Holsclaw | April 11, 2007 at 06:59 PM
Sebastian specifically said that he didn't think the 5-day blastocyte was a person, but that he would be more comfortable with clear guidelines about when it is. Hence the thread turning into a discussion about when the fetus *is* a person.
At least - that's how I read it.
Posted by: dutchmarbel | April 11, 2007 at 07:00 PM
Stating that abortions that late are rare, but still saying that it is only the women who should decide feels like saying that infanticide is rare so it should not be made illegal.
It's not just that late-term abortions are rare, it's that (we believe) they don't happen without a good reason, like serious health complications. If women are routinely marching into hospitals across America after 7 or 8 months of pregnancy and demanding elective abortions, it's certainly news to me.
That's not to say that we can't have third-trimester bans, but we need to make sure they leave exceptions for the times when there's a good reason. And people like Seb have a way of saying no, we can't have exceptions because then people who want purely elective abortions will find a way to exploit the exceptions. Hence the difficulty in finding a rule we can all agree on.
Posted by: Steve | April 11, 2007 at 07:01 PM
And that was back when the doctors had to document it. Now they doctor doesn't have to document it.
Where is it that doctors don't have to document abortions? A tiny handful of jurisdictions?
Posted by: Steve | April 11, 2007 at 07:03 PM
I'm not certain what Sebastian's talking about with 'don't have to document' abortions. It's a medical procedure, and there are the same requirements for documentation as with any other medical procedure. There seems to be some particular kind of documentation he's worried about, but I don't know what it is.
Posted by: LizardBreath | April 11, 2007 at 07:09 PM
"With nurses, and multiple doctors, and charts."
And clerks and orderlies and technicians. Who talk to co-workers and relatives and friends.
But, after all, the security checks and polygraphs prevent anyone even remotely bothered by "5-minutes before birth" whimsical abortion decisions getting even a hint of the multitude of last-minute abortion decisions that we suffer from in America.
Hell, it was impossible for anyone in WWII to find out about the Holocaust, too, since all the prisoners were killed, and they actually had Gestapo-level security.
Oh, wait, it was reported in American newspapers in 1942. Even though the people who were killed were dead! (And the German authorities weren't "investigating" the deaths.)
There, now someone can claim that their understanding of Godwin's Law means that the thread is over.
New subject: what form of gun control is and isn't acceptable for Windows, Mac, and Linux, users to require for those evil people using those wack other OSes? Which OS users tend to have the best positions on gun control, and does Captain Kirk use the best OS, or Captain Picard? Was abortion treated more perceptively in Lord of the Rings, the books, or the movies? Who deserves to be aborted more: crunchy peanut butter fans, or those of smooth?
Posted by: Gary Farber | April 11, 2007 at 07:11 PM
But not just that, related to that, I was required to lie to the women over the phone. And the way he'd explain it to me was, without coming right out and saying it, these are really third trimester abortions, but we're going to tell them they're only in the second trimester.
This looks marvelously credible. Innocent women, being deceived into having illegal abortions by a doctor lying about their medical condition.
Posted by: LizardBreath | April 11, 2007 at 07:12 PM
"Sebastian specifically said that he didn't think the 5-day blastocyte was a person, but that he would be more comfortable with clear guidelines about when it is. Hence the thread turning into a discussion about when the fetus *is* a person."
Except it hasn't at all. So far I haven't seen Jesurgislac, or CaseyL or Gary suggest when they think the fetus is a person. They all seem to think it is COMPLETELY OBVIOUS but won't bother telling. (Except from previous discussions I know that Jesurgislac thinks "after birth" which for medical experimentation purposes doesn't reassure me).
Posted by: Sebastian Holsclaw | April 11, 2007 at 07:17 PM
"Where is it that doctors don't have to document abortions? A tiny handful of jurisdictions?"
Argh. They document the fact of an abortion. They don't have to document the medical reason for it.
Posted by: Sebastian Holsclaw | April 11, 2007 at 07:18 PM
"Innocent women, being deceived into having illegal abortions by a doctor lying about their medical condition."
C'mon, everyone knows that third-trimester abortions are far more fun than second-trimester ones! After all, our goal is to abort as many babies as possible, and we get extra points for the third trimester!
Gadzooks, Sebastian is onto us! Am-scray!
Posted by: Gary Farber | April 11, 2007 at 07:18 PM
"So far I haven't seen Jesurgislac, or CaseyL or Gary suggest when they think the fetus is a person. They all seem to think it is COMPLETELY OBVIOUS but won't bother telling."
Not my job to answer that. Not even my hobby.
I'm not even required to have an opinion.
I'm perfectly willing to live with Roe v. Wade, though, until such time as technology may make it obsolete (artificial external wombs, for instance).
Posted by: Gary Farber | April 11, 2007 at 07:21 PM
They don't have to document the medical reason for it.
Of course, just as for any other medical procedure, they do -- it's not as if someone's chart says "Quintuple bypass" without any indication of why the surgical procedure was indicated. You may be dissatisfied with the level of oversight of documentation, or you may think that doctors are systematically documenting third trimester abortions falsely, but it's nonsense to claim that abortions are exempt from the normal documentation requirements that cover medical care generally.
Posted by: LizardBreath | April 11, 2007 at 07:23 PM
"That's not to say that we can't have third-trimester bans, but we need to make sure they leave exceptions for the times when there's a good reason. And people like Seb have a way of saying no, we can't have exceptions because then people who want purely elective abortions will find a way to exploit the exceptions. Hence the difficulty in finding a rule we can all agree on."
I'm saying that since we are talking about killing a baby post-viability, there should be some documentation more than just "I said so" to the idea that the abortion was necessary for the health of the mother or that the baby was non-viable. Prosecutors and judges are professionals too, but no one here would be ok with executions based on "According to my professional judgment he was guilty" with no further documentation.
"This looks marvelously credible. Innocent women, being deceived into having illegal abortions by a doctor lying about their medical condition."
You aren't reading very carefully. These women wanted abortions but other providers had told them that they fetus was too far along in the pregnancy for the abortion to be legal. The deception was in the "They would say, well, I've already had a sonogram, and my bpd was 7.8 or 8.3 or whatever. He said, when they tell you that, don't turn them away as being too far along. Tell them to come in, and we'll do our own sonogram, and it will show they're not that far along."
