A colleague of mine once said, "Everyone in America over the age of eleven has a great deal of information about abortion, and almost all of it is wrong."
As an abortion provider (MD) I performed an early first trimester abortion on a college senior some years ago. She had been seen a number of times among protestors at my clinic, and prior to her procedure she had told a clinic counselor that she was the president of her campus "pro-life" organization. Think about that. That must mean that she was one of their most committed and hardest working agitators against legal and safe professional abortion care for several years, but when she got pregnant herself, she was in the clinic having an abortion within a week of her positive pregnancy test.
After I completed her abortion, I matter-of-factly asked her what she was now going to do about her affiliation with that anti-choice club. Startled, she gasped, sat abruptly upright on the operating table, and with horrified expression blurted out in a tremulous voice, . . .
. . . "You're not going to tell them, are you?" I, of course, assured her we were not going to tell anyone, hopefully relieving her of that worry on top of all the other worries and fears she had. She likely returned to her (now unequivocally hypocritical) role of being the champion antiabortionist on her campus - unalterably opposed to safe, legal abortion care for every woman in the world but herself.
Many "pro-lifers" believe abortion should be outlawed with only four exceptions: endangerment of the life of the pregnant woman or girl, rape, incest, and "me."
Many others would omit the first three.
We see that degree of hypocrisy, and worse, regularly. However, it is not always simple hypocrisy. Many women (and men) just don't "get it" until they are personally faced with unexpected and unwanted pregnancy in themselves or in someone they care about. That's just often the way it works. It's often hard to relate to or understand until you experience it personally in yourself or in someone close to you.
Abortion is a decision that's very easy to judge when you're not in the position of having to make it for yourself.
To those who advocate that the abortion issue should just be ignored, soundbyted, weaseled around, or whispered about in vague generalities, I say, "Wake up!" It is far too important an issue to just fade away, and no single issue separates Democrats from Republicans to the extent it does.
Forty million American women have had abortions. Add to that forty million all the families and friends of those women and girls and you have an enormous voting bloc. Quoting a diary by Ann Rose, long-time abortion rights advocate and provider:
Who and where are the women who've had abortions? I'm one. Look around you. There is definitely a woman within earshot of you right now who’s had an abortion. But, you say, there's no "slutty" looking women around me now. I'm at work. Or, I'm in church. Or, I'm at the gym. We're there though. You can't avoid us.
And to you politicians and candidates paying attention out there. Women who've had abortions are on your staff. They are relatives. They are friends, relatives, co-workers, volunteers, Republicans, Democrats, mothers, wives, sisters, daughters, etc. Women who've had abortions are everywhere.
40 million plus votes. The estimates of the Evangelical Christians that supposedly won the 2004 election for George Bush are only 20 million.
So, a candidate speaking at a political rally needs to know that there are lots of women out there who've had abortions. And there are many men listening in the audience who've paid for an abortion. There are also friends and families of women who've had abortions.
Their reasons are many and varied. That's their business. Your business as a politician who wants to get votes and win elections is to make people feel good about you and your issues so they'll support you, both financially and with their vote. So, don't piss them off.
Don't muddle your message with platitudes such as:
"I'm really against abortion, but..."
You don't know what you're "for" or what you're "against" when it comes to abortion until it happens to you. Believe me, there are many self-described "anti-abortionists" out there who have chosen abortion when they need one.
Also, don't say:
"Abortion is such a painful decision."
How do you know that? Maybe it was the most painless, empowering decision many of the women in your audience have ever made. Maybe they were very sure of their decision. Maybe they're very OK with their decision and are wondering why you're not.
An amazing amount of simple factual truth has not dawned upon many of us or is generally actively denied since we all have a strong tendency to believe only what we want to believe, what we feel we must believe, what we have been manipulated and indoctrinated into believing, what we think will win favor with important others if we believe it, what we believe is good and proper to believe, and/or what we have a compelling emotional need to believe, and to resent and defend against acknowledgment of anything that threatens or runs counter to such belief - all in the service of believing that we know we are right - so right that everyone else in the world should believe, think, feel, and behave just like us, and be made to by force of law if necessary.
Trouble is, no matter how fervently one believes that one knows what one merely believes, one merely believes it and one might be wrong - very wrong.
I don't believe in evolution. I am convinced by the evidence. The implied converse should be equally true, i.e., to quote Mark Twain, "Faith is believin' what you know ain't so." (Well, if you don't know something that "ain't so" "ain't so," based upon the complete lack of evidence of its being so, you should, because this is the 21st century, and you have every opportunity, and the responsibility, to either educate yourself or shut up - please pardon the arrogance. I'm fed up.)
There is perhaps no area of human behavior in which clear rational thought and understanding of factual reality is more obscured by emotionally charged irrational belief and misinformed opinion, and in which the consequences of this failure to face and accept truth are more catastrophically cruel, than in matters concerning sexuality and reproduction, even among some physicians and others who have had every opportunity to know better. I will lay out here a few factual truths that are so unpleasant or threatening to some in all walks of life that they are commonly denied and smothered by contradictory belief and even blatantly lied about by those fanatical enough to strive to force their beliefs upon everyone.
