No one should be compelled to commit abortion

[aelfgyfu_mead]

Everyone can agree that no one should be compelled to commit murder, right? Well, why is it that when some of us disagree on the definition of murder, many of the same people who join me in opposing war and opposing the death penalty think that it's perfectly all right to require who believe that abortion is murder to perform abortions?

If you don't believe it's murder, I'm not stopping you from performing or having an abortion. (Yes, I know some people are trying, but many pro-lifers are trying through purely legal means like changing the laws, or doing what I do and working instead to support alternative.) But I don't think anyone the right to compel someone else who thinks it's murder to do it (except in the case where the mother's life is in danger). I live in a society where abortion is legal. I wish it weren't, and I work and give money to make alternatives to abortion more available. I don't interfere with anyone's legal right to get an abortion. Why should people interfere with the rights of conscience of people like me?

Saying something is legal should not mean people are actively compelled to do it. Execution is legal in many states (including mine, to our shame), but that doesn't mean medical personnel should take part in it—and in fact they are legally banned from doing so, as I understand the matter.

Those of us who believe a fetus is a living human being with rights do not have a legal right to interfere with others' abortions, but we should have a right not to be compelled to participate in abortions. Medical professionals should no more be forced to participate in elective abortions than to participate in executions, compulsory sterilization, or experiments such as the Tuskegee syphilis study. (I'm talking about people actively involved: doctors and nurses, not pharmacists or their assistants, office staff, etc.)

If all medical personnel followed their consciences at all times, we should have had a lot fewer crimes in the twentieth century, including in our own country—and that's true even if you believe there's nothing wrong with abortion.

I have known doctors who would not perform abortions and nurses who would not assist, and indeed the doctors may have avoided OB/GYN as their specialty to limit the possibility of being put in a position where they could be forced to participate in abortion. Some of them contributed their time, effort, and even medical supplies to care free for pregnant women who lacked—guess what?—insurance! I strongly do not believe the world would be better off if they were forced to choose between remaining in the medical profession but having to participate in abortion, and leaving and being unable to help all their patients in so many ways besides abortion. Do you really want these doctors and nurses to feel they have to give up their practices—both paid and charitable?

I've heard many analogies. If you don't believe in taking human life, you shouldn't join the military. True. But it's pretty darned obvious that the military takes human lives, isn't it? Is it obvious that the medical profession should take human lives as well as save them? You can tell me the fetus isn't fully a human being, and we can agree to disagree. But you can't tell me it's not alive, and that it's not human.

I'm really surprised that so many people seem insistent that any medical professional should have to perform abortions, and that any medical facility should have to have them there. Doctors and to a lesser extent nurses can choose specialties. They can say that there are procedures they are not comfortable performing: lots of medical personnel don't choose to do plastic surgery, or bypass surgery*, because it's not what they want to do. Hospitals can choose to offer or not offer services. More and more US hospitals have no emergency room, for financial reasons, which I think is terrible—but as far as I know, it's totally legal. I don't see Americans up in arms that any hospital MUST provide an emergency room. It is not discrimination to say "I will not perform abortions" or "This hospital will not perform abortions" in the same way that it would be to say "We will not treat African-Americans" or "We will not treat gays" or "We will not treat Republicans."

I suggest that it is discrimination to say that it's okay to choose not to do plastic surgery, but it's not okay to choose not to do abortion.

I do not, of course, include non-elective abortions: if a patient's life is in danger, then any qualified medical personnel has a duty to assist, whether it's by performing life-saving skin grafts or doing a bypass or performing an abortion because that's what the mother needs to live. Any doctor or nurse who is not qualified to perform or assist in a particular procedure, of course, should not.

* I think I'm not referring to heart bypasses in quite the right way, but I'm not sure where I've gone wrong.

Comments

[sg-betty.livejournal.com]

So...what about situations where there is no hospital or doctor in an area who will perform an abortion? That effectively makes it a right of the privileged who can afford to travel to wherever they need to, and consigns the poor to back rooms and coat hangers.

I don't think individual doctors should be made to perform abortions, but hospitals have to make sure they have a doctor on staff who will. Being as it is legal, there should be equal access, not just access in some states, or for certain income levels.

[abyssinia4077.livejournal.com]

And yet one of the main tactics of the current anti-abortion movement in this country is to make abortion so difficult to access and expensive and put up enough barriers to prevent doctors and patients from getting or giving them that they are available in fewer and fewer places (terrorizing doctors, forcing through laws that require them to show pregnant women pictures of fetuses first, so on).

