Friday, December 23, 2011

Update: NJ Nurses Can Refuse to Provide Abortion Care

A New Jersey hospital has reached a deal with twelve nurses that claimed they were forced to help care for abortion patients. The University of Medicine and Dentistry of New Jersey has agreed to allow the nurses to remain in their current positions and refuse to assist in any part of an abortion. The nurses must still assist a patient that is in a life-threatening situation if no other nurses are available to help - but only until someone else can be brought in to take over.

While both the hospital and the nurses say they are happy with the outcome, concerns still remain for what this settlement could mean for women that need abortion care. After all, these nurses have basically been given the okay to discriminate against patients based on their personal ideology. As Brigitte Amiri, an attorney with the ACLU's Reproductive Freedom Project, pointed out to The Washington Post, "“No one should ever have to worry about facing discrimination when they check into the hospital."

The nurses' attorney claims that his clients will never compromise either their duty to patients or their professional oath. Which is an interesting statement to make, because it seems like they already have.

Wednesday, December 14, 2011

Pennsylvania Wants to Make Abortion Safer by ... Closing Safe Clinics?

Apparently Pennsylvania has decided to follow in Virginia's ill-advised footsteps, at least when it comes to regulating abortion clinics out of existence. The state House has approved a bill that would require clinics to adhere to new structural guidelines and staffing procedures that would likely be expensive and logistically difficult. If it is passed, the bill - which includes requirements like upgrading elevators and doubling the size of procedure rooms - could force "most, if not all" of the state's 20 freestanding clinics to either move or stop offering abortion services entirely.

The bill's supporters argue that this level of regulation is needed in the wake of allegations surrounding Kermit Gosnell, the Philadelphia-area doctor that was charged earlier this year in the death of seven infants and one woman. Republican Rep. Matt Baker, chairman of the House Health Committee, claims that the bill "is about patient safety and preventing future cases of murder and infanticide within abortion clinics." What Baker and his colleagues seem to miss is that different building codes would not have made a difference in the Gosnell case; larger exam rooms aren't exactly going to deter someone from practicing the kind of bad medicine that Gosnell is accused of.

Of course, had the Department of Health and Department of State actually enforced the already-existing laws regulating abortion clinics, the entire tragedy of Gosnell's clinic might never have happened. But since the lawmakers seem determined to only look ahead and not reflect on what state agencies could have or should have done, how about ensuring that women and and teenage girls have access to reliable and affordable methods of birth control? Or, I don't know, not trying to do away with insurance coverage for abortion care?

There is no question that the Gosnell case is horrifying. But this bill is targeting existing, reputable clinics that have an excellent safety record, even if their elevators aren't hospital-grade. Forcing these clinics out of business makes it that much more likely that women will turn to other, riskier sources to obtain abortion care. It is hard to see how Pennsylvania, much like Virginia before it, has anything close to women's best interests in mind.

Wednesday, December 7, 2011

Obama Administration Overrules FDA, Won’t Ease Restrictions on Plan B

Earlier today, the Obama administration overruled a decision by the FDA to allow teenage girls to purchase Plan B without a prescription. Even though FDA Administrator Margaret Hamburg said in a statement that the pill could be used safely by girls and women, Kathleen Sebelius and the Health and Human Services Department apparently felt otherwise. According to Hamburg,

"[T]his morning I received a memorandum from the Secretary of Health and Human Services invoking her authority under the Federal Food, Drug, and Cosmetic Act to execute its provisions and stating that she does not agree with the Agency's decision to allow the marketing of Plan B One-Step nonprescription for all females of child-bearing potential."

For her part, Secretary Sebelius states that, "The science has confirmed the drug to be safe and effective with appropriate use. However, the switch from prescription to over the counter for this product requires that we have enough evidence to show that those who use this medicine can understand the label and use the product appropriately. ... The label comprehension and actual use studies did not contain data for all ages for which this product would be available for use."

