Wednesday, October 31, 2012

Abortion and the rape exception

It seems like the news lately has been dominated by stories involving fights over abortion and rape. I think abortion in the case of rape draws so much attention because it forces consideration of what is, really, the primary question of abortion: What is the value or status of the 'unborn' relative to the value or status of pregnant women? Whose interests or status is primary and superior to the other?

Many people who self-identify as "pro-life" nonetheless believe that women should be able to have an abortion in cases of rape, despite the fact that the ontological status of the unborn child is same regardless of the circumstances of conception. Put another way, many people who oppose abortion accept a victim of rape obtaining one, even though a fetus is a fetus regardless of how it is conceived.

Furthermore, the question of whether a pregnant woman should bear responsibility for the consequences of engaging in sexual behavior is set aside in cases of rape. (Whether women in more socially conservative societies really have the freedom to not enter marital relationships and not have sex is worth discussing, but let's set that aside.) The charge of 'responsibility' allows pro-lifers to avoid a direct balancing of the relative interests of pregnant women and the unborn, because women, they assert, are morally obligated to see through the consequences of their own 'voluntary' behavior: sexual intercourse that carries the possibility of conception. Because women are seen as ultimately 'responsible' for getting pregnant, they are not entitled to put their own interests above those of their unborn child.

This underbrush is cleared away in the case of rape-- by definition, a woman is not responsible for being pregnant. The sole issue in cases of rape, then, is whether a woman's interest in avoiding the trauma of having to endure pregnancy, delivery, and the raising of their rapist's child outweighs the interests of the human product of the rape.

For people who are pro-choice, there is no question that the woman's interests (or her right to be the person responsible for weighing those interests) outweigh those of the embryo or fetus. For some who are pro-life, consistency rules, and the interests of the unborn child always are superior, except perhaps in cases where the physical life of the mother is at stake.

For many pro-lifers, however, the trauma and aftermath of rape is so awful that they acknowledge that, in this situation, pregnancy, delivery, and child-raising is too much to bear. That, I think, is a fundamental concession to pro-choice reasoning about abortion. It employs the same logic that allows pro-choicers to argue that abortion should be generally-- or at least more widely-- allowed: the interests of the pregnant woman in X situation outweigh the life interest of the unborn.

Now, some pro-lifers may accede to a rape exception but not others by arguing that rape is an isolated case due to the fact that women are seen as not responsible for getting pregnant. In other situations where pro-choicers think abortion is justified for 'situational' reasons, pro-lifers can say, "well, in those cases, the situation is ultimately of the woman's choosing, by engaging in sex that is open to procreation, and therefore the natural human interests of the unborn child take precedence."

People who are pro-choice may retort that pro-lifers overestimate the agency of women over their lives and their ability to avoid pregnancy. More importantly, they may argue that the self-responsibility/non-responsibility distinction is irrelevant. As pro-lifers point out, the status of the fetus is the same regardless of the circumstances of conception-- yet many pro-lifers still allow for abortion in cases of rape. Therefore, a woman's interests can outweigh those of the fetus, regardless of the circumstances of conception-- even in those circumstances in which a woman may have played some 'voluntary' role in getting pregnant.

In other words, once that line has been crossed-- namely, a woman's life situation can override the life interest of the embryo or fetus-- then the argument about abortion fundamentally shifts away from the ontological status of the fetus and toward a discussion of the interests of women. That is pro-choice logic.

In short, allowing abortion in cases of rape opens the door to justifying abortion in a wide range of situations. For this reason, pro-choice and pro-life activists see the issue as a particularly important battleground-- and they are right.

Poland, rape victims, and abortion

In Poland, abortion is generally prohibited but the law does allow for them in cases of rape, incest, or danger to the life of the mother.

That does not mean that it is easy to have an abortion under an approved exception.

In 2008, in Poland, a 14-year-old rape victim encountered tremendous trouble terminating her pregnancy. She was turned away from two hospitals due to pro-life pressure on doctors and administrators, and was even separated from her mother and placed in a shelter by police at one point:
In accordance with the law, she got a certificate from the public prosecutor confirming that her pregnancy was as a result of unlawful sexual intercourse.
The girl, named only as "P" went to two different hospitals with her mother in her hometown of Lublin in south-east Poland to try and obtain an abortion.
At one, a Roman Catholic priest attempted to convince her to have the child. Hospital management then issued a press release saying they would not perform the procedure, leading to her case becoming caught up in Poland's ongoing debate about abortion.
The girl then travelled to a hospital in Warsaw, but doctors there said they were under pressure not to go ahead with the procedure.
 
