quote:“We now have a global picture of induced abortion in the world, covering both countries where it is legal and countries where laws are very restrictive,” Dr. Paul Van Look, director of the W.H.O. Department of Reproductive Health and Research, said in a telephone interview. “What we see is that the law does not influence a woman’s decision to have an abortion. If there’s an unplanned pregnancy, it does not matter if the law is restrictive or liberal.”
And some of the criticism:
quote:Anti-abortion groups criticized the research, saying that the scientists had jumped to conclusions from imperfect tallies, often estimates of abortion rates in countries where the procedure was illegal. “These numbers are not definitive and very susceptible to interpretation according to the agenda of the people who are organizing the data,” said Randall K. O’Bannon, director of education and research at the National Right to Life Educational Trust Fund in Washington.
The study and article also go into the issue of safe provision of abortion in countries where it is legal versus unsafe provision of abortion in countries where it is not. The criticism of this aspect of the study is that many countries where abortion is illegal have less safe medical systems in general, and that the legality of abortion may not be the causal element in the safety of obtaining one. I would like to think that the researchers accounted for this, but without reading the study itself, neither I nor the study's critics know the answer.
I will say at the outset that I do not expect the study's conclusion to change anyone's mind. This debate invariably plays out along ideological lines and those lines are extremely unlikely to shift. However, if the study's findings are accurate, then those who wish to end or at least reduce abortion rates should consider focusing their emphasis on preventing pregnancies in the first place through contraception, provided their ideology is permissive toward contraception. Note that I say "should consider," not "should do," and also that I do not suggest that abortion opponents abandon their efforts to criminalize it. Rather, it is a question of priorities. Provided contraception is acceptable and the findings are accurate, working to expand availability and understanding of contraceptive methods will prevent more abortions than working to make abortion illegal.
posted
I've argued that preventing pregnancies in the first place will lower abortion rates, and I wish that pro-life groups would work to make contraception more easily available. It would be ironic if pro-choice groups pushing for better access to contraception actually made more of a dent in the abortion rate.
I'll reserve judgment on what I think about the accuracy of the study, but if it's true that laws affect the safety only and not the rate, then I suppose the ethical thing to do would be to keep it legal. Also, has anyone looked at the birthrate before and after Roe v. Wade, particularly in states that had abortion bans in place before? I would think that if there were a significant drop in the birthrate afterward (or at least, a slowdown in the increase), that would be evidence that the abortion rate went up. If a drop isn't present, that would be evidence that the abortion rate did not go up. Anyone know of a study on that?
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quote:Also, has anyone looked at the birthrate before and after Roe v. Wade, particularly in states that had abortion bans in place before? I would think that if there were a significant drop in the birthrate afterward (or at least, a slowdown in the increase), that would be evidence that the abortion rate went up
While there are many issues that can be taken with the book, I seem to recall reading in Freakonomics that post-RvW, the birth rate for the demographics most likely to get abortions fell as people (presumably) chose to have abortions.
posted
Yeah, I'd say there are inherent difficulties in trying to piece together statistics on illegal activities of a quality to compare to statistics where it is just a matter of pulling medical records.
And as you mention, it's a moral matter. We can't make shoplifting legal just because people do it anyway.
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posted
I am not impressed by the study, which I have read through (it is available via ScienceDirect, if you have access to that).
The study does not show what the quotation says it does. The study is data gathering combined with a few simple statistics (increases or decreases in various regions). There was no statistical analysis done to even attempt to estimate the effect of legality on abortion.
The person saying the study shows that is blustering.
Additionally, the strong correlation they show between legality and safety is hardly surprising -- any abortion which is legal (in fact or in practice) is considered safe in their study. Look, a correlation! They'd have a lot more credibility if instead of looking at safe/unsafe abortions, they attempted to estimate rates of death of the mother due to an abortion (there are some decent ways to go about that even where abortions are covered up).
The study is useful insofar as it provides better estimates of abortion rates. All the other conclusions I've seen people say about it are unsupported unless enriched with further information, and no such information has been presented.
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That's too bad. It's a shame the results are being misrepresented. Added: I updated the thread title.
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quote:They'd have a lot more credibility if instead of looking at safe/unsafe abortions, they attempted to estimate rates of death of the mother due to an abortion (there are some decent ways to go about that even where abortions are covered up).
It's actually not that easy to get true estimates of injuries and deaths caused by abortions in a society like ours where it's legal. There's a very simple, obvious reason for it - there's not a category for "abortion injury" on most emergency medical forms. My husband took a lady to a hospital once when she was severely damaged by an abortion doctor and had to check it as an "obstetric hemorrhage," because that's the only option his forms gave him. He specifically wrote in his comments section what happened, and yet still when he received a copy back of the form after it was filed, all that was noted is that she was suffering from an obstetric hemorrhage. In order to report what really happened, he had to initiate a malpractice report against the doctor with the State Medical Board, and fill out hours worth of paperwork, and he wound up testifying in hearings. How many emergency medical personnel are going to go through that effort? How many people treated in emergency rooms for "obstetric hemorrhages" are really people injured by abortion doctors and we, the public, will never know the true number?
Abortion injury reporting to the CDC is voluntary reporting from the state health departments and I know for a fact that it's inaccurate for Alabama. My husband used to cover a territory that included an abortion clinic and had to respond to abortion injuries, and take women to the hospital. He knows of two deaths that he personally was involved with the care of the patient, so he is definitely sure they were caused by the abortion. I'm not sure what year they occurred in, but it was early 2000's. For year 2002, the CDC reported 9 deaths nationally from abortion injuries. I personally don't think that number can possibly be right, not if my husband has taken dozens of women to the hospital who've been injured, and at least two have died that he knows of - the number is probably higher, and he's just one paramedic working one station covering one abortion clinic 1/3 of the time.
I suspect if we knew the true numbers on abortion injury, it would be a lot higher than is reported now.
The Abortion Surveillance report, put out by the CDC, has a form that is filled out by every provider that performs abortions. You can see a copy of it here - link is a pdf and the form is page 19 - and nowhere on that form does it ask the provider to report whether an injury has occurred. To get the injury reports, you have to go from medical records, and as my husband can tell you, there is nowhere on those forms to mark "abortion injury."