(Aelf, I realize you don't condone the terrorism that goes on in the name of the pro-life movement, but unfortunately a lot of them are not like you)

[aelfgyfu_mead]

I think that a lot of pro-lifers have gone completely down the wrong path. I cannot imagine abortion laws truly changing significantly in my lifetime. I can understand why some people oppose it in the way they do, although I do not agree with some—and I neither understand nor in any way condone violence or illegal tactics.

If all the pro-life people who went to rallies and marches and pray-ins and gave money to political campaigns gave that time and money instead to helping with sex education (if they're comfortable with that—some are, some aren't), assisting pregnant women, and helping families with young children, I think we could see a real decrease in abortion and improvement for the lives of mothers and fathers as well as babies and small children. I only wish they'd see it the way I do.

I've said it before and I'll say it again, though: one of the reasons I feel compelled to speak up is that I'm speaking both for myself and for a lot of other people who give greatly of their time and money to help women in crisis pregnancies, newborns, and teenagers facing tough choices about sex. An awful lot won't speak up because they're afraid they'll be pilloried, and with good reason. I have received some very nasty tongue-lashings for the views I'm airing here—but not on LJ. I speak up here so that people can't forget that people like me exist, and to encourage others who agree with me to speak up too. And because it encourages me to know that people can disagree with me and not denounce me and drop me from their friends' lists, so that I feel I can speak in public, in person, too.

[aelfgyfu_mead]

Yes, I realize there are areas where one cannot get an abortion. I do not have a good way to balance that against the right of an individual not to be forced to commit what he or she believes is murder.

I'd add that hospitals should have conscience rights too because some are organized and run by groups of individuals with these sorts of values.Catholic hospitals have been around a lot longer than abortion has been legal. To require such hospitals to offer elective abortions would be to compromise their values to the point where they could not continue. I do not think that hospitals that oppose abortions should be forced either, both as a moral matter and because I honestly believe we'd suddenly end up short a good number of hospitals.

I can't say that making something legal should be a guarantee of availability. I can think of lots of things that are legal that are restricted by income: housing and education come immediately to mind. These are positive goods and things that I wish were more available, but we can't simply mandate that everyone have them (school is mandatory until a certain age, but private schools cannot be forced to take everyone). Abortion is not something I wish were more widely available, as you can tell—but even I did wish it, I can't say for sure I'd put it in the category of things that should be legally mandated.

[sg-betty.livejournal.com]

This is why I think private hospitals are a bad idea. If hospitals are secular and not-for-profit, you are more likely to end up with equal access for all. A poor woman in South Carolina shouldn't have a different set of options as a rich woman in say, New York, or San Francisco. The choice she makes is her own, but the options should be equal.

[abyssinia4077.livejournal.com]

*blink*

In every conversation I've had about abortion rights over the years and everything I've ever read I have never, ever, ever, ever heard anyone say a doctor should be forced to perform abortions.

Are people actually saying this? Because, yeah, doctors go into specialties and abortion belongs within a specific specialty. Heck, I've never even heard anyone say that Ob/gyn's should be required to perform abortions (personally I think it would be unethical, though not illegal, for them to refuse to refer a patient to a doctor who would but not to refuse to do it themselves).

The only argument of this type I've seen are due to the law Bush passed near the end of his time in office that allowed pharmacists to refuse to fill prescriptions (so a pharmacist could refuse to fill birth control or emergency contraception) based on "moral" grounds, which I do think is 100% unethical and wrong and should not be legal.

[sg-betty.livejournal.com]

Of course, there's the irony of the fact that making drugs that prevent pregnancy less available increases abortions....

[aelfgyfu_mead]

Oh, yesss. bang bang bang That's my head bouncing repeatedly off the desk.

(Some days it feels like there are about five people in the world who agree with me. Virtually no one shares my mix of positions on abortion, birth control, and sex education. It would take me hours to give you all the details.)

[abyssinia4077.livejournal.com]

Right, but ultimately a lot of the anti-abortion movement (I'm not talking about Aelf here, but the more militant, often male-lead/dominated parts) is more about controlling women and coalescing power than it is about saving babies.

When a woman's main job is supposed to be to pop out babies, she shouldn't be allowed personal choice over her reproductive system. Her body doesn't get to belong to her.

[aelfgyfu_mead]

It's possible I misunderstood, but I'm pretty darned sure I've seen at least one person say it on LJ, and I've seen it elsewhere too. (I'm not counting or_mabinogi, because I believe Mabi is referring to institutions rather than hospitals. His post did in a way prompt this one, but it was only the proximate cause; it has been on my mind for a while.)

