The Death of a Doctor: Finding “Common Ground” on Abortion is Not Likely

With a single bullet, the killing of Dr. George Tiller, an abortion provider in Wichita, Kansas, made the process of finding “common ground” in the abortion debate much more difficult.

As much as President Obama has been talking up conciliation, the rhetoric and ideology espoused by some abortion foes makes it almost impossible to work toward a national reconciliation on abortion and freedom of choice. So far, seven abortion clinic workers and doctors have been murdered by right-to-life extremists since 1994. More than a dozen clinics have been bombed over the last fifteen years and many others have suffered vandalism and near-constant threats of violence. These acts of violence are condemned by traditional right-to-life groups and conservatives, but the level of rancor coming from many of these groups serves to incite the acts nonetheless.

In my previous post I mention that there is a severe shortage of doctors who will provide abortions. This killing will make that shortage even direr—a goal that abortion foes have actively pursued.

One important issue that is raised by Tiller’s shooting death is that of late-term abortions. Tiller was long considered “controversial” because his clinic performed these kinds of abortions; defined as taking place either in the third trimester—or alternately, after fetal viability which occurs at 22 weeks.

But, writing in RHRealityCheck today Lynn Paltrow of the National Advocates for Pregnant Women describes the reality of who Tiller was and the way he helped women:

“Many of the women who traveled to Dr. Tiller's clinic were not women who wanted to have abortions, or who even support the right to choose to have an abortion. Many were women with wanted pregnancies who learned that their baby had no brain, or kidneys growing on the outside of their bodies or things their doctors described to them as "severe fetal cardiac malformations." They were women who could not face two or three more months of pregnancy with people patting their bellies and saying, "Oh honey you must be excited. When are you due?" Some women deal with such crises by continuing to term even knowing the baby cannot survive. Others find that their dignity depends on being able to end the pregnancy.”

Confusion over the definition of “late-term abortions” and under what circumstances they can take place is rampant, although some 40 states currently have some kind of ban on the procedure. The majority of these bans include exceptions to protect a woman's physical and emotional health.

In Roe v. Wade, a woman’s right to access abortion is loosely tied to a trimester framework. The Guttmacher Institute offers a summary of the law and its built-in subjectivity:

“[T]he Court declared that a woman has a constitutionally protected right, in consultation with her physician, to terminate a pregnancy free of state interference or intrusion, at least in the early stages of pregnancy (defined loosely as the first trimester of gestation). In the second trimester—or more specifically, prior to the viability of the fetus—the Court ruled that states could impose only those regulations that were reasonably related to the protection of the woman's health.

The Court acknowledged that after fetal viability, the state has acquired a ‘compelling’ interest in ‘potential life’ and could prohibit abortion altogether ‘except when it is necessary to preserve the life or health of the mother."

Why do women seek out second and third-trimester abortions? Some of these procedures are performed when a mother’s life is at risk or her health is severely compromised. But more of these pregnancies are terminated after diagnostic tests have revealed profound deformities and other serious health issues in the fetus that are either life-threatening or would lead to a lifetime of pain and suffering for the child. These fetal problems might compromise a woman’s physical health. But many of these procedures are performed because the birth of a severely affected infant will cause mental anguish and distress to the mother.

In her 2004 piece for the Boston Globe, Gretchen Voss offers a poignant account of her choice to have a late-term abortion after her much-wanted baby was diagnosed at 18 weeks with profound defects:

“What they knew — that the baby would certainly be paralyzed and incontinent, that the baby's brain was being tugged against the opening in the base of the skull and the cranium was full of fluid — was awful. What they didn't know — whether the baby would live at all, and if so, with what sort of mental and developmental defects — was devastating. Countless surgeries would be required if the baby did live. None of them would repair the damage that was already done.”