Posted by: Sebastian Holsclaw | April 11, 2007 at 07:23 PM
"C'mon, everyone knows that third-trimester abortions are far more fun than second-trimester ones! After all, our goal is to abort as many babies as possible, and we get extra points for the third trimester!
Gadzooks, Sebastian is onto us! Am-scray!"
Wow, what happened to you famous reading comprehension Gary? Did you read the quote or just spout off? Unlike my questions on the other thread, THAT was a rhetorical question with an obvious answer.
Posted by: Sebastian Holsclaw | April 11, 2007 at 07:25 PM
Like I said, being deceived into having illegal abortions -- the quote describes women seeking legal abortions, and being tricked into going ahead despite the fact that they were far enough along that their abortions would be illegal.
Posted by: LizardBreath | April 11, 2007 at 07:26 PM
Possibly, but the pro-choice position is that it's not relevant: the individual pregnant woman gets to decide.
Um, I am fairly certain that there is no such thing as "the pro-choice position," as the simple expedient of reading the thread will demonstrate.
Not one woman, nor one doctor, who regrets their decision to break the law enough to come forward? If these laws are broken with any frequency whatsoever, you're envisioning a hell of a conspiracy of silence there.
Indeed, especially given the nontrivial number of women in the pro-life movement who claim to have had abortions and now regret it. If any of them had had such an illegal procedure, I can't think of a better motivator for talking about it.
Posted by: Phil | April 11, 2007 at 07:28 PM
"You aren't reading very carefully. These women wanted abortions but other providers had told them that they fetus was too far along in the pregnancy for the abortion to be legal."
That would probably be because what you quoted said no such thing, and you provided no link. Darn LizardBreath for not reading more carefully what isn't there!
(Hint: the sole information on the women in what you quoted is that they are "women.")
Posted by: Gary Farber | April 11, 2007 at 07:28 PM
To put it another way -- I can see a motive for a woman who wants an abortion to lie and claim to be earlier in her pregnancy than she is. I could imagine a sympathetic doctor going along with that. What's the motivation for the doctor to lie to the patient there? Just enjoys it? Not enough business? How does that work?
Posted by: LizardBreath | April 11, 2007 at 07:29 PM
According to Luhra Tivis Warren (Operation Rescue member but former medical secretary to famous late-term abortion doctor Tiller):
Um. I have firsthand experience that Operation Rescue members are . . . what's the polite term? . . . often great big fat liars.
Posted by: Phil | April 11, 2007 at 07:32 PM
"Wow, what happened to you famous reading comprehension Gary? Did you read the quote or just spout off?"
I read it. Since you're asserting that you quoted things that you didn't, it seems possibly that you might want to quote slightly more carefully, and provide links to whatever it is you're quoting, rather than berating people for not reading material you didn't provide or enable them to read.
All we know is that you quoted one "Luhra Tivis Warren (Operation Rescue member but former medical secretary to famous late-term abortion doctor Tiller," whomever they are, and referred to "women."
If you present an accusation that women (some unknown number in some unknown place at some unknown time for some unknown reason) are being tricked into having third-term abortions, and supply not a clue as to why the doctor would do that, or what's going on, or where this quote came from, or who these people are, readers just might tend to be lacking that information, Sebastian.
Posted by: Gary Farber | April 11, 2007 at 07:34 PM
Argh. They document the fact of an abortion. They don't have to document the medical reason for it.
I'm afraid I don't believe you. I'd like to see the jurisdiction where the reason for an abortion is relevant - i.e. "no third-trimester abortions except where the life of the mother is at stake" - and yet there's no obligation for the doctor to document that the life of the mother was at stake. And your implication that it's like this everywhere is really, really hard to believe.
Posted by: Steve | April 11, 2007 at 07:40 PM
For the record: I believe that there is no moral problem with aborting embryos or fetuses prior to the development of sentience. Last time I checked, conservative estimates put that somewhere around the 22nd week; other estimates were later, but on this I'd rather be conservative.
After the development of sentience, I think abortion is OK when medically necessary, up until whatever time it is that the fetus is not just viable in the "we can keep it alive, but it will probably be profoundly disabled, including cognitively" sense, but viable in the "there's a decent chance this child will not be harmed by being premature" sense. (Don't ask me to make this more precise; that would take a while.) After that, abortions should not be done: the child can always be put up for adoption. It's fine to decline the honor of raising a child; it's not fine to insist that a child be killed so that you won't have to be anyone's mother.
Posted by: hilzoy | April 11, 2007 at 07:55 PM
I tried to look up figures for the UK, as requested earlier in the thread (can't look them up for the Netherlands, abortions are illegal after 22 weeks gestation. We do propose euthanatia if the kids *are* very severely handicapped though. I'm comfortable with both), but it's hard because abortion over 24 weeks is only legal if the child is severely handicapped of a health danger to the mother - so those are the only reasons listed.
I did come across this story, where for me the fetus was entitled to some protection:
And here they refer to a report:
But I couldn't find the report and it is way past midnight here so I'm off to bed.
Posted by: dutchmarbel | April 11, 2007 at 07:56 PM
What's the motivation for the doctor to lie to the patient there? Just enjoys it? Not enough business? How does that work?
He/she thinks he/she's helping them.
Posted by: Ugh | April 11, 2007 at 08:09 PM
Not impossible -- people do nutty things -- but awfully nutty.
Posted by: LizardBreath | April 11, 2007 at 08:14 PM
A colleague here had a "partial birth abortion" recently. Her very much wanted baby had severe birth defects and would not, the doctors said, survive long even if she was carried to term. The docs elected to induce and abort. My colleague's life wasn't at risk. One could argue that it was a matter of convenience. I mean, she could've carried the baby to term, borne it, and had it die right away. Or a couple of days later. Or a week.
I am glad, for her sake, that she was not forced to justify her decision to anyone.
Posted by: lowly_adjunct | April 11, 2007 at 08:17 PM
Argh. They document the fact of an abortion. They don't have to document the medical reason for it.
Then, please let's START from there. Do we have some numbers here?
Everybody is arguing with a distinct lack of numbers. Many of those arguments would really, really be helped with some numbers. Please.