It's worth noting that several studies have shown that girls as young as 11 understand the label and instructions well enough to use the drug safely and effectively. Indeed, Plan B may even be safer than the aspirin and ibuprofen that are already easily accessible - while overdoses of these medications can cause kidney and liver problems and even death, it is virtually impossible to overdose on Plan B.

Plan B will still be available to women ages 17 and older without a prescription, and to younger women that have a prescription. But this decision will keep Plan B behind the pharmacy counter for all women, which can create significant barriers to those that need the pill. Many pharmacies are closed on evenings and weekends, even if the drugstores they operate in are still open; since Plan B is most effective if taken within 72 hours of having unprotected sex, such delays matter. Women have also reported encountering pharmacists that refused to sell them Plan B, because the medication violated their own personal beliefs.

The decision of Sebelius and HHS comes as a surprise, given how rarely the administration publicly overrules its own experts.

Tuesday, December 6, 2011

William Saletan, George Carlin, and the Decency of Chickens

William Saletan recently took on the topic of fetal development and abortion over at Slate. In “Abortion Forever?” he argued that fetal development matters, particularly in the (very rare, he admits) cases of late-term abortion. The differences between an eight-week and a 28-week fetus matter, he says, because “the capacities that make a newborn more significant than a zygote—cognition, interaction, viability—don’t materialize overnight. They develop over many weeks. At some point, they make abortion too much like infanticide.”

Saletan continues this line of reasoning by pointing out that neural development continues for the first three years of life. He then asks, “[i]f a woman feels that eight, 18, or 28 weeks after birth isn’t too late for her, shouldn’t we trust her judgment?” Sounds like someone’s been reading Unwind!

It's disappointing to see a well-versed reporter like Saletan fall victim to the line-drawing fallacy, a slick version of arhetorical fallacy that's older than Aristotle. So let's cut to the chase: there is a logical place to draw the line, and it's called childbirth, the moment when a fetus becomes an independent entity instead of an inseparable part of its mother. This distinction is also found in a whole host of world religions; Judaism, for example, draws a clear line between a potential human and an actual human. Saletan can disagree with this, of course, but he can’t say it’s illegitimate. It is clearly legitimate, in a way that relying on clinical definitions of fetal development is not.

Fetuses command our collective attention because of what they have the potential to become, a human, and it's important that we in the pro-choice community respect that potential. But it's equally true that at any point up until “viability” – and beyond that fuzzy point if you don't have a billion-dollar NICU – the fetus is not capable of independent consciousness or action.

No one is denying that a fetus develops. But focusing on biological markers takes the choice away from the woman and places it solely in the hands of government and a field of science that is still developing itself. These markers may mean the world to a woman experiencing a wanted pregnancy, but the very point of abortion is that not all pregnancies are wanted or viable, and there are as many reasons for this as there are women that choose abortion. Apparently, though, these personal reasons and rights should not matter, not when there’s a defined point at which a fetus has viable lungs and a spinal cord.

Slate has a reputation for clever, counter-intuitive articles designed to grab your attention, but Saletan's argument is just a prolix version of that infamous bumper sticker: "Abortion stops a beating heart." But as the dean of the clever and the counter-intuitive, George Carlin, pointed out, so does eating chicken, and “chickens are decent people.

Saletan closes by urging readers to decide not just for themselves “but for anybody” at what point abortion is too close to infanticide. We're all used to hearing that rhetoric, but it's worth remembering yet again just how radical it is. When abortion's not the topic, every nation on earth draws the line at childbirth, and always has. Since George Carlin again has put it better than I ever could, I'll let him have the last word:

“Well, if a fetus is a human being, how come the census doesn't count them? … If a fetus is a human being, how come people say 'we have two children and one on the way' instead of saying 'we have three children?' ... Even after the egg is fertilized, it's still six or seven days before it reaches the uterus and pregnancy begins, and not every egg makes it that far. Eighty percent of a woman's fertilized eggs are rinsed and flushed out of her body once a month during those delightful few days she has. They wind up on sanitary napkins, and yet they are fertilized eggs. So basically what these anti-abortion people are telling us is that any woman who's had more than more than one period is a serial killer! Consistency. Consistency.”