Where does Obama stand on late-term abortions?  In 2008 he told Relevant Magazine, a Christian publication:

“I have repeatedly said that I think it's entirely appropriate for states to restrict or even prohibit late-term abortions as long as there is a strict, well-defined exception for the health of the mother. Now, I don't think that ‘mental distress" qualifies as the health of the mother. I think it has to be a serious physical issue that arises in pregnancy, where there are real, significant problems to the mother carrying that child to term. Otherwise, as long as there is such a medical exception in place, I think we can prohibit late-term abortions."

Obama suggests that the mother’s “mental distress” is not enough. In that view, which is described here;  women would not be able to end pregnancies in which the fetus is found to have severe abnormalities and is unlikely to survive outside the womb

In other words, medical technology can give parents a clear view of their baby’s devastating abnormalities and even tell them that the fetus is likely to die either before delivery or immediately afterward, but they have no right to seek an abortion. The “mental distress” option for a late-term abortion is, admittedly, a bulky loophole that rightly allows women to abort severely afflicted fetuses. But what’s the alternative?

Here is the story of one woman who found herself in exactly that situation and was denied access to an abortion in her state. Lydia Waddington’s obstetrician (and eventually five others) told her that ultrasound scans revealed that the child she was carrying was afflicted with multiple anomalies and would never live outside the womb. They also told her that she could have a spontaneous abortion which would increase her risk of contracting an infection. But, Waddington says, there were “only potential and no immediate threats to my physical health.”

“Although we had made the decision to terminate the pregnancy, we first had to deal with state law requirements in relation to late term abortions. When our waiver was denied, our doctor referred us to another physician in a nearby state. An ultrasound the morning of the two-day procedure showed that our child had already died. Further tests concluded that I had already developed an infection.”

Writing further about how Obama’s restrictive view of late-term abortions will affect women seeking termination in the case of “mental distress,” Waddington adds:

“Obama's policy clarification states that he would require a ‘strict’ health exception. It's doubtful that the possibility of early fetal demise resulting in an infection would fit the requirements. Most likely, under his policy, I would not have had an option to terminate. I would have continued the pregnancy and, given the known outcome, would have received minimal prenatal care. As a result, instead of the fetal demise going undetected for an estimated two days, it could have gone undetected until I began to experience the full-blown affects of infection.”

Late-term abortions are a flashpoint for conflict in the debate over reproductive choice. Yet in reality, they are performed infrequently: Only 1.1% of abortions are performed after 20 weeks and just 3.5% are performed between 16 and 20 weeks. In contrast, almost 90
% of all abortions are performed before 10 weeks.

The debate continues because abortion opponents see it as an issue that can unite extremists and moderates into a single coalition working toward banning abortion outright. In 2003 Congress passed the federal legislation known as the “Partial Birth Abortion Ban” that outlawed a specific medical procedure that is sometimes performed as early as in the second trimester. This procedure, more accurately known as dilation and evacuation, was not used very frequently, but sometimes offered the safest approach for terminating a difficult, even life-threatening pregnancy. After several challenges, the Supreme Court upheld the federal abortion ban, even without an exemption for when a woman’s life is at stake.

This ban is considered just the first step by opponents working toward increased federal restrictions. We can imagine bans on other, specific, techniques used to terminate pregnancy that the courts decide cause moral distress for women. President Obama’s statement about removing the “mental distress” exemption from late term abortion bans feeds into the opponent’s strategy, especially as new technology pushes fetal viability back to 20 weeks or less.

With the death of George Tiller, the nation will have to confront, once again, the forces that continue to keep us from achieving common ground on the abortion issue. And we also will have to face losing one more provider who strongly adhered to a woman’s right to choose.