Posted by: gwangung | April 11, 2007 at 09:03 PM
A few points:
Stem cells were first isolated in 1998.
Nope. They were first isolated in 1964 by cancer researchers studying embryonal carcinomas. They were first cultured as stand-alone cell lines in 1998--three years AFTER Clinton signed the Dickey Amendment barring the destruction of human embryos in medical research. The Bush admin has kept pre-existing law in place, not imposed new law of their own devising.
Naturally, the whole question is whether a five day old blastocyst should be treated as a human person or not.
Yep. Brownback dances around that--it's a philosophical question, not one of science, not amenable to scientific proof or disproof. But it's not correct to equate embryo harvest with organ donation, either. Unless you're killing people on purpose to get your organs. That comparison also begs the philosophical question.
It's also relevant to note that federal funding for all embryonic stem cell research is not banned. Funding for existing cell lines is not banned. Nor is there any bar to private funding of ESC research. What is banned is federal funding for research on new lines of ESC, per Dickey.
Therapies utilizing stem cells have been around since before stem cells were known to be the agent of therapy. Bone marrow transplants began in the 1950's, for example. It worked sometimes. Good enough.
It's also a bit disingenuous to decry the length of time it takes for techniques to gain FDA approval on one hand in defending ESC research, while on the other hand using FDA approval of ASC therapies as the gold standard for belittling the list of applications for adult stem cell therapies. There are quite a few ASC therapies awaiting approval, and many more under research. There are a few ESC therapies under research using existing cell lines, but nothing terribly promising has yet emerged. Cord stem cell research and ASC research have shown more potential to date. ESC research may yet produce some good stuff--but ASC research using the patient's own stem cells is the most promising area. Both ESC and CSC therapies have the problem potential of immuno-rejection, which ASC using the patient's own cells does not.
And no, none of this is commentary on the abortion debate. That's your own mileage--but it's what fuels the objections and the shouting.
Posted by: Tully | April 11, 2007 at 09:10 PM
I was busy at work (yes, that does happen) and couldn't respond to anything here for a while. Now I'm home, and I can.
1. Sebastian wants to know when I think a fetus is a person. My answer: I don't know. Like hilzoy, I think sentience is a major factor. I would add viability outside the womb to that. So let's say, around the 24th week of gestation.
2. However, although an abortion after the 24th week makes me uncomfortable, I'm not prepared to support an outright prohibition of them.
3. Why? Because at that point, circumstances come very much into play.
I also know someone who was pregnant, who very much wanted the child, and who was told - in the 3rd trimester - it was acephalic: that is, the fetus had no brain; practically had no head. It might, the doctors said, live long enough to be born - but would not live very much longer than that. It might also die before birth. She had an abortion. You would think that would be a self-evident good, if not only, choice - but you would be reckoning without the anti-choicers, who would've insisted she have it anyway, and "let God decide."
I also know women who developed serious health problems in the 3rd trimester - gestational diabetes, extremely high blood pressure, heart problems, spinal problems - that would have put their lives and health in jeopardy if they didn't abort. That, again, is to me a no-brainer to get the abortion. But it is also, to anti-choicers, another opportunity to say "Let God decide."
Since I don't believe in God - at least, not the Yaweh type - I can't take the position of "let God decide" seriously. But even if I were, I would say "Maybe God 'decided' by letting me have this information; maybe God is telling me what I need to know to save my own life and health." Because, really, why should we assume that God would 'want' women to die, or be crippled? That sounds like a very peculiar deity to me.
What it comes down to is, I'm not going to make those decisions for those women. I don't know what their situation is. I do not consider a fetus - however sentient, however viable - to be worth more than the person carrying it.
I also have a really hard time believing that a woman who has carried the fetus that long, has endured the pregnancy that long, would suddenly have a frivolous reason for wanting to abort it.
Even if the reason isn't a medical emergency - maybe she's lost her income, lost her house, lost her partner; maybe she has another child who's developed serious health problems and will need a lot of medical care; maybe any number of things - then I don't see any reason to question her judgment. Because, basically, it is her body, her life, her decision.
In other words, even though I am prepared to say that, yes, fetuses are probably persons after the 24th week, I am not prepared to say they have more value, more moral standing, or more of anything, than the women carrying them.
If you take that to mean I don't value all human life, you're damned right I don't. Neither do most people. Most people will kill in self-defense, or to defend someone else; many people will kill in war, even kill people who aren't threatening them; most people will accept the death of civilians as a regrettable but inescapable fact of war. Trained medical personnel do triage and decide who won't get medical care.
Hell, conservatives believe it's OK - 'unfortunate', but OK - for people to die if they're unable to afford medical care. And many of the people clamoring to save fetuses think it's perfectly all right to let AIDS victims die. What moral value does that uphold?
"Reverence for life" isn't a universal value. It isn't a value most people hold for all life, all the time. Why should fetuses be an exception?
Posted by: CaseyL | April 11, 2007 at 09:11 PM
"That's not to say that we can't have third-trimester bans, but we need to make sure they leave exceptions for the times when there's a good reason."
I'm fine with that. I'm not fine with, per Doe v Bolton, making the doctor's determination that there's a good reason to kill a viable infant utterly unreviewable. As far as I know, Doe v Bolton is still the law of the land. And unreviewable decisions are an open invitation to abuse.
Saying "when there's a good reason" implies "not when there's not a good reason", and if you're not allowed to look at whether the reason is good, you're establishing "when there's any reason, good or bad".
Posted by: Brett Bellmore | April 11, 2007 at 10:04 PM
Tully: it was not my intention to belittle therapies using adult stem cells. On the contrary: they do a lot of good. Similarly, I don't want to belittle new vaccines, or new cancer treatments. But there's no reason to think that we have to choose between any of these things and ESC research.
About this: "But it's not correct to equate embryo harvest with organ donation, either. Unless you're killing people on purpose to get your organs. That comparison also begs the philosophical question."
On the contrary. Someone who is brain dead can be a living organism. Their heart might still be beating, their blood might still circulate, etc. We treat such people as dead on the grounds that their brains are dead. If we treated them as living human persons, then removing their hearts for transplant would, in fact, be murder. The point is that we don't.
Posted by: hilzoy | April 11, 2007 at 10:08 PM
I'm not fine with, per Doe v Bolton, making the doctor's determination that there's a good reason to kill a viable infant utterly unreviewable.