The court documents say the pair left the hospital "feeling manipulated and helpless", after which they were harassed by pro-life groups and eventually taken in for several hours of police questioning. 
The authorities then accused the mother of trying to force her daughter into having an abortion and had "P" placed in a juvenile shelter. 
She eventually managed to go ahead with the termination in Gdansk, 500km from her home, after the Ministry of Health intervened in the case.
(Source: BBC News)   
She sued the Polish government in the European Court of Human Rights and won a judgment against them.

P's experience is similar to that of a woman in Argentina, discussed in an earlier post, whose planned abortion-- and status as a victim of rape-- was outed by the mayor of Buenos Aires, which led to pro-life protests and attempts to block her abortion. I don't think that this kind of behavior does the pro-life movement much good, because they are compounding the trauma of rape victims, making themselves look insensitive to the interests and concerns of pregnant women, and making the pro-choice case for therapeutic abortion in difficult situations even more persuasive.

This story and many others like it recently, in addition to some discussions with my students, got me thinking about why abortion in the case of rape generates so much attention and debate. I'll discuss that in my next post.

Links:

Article in BBC News online (October 30, 2012): Polish rape victim 'should have had abortion access'

Tuesday, October 30, 2012

Denying family planning services for religious reasons

Sorry for the delayed posting this morning-- the big storm knocked out my Internet.

Here's an interesting poll: The group Catholics for Choice commissioned a survey to find out whether Americans think that religious-affiliated institutions should be able to avoid providing family-planning-related health care benefits (like free contraception) and similar services based on religious beliefs.

The poll results indicate that a high percentage of Americans don't like the idea of religious or conscience exemptions. If the poll is accurate, this would appear to be a blow to those objecting to the contraception mandate of the Affordable Care Act.

Is the poll accurate? I leave that to the reader, although I am generally skeptical of polls commissioned by an advocacy group. They polled enough people (the margin of error is +/- 3%, and the results are outside the margin of error). The questions that they used are contained in the report, so you can read them and decide if they might push the respondents one way or the other.

The major concern about the poll I have, ironically, is how high the percentages are against doctors, pharmacists, and organizations denying some sort of care based on religious conscience. The poll is almost too successful in making the point of Catholics for Choice. So it makes me skeptical, especially because a high percentage of people who self-identify as 'pro-life' and/or against abortion would have to agree with the Catholics for Choice perspective in order for the poll results to be accurate.

Take a look and let me know what you think!

Links:

Memo (pdf) summarizing poll results on Catholics for Choice web site (October 23, 2012): American attitudes on religious exemptions

Article in The Sacramento Bee (October 25, 2012): New Poll: Americans oppose using religion to deny reproductive health services

Monday, October 29, 2012

Should people be shocked by Mourdock?

Pro-choice journalist Amy Sullivan, reviewing Richard Mourdock's statements about rape and abortion law, sees nothing new and wonders about the pro-choice outrage. She does not agree with Mourdock. Instead, "I was just shocked why anyone was shocked."

Sullivan, writing in The New Republic (she also gave an interview to NPR), essentially argues that what Mourdock said has always been a central part of pro-life thinking:
  1. God creates life and, if a life exists, then it is not our place to question the circumstances under which it is brought into being. 
  2. Therefore, while rape is evil, a life that is conceived of rape is still fully human, intended by God, valued by God, and entitled to life. 
What makes Mourdock novel, maybe, is not that he opposes a rape exception, but that he spelled out the reason why clearly:
Lots of Republican politicians oppose rape exceptions. Paul Ryan, for one, opposes abortion in the case of rape. Rarely does anyone bother to offer an explanation for why he holds that position. (Todd Akin famously did earlier this year, and that didn’t go so well for him.) I’m not sure what justifications people had imagined for opposing a rape exception that would be more acceptable than Mourdock’s. 
Sullivan also points out that the idea that God intends things to happen (and that it is not our place to get in the way) is embraced by many people:
This is a fairly common theological belief, the understanding of God as an active, interventionist deity. It’s also not limited to conservative Christians. There are liberal Christians who also argue that things work out the way they’re supposed to. Some of them are in my own family, and I disagree with them. But it is one way of grappling with the problem of theodicy, trying to understand why God would allow bad things to happen.
I really like Sullivan's analysis. I deviate just a bit from her analysis in that I think the outrage, where genuine (and not amplified for political effect), originates not so much from the theological principle itself but its bad application.

Sullivan notes that people across the political spectrum selectively apply the 'God intended' principle. Selective application suggests that, when used in a given situation-- in X case, don't mess with God's intent-- the principle is being invoked not just for a theological reason but for some additional reason.