You can see the most recent Abortion Surveillance report, including the table 19 where I got that 9 number for 2002 from here Link is a .pdf.
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"And as you mention, it's a moral matter. We can't make shoplifting legal just because people do it anyway. "
Considering what your Bible says on the matter, I don't see why you'd think it's much of a moral matter, considering God only made harming an unborn fetus worth a small monetary resitution, while in the same sentence suggesting the harm of the mother should equate eye for an eye.
How arrogant of you to disagree with your God. Surely he knows whether a fetus has rights or not better than you.
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So "moral matter" automatically means Bible now? I'm pretty sure we've agreed on Hatrack that atheists can also be concerned about morality.
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quote:Originally posted by pooka: And as you mention, it's a moral matter. We can't make shoplifting legal just because people do it anyway.
This is close to my stance as well*.
I was going to elaborate on this, but I think I'll wait to see of 0Megabyte or anybody else wants to ridicule me first.
*I wouldn't personally use the phrase "morality" in a discussion about laws, but this is similar to my line of thinking. Abortion should be illegal for the same reasons that manslaughter is.
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quote:Originally posted by 0Megabyte: "And as you mention, it's a moral matter. We can't make shoplifting legal just because people do it anyway. "
Considering what your Bible says on the matter, I don't see why you'd think it's much of a moral matter, considering God only made harming an unborn fetus worth a small monetary resitution, while in the same sentence suggesting the harm of the mother should equate eye for an eye.
How arrogant of you to disagree with your God. Surely he knows whether a fetus has rights or not better than you.
Please don't try to advocate for the God of the Bible. He does what he does and says what he says for his own reasons.
Also, taking things out of context is not going to convince anyone that you are right.
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posted
Perhaps I went overboard there. Though it might be reasonable to assume a Christian should or would base their morality on the book they hold inspired/written by God... oh well.
Also: out of context? Lovely. What's the context? God can do no wrong? Or shall we talk about the specific book? I may be in error, and I may be overreacting, but the "out of context" thing, as I've seen it a hundred times in the past, is really an arguement I've seen used to retcon all sorts of things, excuse all sorts of evil and madness... especially when the context is "God is infallible, and that's that."
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quote:Though it might be reasonable to assume a Christian should or would base their morality on the book they hold inspired/written by God... oh well.
It is not reasonable to assume that a Christian only holds moral beliefs that directly come from the Bible.
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Belle: while that would increase uncertainty, it would probably be a good thing for estimating the true effect, since then whatever proxies were used for abortions causing harm to the mother would be more uniform across nations.
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posted
In the hopes of not derailing, I will attempt to keep this short.
I retract my previous "out of context" assertion. While it may still be, it seems to be unimportant to the central issue.
It seems that 0Megabyte has referenced Exodus 21:22-25. That passage says that if men are fighting and hit a pregnant woman and she gives birth premature, that the man is to be fined. If the baby dies, then take life for life, eye for an eye, etc.
dkw: Do you happen to know of any hatrack threads that discuss atheists views on morality? I would be most interested in reading on the subject.
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posted
I seem to recall a thread titled something like "toward an objective morality," possibly begun by Tom Davidson?
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My anecdotal experience as someone who has worked shifts in given ERs over a period of >2yrs each, in 3 separate cities [and starting in 1996], is that there are some providers of voluntary abortion procedures that have stellar records, and some that do not. I am aware of at least one stellar provider that has "refused to do any more cleaning up after XXXX" (i.e., agreeing to come in as a consultant when things went wrong during the procedure) on the grounds that XXXX was too inexperienced to be providing such services and had too great a complication rate.
I have seen a marked decrease in the number of stellar providers as many either retired or withdrew from practice secondary to prolonged and vicious threats against their family members. It is also a service that fewer current physicians in training are willing to provide, given in good part the climate providers face. (there are studies of medical students and recent graduates on this)
Thus over the years, I have been seeing more and more complications, although -- notably -- these are not distributed across the board, but have been highly concentrated with certain providers. This includes some itinerant providers (travelling across the country to cover multiple more rural sites) as well as some stationary.
What this means is that safe voluntary abortion procedures are available to some, and only much less safe to others. As the years pass, there seem to be fewer in the former category and more in the latter. I expect this may be either a desired [as in sought as a necessary step to get past on the path to achieve a greater overriding good, interpretable multiple ways (e.g., see dkw's post below)] outcome [edited to clarify as per Icarus' concerns below: this I expect to refer to some such protestors, notably not claimed to be a large or even significant percentage of them, and possibly only a fringe element, although possibly including some who believe this to be an unfortunate but necessary step -- and note, the "necessary" would distinguish them from the following category -- on the path to banning voluntary abortion procedures outright]
-------- [Edited still further to add: if you read on, you will see that this section is still an ongoing area of contention and/or confusion -- my apologies, as I cannot seem to make it workable, but I do wish to alert readers to the situation] --------
or an unfortunate side effect [i.e., unfortunately tied to the necessity of protesting voluntary abortion procedures, although not viewed herein as a necessary step on the path to banning such procedures outright] for those protesting the current climate in which such procedures are still legal. [And, of note, there are surely many many people who both protest voluntary abortion procedures and who fail to fall into either camp, for reasons including (but not limited to) having not considered the issue, or being unaware of the potential side effect of such protests on the quality of procedures still offered, or who would not continue to pursue the objective of banning voluntary abortion procedures if that course were necessarily accompanied by such a rise in complications, or who reject that such a rise has occurred, and -- most certainly -- etc.] Regardless, I expect (myself) the complication rate to continue to rise.
Of course, this does not mean that such a rate is inherrent to the procedures themselves, but more an artifact of who is left to perform them.
quote:Originally posted by ClaudiaTherese: . . . safe voluntary abortion procedures are available to some, and only much less safe to others. As the years pass, there seem to be fewer in the former category and more in the latter. I expect this may be either a desired outcome or . . . for those protesting the current climate in which such procedures are still legal.
Wow. I'm kind of surprised at what I think I hear you saying here.