I feel like I've been over Doe v. Bolton with you before, although maybe it was someone else. Anyway, the case doesn't say any such thing. Here's a good analysis that I endorse.
Posted by: Steve | April 11, 2007 at 10:15 PM
I checked that link, Steve. It does look like that's a misreading of Bolton, but it also seems that the Sixth Circuit has bought into it. It looks as though the Supreme Court also misread Doe v. Bolton, in Beal v. Doe, but did so in dictum, in a footnote, that was completely irrelevant to any issue in the case, so that shouldn't matter much.
Posted by: trilobite | April 11, 2007 at 10:39 PM
I find it hard to imagine any person who has ever had a child to determine when in the 270 days preceding that birth it would have been okay to abort that baby. Even in the case of a baby that may not live long, or have extreme deformities, the argument for abortion seems no stronger than euthanasia after the birth. I would argue that it is in fact weaker, because at least after the birth you actually know the extent of the deformities, as opposed to a best guess by the physician.
Posted by: jrudkis | April 11, 2007 at 10:42 PM
Even in the case of a baby that may not live long, or have extreme deformities, the argument for abortion seems no stronger than euthanasia after the birth.
That attitude is why the woman I knew with the acephalic fetus only told me about her decision. She worried that other people would say "You should have had it anyway." Easy to say, when it's not you.
It was traumatic enough for her to look at the sonogram. Imagine what it would have been like to give birth to... something... that hardly had a head. To go through labor, hours of pain and effort, knowing that what was going to come out was something you couldn't bear to even think about, much less look at.
Posted by: CaseyL | April 11, 2007 at 11:47 PM
Yeah. Sometimes life is hard. Sometimes people have children that are killed right in front of them, but somehow, most go on.
That it would be hard to have a baby that would likely be deformed sucks, but is not a reason to kill the baby.
Posted by: jrudkis | April 11, 2007 at 11:53 PM
Wow. The compassion fairly drips from the page.
Posted by: Steve | April 12, 2007 at 12:15 AM
Compassion for whom?
Posted by: jrudkis | April 12, 2007 at 01:32 AM
"I'm afraid I don't believe you. I'd like to see the jurisdiction where the reason for an abortion is relevant - i.e. "no third-trimester abortions except where the life of the mother is at stake" - and yet there's no obligation for the doctor to document that the life of the mother was at stake. And your implication that it's like this everywhere is really, really hard to believe."
California. To mention one state with about 1/6th of the population of the US.
"In other words, even though I am prepared to say that, yes, fetuses are probably persons after the 24th week, I am not prepared to say they have more value, more moral standing, or more of anything, than the women carrying them."
So to be clear, are you ok with medical experimentation through the 24th week? What if there were no 'self-defense' problems?
Gary:
I know you're aware of google. But in any case it is right there in the bit I quoted:
I don't know which way you are stretching that, but it sure sounds to me like they wanted an abortion and had previously been told that the fetus appeared too old in the sonogram. He says not to turn them away on the basis of the sonogram, and later fails to read it properly so he can say that the fetus is young enough. (Can we say lower than reported number of late term abortions?)
Posted by: Sebastian Holsclaw | April 12, 2007 at 01:44 AM
California. To mention one state with about 1/6th of the population of the US.
My link above contained this information:
That's not up-to-the-minute information, so I don't have a clue what the current state of California's reporting requirement might be. But 48 states with currently enforced requirements, plus 2 states where the law is in flux, doesn't exactly add up to a successful liberal conspiracy to ensure abortion statistics are never kept.
Surely somewhere in the 48 states that aren't California or Oklahoma, some halfway decent statistics can be located.
Seriously, this is what you've got? After all the rants, after all the indignation and comparisons to prisoners turning up dead and no one looking into the cause, you're giving me 2 out of 50 states where the abortion reporting laws aren't currently being enforced? Good lord.
Posted by: Steve | April 12, 2007 at 02:07 AM
jrudkis: I find it hard to imagine any person who has ever had a child to determine when in the 270 days preceding that birth it would have been okay to abort that baby.
Fetus. You can't actually abort a baby, or a child, though I remember a Not The Nine O'Clock News sketch about a woman asking her doctor if she could abort at 15 years...
The distinction is important: no one on this thread has been arguing that it's okay to commit infanticide.
You might find Pro choice Motherhood by Rivka, who is Respectful of Otters, enlightening. (If you wish to be enlightened, of course.)
Posted by: Jesurgislac | April 12, 2007 at 02:45 AM
"But 48 states with currently enforced requirements, plus 2 states where the law is in flux, doesn't exactly add up to a successful liberal conspiracy to ensure abortion statistics are never kept."
You get reports that the abortion happened and usually the age of the fetus. That is pretty much it.
Posted by: Sebastian Holsclaw | April 12, 2007 at 02:58 AM
Sebastian: You get reports that the abortion happened and usually the age of the fetus. That is pretty much it.
I know I've frequently in the past linked you to CDC webpages with far more information that that on abortions carried out in the US, even in the summary data. But I take you've just forgotten that I did that, and obviously you never clicked on the links I provided and read the information available, which would let you know that the statement you just made was demonstrably false. Perhaps you could devise some mnemonic for yourself to remind yourself to consult the CDC website, to avoid the embarrassment I am sure that you suffer when - every time you make a claim like this, someone points out to you that it's just plain wrong, and that you could have found out that it was wrong by looking at CDC data, publicly and readily available?
Posted by: Jesurgislac | April 12, 2007 at 04:29 AM
Jesurgislac: Rivka refers mainly to how she feels about the first trimester. The majority of abortions (ca 90% in the US, over 95% in the Netherlands) are in the first trimester. We are discussing third trimester pregnancies.
You say that in the third trimester we should not talk about babies, but about a fetus. For me, that advanced in the pregnancy, it is a baby and a person. Calling it fetus implies that for you it isn't. Aborting at that stage for cosmetic reasons (hare lip) seems to be no problem for you, since it is that womens decision. For me it *is* a problem, because at that stage I feel the fetus/baby is becoming a person in itself and thus has rights. I even gave examples (the abortion surviving child, the murder on the unborn baby).