As a physician (MD) educated, trained, and experienced in both psychiatry and obstetrics and gynecology and currently specializing in abortion care, I want to attempt to explain why I provide abortion care and express a deep and urgent concern I have about some of the political developments that threaten the lives, the health, and the general well-being of American women and teenage girls, as well as the integrity of their families, educations, careers, and social relationships. My concern is about those politicians and the propagandists and propagandized voters whose favor they curry who are grossly and shamelessly lying and exaggerating (or ignorantly employing the lies, distortions, exaggerations, and delusions of others) not only to impose unreasonable, unnecessary, and burdensome restrictions and limitations on women’s constitutionally guaranteed right to choose abortion for unwanted or life- and health-endangering pregnancies, but to eventually abolish that right entirely. Despite its profound seriousness, many influential politicians, certainly including our current President, George W. Bush, John McCain, and Sarah Palin seem to know, understand, and care little about this issue except insofar as they can manipulate it politically to gain votes from misguided ultraconservative religious extremists and feel themselves to be morally superior. I ask for your indulgence as I attempt to explain my concern in as few words as I can. I have attempted to moderate the language and emotion expressed herein, but I ask for your understanding if some of what I have to say comes across as less than polite. After years of unrelenting insult, harassment, violence (including the total destruction by arson of the clinic with which I was associated and fourteen other businesses in the same building in 1985 along with a thwarted attempt to burn my house), and threats of violence, even of death, against my family and myself (including two men waiting for me with a "deer rifle" outside a clinic), civil discourse on this issue does not come easily to me. This is neither an attempt at, nor a pretense to, a scientific paper, so there are no footnotes or references. This does not mean, however, that I have been careless with truth or reason or that the views and the facts I express herein are not supported by scientific knowledge and understanding.
The current Supreme Court is composed of five devout Roman Catholics: Roberts, Scalia, Thomas, Alito, and Kennedy, making up the 5 - 4 majority in the recent (April, 2007) Gonzales vs. Carhart decision that, under the rubric of a made-up scourge termed "partial birth abortion," ripped complex medical judgments out of the hands of experienced physicians and placed them into the fickle, untrained, and inexperienced hands of politicians and makers of broad-brushed and ambiguous criminal law.
What is happening to religious freedom in this nation? Oh, I know the stock replies, such as [1] this is a Christian nation and [2] freedom of religion doesn't mean freedom from religion. As appealing as the former is to some who want so much to believe it, it is abundantly demonstrated not to be true by knowledge of the varied religious persuasions of the founding fathers and reading of the public records of what they said and wrote about it, including the United States Constitution. As for the latter assertion, of course freedom of religion means freedom from religion. How could one be free to be Baptist without the freedom from Roman Catholicism and vice versa? How could one be free to be Christian without being free from Islam and vice versa? Could anyone be free to be atheist without freedom from all religions? No, of course not. Enough said. The last time I checked there was no legal requirement in this state or nation that I be a Roman Catholic, a Southern Baptist, a fundamentalist Muslim, or a believer in any other religion, or that I conduct my life according to the dogmatic teachings of any religious belief system and I am not and I don’t.
Laws to force you or me into such compliance with dogmatic sectarian belief, however cleverly camouflaged, are profoundly inappropriate in a country that truly values individual freedom as reality, not pretentious jingo.
Abortion providers, and thus the personal liberty of American women and teenage girls, are being regulated and restricted under false pretenses. In their effort to write the dictates of their religious beliefs into laws requiring the obedience of all to those beliefs, while falsely claiming they are not, the lawmakers behind such regulations and restrictions are striving to deny, on purely ideological grounds not related to the false justifications they claim, religious freedom to any who disagree.
"Abortion hurts women!," they shamelessly proclaim in sweeping, untempered generalization. That is as untrue as saying up is down or left is right or 2 + 2 = 22 but this does not mean that those who proclaim it are lying. By and large, they are not lying at all, because they really and truly believe it to be true. Why do they believe it to be true? Because it is what they desperately want to believe. Why do they want to believe it? Because they are so habituated to pleasing, and fearful of displeasing, those they regard as authority figures, whether their concept of a supreme being, or just their pastor or favorite TV evangelist, or their father, or their supervisor at work, or the prevailing attitudes of their political party, or merely what it takes to get funds and votes in their district and/or to succeed in business. At their core they tremble in fear of losing the approval of such authorities and others of like mind. Their sense of self-worth, and indeed on a deeper level their sense of survival, relies upon this approval - they need those feathers in their caps, those merit badges of approval - those trophies on their tables and walls - and those dollars in their coffers - not that they are likely to admit it, insisting as they do on framing it in the more abstract and mega-authoritarian terms of supernaturalism and spirituality - of religious belief.
In actual fact, legalization and availability of abortion, comprehensive sex education, and effective contraception have represented probably the greatest advances in the history of the world in bettering the health and lives of women and teenage girls. There is no doubt about this to be debated by lay ideologues and demagogues in government cynically pretending to know and understand enough about modern medicine to micromanage a specialized area of medical practice from under the ivory towers of capitol domes. However, the cruel deception is prevalent that reality should be trumped by belief.
Well then, what about reality? Following are some examples of what REALLY hurts women and what "pro-lifers" REALLY stand for.
The World Health Organization has estimated that in those parts of the world in which abortion is illegal, about 70,000 thinking, feeling, often desperate women and teenage girls die every year from illegal attempts to abort unwanted pregnancies. That is more than one every 10 minutes DEAD because they are prohibited by law from accessing a reputable legal clinic for safe, legal, professional abortion care. Many times that number are seriously injured and maimed for life.
In addition, every minute, night and day, no holidays or weekends off, around the world
• one woman dies of complications of pregnancy and childbirth (every minute),
• ten teenage girls undergo unsafe illegal abortions (every minute),
• thirteen infants under twelve months old die (every minute),
• fifty seven people contract an STD (every minute),
• eleven people are infected with HIV (every minute),
• and the already-burgeoned-beyond-the-planet's-capacity-to-sustain human population increases by one hundred fifty more people (every minute),
all sanctioned, encouraged, and even enforced by our callous right-wing-dominated government through international interference with and withholding of funding from worldwide reproductive health and sex education programs, all with the vigorous support and reinforcement of the Roman Catholic Church.