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posted
That I think it is likely the anticipated and desired effect of some protestors as well as an unfortunate and regrettable side effect for others (and, presumably, not even known to others, and for others not even cared about)?
Icarus, some protestors have have been quoted saying just this in the mass media. I would take them at their word, but sometimes people say things for effect alone.
I also would not assume that any given category applies to anyone posting here, their families, or anyone they might have ever come in contact with in any possible way (phone, internet, book, what have you) in their own lives. But the Fred Phelps of the world do exist, you know.
Are you implying that I am accusing particular people of having untoward motives? If so, I can assure you that I am not, and I'd appreciate a clarification for the record if you are not meaning to imply that. It's be great, in fact.
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posted
I'm not implying, I'm trying to understand what you meant.
Let me try to elaborate. Saying some abortion protesters are glad to see abortions become less safe while others see it as an unfortunate side-effect seems to suggests that these are comparable in proportion. Let me make some similar statements:
Some men enter the priesthood because they are pedophiles seeking compliant victims, while others enter it because they feel they have been called by God to serve humanity.
Some people oppose gay marriage because they are hate-filled bigots, while others oppose it because they believe it would damage the institution of marriage.
Some people oppose the war in Iraq because they dislike the United States in general and soldiers in particular, while others oppose it because they believe it is misguided foreign policy.
Some people oppose welfare and socialized medicine because they have no compassion for the poor, and others oppose it because they oppose increasing the size of government.
Some people drink alcoholic beverages because they are alcoholics with no self-control, and some people drink them because they enjoy the relaxing effects of a moderate amount of alcohol.
Some people collect welfare because they are too lazy to work, while others collect it because they can't earn enough, despite their best efforts, to live.
I think each of the above dichotomies is arguably true, but each might be objectionable to the group being characterized, be it priests, people opposing gay marriage, people opposing the war, people who drink, or people on welfare, because it puts what most would consider a fringe element on equal footing with the larger group, thus calling into question the motivations of the group as a whole.
The Fred Phelpses do exist, but it probably helps the conversation to assume that they're a loud fringe element, and not representative of most of their cause.
To put it as clearly as I can, threats against abortion doctors notwithstanding, I would say the fraction of pro-lifers who want abortion to be more dangerous, as a goal and not as an undesired side-effect, who actually wish harm on mothers who abort and doctors who perform abortions, approaches zero.
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I do not read the dichotomies you listed the same way you do; this may be because of my technical training, for which "some" does not carry any connotation of size. When I write "some," it means more or less means "at least one and possibly more." I don't think I'd have had any objection to your having posted any of the dichotomies listed, other than (maybe) a comment along the lines of "of course, the former outnumbers the latter," or other clarifying comment for the record.
It certainly wouldn't have even occurred to me that the original poster might have been saying or implying an equivalence, unless it was a poster (and there are a few -- not many, you understand, but at least 2 or 3) I expected to be trolling for disruption. But I might addenedum the written record for clarifications of further, later reading in which the posters might not be known as well.
***--Of note, nobody in this thread [at this point] is someone I believe to be trolling, or to have trolled in the past, or to wish (or be likely to) troll in the future. I only say this to be excruciatingly clear in my implications.---***
However, I understand and accept your reading of both my wording and the dichotomies posted, and I think it's worth a clarification added to my initial post. Please do read it and let me know whether or not it is what you consider to be fully appropriate.
quote:Originally posted by Icarus: To put it as clearly as I can, threats against abortion doctors notwithstanding, I would say the fraction of pro-lifers who want abortion to be more dangerous, as a goal and not as an undesired side-effect, who actually wish harm on mothers who abort and doctors who perform abortions, approaches zero.
Hmmm. I think there is a difference in category and number between those pro-lifers who want merely that voluntary abortion procedures become more dangerous (and here I would agree this is a very very very small number) and those that believe it is necessary that this become so in the process of coming to the very great good of coming to outlaw abortions in general, as a sort of regrettable-means-justify-sufficiently-the-very-great-good-ends (I would still consider this to be a small number, but more (in my guess, that is) because the issue had not been raised in their minds than because it had been raised and rejected).
I expect a poll of pro-life persons might be useful to get an idea of this, but it is very difficult for me to figure out how to do this without triggering some (understandably fierce) sense of being attacked. It is a most tense subject in general, even at the best of times.
For example, Icarus, would you accept a significant increase in abortion complications if this led to outright banning of such procedures eventually? And if you would accept that increase, would you be willing to act towards that intermediate outcome (temporarily more complications from the procedures) for the sake of the eventual outcome (no abortion procedures whatsoever)?
Or if you don't want to answer (and surely this is understandable, and your right, and not something I would fault you for or draw any conclusions whatsoever about your beliefs on the matter), might you shed some light on why someone wouldn't answer and how to rephrase or recontextualize in a way that would make it a question someone might be more likely to answer?
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quote:***--Of note, nobody in this thread [at this point] is someone I believe to be trolling, or to have trolled in the past, or to wish (or be likely to) troll in the future. I only say this to be excruciatingly clear in my implications.---***
People who get abortions are all going to HELL!!! People who don't believe in abortion are all STUPID!!!
Sorry, I just couldn't help myself. It was such a great setup... *hangs head in shame*
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It does invite skullduggery and shenanigans, but such is the price of being clear. It is hard to assume charitable intent by others, even those one knows well, in topics that are as tense and emotionally fraught as these. These topics almost necessarily seem to come with drawn-up backs and a disinclination to the Principle of Charity.
It is the nature of the beast, and we all suffer from it.
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To put it as clearly as I can, threats against abortion doctors notwithstanding, I would say the fraction of pro-lifers who want abortion to be more dangerous, as a goal and not as an undesired side-effect, who actually wish harm on mothers who abort and doctors who perform abortions, approaches zero.
I think it is also possible that there are people who want abortion to be (or at least be seen as) a more dangerous procedure not because they wish harm to the mother but because they hope that that will discourage women from having one. I would put those people in CT's first category too.
Edit: or maybe have a seperate subcategory for them, since lumping them in with people who actively wish harm on others seems rather harsh. However, that is how I read her initial category -- that the desire was that increasing danger to the mother would prevent women from seeking abortions, not that women who do deserve to be punished with increasing risk of serious complications and death.