Yes, I believe that the argument started over pharmacists refusing to fill prescriptions for RU-486 and birth control pills. I think that pharmacists are a separate case: they are not the prescribers. They may not even know how the drugs are being used (I was on birth control pills not to prevent pregnancy but to redress a hormone imbalance, and I understand that's not uncommon; even RU-486 has other uses). I don't think pharmacists can cherry-pick the prescriptions they'll fill and not fill because they don't have the same level and type of involvement.

I can't give you any links off the top of my head, but I have read blog posts and letters to editors that asserted that if doctors and nurses didn't want to perform abortions, they need to find another line of work. I think that probably reflects a hardening of positions caused by the Bush regulation (was it a law? I thought it wasn't, actually), which is another reason why I think certain types of pro-lifers do more harm than good.

(I think I have known OB/GYNs who wouldn't themselves perform abortions. And I disagree with you: I think that's okay, but I do agree that they have a responsibility to refer patients to someone else in those cases.)

[aelfgyfu_mead]

Are people actually saying this?
Actually, tejas has said it right below; I've asked for clarification on whether she means all medical professionals or just some specialists, but she makes just the kind of analogy I've been seeing. Even if she means just specialists, I'm pretty sure I've seen other people say any doctor or nurse—and a lot of nurses have little choice over where they're assigned. I do think doctors and nurses should be able to refuse certain assignments: abortion, execution (no one in this country can be assigned that right now, but if we're making analogies, that one rings true for me), forced sterilization, electroconvulsive therapy (formerly known as electroshock; it has changed, but it's still a controversial procedure).

[tejas.livejournal.com]

My stance is that if you think abortion is murder, you shouldn't become a medical professional who will be put into the position to have to worry about performing them. I see it as no different than a vegetarian taking a job at a MacDonald's and refusing to sell hamburgers.

[aelfgyfu_mead]

So you think any medical professional should have to provide abortions? My GP of some years back who wouldn't perform abortions but would help pregnant women for free should leave the profession?

Or do you think only people in related specialties should have to perform abortions?

What it could come down to is saying, "If you're pro-life, you'd better give it up or not be a nurse—or a doctor." I see that as a form of discrimination in itself. My baby was delivered at a hospital where all the nurses refused to assist at an abortion. I really do not think any of them should have to leave the profession for that stance—and if they did, there'd be one area seriously hurting for nurses very suddenly.

If you refuse to sell hamburgers, you can't work at McDonald's—but the primary job at McDonald's is to sell hamburgers. The way many of us see it, the primary job of a doctor or a nurse is to save lives.

Do you also think doctors and nurses should perform compulsory sterilizations? There are judges that have ordered such things recently—and there are medical personnel who won't do it. I think they have a right to refuse.

[or-mabinogi.livejournal.com]

You do this all the time. You write these really long posts about this subject that are thought-provoking and just amazing to read, and I do want to read them thoroughly but my mind blanks out. Just kidding. It's very good.

Actually, your final paragraph is the clincher. I agree with it 100%. That's exactly where I see the necessity of the procedure. (Sometimes I wonder if I intentionally use the word 'procedure' while others would insist on the word 'murder' in order to strengthen our own positions. Vocabulary has a very strong impact.) But I'm thinking that we may differ in the extent to which we may apply the necessity. While physical, life-threatening danger is obvious, mental stability is a factor in my opinion.

I think a common trope bandied about by the (less erudite than yourself) pro-lifers is that there are woman who get abortions willy-nilly without any consideration for themselves, the possible life they are carrying, or anyone else. I don't believe anyone takes the decision lightly, even when it's life-threatening. I do think that electives should always remain allowed, but only after conditions of psychological, emotional, and financial evaluations are taken. There should be assurances taken that it is an absolute last resort. I would prefer it never came to that. An additional factor might be better sex education and easier access to birth control which should reduce almost all cases of elective abortions.

[aelfgyfu_mead]

You do this all the time.
You realize, of course, that I read this shortly before bed at the end of a very stressful day, and my brain reeled and I thought, "What do I do all the time? I go on forever when I could have said it in a few words?" before I could even finish that first paragraph.

The trouble is that the loud pro-lifers, the kind that maintain women get abortions so they can wear bikinis and such, drown out a lot of other people. It doesn't mean the rest of us aren't there.

[nialla]

Why would I want to "force" a doctor to perform a procedure on me they don't want to do? There's no sense in that no matter what type of procedure is involved. However, the ability to have another doctor follow my wishes as a patient should be honored.