Let's not forget the women brutalized and incarcerated by law enforcement in those countries in which the Roman Catholic Church has pushed for and won the criminalization of abortion and achieved that mercilessly cruel piece of "God's will on Earth be done." In countries such as Chile and El Salvador women having not only induced abortions, but spontaneous abortions (miscarriages), are routinely subjected to police investigations and interrogation, arrested, and incarcerated. Many women having natural miscarriages are so afraid of such persecution and prosecution that they avoid seeking medical care in such situations, and some (many I would think) die.
That is what so-called "pro-life" voters and politicians stand for, and they won't stop until they succeed in creating conditions in this country mirroring those in the Third World and in Chile and El Salvador in my examples above. Or until we stop them at the polls.
Does anyone really not see an unbroken continuation of the Holy Inquisition in such barbaric atrocities?
As with that famous rose, an Inquisition by any other name - or a prettier name - or no name at all - is still an Inquisition.
I strongly believe (yes, I hold beliefs, too, but beliefs that are supported by evidence in factual reality) that defending abortion rights and other issues targeted so irrationally and callously by religious extremists are [1] issues of far too heavy import to ignore or whisper about and [2] winning issues politically if addressed rationally and assertively.
In the United States we are vastly more fortunate. Almost 4,000 women every day obtain professional abortion care in the United States that is legal, professionally provided, and therefore extremely safe. Approximately 40% of all adult women in the country have had an abortion. 40%. Maybe your sister - the teenage girl next door or down the street (yes, no matter how perfect her Sunday School attendance) - your daughter your best friend's daughter - your wife - your mother - your teenage son's girlfriend! You just aren't likely to hear about it because they fearfully keep it secret. Its one of those taboo subjects most people don’t feel free to discuss. Nor do many people want to hear about it, preferring to bolster their comforting false beliefs that it just couldn't be so by screening out and denying factual knowledge of it.
Abortion was not always so safe in the United States, because it was illegal in most states here, too, until January 22, 1973, when the United States Supreme Court issued its decision in the case of Roe vs. Wade. Prior to that momentous decision, which declared unconstitutional, and therefore unenforceable, all state laws prohibiting abortion, the statistics in the U.S. were similar to those quoted above for illegal abortion forced underground in the third-world, and many major U.S. hospitals were forced to provide entire (and often overflowing) wards for the victims of injuries from illegal abortion attempts those who didn't wind up on slabs in morgues. Even so and tragically, there are today those willfully ignorant and misguided persons and their narrow and uncompromising political, legal, and religious organizations in this country who are fervently struggling to throw history into reverse and turn the clock back to those horrific times. They strive to recreate the blood bath and the wrecked lives that existed prior to Roe vs. Wade as one especially pernicious plank in their ardent campaign to transform our free society into a religious tyranny motivated by much the same sort of fervent and uncompromising beliefs that moved other religious fanatics of a different religious persuasion to guide large airliners full of people into large buildings full of people on September 11, 2001. (I'm merely connecting the dots.)
Incredibly, those obsessed individuals who strive, contrive, and deceive in order to criminalize abortion and throw us all backwards into the suffering and death illustrated by those statistics quoted above call themselves "pro-life." To emphasize the absurdity of this I never use that misguided, hypocritical term outside of quotation marks.
Those politicians who believe their personal political ambitions and those of their party will be favored by further restricting womens access to professional abortion care and who are callous enough to value their political ambitions and agendas above the lives and well-being of women and teenage girls and their families - have a rude awakening ahead as the body count in dead and injured women and teenage girls mounts in direct proportion to their tragically misguided legislative "successes." Oh, to be sure, they might continue to "succeed" in pitilessly oppressing the human rights of women until the tally in wrecked and extinguished lives grows large enough that it can no longer be ignored or covered by denial, pretense, delusion, and lies, but a time of reckoning is inevitable. You can't fool most of the people all of the time.
Opposition to safe, legal abortion is often speciously supported by references to a few bad outcomes that are presented, with extreme dishonesty and in sensationalized, exaggerated form, in antiabortion propaganda as commonplace. In reality, they are not commonplace at all, but quite rare. There is no form of medical or surgical treatment that is absolutely safe. All medical and surgical interventions carry some degree of risk of bad outcome, and this is no more or less true of abortion than of any other medical or surgical procedure. For example, having an abortion in the United States and other progressive countries where abortion care is legally provided by trained and experienced professionals is safer than a shot of penicillin. The risks of abortion when provided legally and thus openly and relatively extremely safely are possible, but extremely rare and the risks are much higher with continuing a pregnancy and giving birth, the one and only alternative, than they are with abortion.
Abortion carries essentially the same risks as continuing a pregnancy and giving birth, the difference being that the risks are many times less likely and less severe with abortion. Additionally, there are risks of later pregnancy that are avoided by abortion, such as life-threatening hemorrhagic complications of later pregnancy, pregnancy-induced hypertension, the aggravation of certain chronic diseases, post-partum depression, and a serious convulsive disorder known as eclampsia or toxemia of pregnancy, as well as the frequent possibility of major abdominal surgery if a cesarean section is needed. [Please refer back to the statistics above. Abortion is safer (not implying anything about its morality, which I think should be a matter of individual conscience) than continuing pregnancy through to childbirth even in those third-world countries where abortion is outlawed and about 70,000 women and teenage girls annually die from complications of illegal abortion attempts.]