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posted
Icarus, I have amended the post to which you objected, and if you want further amendment (or just have further suggestions as to how to be more clear), I will happily try to incorporate them as best I can when I get back later today. For those items in the post on which me may disagree as to claims of fact or decidedly firm opinions, I will certainly (at least!) modify further to note your continuing objections, if any.
Additionally, I posed a question to you about whether you would be willing to accept a rise in the medical complications of voluntary abortion procedures if you truly believed it would lead to a ban on such procedures, etc. I'd like to underscore as firmly as possible here that I see no reason you should feel compelled to answer the question, nor that any particular conclusions should be drawn about your beliefs (or character, or even just your current mood) from declining to answer, should you decline to do so. (And I do not presume that you will decline to do so, by the way.)
But regardless of whether you do or don't decline to answer, I'd appreciate an assessment of how to ask such a question in the least offensive way possible, as I would like to ask the question more generally here. On the other hand, you (of course!) may decline to answer that question as well, on the same grounds as for the other.
quote:Originally posted by ClaudiaTherese: For example, Icarus, would you accept a significant increase in abortion complications if this led to outright banning of such procedures eventually? And if you would accept that increase, would you be willing to act towards that intermediate outcome (temporarily more complications from the procedures) for the sake of the eventual outcome (no abortion procedures whatsoever)?
Or if you don't want to answer (and surely this is understandable, and your right, and not something I would fault you for or draw any conclusions whatsoever about your beliefs on the matter), might you shed some light on why someone wouldn't answer and how to rephrase or recontextualize in a way that would make it a question someone might be more likely to answer?
It's not that I don't want to answer the question so much as that it seems to pose dichotomy where my view is neither of the ones you suggest. I do not view an increase in abortion complications as either a goal or a means to a goal. It's not an "ends justify the means" question at all. So the answer is no, I would not "accept a significant increase in abortion complications if this led to outright banning of such procedures eventually." That sounds coercive to me. As long as abortion is legal, I would want it to be done as safely as possible.
But I worry that this position which is not my own (i.e., viewing a decrease in the safety of abortions as a means to outlawing abortion) is all to easily conflated (by pro-choicers) with things that I do believe. For instance, I don't think that abortion should remain legal simply to prevent botched illegal abortions. Legal abortions should be safe--it's incomprehensible to me to believe that someone's life should be endangered for doing something the law grants them permission to do--but abortions should not (IMO, of course) be legal. I don't believe, in general, that laws should be changed in order to prevent harm coming to lawbreakers. If lawbreakers would not break the law, they would not come to harm while doing so.
Reading your clarification, I see that you're linking the complication right to protesters in general, and not merely to the more militant ones. In that case, I still don't see an increase in complications as a means. Law-abiding protesters are not trying to make abortions more dangerous. If fewer people become abortion doctors because nobody wants to work with nonviolent protesters outside their office, well, I see that as not a bad thing. If this leads to greater complications, I see that as a bad thing, but not a bad thing for which the protesters bear responsibility. People have a right to protest against the things they perceive to be evil.
Protesters outside of a military recruitment office might lead to fewer people joining the military. If fewer people join the military, those serving in dangerous zones might have less backup, and be more vulnerable to attack. Fewer people joining the war is, in the eyes of the protesters, a good thing. People dying in dangerous zones is, in most of their eyes, a bad thing. But war protesters bear no guilt for these increased deaths, and would argue that none of these soldiers would be dying if, for example, we were not occupying Iraq. Their deaths are not intended to be a means toward turning the tide of public opinion against the war. Rather, they're an unintended consequence, but protesters should not cease to protest out of fear that they may succeed.
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quote:Originally posted by dkw: I think it is also possible that there are people who want abortion to be (or at least be seen as) a more dangerous procedure not because they wish harm to the mother but because they hope that that will discourage women from having one.
This strikes me as monstrous, and I'd be stunned if this was more than a tiny minority.
quote:Originally posted by dkw: However, that is how I read her initial category -- that the desire was that increasing danger to the mother would prevent women from seeking abortions, not that women who do deserve to be punished with increasing risk of serious complications and death.
Heavens! The latter possibility did not even occur to me. I would certainly suspect that the number of people who would rub their hands in delight at an increasing number of such complications -- for reasons purely as punishment to the women -- would be vanishingly small.
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ClaudiaTherese, I have read your ammended statement, but I don't have a chalkboard handy on which to diagram it, so I'm afraid it is incomprehensible to me at this point. It may be that there is no way to both make it comprehensible and to avoid what I was criticizing in it. So I ask you, in all honesty and not as an attempt to control your post: what was your point? I mean, was breaking down the list of possible views on increased complications on the part of pro-lifers into an incomplete listing of possibilities actually elucidating some point?
I read it initially as pointing out that pro-lifers stand to benefit from the situation. I found pointing that out to be distasteful, as it suggested that they would be pleased at the thought of women dying. Now you have indicated (I think) that you by no means mean to suggest that a significant number of pro-lifers feel this way, just that some small fraction almost certainly do. Um, okay. Does that really mean that much then? I mean, if you think it is a large fraction, then we have a point to debate.
Let me try another analogy. It is plausible to me that some people who favor Zero Population Growth think it's a good thing when a woman has a miscarriage, and see it as a harm averted. Most probably disagree with her decision to have a child, but think it's awful that she would have to go through such a tragedy. Now I could point out the existing of the former group, with the caveat that they're a tiny minority, but what would be the point, really?
CT, I'm genuinely sorry that you seem to feel I have not assumed charitable intent on your part. Would it have been more proper for me to not comment? I actually feel that I have assumed charitable intent, because I have not (in my opinion) been discourteous, and because I allowed, in my original post to you, for the possibility that I was misinterpreting you. When you later said that you didn't understand what I was objecting to, I provided several examples and maintained what I thought was a courteous tone, and took at face value your claim not to have meant to imply that the more extremist pro-lifers are in any way representative of the movement as a whole. I don't believe my tone has been angry. I like you and think the world of you; I'm sorry if it seems otherwise.