14 thoughts on “The Death of a Doctor: Finding “Common Ground” on Abortion is Not Likely

  1. The problem is that abortion is a proxy for the real argument – the loss of dominance of men in contemporary American society.
    The feeling of powerless comes first (especially among working class men who are losing their social status and economic well being) and the justifications for opposition are post hoc.
    Catholic religious objections are countered by the fact that Catholic women tend to have abortions and use birth control at levels similar to the rest of the population.
    The same goes for Evangelicals, although I’m not sure the abortion percents are so high, especially because many of these households are still run by authoritarian men.
    “I may not be able to control my kids, my job or my economic status, but by gum I’m going to control my wife.”
    Arguing about the rationalizations without getting to the source of discontent is ineffectual. What is inexcusable is hypocritical politicians like Obama pretending that a similar amount of good will will solve these deep seated issues. Either he is incredibly naive or he is ducking the tough issues of the day.

  2. I am a Democrat, in favor of abortion (within some limits), believe that life starts somewhere between conception and birth and think that Roe v Wade was a good practical decision.
    Having said that, it sounds to me like Robert Feinman has spent too much time taking women’s studies courses: “The problem is that abortion is a proxy for the real argument – the loss of dominance of men in contemporary American society.”
    In the first place there are many women who are opposed to abortion. Secondly, the Catholic Church has a clear and logical position with respect to abortion; life starts at conception, abortion is the taking of a human life and therefore is murder, one cannot merely sit by and allow murder to occur.
    It is a mistake to underestimate, publicly “psychoanalyze” or characterize in a demeaning way (men who have lost dominance) those who we disagree with on abortion.
    Frankly, I think Obama’s approach – “I disagree with you, but wish to discuss this in a civil matter” is a very good one to such a polarizing issue as abortion.

  3. LF:
    A sign of a lack of meaningful argument is to invoke ad hominem arguments about those taking a position you disagree with.
    I clearly made a distinction between the dogma of the church and the actual behavior of American women. Apparently many women don’t agree with the dogma or find a way to reconcile the inconsistencies with their conscience – in the pysch biz it’s called “cognitive dissonance.”
    Now do you have anything useful to add, or just character assassination?

  4. Who started the ad hominem?
    What was the essence of your argument about the reasons that men oppose abortion? Is it not an ad hominem argument to suggest that their oppostion is based on a sense of loss of power?
    Is it not possible that those who disagree with us are sincere (and not afflicted with some type of psychopathology), but just see things a different way?
    Also, as I think I pointed out, your reasoning fails to explain the large number of women who oppose abortion. The fact that many women don’t agree with the dogma of the Church doesn’t explain the large number of women who oppose abortion – not all of whom are Catholic.

  5. “Ad hominem argument is most commonly used to refer specifically to the ad hominem abusive, or argumentum ad personam, which consists of criticizing or attacking the person who proposed the argument (personal attack) in an attempt to discredit the argument. It is also used when an opponent is unable to find fault with an argument, yet for various reasons, the opponent disagrees with it.”
    You attacked me personally, I floated a hypothesis about a certain category of men. That you fail to see the difference means that you also don’t understand the term.
    That some women may also oppose abortion is irrelevant to my point which was about men. If you want me to offer a hypothesis for why certain women also oppose abortion, you’ll have to pay for my ideas.
    Send a contribution to Planned Parenthood and then we can talk…
    Further remarks about me personally shade from ad hominem into trollism, so this is my last reply.

  6. Robert,
    My apologies to you to the extent that my argument was ad hominem (I think of it more as a snide remark).
    I sincerely believe that your argument about why some people oppose abortion portrays at least some of these people unfairly. For many years I worked at a Catholic hospital where there was sincere opposition to abortion on the part of both men and women.
    I have made a number of contributions to Planned Parenthood. Perhaps more than you.