By misguided law in several states physicians are required to tell women considering abortion that there is a possibility of an increased risk of breast cancer later in life for women who have had an abortion. However, there is no sound medical evidence to support this idea, the false claims of anti-choice propagandists notwithstanding the test of truth. In fact, this has been taken very seriously, studied very painstakingly, and thoroughly disproven by medical research, although I am well aware that there are those purveyors of antiabortion propaganda who falsely present themselves as "experts," some even with phony degrees, and proclaim otherwise, even publishing dishonest and deceptive "studies" that speciously support their claims.
Another well-known false claim made in anti-choice propaganda to shame and frighten women and demonize abortion and abortion providers is the specious assertion that all, or a large percentage of, women who have abortions of their own free choice will have subsequent serious psychological-emotional problems directly caused by the abortions. Abortion hurts women they loudly and unashamedly proclaim. However, extensive surveys and objective psychological studies have firmly established what all abortion providers know - that the vast majority of women who have had abortions adjust well and absolutely do not subsequently suffer significant regret or psychological or emotional problems, and that in those few who do, the emotional dysphoria/dysfunction is not simply the result of the abortion per se, but of the totality of the complex and varied circumstances surrounding unwanted pregnancy and the decision to have an abortion, including religious belief-induced fear, shame, and guilt. We know that devastating emotional distress can be associated with childbirth, adoption, parenting, infertility, and, yes, abortion, and with lack of access to safe abortion care. Political polarization tricks us into focusing on abortion, when the fundamental issue is the constellation of emotional, spiritual, physical, and social experiences that surround pregnancy and motherhood. Of much greater concern to me as a psychiatrist, an obstetrician/gynecologist abortion provider, and a human man who cares about human women is the emotional distress the crisis of unwanted pregnancy with no way out creates in women's lives.
We don’t know all the factors that make some women emotionally vulnerable, but it's not hard to guess that lack of support, abuse, poverty, depression, powerlessness, social expectations, perfectionism, indoctrinated belief systems that produce fear, shame, and guilt, and even genetic factors contribute. Most of the devastation is secret. We see it when a woman drowns her children in the bathtub, or a celebrity risks talking about postpartum depression. Healing requires telling all the truths and unmasking punishment and control in the guise of caring.
Some women terminating an unwanted pregnancy may feel sadness and a sense of loss. However, the overall negative social and political climate surrounding abortion has vastly much more to do with creating the psychological difficulties some women face than the abortions themselves. The condemnation and lack of social support for unplanned pregnancies and abortion, misleading anti-choice messages that are designed to inflict fear, guilt, and shame, and anti-choice protesters who harass and intimidate women at clinics have more to do with the experience of emotional distress than the actual abortions.
Some (a few, meaning a very small proportion of the total number) women who have abortions also have emotional problems and some (a few) women who have babies also have postpartum depression and psychosis, generally much more severe conditions than anything seen in women who have had abortions of their own free choice.
If the idea of lawmakers is really to safeguard women from being hurt, physically or emotionally, wouldn't they be interested in warning women of the greater dangers of continuing their pregnancies to term and giving birth?
I don't think it is a tenet of American law that freedoms should be restricted because some (a few) might later regret their exercise of these freedoms. If it were, of course, one of the first of many freedoms to go would be the freedom to get married. Should marriage, whether homo- or heterosexual, be outlawed? Think about it. Do you believe otherwise?
It is those twin pillars of support for religious fanaticism, willful ignorance (wanting to believe only what chosen authority seems to require, and doing so despite clear evidence to the contrary) and hypocrisy (acting in ways to gain approval from chosen authority whatever the cost in honesty, integrity, freedom, or justice), which constitute the motivation and ambition of the outrageously false claims that freely chosen, legal, professionally provided abortion care hurts women.
"Pro-life" counselors are probably truthful in their assertions that all the post-abortion women they counsel have emotional problems, often many years later. They are probably right about this for three obvious reasons: [1] Believe me, there is not a person alive who does not have emotional problems, and "pro-life" counselors, out of their bias, strongly tend to falsely attribute the emotional problems of their clients to their past abortions, no matter how much more complex and varied the actual causes might be. [2] Again out of their own bias, "pro-life" counselors tend to "rub the noses" of their clients in their "mistakes" of abortion, engendering exactly the shame, guilt, fear, depression, and other signs of emotional distress (signs of "emotional illness" to them) they expect and want to find. [3] It is obviously only the relative handful of women who believe they are having emotional problems caused by their abortions who are likely to seek the services of a "pro-life" abortion trauma counselor in the first place. Women would be much better off protected from anti-abortion prejudice and misinformation - from deliberate efforts to engender shame, fear, and guilt - than from freedom of choice - better allowed the degree of self-determination guaranteed all citizens by the covenant upon which this nation was founded than "saved from themselves" by sanctimonious, self-righteous, know-it-all zealots who are deluded that they know what is best for everyone else, demand that their uninformed and misinformed puritanical prejudice based upon their religious beliefs be mandated for all by oppressive law, and are willing to use tactics of inducing unnecessary and groundless fear by lying about the nature and risks of abortion to achieve their goals.
The especially ridiculous notion is advanced in antiabortion propaganda that "family values" would be supported by abolishing, by means of broad-brushed restrictive laws that actually prohibit families from exercising their autonomous rights, the choice of the alternative of abortion for unwanted pregnancies. It is obvious that such governmental interference in family matters actually seriously reduces the abilities of individuals and their families to make such momentous personal decisions on their own in consultation with their own physicians and their own religious faith and their own moral values. Taking the fate of any individual or of any family out of their own hands and placing it into the hands of the laws of politicians and government influenced by the narrow religious beliefs of others does not strengthen or support families or family values, forgodsake! It weakens them, often with tragic results, as I have personally witnessed many times.
Is abortion murder?