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quote:Originally posted by Icarus: So the answer is no, I would not "accept a significant increase in abortion complications if this led to outright banning of such procedures eventually." That sounds coercive to me. As long as abortion is legal, I would want it to be done as safely as possible.
What do you think about a likelihood of such complications increasing as there are fewer and fewer physicians well-trained to do the procedures?
Given what you said about other analogous situations, I think you might view that as "an unintended consequence," but a consequence that you would be willing to accept even if you thought it likely, no? (Albeit that you would not accept responsibility for that happening, nonetheless you would be willing to go forward even if you have good reason to think this consequence would occur. That is, foreseeable as likely to happen, although not a matter of your responsibility.)
I am not trying to imply anything about that decision, mind you, rather to understand your position. I myself do accept foreseeable negative consequences for policies I advocate, including those situations for which I still do not accept responsibility for those consequences.
---
Edited to add: Have to leave, but I will come back, Icarus. I can do no more than skim your last post -- my sweetie is half out the door and waiting -- but my apologies if I have given offense. Will return, I promise.
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What choices do I have? How can I act to prevent these unintended consequences? If my only means of preventing this unintended consequence is to cease to advocate against abortion, then no, I would not do that, and I see any suggestion that I should as absurd.
Remember that, from my point of view, abortion has foreseeable negative consequences that must not be accepted. Most who favor legalized abortion seem to believe that a fetus, no matter the stage of development, does not have the rights that a born human baby has. Therefore, it's easier to be on that side of this particular divide, because on one side you have an foreseeable negative consequence, and on the other you have none. From my standpoint, there is a foreseeable negative consequence on either side, one of which by far dwarfs the other in scale. It's not fair to me to suggest I am uncompassionate about the other one--or that I don't share your desire to eliminate foreseeable negative consequences for policies I advocate--but I can't help but feel that I am being painted into that corner by these leading questions. I will not decline to answer, because I don't want that to be held up as proof of something about me. But my choice of words would not be your hypothetical choice of what I might say.
You seem to be suggesting that it may be wrong to advocate against the legality of abortion because doing so has this unintended negative consequence. I favor whatever licensing and safeguards are used to make sure other doctors are competent to be applied to doctors who provide abortions. These are licensed doctors we're talking about, no? Then why the heck don't we expect them to be competent? You seem to be attempting an end-around my statement that those who oppose abortions are not responsible for this foreseeable negative consequence, by granting it and still questioning the morality of allowing bad things that are not your fault to happen. (Incidentally, I would suggest that there are probably reasons being an abortion doctor is an undesirable career quite apart from the actions of anti-abortion activists. Like perhaps some of those doctors are themselves morally uncomfortable with performing abortions. It is probably different--at least for some--to perform abortions oneself than it is to speak in hypotheticals about whether they should or should not be legal for others.)
Is it immoral to carry a gun if I am a police officer or soldier? After all, there is a foreseeable negative consequence if I do.
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I usually avoid these threads, but couldn't seem to help myself today. I'm interested in the comment below, from CT:
quote:My anecdotal experience as someone who has worked shifts in given ERs over a period of >2yrs each, in 3 separate cities [and starting in 1996], is that there are some providers of voluntary abortion procedures that have stellar records, and some that do not. I am aware of at least one stellar provider that has "refused to do any more cleaning up after XXXX" (i.e., agreeing to come in as a consultant when things went wrong during the procedure) on the grounds that XXXX was too inexperienced to be providing such services and had too great a complication rate.
I have seen a marked decrease in the number of stellar providers as many either retired or withdrew from practice secondary to prolonged and vicious threats against their family members. It is also a service that fewer current physicians in training are willing to provide, given in good part the climate providers face. (there are studies of medical students and recent graduates on this)
Thus over the years, I have been seeing more and more complications, although -- notably -- these are not distributed across the board, but have been highly concentrated with certain providers. This includes some itinerant providers (travelling across the country to cover multiple more rural sites) as well as some stationary.
My question is this. Aside from the specific dynamics related to doctors leaving or avoiding abortion practice, is the situation in regard to uneven quality in medical care really unique to abortion?
I ask because I've been doing a blog now for almost two months. One of the things I've covered is professional accountability in medicine - or rather, the lack of it. (I won't put self-promoting links in here - most know how to look me up through my profile. )
Virtually every state sooner or later has scandals regarding the lack over oversight and accountability that state medical review boards actually provide. It's news for awhile and then everyone forgets.
As a result of the blog, a few mainstream bioethicists are corresponding with me now. They admit readily - in private, anyway - that there isn't much accountability for medical practitioners and groups like the AMA work hard to keep it that way.
I realize this is a partial derailment and I apologize for that. But I am curious as to just how much worse the picture is in terms of abortion than for other aspects of medical practice - and how we can even know.
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quote:Originally posted by Icarus: (Incidentally, I would suggest that there are probably reasons being an abortion doctor is an undesirable career quite apart from the actions of anti-abortion activists. Like perhaps some of those doctors are themselves morally uncomfortable with performing abortions. It is probably different--at least for some--to perform abortions oneself than it is to speak in hypotheticals about whether they should or should not be legal for others.)
Of course.
There have always been physicians who choose not to provide these procedures because of what they consider to be personal moral conflicts. However, when the choices of medical students and recent graduates have been studied, the drop in number of providers -- that is, the increasing lack of physicians willing to provide this, over and above the ongoing background rate of those who would not have chosen to do so anyway -- has been tied quite closely to concerns about personal safety and the safety of one's family.
[Edited to add: I did specify this in my first post. If it was unclear, my apologies. So, for full clarity (I hope): although there has been an increase in the number of young physicians who decline to provide voluntary abortion procedures specifically because of the current climate surrounding providers, this should not be taken to imply that there are not other reasons -- particularly, perceived conflicts with one's own morality, as well as other reasons -- why young physicians may decline to do so, just as some physicians always have had such reasons in the past.]
quote:Originally posted by Icarus: Is it immoral to carry a gun if I am a police officer or soldier? After all, there is a foreseeable negative consequence if I do.
*mildly
I expect that police officers and soldiers accept that there are such foreseeable negative consequences and judge them to be outweighed by the good achieved nonetheless.