I consider myself pro-choice, yet we're not really all that different in a sense. In my perfect world everyone would have access to sex-ed, parenting-ed, and birth control in order to decrease the need for abortion. Not required, just available instead of repeating "do not have sex until you're married".

I know how hard it must be to be anti-abortion when those who've claimed the name often come off as nutjobs instead of people of conscience like yourself. It's sort of like being a voice in the wilderness. Or like a liberal in Texas. [sigh]

[aelfgyfu_mead]

Why would I want to "force" a doctor to perform a procedure on me they don't want to do?
Here I've spent hundreds of words on the issue, but I think that one sentence is more convincing than anything I wrote!

I know how hard it must be to be anti-abortion when those who've claimed the name often come off as nutjobs instead of people of conscience like yourself. It's sort of like being a voice in the wilderness. Or like a liberal in Texas. [sigh]
Probably! I do know others, and some of them even speak out, but they don't seem to get heard very much.

[chocolatekettle.livejournal.com]

This subject, along with the subject of contraception, came up in an ethics class last year. Abortion is illegal here, though that doesn't mean it doesn't happen (I include here both backstreet abortions and those who go over to England for legal and much safer day procedures), and a large part of the class argued in favour of legalising it. Personally, I am against abortion, though I dislike the term 'pro-life', and I was surprised at how many of my class mates seemed to be advocating it. But, as the discussion went on..

The Hippocratic oath is somewhat outdated these days, but the main principles of medical care still hark back to it - first, do no harm. The question seems to be for whom we should be concerned - the mother, the visible, speaking, indisputably alive individual, or the dependent, voiceless foetus whose status is debated. The arguement that was made was that the illegality of abortion was not preventing it from happening, it was rather making it more likely to cause harm to the mother as well as the baby. I find myself leaning more and more towards this side of the argument. I wish it wasn't necessary, I wish others felt the same way about the life of the foetus as I do, but if abortions are going to happen, there has to be as little risk and trauma as possible.

What really annoyed me was the fact that two of the girls in the class live in an area where the only pharmacist in 20 miles refuses to stock any form of contraception. I recognise their right to choose what products to provide, I do, but I can't help but feel that it is a failure on their part to provide the best service.

As for forcing Ob/Gyn doctors and nurses to perform a procedure that goes against their personal moral beliefs, I don't know quite where I stand. Unfortunately, abortion does fall into that specialty. I don't think I could do it, but then I don't plan on going into obstetrics. I don't think the cardiology analogy above applies though - a cardiologist who refuses to provide more than palliative care for a congenital heart abnormality (many of which can now be fixed or at least alleviated to the point of presenting few clinical symptoms) would not be considered to be doing their job and wouldn't keep it for long.

[tejas.livejournal.com]

And that last is, of course, the issue. Why is one doctor's moral stance more important than anothers?

There are arguments against treating congenital disorders. (I don't necessarily agree with them, but I do see their point and am enough of a "futurist" to see the potential problems down the road.) While it is my hope that gene therapy will be developed to eliminate such problems before it becomes a "public health matter", it doesn't alter the fact that medical science now allows people who would never have survived in the past to not only survive but pass on damaged or dangerous genes to future generations. (NO, I'm not advocating eugenics, I'm simply pointing out the problem.) For example, there's no way on Earth that my daughter would have been born alive without medical intervention. It's quite possible that I, too, would have died in childbirth. It it also quite possible that she will not be able to give birth without medical intervention. Let's postulate, as some have already done, that three or four or ten generations down the road, this has become a serious issue; a serious drag on medical services. Should an obstetrician be allowed to refuse to provide extraordinary means in the process of childbirth if she takes the moral stance that doing so will do more harm than allowing nature to take its course?

[lydiabell.livejournal.com]

The question seems to be for whom we should be concerned - the mother, the visible, speaking, indisputably alive individual, or the dependent, voiceless foetus whose status is debated.

One of the greatest failings of the public debate on this issue is the notion that we must pick only one, and that to have concern for the other weakens our chosen stance. We should be striving for balance.

[cleothemuse.livejournal.com]

Much of the screeching of the "loud" side of the pro-life movement has the unfortunate FOX News-ish mentality that spreading misinformation very loudly is way better than giving a rational treatment of facts and solid evidence. It's the same as with the health care debate, legal reform, and anything else that smacks of socialism (wrongly paralleled with and labeled "communism" in yet another spate of misinformation).

I'm both pro-life AND pro-choice, and I see no contradiction in that. Just because I don't think I would ever want to get an abortion doesn't mean I want to close that door for someone else. Likewise, I wouldn't want to force abortions on a doctor who has a moral objection to the procedure, with one exception: when the mother's life is in immediate peril.