I have been asked a question that is simplistic, ignorant, and misleading: "Just what is the magic of passage through several inches of birth canal that makes the difference between abortion and murder?" My answer to that question is just to state the honest, simple, obvious factual truth, as far as I can know it: "Nothing." No magic - and no difference in my opinion when the fetus is far enough along in development to be sentient and to survive outside the uterus. Implied in this answer is that I am no supporter of unrestricted elective third trimester abortion, or unrestricted abortion after the age of independent viability of the fetus - that is, the age at which a fetus can be expected to survive outside of a womans body.
However, let's go to the other end, to the beginning, of the 38 weeks-long period of fetal development deep inside the corporeal domain and deeply personal jurisdiction of a woman's body, and consider the same question from the other direction. The question becomes: What is the magic that makes its destruction murder in the estimation of some when the DNA of a sperm and the DNA of an ovum share a common cell membrane when just a moment ago, before the event of conception, or fertilization, the same two clusters of DNA were just as alive, and each, one a living sperm and one a living ovum, was contained within its own cell membrane, and their destruction would have borne no moral significance whatsoever, or relatively very little? I think the honest, obvious answer is exactly the same: "Nothing." No supernatural magic.
• Is a newborn baby a person? Yes. Of course. It has developed into what we have through many centuries of legal and moral tradition defined a person to be.
• Is a fertilized egg, or zygote, two DNA clusters occupying the same space inside a single cell shortly after conception, a person? No. Of course not. It can and might develop into a person, although most do not under natural circumstances.
As for the belief that there is no difference, or no difference in value, between even a very early embryo or fetus and a newborn baby or child, consider this analogy: What do you have if you have a bowl containing a mixture of flour, sugar, shortening, baking powder, and eggs? Cake batter. Not a cake. It has all the ingredients, but it is only a potential cake - a cake-to-be in the making, not a cake. It must be placed in the proper atmosphere in the proper vessel and subjected to the proper conditions for the proper span of time before it can be considered a cake.
Actually, an even better analogy pertaining to the early stages of embryonic development is that of a blueprint (DNA) for construction of a building before the building materials have even been ordered. A bit simplistic perhaps, but a fetus is a baby-to-be in the making, not a baby. It is human life, as is any cell or group of cells in a human body, but not a human life, not a human being, not a person - not until it becomes "ensouled" at the time it takes its first breath some believe, while others believe "ensoulment" takes place earlier, even as early as conception, and still others determine the emergence of personhood upon other criteria that are more objective than varied and conflicting religious beliefs about "ensoulment." (Question: Multiple pregnancies result from division of the very early embryo after conception. If "ensoulment" occurs at conception, does a twin therefore have half a "soul?" A triplet one-third?) Similarly, we differentiate between an acorn and an oak tree. Scrambled eggs are a popular breakfast entree, not scrambled chicken.
Ive been asked questions of the nature of, "By the way, my wife was adopted, so I look at her and think what would be if she weren't around." To this sort of question I reply, "Well, yes, but that's one of those BIG IF's. Sure, she wouldn't be here IF the embryo that developed into her had been aborted, or IF her biological mother and father had not done it that time, or IF her biological mother had not ovulated that cycle, or IF the condom hadn't burst that time, or IF the embryo that became her had gone the way of the majority of early embryos and spontaneously aborted (miscarried) - or IF her mother had had a headache that night. And what IF she weren't around? Well, just as in cases like the aforementioned, she would not then exist, and you'd be married to someone who does exist. Why, you might as well dwell on all the millions of unfertilized eggs and spontaneously aborted embryos, any female one of which might have been your wife IF they had only been fertilized, gestated, born, and then grown up to meet and marry you. There is no bigger subject in the world than what might have been IF_____, nor one any more irrelevant to what is.
You might not want to believe it, but uncountable billions of early human embryos are thrown into the garbage or flushed down the sewers on used tampons and pads by women who didn't even know they were pregnant prior to their very early miscarriages, but this is not regarded as a great tragedy by any but the most ardent "pro-lifers." Their deaths are not solemnized in funeral rituals. Used tampons and pads are not buried in cemeteries in graves marked by marble monuments. We are issued certificates of birth, not certificates of conception, a pregnant woman requires only one passport when traveling abroad, and she is counted as one in the census, not two or more.
Many ardent Christian believers describe themselves as born again Christians, not conceived again Christians.
There are profound differences between prenatal and postnatal life, and previable and viable life, that we acknowledge in various ways every day. Therefore, the concept of attained personhood, which underlies the U.S. Supreme Courts Roe vs. Wade decision that in effect legalized abortion nationwide, is not frivolous or unsubstantial. It is of central importance in this controversy. A zygote can become a baby, but is not one now. A baby was once a zygote, but is not one now. Between these two extremes, personhood is attained as the result of slowly progressive development and differentiation of what did indeed begin as what, in the beginning, could reasonably, if not precisely, be called "just a blob of tissue" a single cell and then a growing cluster of undifferentiated embryonic cells beginning a long and complex journey of multiplication, differentiation, and specialization toward becoming a person.
• Should we be obligated to fully include a baby in the social contract that defines the legally protected rights of all persons and grant to it a right to life? Yes. Of course.
• Should we be obligated to include in this secular social contract and grant a right to life, independent of a pregnant woman's consent, to a zygote, a single cell composed of two DNA clusters sharing the same cell membrane, unconscious and insentient, visible only with the aid of a microscope, that is totally dependent for that life upon the 24/7 donation of one specific woman's body outside of which it cannot live? No. Of course not.