I don't think less of police officers or soldiers for making that judgment. Honestly, I don't -- I may disagree with the judgment, or I may think it is not based on a realistic assessment of the circumstances at hand, but the fact that someone would accept foreseeable negative consequences of an action because that action lead to a greater good would not (in itself) lead me to think less of that person.
quote:Originally posted by Icarus: So I ask you, in all honesty and not as an attempt to control your post: what was your point? I mean, was breaking down the list of possible views on increased complications on the part of pro-lifers into an incomplete listing of possibilities actually elucidating some point?
My point was this, the conclusion of my initial post:
quote:Regardless, I expect (myself) the complication rate to continue to rise.
Of course, this does not mean that such a rate is inherrent to the procedures themselves, but more an artifact of who is left to perform them.
What you quoted and commented on was just one bit out of what I wrote, and it was not intended as a primary point, but as an aside. When I have commented on this rise in complications in the past here at Hatrack (notably, this was without any comment regarding potential intentions), I have been perceived as saying that this was the intent of the pro-life movement; or, at least, a Hatracker or two has strenuously rejected the [perceived by that/those person(s)] implication that this was his or her intent. (The threads are quite prior -- I haven't found them via search today, but then I have not undertaken an exhaustive search.)
And here again it came to pass that the discussion turned to the complication rate of abortions. Specifically, the discussion turned to anecdotal evidence of a particular provider being one with unreported/unreportable and outrageous complications as a result of the voluntary abortion procedures he or she provided relatively recently.
I was speaking in agreement that I have seen a rise is such problems (anecdotally) myself, and at least in good part for reasons I think are often missed in these discussions. I brought up the same issue I had in at least one or two previous discussions, but this time I tried to ward off being misread with regards to ascribing intent by acknowledging that though it may be the intent for some, it is an "unfortunate side effect" for others -- in my intent and by my assessment, an act towards not being divisive or casting aspersions.
I can see it didn't work. That is a shame. Truly, it is, for both of us.
quote:Would it have been more proper for me to not comment? I actually feel that I have assumed charitable intent, because I have not (in my opinion) been discourteous, and because I allowed, in my original post to you, for the possibility that I was misinterpreting you.
My preference would not have been for you to say nothing, Icarus, but rather for you to have avoided phrasing it this way:
quote:Wow. I'm kind of surprised at what I think I hear you saying here.
and instead just asked whether I was actually meaning to say something "surprising" in this way, or just to have assumed I was not saying something "surprising" (and noted this clearly, out of charitability), even if you went ahead to clarify a potential misread.
However, this is likely a matter of style more than substance. I am sure you did not mean to offend, nor to imply something offensive, and I am sorry to have taken it as casting aspersions on my intent.
As I said, we all suffer from a disinclination to applying the Principle of Charity in these cases.
quote: Um, okay. Does that really mean that much then? I mean, if you think it is a large fraction, then we have a point to debate.
No, it was an aside on my part, and if I had my druthers, it would have remained just an aside. It was far from the central point of my post.
If you were not present for those previous conversations, or if you were but have forgotten them, I can see why that initial aside would have struck you as sticking out like a sore thumb. Again, it was meant as an aside, and indeed as an attempt to ward off a misreading of my general post as casting aspersions on others (not the reverse).
quote:I like you and think the world of you; I'm sorry if it seems otherwise.
I like you too, and I think the world of you. I think you are an intelligent man with great passion and kindness. I do not want you to think ill of me, either.
posted
sndrake, I think that is an interesting and useful topic to pursue. I am not sure I understand the question itself, and I am certain I am not in a position to add much to that discussion at this current time, but I do wish you all the best in pursuing it.
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posted
For further reading about this trending down in the number of providers, there is a lay article in The New York Times, Who Will Do Abortions Here?, from 1998. That article also discusses some other reasons why the trend is occurring (such as more mergers of secular hospitals with Catholic hospitals that abide under different constraints) as well as some of the reasons having to do with the current climate of picketing, personal threats, and hate mail -- reasons to decline to provide both for current physicians and incoming students.
[Edited to add, just for clarity: those are not the only reasons (as specifically noted above, this article does bring up several other reasons, including personal concerns about moral conflict) and I do not think those are necessarily the reasons any given person here would have (or not) -- I merely note them as reasons which are playing a disproportionate role in the responses of the students and young residents for surveys published in the literature.]
In 1998, over 1/2 of the voluntary abortion providers in the US were above legal retirement age (65 years old). If I recall correctly, this percentage has only increased. This comes with less training for young physicians in how to deal with complicated spontaneous abortions, as well as therapeutic voluntary abortions (such as when the fetus has died in utero and there is a problem with spontaneous resolution -- not a frequent occurrence, but it happens).
I take this to be a foreseeable consequence of the current climate. I do not think it is untenable to accept that as a foreseeable consequence, nor do I take it as untenable to see that as a consequence for which someone bears no responsibility merely because he or she is pro-life. But it is what is happening, and I think that is worth noting and remembering, even if we individually may find it regrettable (or not).
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[Edited to add for further clarity: when I say "(or not)" in that last sentence, I do not mean to imply that any given person or percentage of persons does or does not find this situation regrettable but am merely trying to acknowledge the breadth of opinions people might have about such matters, including those in disagreement with my own -- an attempt not to exclude persons, but to include them, and for reasons the opposite of divisive.]
posted
Icarus, I am sorry. You made overtures of friendship and I disregarded them quite insultingly.
My husband says that when I am talking about or dealing with medical matters, I become persnickety, abrupt, and condescending, and he is right. This is over and above my devolution into umbrage and ruffled feathers when I perceive I am being attacked.
Dave and I fought about this just tonight, actually, and it brought to my mind that I am behaving the same way to you. I am so sorry.
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posted
If you were abrupt you wouldn't have put in so many qualifiers and provisos CT. Don't be so hard on yourself.
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posted
Thanks for the link, CT. It brings up a lot of good points. I'm curious to see what will happen to the people who can't be bothered to think about birth control when the experienced doctors have retired and no one wants to take their places.