Caseyl: Your example has happened with someone I know too. Actually, since the baby is not viable, it is one of the very few instances where you can abort late. Nowadays it should be detected earlier though, with prenatal screening (they've now extended the free prenatal services with a 'structural' ultrasound at 18-22 weeks), which makes it easier to meet the legal limit. But that is also because of our 'socialized' healthcare system.
When there is a risc for the mother (HELLP syndrom is more prevalent than diabetes), they will usually do an emergency ceasarean. If they have to choose between mother and child they will choose for the mother. Refusing to abort a viable fetus/baby does not mean that you see the woman as an uterus on legs, it means that you have to way the interests of two parties. That one party (the mother) is more important does not mean the other party (the fetus/baby) should not be considered.
Posted by: dutchmarbel | April 12, 2007 at 05:04 AM
You say that in the third trimester we should not talk about babies, but about a fetus.
The biological reality is that it is a fetus, yes.
For me, that advanced in the pregnancy, it is a baby and a person.
But nevertheless, it is a fetus.
For me it *is* a problem, because at that stage I feel the fetus/baby is becoming a person in itself and thus has rights.
But that's not relevant, unless you can show that in the third trimester of pregnancy a woman ceases to have rights or can have her right to make decisions about her own body involuntarily removed. If you can, can you make the same argument for any parent having their right to decide involuntarily removed when a child needs a pint of their parents' blood or a parental kidney to stay alive?
Note, if you're just arguing about what in your view is morally right to do, we're not arguing: I'm pro-choice, so I support your right to do what you want according to what seems best to you at each stage of each pregnancy - but not to impose your moral views on anyone else who might make a different decision.
There are reasons I am fairly sure I would not agree with for having an abortion, no matter when it happened. (The example someone offered me once was, supposing there were a "gay gene" test, a homophobe who aborted because her fetus tested positive for homosexuality.) But I neither think it right or practical to give anyone but the woman herself and her attending physician to have the legal right to say "This abortion is unnecessary" - because it is never either right nor practical to argue that the woman must be forced to continue the pregnancy and give birth against her will.
Posted by: Jesurgislac | April 12, 2007 at 06:33 AM
Fetus. You can't actually abort a baby, or a child, though I remember a Not The Nine O'Clock News sketch about a woman asking her doctor if she could abort at 15 years...
One might suggest asking actual pregnant women how they refer to the being in their respective uteruses, particularly as the day of delivery draws closer, usage being the primary determinant of meaning and all that, but one suspects you're less interested in doing that than in winning some semantic battle which would keep you from having to ever give any ground at all in an abortion discussion.
PS: You aren't Dr. House.
Posted by: Phil | April 12, 2007 at 06:36 AM
The only difference between a viable fetus, and a baby moments after it's born, is location. Inside, we call it a "fetus", outside, a "baby", but it's the same entity.
"because it is never either right nor practical to argue that the woman must be forced to continue the pregnancy and give birth against her will."
Once the fetus/baby is viable, it is no longer necessary to kill the baby in order to end the pregnancy. She can end it with a live birth instead.
Post viablity, a decision to abort instead of deliver isn't about ending the pregancy, it's about a determination to kill the baby. At that point you're elevating the woman's whim above the baby's very life.
You and I agree on probably 98+ percent of abortions. By your own arguments, you think post viability abortions are essentially unheard of. So why do you feel the need to defend them?
Posted by: Brett Bellmore | April 12, 2007 at 06:55 AM
Brett: Once the fetus/baby is viable, it is no longer necessary to kill the baby in order to end the pregnancy. She can end it with a live birth instead.
She can, yes. If she chooses to do so.
You and I agree on probably 98+ percent of abortions. By your own arguments, you think post viability abortions are essentially unheard of.
So do you. So does Sebastian. So does everyone on this thread, evidently.
So why do you feel the need to defend them?
I defend a woman's right to decide for herself what she'll do.
Why do you feel it necessary to attack that right?
Note, you agreed that "viable" means "26w+". Marbel earlier cited as an example of bad decisions 12 women who had apparently decided to abort "late-term" because a fetus had a cleft palate. In the UK, because the limit of viability has been legally fixed at 24w, doctors will in practice not agree to perform an abortion if the pregnancy is at 20w+ unless it's actually life-threatening/damaging to health, because they assume that a woman can have made a mistake of up to 4 weeks in how advanced her pregnancy is. So, "late-term" in that article could not have been more advanced than 20w: below the most optimistic estimate of fetal viability if delivered.
Phil: One might suggest asking actual pregnant women how they refer to the being in their respective uteruses, particularly as the day of delivery draws closer, usage being the primary determinant of meaning and all that
One pregnant friend used to refer to it as her parasite, but her partner got upset about that, so she took to referring to it as "small", which didn't, and which she could live with. Another pregnant friend, in both pregnancies, referred to it as "futurebaby", all one word. My sister, as I recall, said "IT" - with such meaning one always knew which IT she was referring to. None of them wanted to know the gender of the fetus before birth. Another friend had all the tests, discovered her fetus was a boy, named him and referred to him as Fred (well, no, but I won't say the actual name) and had a miscarriage in the sixth month: whenever we've discussed her loss, we've referred to him by name. (Her next pregnancy may also have been named, but she didn't share the name with friends until after birth: I assume her partner knew.) I can't remember all of the names/identities/labels my friends have used when they were pregnant, but that's a fair sampling of those I do. In my experience - YMMV - how pregnant women refer to the fetus varies by individuals, and the polite thing to do is to go along with an individual woman's usage for each pregnancy.
That does not affect the point, however, that when speaking generically, we're discussing a fetus, not a baby.
Posted by: Jesurgislac | April 12, 2007 at 07:16 AM
"I defend a woman's right to decide for herself what she'll do.
Why do you feel it necessary to attack that right?"
Because in some instances she's deciding she's going to kill somebody.
Posted by: Brett Bellmore | April 12, 2007 at 08:23 AM
Because in some instances she's deciding she's going to kill somebody.
Okay, that's explicit. So, present this as an ethical case for all examples: No parent can be permitted to decide whether or not their bodily organs will be used to save their offspring's life.
For example, if a child needs a kidney and one of their parents is a tissue match, that parent will be short one kidney as soon as the operation can be arranged. That's your ethical position, right?