The consideration in deciding whether to terminate an unwanted pregnancy at any stage of fetal development places the rights and conscious desires of a pregnant woman directly in conflict with any rights her fetus might be considered to have. Legally, the principle of an individual's right to bodily sovereignty, a fundamental principle of personal liberty firmly grounded in United States law and an essential requirement of individual freedom, along with consideration of the biological and developmental status of the fetus in relation to evolving personhood, should be applied in resolving such conflict. This principle prohibits an individual's being required, or forced, to donate an organ, even a pint of blood, to another, even if the other would die without it and even if the donation would represent a negligible degree of risk or inconvenience to the donor. Viewpoints may be argued concerning the morality of such refusal, and honest, civil attempts at moral persuasion should continue to be freely allowed and deemed completely appropriate, as covered by the basic rights to freedoms of thought and speech. However, the law is clear, and should remain so, that no person shall be required by law to donate the use of any part of his or her body to any other person, even if the other person would die as a result of the refusal, and even if the granting of this use would entail only minor or temporary inconvenience and minimal risk to the unwilling donor.
The issue in abortion rights is whether one person (granting only for the sake of discussion that a previable fetus should be considered a person) has the legal right to use another person's body to sustain its life, whether or not that other person is willing. If such a right were granted to fetuses, it would be a special right that unequivocal persons, such as you and I, do not have. If such a special right were granted to embryos and fetuses, shouldn't the law, to be even-handed and consistent, force donations by others, and from the bodies of others who have died, of blood, bone marrow, livers, hearts, lungs, kidneys, eyes, and other organs, whether or not the prospective donor or his or her next-of-kin is willing? If one unequivocal person does not have the right to use another unequivocal person's body for sustaining or improving the quality of his or her life without consent, then the law should not allow it for a fetus whose personhood is not established and is at best controversial. It seems only reasonable that a woman should have the same right in regards to either permitting or refusing an unwanted fetus the use of her body for its development, even if the fetus would die as the result of her choosing to refuse it that right. At stake is no less than her dominion over the insides of her own body, her life and its quality, and her physical and emotional health and well-being.
I have heard "pro-lifers" say in response to this that choosing not to carry a pregnancy to term does not fit this analogy, because the woman chose to have sex, voluntarily accepting the risk of pregnancy and consenting to its completion in the birth of a baby. But of course sex is not a contract for pregnancy. People should have a legal right to enjoy non-procreative sex, its morality being an entirely different matter of individual conscience. This "pro-life" counter-argument is like saying that consent to go swimming implies consent to drown. Should no attempt be made to resuscitate a drowning victim because s/he chose to enter the water? To treat the injuries of a motor vehicle accident victim because s/he chose to ride in the car? To "play God" by interfering with those "acts of God" like pneumonia, coronary artery disease (hey, no one is required to choose to eat all those bacon cheeseburgers, and those who do could be regarded as consenting to heart attacks), or cancer, by treating them? Et cetera? Besides, if a woman was using contraception at all, as most women who have abortions but nevertheless got pregnant do, she was clearly not consenting to pregnancy. This argument is also sexist and puritanical because it punishes women, not men, for their sexual behavior. It must be her choice, unintruded upon by government and unhampered by law or the opposition of others who hold different views of its morality, if personal liberty is to be at all meaningful as a right of women in our society.
For purposes of deceptive propaganda, "pro-life" advocates like to perpetuate the myth (the belief) that abortions are performed on viable, healthy, fully developed fetuses right up to the moment of birth, which of course they never are. There is ongoing political clamor in and around Congress and in state legislatures to criminalize what "pro-lifers" call "partial birth abortion," and "pro-life" propagandists persist in using this myth, complete with shock pictures and videos, to create the very false impression in the minds of the people that legal abortion is about killing fully developed late term fetuses that could simply be born instead.
Actually, at least 89% of abortions are performed in the first trimester, or the first twelve weeks of fetal development, and less than 1% are performed in the third trimester, these almost invariably, as far as I know or find believable, for reasons of gravely serious medical considerations. The deceptive and inflammatory term, "partial birth abortion," invented by "pro-life" (as I've said, another deceptive and inflammatory term) propagandists, has no medical meaning and is not a medical term. It has been the subject of a deluge of hysterical, dishonest, rancorous, demagogic political posturing, campaigning, fund-raising, and pandering and the passage of unconstitutional restrictions by a number of state legislatures. This phony, ambiguous, deliberately misleading and inflammatory term refers very loosely not to third trimester, or late term, abortion at all, but loosely to a specific technique of abortion that is usually employed, when at all, infrequently in the second trimester and only very rarely in the third trimester, although its meaning has become progressively more blurred in the deceptive attempts by "pro-life" lawmakers in various state legislatures and in Congress to write prohibitions of it in wording that could be used in effect to criminalize all abortions.
The term itself is inaccurate and misleading because it carries the false and misleading implication that fetuses aborted by this procedure are normal, healthy fetuses that are far enough along in development that they could simply be born instead, which is virtually never the case. If such a law ever stands, it will prevent no abortions at all unless it is so ambiguously written and so liberally interpreted that it might lend itself to effectively banning all abortions. If clearly written and strictly interpreted to apply to only one technique of abortion, it will merely require physicians to use other methods that in some cases will present greater risks to the women involved.
The central questions in this raging controversy are [1] at what point in development would it be reasonable and just to consider the developing fetus to have attained sufficient attributes and characteristics of personhood to be fully included in the social contract of rights and legal protection of those rights that binds us all and [2] when should the developing fetus be granted a legally protected right to life independent of the consent of the woman in whose body it resides? This would have to be somewhere between two molecular helices of DNA sharing a common cell membrane at conception (for which there is, BTW, no "moment," but a process that takes place over hours) and the birth of a baby, normally about 38 weeks later.