As for my question last time if minority mothers have a hard time placing their babies for adoption, AbortionFacts.com seems to support the idea. Surprisingly, it's not that white couples don't want to adopt the babies.
quote: Actually, there are enough couples wanting these [minority] babies, but, sadly, they frequently aren’t adopted. Reasons include unwillingness of the natural mother to release the child, unrealistically high standards for minority parents to meet in order to qualify, and unwillingness of agencies to allow white parents to adopt them. E. Lee, "White Couples’ Obstacles to Adopt Nonwhites," Wall Street Journal, Feb. 27, 1987
The article also alleges that agencies tend not to place minority babies because they receive more money for them as they get older. I have no idea how reputable the site is, but it came up high on Google. Be forwarned, the link goes tot he top of the article which is a bit inflamitory, IMO. The bit farther down talking about race and adoption is more neutral.
[Edit: I reviewed the link, and it doesn't go straight to the bit I wanted.]
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quote:Originally posted by ClaudiaTherese: I have seen a marked decrease in the number of stellar providers as many either retired or withdrew from practice secondary to prolonged and vicious threats against their family members. It is also a service that fewer current physicians in training are willing to provide, given in good part the climate providers face. (there are studies of medical students and recent graduates on this)
Honestly not trying to make a US/Canada point, but rather in order to have as much information as possible (in case the situation comes up to a family member or friend): Would you describe the situation in Canada as being very similar, very different, or somewhere in between?
posted
I don't have enough experience in Canada, since I am not licensed to practice yet (so I don't work with other providers on a regular basis). I teach medical students, but they are not at a level at which they have much experience in the field -- and even so, I'd be wary of secondhand information.
When I can, I will let you know.
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posted
I hate to make posts now because I'm awaiting a new motherboard for my computer at home, so I'm not able to get online much.
I find that I'm coming to discussions very late, which bothers me because I can't respond as quickly as I'd like to things. Therefore, I'm coming in late and I apologize, but I cannot let the following go unsaid.
To the issue that CT and Icarus and others discussed - as someone very active in the pro-life community I find it very hurtful that anyone would suggest people who advocate for an end to abortion would welcome increased complication rates. How monstrous. How insulting.
My husband spent over three years of his life being deposed and testifying against an abortion doctor - he lost time from work, it cost us money and family time together because all the hearings were held a half-day's drive from home and he never received one cent of compensation - it was all voluntary. He did it because he thought the doctor was a danger to women and should have been removed, so he would not harm any more women.
The clinic replaced the doctor when he lost his license. I'm sure not one abortion was actually prevented - anyone who wanted one still got one, because anybody who wanted to go to that clinic while it was shut down was just referred to another one that was open and operational.
My husband was not out to prevent abortions, but to prevent an unqualified monster from butchering and/or killing anymore women.
My experience in with the Physicians for Life group in Alabama - one of our friends is a member and was past president of the organization - is that they advocate for safer conditions and more awareness of the complication rate not to prevent abortion, but to prevent maternal injury and death. See, they're Physicians for LIFE not just unborn life, but they actually do care about the lives of the women too.
As for why there are not that many people going into abortion - my friend told me once that it's not got much to offer a physician. It's not very challenging, there is no intellectual challenge at all - nothing to diagnose - and it's very repetitive and boring doing the exact same procedure day in and day out. He says most doctors actually care about people and want to help patients, and there is little joy to be found performing abortions. Even when you do your job well, the patients rarely think well of you afterward - it's a terrible experience all around.
At any rate, posting this is probably not going to do any good, but I couldn't just let it go. I'm hurt, and angry, and insulted. And it's very upsetting.
Maybe my motherboard dying is a good thing, perhaps a break from hatrack is a welcome thing for me right now.
(No, I'm not trolling for attention - if I ever take a break or leave for good I promise I will just vanish in the night and not make a spectacle.)
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quote:as someone very active in the pro-life community I find it very hurtful that anyone would suggest people who advocate for an end to abortion would welcome increased complication rates
I think it's roughly equivalent to suggesting that people who protest the war in Iraq want us to lose.
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posted
Belle, of course I have nothing to disagree with in your post, other than that I'd clarify that I am clearly not (of course, I'm certain you did not mean to imply this, although I would like to make it clear for future readers that that you -- in fact -- did not suggest this):
someone [who] would suggest [all, most, or even many] people who advocate for an end to abortion would "welcome"*** increased complication rates
as I clarified above (in, I think, about a gazillion ways) that this is not what I said. Although I am sure there may be persons who will still read it that way, I cannot do anything else about that.
[I am glad, though, to clarify that I am neither monstrous nor insulting in your or anyone else's eyes. ]
However,
quote:some protestors have have been quoted saying just this in the mass media. I would take them at their word, but sometimes people say things for effect alone.
and
quote:I also would not assume that any given category applies to anyone posting here, their families, or anyone they might have ever come in contact with in any possible way (phone, internet, book, what have you) in their own lives.
If you have never seen these comments, well, then that is a good thing, and I am both happy and unsurprised that you neither hang around people with these views or expose yourself to such unsettling views.
And furthermore, as I said previously with regards to the anecdote of your husband,
quote:I was speaking in agreement that I have seen a rise is such problems (anecdotally) myself, and at least in good part for reasons I think are often missed in these discussions.
Given that you note:
quote:As for why there are not that many people going into abortion - my friend told me once that it's not got much to offer a physician.
I am not surprised this is the view of your friend, and I certainly would never doubt that this is true or that you reported it accurately.
If I may repeat that without causing offense: I don't doubt you or your friend.
However, from the 12-page New York Times article I linked above (Who Will Do Abortions Here?) you can see that there are a myriad of reasons that other people than your friend give for not performing those procedures -- namely, some of the ones I mentioned in this thread, as well as others. And surveys of many students and young physicians across the nation also list such reasons.
Of course -- of course! -- this does not mean your friend is inaccurate about his own beliefs, merely that in the wider scope of the matter (beyond this one person), people involved do seem to have other concerns as well.
Does this mean you should not still protest? Of course not! Does this particularly mean you yourself, Belle, are a bad person, or that you yourself bear responsibility for anything at all regarded to this or any other matters related in in way, shape, or form to the subject at hand? Of course not!