With modern prenatal care, there are very, very few situations in which a mother's health could be jeopardized by her pregnancy so suddenly. Ectopic pregnancies? The fetus isn't viable anyway.

Of course, that assumes the mother has access to prenatal care. My health insurance doesn't cover it... which brings us right back to the health care debate.

[aelfgyfu_mead]

that assumes the mother has access to prenatal care. My health insurance doesn't cover it
That is frelling insane. How does that even make sense? A woman who ends up gravely ill because lack of prenatal care made her sick will presumably be covered then, won't she? Yes, poor prenatal care can definitely harm the fetus—but fetuses have a way of taking what they need. If the mother isn't getting proper nutrition (prenatal vitamins are great for this, and tests to make sure the mother isn't getting gestational diabetes, etc.), she can end up hospitalized. Even if we set aside the moral and ethical dimensions (which I suspect many companies do set aside), it doesn't even make practical sense!

Your insurance stinks, and I'm sorry. I really want health care reform to go through, both for those who have no insurance and those whose insurance is so inadequate.

[delphia2000.livejournal.com]

My only new addition to all this is to point out that your belief that abortion should be available if the mother's life is in immediate peril is not the Catholic belief as I've been taught. I was under the impression that the baby's life takes precedence over the mother's life. Correct or no?

No, I don't think a doctor should be forced to perform an abortion if they are against it, but a doctor who can and will should be available instead.

But at what point should doctors be allowed to decide what procedures they will or won't do?

[aelfgyfu_mead]

I think you mentioned this before. My understanding is that it is not official church teaching that the baby takes precedence, but it has become a sort of unofficial teaching that many priests accept and pass on uncritically. I cannot find anything in the Catechism dealing with the potential conflict, but the Catechism does say that abortion is a grave sin and must never be committed. So I think it's possible I'm not in agreement with my Church here. (Wouldn't be the first time.) My thinking is that if one must take precedence over the other (fortunately a fairly rare occurrence with modern medicine, but unfortunately not unheard of), there are both practical and moral reasons to put the mother first.
1. My unscientific guess is that the mother would have a better chance of survival in cases where both are imperiled. Rather than letting the mother die and then being unable to save the baby, doctors should, I think, save the mother.
2. If someone is going to die, and the only way to save her would kill the baby, I take abortion not to be the goal but a tragic side effect. I do believe that I disagree with the Catechism here, that refers to abortion as either an end or a means—but it doesn't say a means to what. That's my moral stance. I think my parish priests wouldn't agree. (Now if it were me or the baby, I like to think I'd choose the baby—but it's one thing to say I would put my baby ahead of my life than to say that everyone should do that.)

I think that abortion is a special case because human life is involved. Even those who believe the fetus is not fully human do not deny that it is alive, nor that it is human, correct? A doctor should have a serious reason to refuse to perform a procedure, but I believe that's about as serious as it gets.

Doctors currently have lots of rights not to perform procedures, or at least not in specific cases. Several doctors turned down the so-called "octo-mom": they had no opposition to IVF in principle, but they would not treat her because they did not believe she was a suitable candidate. Doctors routinely refuse to prescribe Accutane, a strong acne medicine, for women who are not also taking birth control pills, because it can cause grave birth defects. That's perfectly legal, though it limits women's free choice and the concern arises out of concern for unborn—indeed, not yet conceived!—children! (When I was still watching ER, a teenager who insisted she was not sexually active and would not become sexually active was denied Accutane because she wouldn't take the Pill. Okay, that was fiction—but I think that plays out in real life.)

I don't think doctors should be able to discriminate in ways that are illegal (on the basis of sex, gender, race, religion, etc.), nor should they make decisions not to perform procedures or give certain prescriptions without good reason. But we trust our doctors to make decisions about our lives; can we not trust them to make decisions with good reason? Institutional review boards and medical associations also exist in case doctors make poor judgments.

[a-phoenixdragon.livejournal.com]

Well, I'll quietly disagree about abortion, but I do agree that if you are a medical professional and do not believe in it, you should not be compelled to do so. There are doctors who perform them because they are afraid the mothers may hurt themselves as well as the baby by trying to DO it themselves - and that's why tehy asssist, but I do not feel anyone should be compelled either way - to do them or to NOT do them. I'm pro-choice - but that's what I bleieve in...choice.

I think my problem with the medical industry and abortion is that I'm seen as no more than a cow, most of the time. I will ( AND SHOULD) have kids, so MY rights are overlooked a great lot of the time. This...annoys the crap out of me.

*hugs you*