But when? When morally? When legally? At what point in time should the line be drawn? The answer to such questions cannot be found in strictly scientific fact or expert medical opinion, since such disciplines are properly essentially mechanistic, objective, and morally neutral in relation to the objective nature of factual reality. The question requires its answer not just from accurate knowledge and understanding of objective scientific fact, but from the inevitably subjective philosophical, religious, political, and legal considerations of how the moral and ethical significance of those facts should be adjudicated by law in a free and pluralistic society. Various factual considerations, all with superimposed moral and legal substance, must enter into this determination: [a] sentience (determined by the progressive capability of the developing fetal brain for conscious awareness and intentional behavior), [b] independent viability (the ability of the fetus to live on its own apart from the woman's body), [c] the will and state of health of the pregnant woman, and [d] the health of the fetus. I think the point, of necessity subjectively determined and inevitably arbitrary to a large extent, at which all these considerations would be reasonably balanced is the junction between the second and third trimesters of pregnancy, or at about 24 to 26 weeks gestation. At this point, contrary to the sensationalized misinformation common in "pro-life" propaganda, the developing fetal brain is still developmentally at least several weeks short of sentience, and it is extremely rare for a fetus earlier than this stage to survive physical separation from the mother's womb, or birth, with even the most advanced neonatal care.
I personally support the legality of late term (third trimester) abortion only in those cases in which the fetus is discovered to have severe anomalies incompatible with survival or meaningful life outside the womb, in cases in which the life or health of the pregnant woman would be seriously jeopardized by continuation of the pregnancy, and in some cases of rape or incest in which womens awareness of being pregnant is occasionally delayed by psychological denial related to their post-traumatic mental states and, of course, then only if freely chosen by the particular pregnant women involved.
A colleague recently asked me, Bill, please tell me, in your opinion what is the difference between religious fanaticism and pharmacologically treatable psychosis? Good question. Basically, in most cases, I think, little difference at all, with the qualification that only a minority of the psychoses to which I presume he generally referred are really treatable pharmacologically beyond mere behavioral control and most go undiagnosed and untreated by any means. "Insanity" is a legal term, not a scientific or medical one. The closest parallel to that term in science and medicine is "psychosis" which is defined basically as sensing stimuli that don't exist (hallucinations) and/or holding fixed convictions of the literal factuality of beliefs that are actually illogical inferences and either not founded in demonstrable objective reality or directly contradictory to objective reality (delusions). Fanatical religious belief, with or without hallucinations, conforms to the latter category, and a great many psychotic individuals are irresistibly attracted to religious fanaticism. Psychotics are totally unable (deeply unwilling?) to make logical connections or draw rational conclusions that don't fit within the tight little boxes of their illogical and irrational delusional belief systems.
Many psychotic and borderline psychotic individuals gravitate toward the fringes of social and cultural affiliation, and we have provided them in this country with a richly varied substrate of fanatical religious insanity (or preposterous fiction masqueraded and spuriously put forth as reality) in which to implant themselves and find acceptance (although often only insincere pretension of acceptance and highly conditional), speciously intellectualized structure of beliefs, inspirational symbolic content, false certainty where none really exists, and pseudo-authoritarian validation and guidance for their delusional dogmatic beliefs, myths, and fabrications. As such, it is for many of them a powerful psychological addiction.
Intellectual dishonesty and cowardice, determined and intransigent ignorance, paranoia, and self-righteous arrogance generally walk hand in hand with zealous religious beliefs, alongside opposition and even hatred of those who do not share exactly the same dogmatic beliefs. It has been so through the ages, and the history of science and sociocultural progress is largely told in the ages-old, determined, hard-fought struggle against the zealous tyranny of entrenched religious doctrine. The struggle continues.
Perhaps religious fanaticism is not all bad from a pragmatic perspective. For example, maybe the fear of mythical "Hell" keeps more of these unstable, addictively self-righteous cranks from "mowing down" the neighborhood or the workplace with assault rifles or hurting others with the far more common and everyday, less dramatic forms of condemnation and abuse than it motivates others to commit such atrocities. Maybe it keeps many of them from hurting and killing themselves and others by the results of more apparent and immediately destructive addictions, such as to those drugs that are truly dangerous, and thus in some ways has, on balance, redeeming social value. However, who among us has not noticed, for example, that a disproportionately large number of child molesters, abusers, and abductors are sexually repressed and confused, extraordinarily hypocritical sociopaths who are defined as "pastors," "men of God," "priests," "fundamentalists," etc.?
In many of our sanctimonious anti-abortion fanatics, I think, their obsession with seeing us abortion providers as "murderers" and controlling our "killing" represents a projection of their own denied and unconscious murderous and twisted sexual feelings and impulses onto us in a fixed, delusional manner. Their striving to control us is thus a way in which they feel more in control of their own aggressive homicidal and suicidal tendencies and their own anxiety- and guilt-producing sexual impulses and thereby atone for past behaviors and ongoing unacceptable desires about which they carry a burden of self-generated shame, fear, and guilt inspired by their religious delusions.
In this manner they are able to attain a reduction of emotional pressure and pain quite as effective as that attainable by the most powerful drugs. They are thus locked into a psychological addiction, an obligatory dependence upon misreading our motivation as homicidal and sexually perverse, and thus quite incapable of ever truly understanding us, what we do, and why. In other words, I think they project their own "bad" onto the designated "villains" of their choosing, in their case onto abortion providers, and misperceive their murders as a sort of perverse and crazed self-cleansing by the displacement and symbolic destruction of their own "bad" – and what a "righteous" thing that is to do! All of the killers of abortion doctors and abortion clinic workers have been granted the status of cult heroes by a large segment of the "pro-life" constituency.