  7. ” The Catholic Abortion Paradox
    Why are Catholic women in the U.S. more likely to have an abortion than their Protestant counterparts? ”
    http://www.beliefnet.com/Faiths/Christianity/Catholic/2001/01/The-Catholic-Abortion-Paradox.aspx?p=1
    Surveys of attitudes are of little value. Many women will maintain their anti-abortion attitude on surveys even after they have had one themselves. They manage to rationalize their personal decision while not seeing any contradiction.
    Surveys suffer from something called “social desirability bias”. People give answers they think are more socially acceptable to the interviewers. It takes a very clever type of interviewing protocol to eliminate this. Polls fail in this respect.
    Asking what people “believe” without correlating it to how they actually behave gives misleading data. Church attendance, as self reported, is twice as high as that when determined by census.
    Christine Wicker’s book deals with attitudes among Evangelicals. Her web site:
    http://www.christinewicker.com/

  8. Women are often just as invested in perpetuating patriarchy as men are. I think robert was alluding to the fact that the goal is just as much to make sense of a changing world as it is to consolidate power. Women can be just as susceptible to fear of social upheaval as men and react by bequeathing more power to men because “traditional” means “comforting” to them.
    Not sure how much of any of this is relevant to the discussion at hand, but it’s not like men are all anti-abortion for power and all women are anti-abortion for consistent religious beliefs. Members of each gender use each justification regularly. Sometimes/often both.

  9. Those pro-lifers are still killing people?
    What sort of statement is that supposed to make? That a fetus is as viable to society as a grown man with a medical degree? Shoot him to death at church so the fetus’ can live? Do the murdering pro-lifers raise the babies born from unwanted pregancies? Do they realize fetus’ need grown men and women to care for them after they are born? Pro-lifers have as much credibility as single payers.
    What does ad hominem mean?

  10. Legacy Flyer and Robert,
    I cannot claim to be an expert on why men oppose abortion, but my best guess is that it can be a combination of reasons. The most obvious is that it’s hard to relate to the idea of having an unwanted pregnancy when you will never be faced with one! It’s hard to deny that women bear far greater responsibility both physically and emotionally for children. That men choose to become vocal opponents of the right to choose may indeed have something to do with feeling that they’re ultimately powerless to control the childbearing practices of women.
    The Catholic church certainly does have a “clear and logical” position on abortion, but just as in sex before marriage, divorce and contraception, this position is sometimes ignored when an individual finds herself pregnant and either unable or unwilling to bear a child.
    All of this goes back to my original point that abortion is an issue that causes conflict even within an individual. It is a mistake to demonize anyone who has these conflicts, but also important to remember that freedom of choice allows each of us to get direction from our own moral compass.

  11. Lisa,
    An ad hominem argument is an argument against a person rather than against an idea proposed by that person. The argument is “against the man” – which is what I believe ad hominem means in latin.
    For example in a debate about a particular issue rather than discussing the issue itself, you could try to undercut your opponent by characterizing him as “stupid” or “a nazi” or “a crook”, rather than dealing with the issues raised by that person.
    Back when my brothers and I were young, this was the favored form of argument among us. “You’re stupid” – “I know you are but what am I” – “I’m rubber and you’re glue, everything bounces off me and sticks to you” – generally followed by somebody hitting somebody.

  12. Lisa,
    Ad hominen (I had to look it up too…)is a personal attack on someone. Seems like the abortion issue is full of these kinds of attacks, the most terrible being the murder of George Tiller.
    I agree that anti-choice folks should work on solving some of the social and economic inequities surrounding unwanted pregnancy first before demanding that abortion be illegal.

  13. I told Maggie I’d check the Canadian position on abortion within the context of their national “Medicare-for-all” system. In Ontario and in most other provinces, the “provincial health plan covers costs of abortions at hospitals and clinics” (www.prochoice.org).
    Although anti-abortion groups and sentiments mirror those in the US, the provincial ministries of health comply with the law of the land. The Supreme Court of Canada consulted the rulings in both Roe v. Wade and Doe v. Bolton and found a federal law restricting access to abortion unconstitutional.[Wikipedia, citing R. v. Morgentaler 1 S.C.R. 30 (1988).]
    Personally, I share President Clinton’s view that abortion should be safe, legal and rare. I fear that the rise in unemployment and financial hardships will lead to a rise in the number of US abortions. At a health care rally last week, I spoke to a young woman who actually has health insurance. She said she and her husband had a baby last year. It cost them $2000 out-of pocket.

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