Posted by: Jesurgislac | April 12, 2007 at 08:36 AM
Pregnancy is not comparable with giving organs Jesurgislac. The women *is* pregnant, has been for at least 6 months and carries a child that could survive outside the womb. The natural order of things is that she gives birth. What we are discussing is actively terminating the life inside of her and than give birth, *instead* if giving birth without the killing.
Posted by: dutchmarbel | April 12, 2007 at 10:03 AM
Because in some instances she's deciding she's going to kill somebody.
Only in the humpty-dumpty world of the 'pro-life' movement.
Posted by: freelunch | April 12, 2007 at 10:18 AM
Pregnancy is not comparable with giving organs Jesurgislac.
Pregnancy is giving organs, Marbel. Renewably, usually, though permanently, sometimes.
The women *is* pregnant, has been for at least 6 months and carries a child that could survive outside the womb. The natural order of things is that she gives birth.
So the six-month miscarriage my friend suffered was, in your view, completely outside the "natural order of things"? Just checking.
What we are discussing is actively terminating the life inside of her and than give birth, *instead* if giving birth without the killing.
No, what we are discussing is what rights a woman has over her own body. You may feel that fetal rights trump the woman's rights: I disagree.
Posted by: Jesurgislac | April 12, 2007 at 10:23 AM
Let's try this ethical case: Where ejecting a tresspasser alive is not significantly more dangerous than killing them, people are not permitted to kill tresspassers.
Abortion isn't arguably any more of a moral issue than any other medical procedure prior to viability. But once you've got more than one way to eject the trespasser, insisting on the right to chose the one that kills is insisting on a right to murder.
This is a regrettably common stance in the pro-choice movement, and it's every bit as loony as the pro-life movement's obsession with protecting 5 day old blastocysts.
Posted by: Brett Bellmore | April 12, 2007 at 10:58 AM
Jes: your friend gave birth, the baby didn't survive. Unfortunately that sometimes happends - I have friends with similar experiences.
Comparing pregnancy with giving organs is comparing apples with pears, as the Dutch expression goes. The fact that there are similarities does not mean they are the same.
You feel that untill birth actively terminating the life of the child is completely the right of the mother - I feel that the child at that point in time is a person, no matter where she (or he) is located, which means that she should have some rights of her own. It seems silly to say that those rights only exists once the child travels outside of the body of the mother.
Comparing pregnancies to other things doesn't help, because it is a rather unique proces.
Posted by: dutchmarbel | April 12, 2007 at 11:15 AM
Brett; Let's try this ethical case: Where ejecting a tresspasser alive is not significantly more dangerous than killing them, people are not permitted to kill tresspassers.
If you like, but you'll have a hard time convincing me that trespassing on property is equivalent to making use of your organs. Do try, if you like. You see no ethical difference between Hawkeye and Trapper removing a pint of Frank's blood while he's asleep, and Ho Jon stealing Frank's silver picture frame?? None at all?
But once you've got more than one way to eject the trespasser, insisting on the right to chose the one that kills is insisting on a right to murder.
So, again, you see anyone who insists that a parent has the right to decide whether or not to be organ donors to their children as insisting on the right to murder their children?
Posted by: Jesurgislac | April 12, 2007 at 11:17 AM
So, again, I don't see the analogy to organ donation as valid. You've already noted that a post-viability abortion is a major surgical procedure. The woman IS going to undergo a significant procedure, the only question being whether it's the one that removes the baby alive, or the one that removes the baby dead. Chosing the latter isn't a decision about the mother's body, it's a decision about the baby's life.
Posted by: Brett Bellmore | April 12, 2007 at 12:10 PM
Comparing pregnancy with giving organs is comparing apples with pears, as the Dutch expression goes.
You may know that the American version of the expression is "comparing apples to oranges." While everyone is free to adopt their own analogy, I find it somewhat odd that the Dutch, of all people, would have an aversion to Oranges.
Posted by: Steve | April 12, 2007 at 12:25 PM
They may have an aversion to comparing them to other things :^)
Posted by: liberal japonicus | April 12, 2007 at 12:30 PM
Marbel: Comparing pregnancy with giving organs is comparing apples with pears
Agreed... two very similiar things? ;-)
Brett; So, again, I don't see the analogy to organ donation as valid.
It's not an analogy: it's an equation. If it's ethical to remove a woman's right to decide because one of her choices may be that she decides to abort, it's equally ethical to remove all parents' rights to decide in such circumstances since one of his/her choices may be that s/he's not going to provide a kidney.
the only question being whether it's the one that removes the baby alive, or the one that removes the baby dead.
There is no baby, again: it's a fetus.
And no: the only question is whether the person who gets to decide what to do with her own body is the pregnant woman, or if she should have that basic human right removed. She is the one who decides (with, yes, her physician).
An imaginary example (which I admit I stole from House, pretty much): there's a woman who's 24 weeks pregnant who's suddenly diagnosed with cancer. Bad cancer.
She can't have chemotherapy while pregnant; before she has chemotherapy, she has to terminate. If she has chemotherapy immediately, the prognosis is very good - she might well have 10-15 years to live, maybe more, if she takes good care of herself or if new techniques are developed in that time.
But every week that goes by, the cancer is more established and the less effective chemotherapy will be. She can certainly survive till the baby is born naturally, but if she delays chemotherapy that long, she'll be dead before the child's first birthday.
The longer she waits, the better chance for her child, the worse chance for her.
Who gets to decide, then? When or if to terminate? Now: two weeks time: never?
You and Marbel argue that she must not have the right to decide for herself.
I say she must, and she's the only one who really can. And while is an extreme scenario, the fact is all choices about her pregnancy directly concern her body: arguing that she can't be allowed to decide for herself suggests strongly that you think if a pregnant woman does get to make her own decisions they'll be bad ones. Yet you're unable to come up with a single example of this happening...
Posted by: Jesurgislac | April 12, 2007 at 12:35 PM
I don't think anyone is saying that a post viable baby most be carried to term, just that rather than an abortion the baby should be induced or c-sectioned.
Posted by: jrudkis | April 12, 2007 at 01:18 PM
That gets really weird, though, because prematurity is strongly associated with morbidity for the baby -- it's not as if 'viability' is a bright line immediately after which a c-section would produce a healthy child. I can't imagine a doctor being willing to perform a c-section with the goal of terminating a pregnancy early, at the substantial risk of producing an injured or disabled baby.