It just is -- as a part of the world, apart from you. That's all. I think it's a part worth knowing about, but I am sure other people will continue to disagree with me (maybe you and/or Icarus, maybe not -- I don't know, and I will not assume), and I will not lay fault here with them for that.
----
***Edited to add: I'd also distinguish between "welcoming" this increase in the complication rate and "being willing to accept" this increase in the complication rate. I do think here are more pro-life people who fall in the latter category, especially if it is read as "being willing to accept that rise foreseeably happening without assuming personal responsibility for it."
This in fact does describe my perspective on widespread troop withdrawal from Iraq. (Thanks for the analogy -- broadly speaking! -- Tom). I think this would come with an associated increase in violence, even if temporary. I also think it's important to know about and understand the associated consequences of my position -- actually, I think such problems should be widely covered and in great detail in our mass media. I think they should not be overlooked or forgotten, especially if it is our choices that foreseeably lead to them.
---
Edited again to add: And of course I do not wish to imply that you, Belle, or any other given person here (or anyone he or she may know) does think that any particular foreseeable consequences of a given decision should "be overlooked or forgotten, especially if it is our choices that foreseeably lead to them." In my last paragraph, I am attempting to explain why I think that talking about these matters is important --
-- of course, not that anyone would not want me to talk about them, merely that I think it is important that we continue to do so ---
-- and trying to emphasize that I myself hold positions which I expect will lead to foreseeable but very regrettable associated negative consequences --
-- not in order to suggest that anyone else does or does not do the same, but to underscore that I myself do not consider that to be an untenable or monstrous position. You understand?
A rise in the negative complications of voluntary abortion procedures is foreseeable and almost inevitable as fewer and fewer physicians are willing to perform them. One of the primary reasons identified by both multiple national surveys and individual interviews (see the prior linked NYT article, among others) is the current negative climate raised by certain ways of protesting against providers and direct harrassment against providers. (Of note, these are ways of protesting and harrassment behaviors that are not engaged in by most people who identify as pro-life.)
In the past, when I have mentioned this as a significant reason why we may be seeing more and more such negative complications and, actually, why we may be seeing more and more less-well-trained and/or less admirable physicians who provide these procedures in the US, I have been taken to mean that people here at Hatrack (or others they know) who identify as pro-life are supporting those negative outcomes.
In this thread, I tried to bring up this point again, but this time I acknowledged that although there are people who have stated in the mass media that such an outcome is a necessary step in voluntary abortion being made illegal again, there are others for whom this must be just an unfortunate side-effect of the process. And, as dkw notes, there are additional categories that must hold, too.
It appears I was taken to mean the opposite -- either that there are people here who avidly seek out such an outcome, or at least that there is a a significant number of people who protest abortion and who avidly seek this raise in complication rates. I am not sure why I was read this way. I do find that misreading distressing, but I am sure it was a genuine reaction and not a deliberate action of bad faith.
I have tried to clarify this. Such further posts are very bulky and unwieldy.
Moreover, I have continued to emphasize that I myself hold positions which have negative foreseeable outcomes, and that I do not look down on people merely for holding such a position. In fact, I find it both admirable and important to be aware of the foreseeable negative consequences to one's positions, and to keep those firmly in mind as we carry through on decisions we make for those positions.
I don't see how this adds up to me attacking or disparaging anyone here, but if it still does read this way to someone, I am happy to try to continue the conversation and work through it.
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posted
Apropos to nothing, but CT, or anyone else, do you know if Medical removal of a fetus/embryo due to a mis-miscarriage added to "voluntary abortion" rates? As far as I know, the procedure at that early stage is the same for both.
posted
There are many differences in the terminology, depending on who is using it and when they used it.
Distinctions can be made between "abortions" and "abortion procedures;" amongst the various qualifiers, including "spontaneous," "elective," "induced," "clinical," "therapeutic," "medical," "voluntary," and "involuntary," amongst others (and these are not necessarily listed as antonym pairs); and regards "hospital," "clinic," and "home" sites.
It's impossible to know which categories were used (and not used) and how they were used unless you note which particular report you are trying to interpret. Any official report will give at least some indication of the specific terminology applied.
However, given that different people will use different terms, and that some people will lump them all under just "abortions" (or, perhaps, just leave out the "medical"/"therapeutic" procedures without even considering that this could mean the numbers are misread, etc.), and that the terminology has changed over time -- well, it makes it very difficult to summarize and compare across different studies and different years. This is true even for the professional literature -- and the mass media is (IMO) hopeless in this regard.
Do you know which study or which reporting agency you are most interested in finding out about? I would be happy to try to tease out what was and was not included.
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posted
No particular report, but there have been threads in the past that mentioned the very large number of abortions that happen per year, and how the numbers jumped once abortion was legalized, and wondering how it all jived.
I'm more speaking in light of semi-recent experiences my wife and I have had. "Voluntary", "medical", and "elective" could have all applied in our case, though our options were procedure, medication, or wait (with the possibility of a procedure being required anyway).
To complicate matters, the other option you list of "medication" may well appropriately be categorized as a "medical abortion" or "medical abortion procedure." [sometimes "procedure" implies implementation, and sometimes it merely implies a process, depending on who is using the word]
Often in the field of medicine a distinction is made between medical (i.e., usually pharmacologic) and surgical. Thus giving a woman a medication in order to cause her to expel a partially developed fetus for therapeutic medical reasons can be (and often is) termed a "medical abortion."
Even more confusingly, the option of "wait" may well be appropriately categorized as a "spontaneous abortion."
Depending on who you talk to and when, any or all or some subset of these might be considered "abortions," or not. I try to be as scrupulously clear when I write about it, in large part because I have had to pour over countless technical articles, policy statements, and surveys while trying to figure out what the writer intended to say.
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I am so very sorry to read that things likely were difficult for you and your love recently, regardless of the details.
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It may be that there is no way to both make it comprehensible and to avoid what I was criticizing in it. So I ask you, in all honesty and not as an attempt to control your post: what was your point? I mean, was breaking down the list of possible views on increased complications on the part of pro-lifers into an incomplete listing of possibilities actually elucidating some point? ![[Smile]](smile.gif)
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