Another question I have been asked is, "Do you deny a connection between abortion and rising rates of infanticide? How do you explain to a teenager that it is okay to have a doctor kill her child before it is born, but it's murder if she does it herself a few moments after it's born?" First of all, there they go again, falsely implying that elective abortions are performed on late-term, healthy, viable fetuses that could simply be born instead. This does not happen as far as I know or find believable. Furthermore, it is just another of their unexamined assumptions that the rate of infanticide is rising. There is really no clear indication that that is so, and if it is so the causes are certainly much more complex and wide-ranging than simply the legality of abortion. More likely we just hear about more cases as the result of better reporting and record-keeping, modern mass communication, and twenty-four hour news cycles, and this creates the illusion of an increase that doesn't actually exist. However, for the sake of discussion, let's assume it is so. Then let's assume even further that there is a link between legal abortion and this supposed increase of infanticide. What could the link be? It is much more likely that this hypothetical confusion between abortion and infanticide, if it exists at all to any significant extent, would be linked to the pervasive "pro-life" rhetoric that blurs that critical distinction between abortion and murder in the confused minds of immature and emotionally stressed young women. If there is no difference between infanticide and abortion, as "pro-life" rhetoric trumpets from the rooftops, and abortion is legal, why not kill a newborn? On the other hand, pro-choice philosophy and rhetoric preserve very clearly that distinction between abortion and infanticide or any other form of murder and is thus much more likely not to cause such tragic confusion in fragile, frightened, and impressionable young minds.
Intellectual dishonesty and cowardice, zealous efforts to control and punish, willful ignorance, paranoia, and self-righteous arrogance generally walk hand in hand with zealous religious beliefs, alongside opposition and even hatred (often transparently denied) of those who do not share exactly the same dogmatic beliefs and behave in strict adherence to them. It has been so through the ages, and the history of science and sociocultural progress is largely told in the ages-old, determined, hard-fought struggle against the zealous tyranny of entrenched religious doctrine.
The struggle continues. Not only have effective comprehensive sex education, hormonal contraception, and the freedom to choose to safely terminate unwanted pregnancies been among the greatest medical advances in history in bettering the lives, health, and well-being of women, but in embryonic stem-cell research quite possibly is to be discovered the greatest advances in the entire history of medical therapeutics. There is no one, male or female, who has not been touched positively, personally or through someone they value or love, by effective contraception and legal abortion and tragically by the diseases for which embryonic stem-cell research offers hope.
Incredibly, but sadly true, the same champions of unreason who zealously oppose effective comprehensive sex education, contraception, abortion, and embryonic stem-cell research, even oppose the newly available vaccine that protects women against cervical cancer out of irrational fear that making sex seem somewhat safer will encourage teenage girls to fall into sexual promiscuity. The religious fanatics among us are still throwing Galileo to the Inquisition for promoting factual truth that contradicts prevailing religious belief.
It is a waste of time and effort to attempt to reason with fanatics. In my experience, they have been rigidly and absolutely unwilling to listen or to even try to comprehend anything that doesn't fit snuggly into their tightly wrapped belief systems, and the underlying emotional and psychological pressure forcing their particular ways of thinking and believing on them is far too powerful a psychological compulsion to be overcome by reason or logic. After years of trying to reasonably discuss this issue with sanctimonious anti-choice bigots, I have long-since realized it to be as futile as the attempts I once made, as a naive first year resident in psychiatry to have rational conversation with frankly psychotic mental patients. They invariably display an uncanny ability to stare obvious, concrete, and unequivocal factual reality squarely in the face and totally ignore and deny its very existence unless it conforms to and confirms what they deeply and strongly want to believe - their fixed delusional belief systems (you know, like Republicans).
I have learned from experience to expect only a knee-jerk outpouring of the same tired, mindless old "pro-life" rhetoric of extreme, intolerant, misguided, misinformed, pious, self-righteous, and often rageful denial of reality, with substitution of unfounded opinion and belief, often quite bizarre, masquerading and claimed as factual truth, demanding that their beliefs be empowered by coercive law to tyrannize all of society - the rhetoric that inflames some of their more deranged comrades to the harassment, terrorization, and violence that has already struck my family and me more than once and seems destined to get worse.
If they refuse, as they invariably do, to at least acknowledge [a] that their regarding a developing fetus as a person with human rights is a matter of opinion, not fact, and misinformed and misguided opinion at that, [b] that the nature of fetal existence inside the body of a person is a profoundly personal, unique, and unparalleled situation in which the opinions of others, religion, and government have no right to intrude if individual liberty means anything at all and still exists in this nation supposedly devoted to guarantees of the maximum amount of individual liberty that is compatible with social order and stability, and [c] that these acknowledgments are of profound significance in this controversy, what could I ever say that could have any impact upon their prejudice? And why would I, a "wanton murderer of innocent children" in their ignorant, obstinately prejudiced, seemingly immutable, and twisted beliefs and opinions, waste time and effort in discussing it with them? I have tried. It does not work. It seems pointless.
However, despite the fact that they are no less "certain" than Osama bin Laden that they are doing the "will of God" and no less uncompromising than he, I must keep trying to counter their horrific efforts to oppress women and teenage girls and take us backwards in history to the darkness of unnecessary suffering and death. It is the only honorable and moral thing for me to do.
Meanwhile, back in reality, as pious hysteria runs amok in the highest councils of government and sanctimonious bigots blinded by indoctrinated belief bask in smug self-righteousness, women and teenage girls suffer and die.
Isaiah 1:18 - Come now, and let us reason together, saith the LORD.
Exodus 20:16 - Thou shalt not bear false witness against thy neighbour.
George Orwell - They could be made to accept the most flagrant violations of reality, because they never fully grasped the enormity of what was demanded of them and were not sufficiently interested in public events to notice what was happening.