Posted by: LizardBreath | April 12, 2007 at 01:24 PM
I agree that it is sticky the closer to the line you get, but babies are induced early, especially in the third trimester, or when there are multiples.
Posted by: jrudkis | April 12, 2007 at 01:27 PM
"I can't imagine a doctor NOT being willing to perform a c-section with the goal of terminating a pregnancy early if the alternative was simply killing the baby outright.
Posted by: Brett Bellmore | April 12, 2007 at 01:29 PM
But at that point we're again talking about imaginary abortions. No one's having an abortion in their eighth month (or at least it's insanely, insanely, unlikely), and no doctor (same caveat) would induce or perform a c-section earlier than that without a medical justification. So talking about induction or c-section as an alternative to abortion is pure thought experiment -- it's not relevant to anything with any likelyhood of happening.
Posted by: LizardBreath | April 12, 2007 at 01:32 PM
On this thread there have been examples of terminations in the third trimester as mercy killings (which in my mind is one step removed from eugenics.) Alternatively, the pregnant woman with cancer in the 6th or 7th month would be a candidate, rather than abortion.
Posted by: jrudkis | April 12, 2007 at 01:40 PM
LB: But at that point we're again talking about imaginary abortions.
Which is why I have a problem of expressing it in terms of regulation. (Not in terms of moral choice, as I hope I made clear.)
When you legislate to remove human rights from a class of people (such as pregnant women) you need (I think) to show that there is a real need to do so.
Ugh's example earlier of the draft - the real need there is explicit: the country is at war, men (usually!) are needed to fight, more men than are volunteering: the government thus removes the right of a person to decide for themselves whether or not to join the military. Agree or disagree that the need is real, it is at least explicitly stated.
Where is the need that requires removing women's human rights in pregnancy, early or late? Neither Brett nor Sebastian were able to provide an example of a woman having a healthy fetus aborted at 26w+ - for any reason or none.
Posted by: Jesurgislac | April 12, 2007 at 01:43 PM
Sorry, I should have said no one's having an abortion in their eighth month other than for self-preservation or because the baby isn't viable. The odds of an elective abortion at that point are pretty much zero.
Posted by: LizardBreath | April 12, 2007 at 01:44 PM
In the strict legal sense there are occasions where one person's (independent of sex) right to decide can be removed temporarily, provided that person's actions endanger other persons (if that 'other' person can be the person itself is an open legal question that is answered differently in different places).
I consider it at least possible that a late term pregnancy that is not a likely danger to the life/health of the pregnant woman can be reasonably considered such an occasion.
This makes no statement about the pre-viability period or the case of probable danger to the pregnant woman.
This is clearly not a case of 1-size-fits-all and any decision should take primarily female considerations into account.
My (therefore not relevant) opinion/belief is that there are (very) rare cases of "irresponsible abortion wishes" where I would consider a law that puts restrictions on "choice" as not completely out of question.
The problem I see - and on this I think I am 100% on Jes' side - is with an abuse of any kind of law by the "pro-life" goalpost shifters that would see it as primarily a gap in the armor that could be exploited.
---
On a different point discussed far above:
The military (at least over here) is authorized to extract certain amounts of bodily fluids from its members even against their will. To be exact: the amount sufficient for a full exam (my rough guess is that this would mean an upper limit of about 50 ml of blood). In theory this could be used for other purposes (because the drafters of the regulation probably hadn't enough imagination to imagine a "transfusion by many drops" by pooling the samples of enough people) ;-)
---
The question whether parents can be forced to donate blood (though not organs) for their own infant is actually legally discussed. As far as I remember the topic in real court is/was about the legality of seizing the children if the parents refuse life-saving medical procedures (in this case a blood transfusion) for their children (out of religious beliefs). In the case in question it was at least seen by legal authorities that one was moving in uncharted regions and the outcome was by no means a foregone conclusion. Sorry, I can't remember what the outcome was in the end, I only mention it to state that this is a potentially unresolved legal question.
Posted by: Hartmut | April 12, 2007 at 01:44 PM
I think instances have occurred in the UK of children of Jehovah's Witnesses who needed blood transfusions to survive, whose parents refused to consent, being made legally wards of court so that the children could have the blood transfusions.
I know of no instance where a JW was forced to provide the blood.
Yet I can conceive that a parent and child with a rare blood type could be the only two donor partners for each other in a region.
Are Marbel and Brett and Jrudkis going to argue that because the parent could choose to let their child die rather than provide a blood transfusion, no parent should have the right to refuse to provide blood to their child?
Posted by: Jesurgislac | April 12, 2007 at 01:50 PM
My (therefore not relevant) opinion/belief is that there are (very) rare cases of "irresponsible abortion wishes" where I would consider a law that puts restrictions on "choice" as not completely out of question.
But of course, laws that place restrictions like that on abortion exist almost every place, and there's no groundswell of hostility against them. The argument Sebastian was making above was whether the existing laws need to be more stringently enforced.
Posted by: LizardBreath | April 12, 2007 at 01:55 PM
There have been real cases* where women refused a c-section despite being informed that in that case both she and the child would die.
I think the legal status quo on this is "suicide is legal, we can't do anything".
In cases were the medical opinion is that both could live if a c-section is performed, I'd seriously question the mental state of the woman in question but would really not want to be the one to decide whether her will should be overridden.
*i.e. I have read about it at some time in the past in sources I consider reliable but technically cannot link to (printed German newspaper).
Posted by: Hartmut | April 12, 2007 at 01:59 PM
There you get into messy considerations of 'when otherwise do you compel people to submit to medical treatment against their will' to which the answer is pretty much 'if they can express their will, you don't'. I can't remember the details well enough to link to it, but there was an American case of a doctor/hospital trying to legally compel a pregnant woman to have a c-section, when the medical evidence that it was necessary appeared to be far from overwhelming.
Posted by: LizardBreath | April 12, 2007 at 02:02 PM
No objection LB. I just wanted to state that there can easily be tricky situations that probably noone of us could judge with certainty. Noone could legally stop the woman (or anyone else) from simply committing suicide or refusing medical help to the same effect. The case of a an extra endangered live that could be rescued without doing real harm*/** creates a/the real dilemma. I would not be able to come up with a non-abusable or not otherwise flawed legal solution here.
*i.e. within reasonable conditions
** still better than the notorious situation with the police having to decide whether they should kill a hostage taker to save the hostages (the pregnant woman would be no criminal with evil intent to name just the most obvious difference)
Posted by: Hartmut | April 12, 2007 at 02:42 PM
"I can't imagine a doctor being willing to perform a c-section with the goal of terminating a pregnancy early, at the substantial risk of producing an injured or disabled baby."
I don't understand why you seem to think this, but think that it is defensible to go through the same exact procedure to make certain you get a dead baby.
"Sorry, I should have said no one's having an abortion in their eighth month other than for self-preservation or because the baby isn't viable. The odds of an elective abortion at that point are pretty much zero."
Pretty much zero, or zero? Because if it is 0.1% or so we are still talking about 2-4 viable babies being murdered (non-accidentaly having their lives terminated)each year. Now maybe you are saying that 2-4 murdered babies per year are worth what it would take from the point of view of civil liberties in order to stop it. But that is a very different argument from pretending that it just couldn't possibly happen.
That is why I keep bringing up capital punishment. At viability, the child is legally supposed to have the rights of a person in most states. If we strongly suspected that 2-4 factually innocent people were being executed in the criminal justice system each year (which so far as I know even reputable death penalty opposition groups don't claim) there would be quite a bit of clamoring for more serious controls.
The idea that in the late term abortion case, we should have completely unreviewable, single doctor decisions of the same magnitude, just doesn't make sense to me.
Posted by: Sebastian Holsclaw | April 12, 2007 at 04:14 PM
If we strongly suspected that 2-4 factually innocent people were being executed in the criminal justice system each year (which so far as I know even reputable death penalty opposition groups don't claim) there would be quite a bit of clamoring for more serious controls.
Well, that's probably because you'd be talking about 5-10% of the executions being of innocent people, as opposed to 0.1%, since there are a lot more late-term abortions than executions each year. The other obvious difference is that scrutinizing the cases of the 99.9% of guilty people more closely in order to identify the 0.1% of innocent people wouldn't invade anyone's privacy. In fact, the guilty people would probably welcome a closer review, in hopes they might somehow get off.
Let's go with the idea, though. Say there are 2-4 cases per year in the United States of completely elective abortions in the eighth month of pregnancy, purely on a whim with no reason. In specific terms, what would you propose we do about it?
Posted by: Steve | April 12, 2007 at 04:31 PM
In specific terms, what would you propose we do about it?
Whatever your proposal is, I'd also be interested in why you think it's more necessary or a better use of resources than any change in policing practices or other governmental policies that might be statistically expected to save 2-4 lives of adult murder victims nationwide every year. Or hell, people generally, not just murder victims.
Posted by: LizardBreath | April 12, 2007 at 04:37 PM
I haven't followed the whole thread, but let me suggest that one reason for the lack of clamor, outside the hard-core of the anti-abortion groups, about the 2-4 viable deaths, would have to do with varying understandings of viability. Plenty among us may not like the notion of eugenics, but I strongly doubt that any of the 2-4 are perfectly healthy, and there's an understandable reluctance, on the part of many people, to compound tragedy with insult. There's a sizable minority always ready to go all Schiavo, I'll grant you. But a little of that goes a long way, and that spectacle itself set the movement back by maybe a decade.
You can postulate some woman willing to abort a near term perfectly healthy child, I suppose, but this is a situation far enough outside of normal human experience that I think you're going to have to show an example to get people to believe in it, and complaining that you can't get the data because it's not being kept isn't enough to overcome the presumption most people have about how humans act.
Posted by: CharleyCarp | April 12, 2007 at 04:51 PM
"Whatever your proposal is, I'd also be interested in why you think it's more necessary or a better use of resources than any change in policing practices or other governmental policies that might be statistically expected to save 2-4 lives of adult murder victims nationwide every year. Or hell, people generally, not just murder victims."
Why would it take more resources than your average murder investigation or malpractice suit? Require that medical reasons be stated for each late term abortion be kept by the doctor along with the medical tests that confirm it. Since there are only a few thousand each year, and since so many of the cases are allegedly crystal clear, why is that such a ridiculous burden? If it is indeed true that only serious problems lead to late term abortions, there will be almost nothing to investigate--maybe two or three dozen not-super-clear cases.
And if it is NOT true, well that is a different problem, but it undercuts your whole argument anyway.
"Well, that's probably because you'd be talking about 5-10% of the executions being of innocent people, as opposed to 0.1%, since there are a lot more late-term abortions than executions each year."
I gave you 0.1% to be generous, because even LizardBreath seems likely to agree that 1 out of 1000 cases of things having to do with human beings can lend to ridiculousness. Considering this Guttmacher Institute study about why women have abortions (including at least 9% of women who reported just taking a lot of time to decide and 4% who waited for a relationship to change) I think you could easily put it in the 5% range being remotely ridiculous. That would put us in the low hundreds of viable babies being killed. (The Institute used 4 months as the basis for 'late' which is why I don't assume that the 90%+ non-medical reasons shown in the late term abortions would hold all the way into the area I'm talking about)
Posted by: Sebastian Holsclaw | April 12, 2007 at 06:37 PM
If we strongly suspected that 2-4 factually innocent people were being executed in the criminal justice system each year (which so far as I know even reputable death penalty opposition groups don't claim) there would be quite a bit of clamoring for more serious controls.
Why do you think this? We know that at least that many are being let off death row nearly every year, and yet I bet the issue doesn't even register on 99% of people's radars.
Posted by: Phil | April 12, 2007 at 06:47 PM
The main objection I have to the "use of her body against her will" argument is that consent has a fading value. To deny consent at the beginning of pregnancy allows for a fairly accurate analogy. To deny consent near the end of pregnancy is to assert it is legitimate to give medical aid for five months or longer, only to pull the plug as the patient is nearly healed.
It is far better to define personhood as beginning with the functionality of the cerebral cortex, since it is the seat of consciousness and fine motor control. This point happens to coincide closely with viability, so it is reinforces an already legally strong position.
Posted by: Step2 | April 12, 2007 at 06:48 PM