The outrage, then, derives from seeing someone like Mourdock selectively choosing to apply the "God intends" principle in the case of rape despite the awful logic that it entails: God intended to compound the trauma of a sexual assault by using a rape victim's body as a vehicle for bringing another life into the world.

While many pro-life people embrace the 'lemonade out of lemons' argument when it comes to rape, pro-choice people-- and many pro-life people, too-- find it unacceptable. Mourdock unintentionally did us a service by reminding us why.
Links:

Link to National Public Radio interview of Amy Sullivan (and transcript) (October 26, 2012)

Original article in The New Republic (October 25, 2012): Why Liberals are Misreading Mourdock

Sunday, October 28, 2012

A pro-life Catholic who will vote for Obama

Here's one!

Unusual? I imagine so. I suspect many more pro-choice Catholics will be comfortable supporting President Obama than pro-life ones.

What is a little unusual is that the author of this essay, Charles J. Reid, Jr., is a professor at the University of St. Thomas School of Law, a Catholic institution. My impression is that strongly Catholic employers are not terribly happy about these kinds of public dissensions on abortion.

Professor Reid is pro-life, but he argues that President Obama's attempts to address poverty and reform the health care system are more likely to save unborn lives than a single-minded focus on overturning Roe v. Wade, especially when coupled with a  political philosophy of "Randian individualism and the unfettered quest for riches above every human value."

"Fight poverty, and you fight abortion. So, I am voting for life-- Obama-Biden 2012."

Professor Reid also spends time describing President Obama's earlier life connections to the Catholic Church, in particular the part that focuses on social justice and poverty reduction. He's persuasive-- but maybe more persuasive to people who are on the more pro-choice end of the spectrum and already inclined to vote for President Obama.

Pro-choice Democrats love the idea that the term pro-life should be framed much more broadly to include proactive reduction of poverty, the protection of the social safety net, pregnancy and young-mother support, effective sex education, affordable access to effective contraception, gender equality, etc. Addressing all of these things-- rather than the myopic and reactive quest to stop any unplanned pregnancy from being aborted--  will more effectively reduce abortions and achieve social justice in line with Catholic social thought.

Just today, Thomas Friedman of The New York Times published a column making the Democratic "pro-life" case, even to include things like gun control and environmental protections:
The term “pro-life” should be a shorthand for respect for the sanctity of life. But I will not let that label apply to people for whom sanctity for life begins at conception and ends at birth. What about the rest of life? Respect for the sanctity of life, if you believe that it begins at conception, cannot end at birth. That radical narrowing of our concern for the sanctity of life is leading to terrible distortions in our society.  
Respect for life has to include respect for how that life is lived, enhanced and protected-- not only at the moment of conception but afterward, in the course of life. 
Links:

Essay by Charles J. Reid at Huff Post Religion blog (October 26, 2012): Catholic, Pro-Life and Voting for Barack Obama

Column by Thomas Friedman at The New York Times (October 27, 2012): Why I Am Pro-Life

Saturday, October 27, 2012

Free abortion and contraception in France

Ireland, Northern Ireland, and Uruguay have all been in the news lately because of controversy over modest attempts to move away from restrictive (or total) bans on abortion.

The context in France, meanwhile, is completely different. Abortion is available 'on demand' in France through the first trimester of pregnancy then more restricted after that. The French government is expected to pass a law that provides free contraception for all and funds all abortions, even for minors. One gets the sense that this move is not terribly controversial. Furthermore, minors in France already have widespread access to contraceptives and are not required to seek parental consent to have an abortion.

The differences between French and American political cultures are interesting, too. In France:
  1. The link between free access to contraception and lower abortion rates is accepted.
  2. Not only is it appropriate that minors have access to contraception and abortion, it especially important that they have it, and for free.
  3. Control over family planning via contraception and abortion is viewed as a basic human right.
  4. The state, as part of the general social contract, has a positive obligation to provide the resources necessary to make one's human rights concrete and not just theoretical. 
If this news is going to have any impact in the U.S., my guess would be that pro-life groups will use the French experience as an example of what happens when one goes down the slippery slope of 'socialist' government support for family planning. 

Links:

Article in The Huffington Post (October 26, 2012); the article, in its tone and emphasis, betrays obvious sympathy for the general French perspective: France Free Abortion Bill: Lawmakers Vote to Fully Reimburse Procedure

Article in LifeSiteNews.com (October 26, 2012): French Natl Assembly votes for full funding of abortion, free contraception for girls 15 and up


Summary of French abortion law by Choice Ireland: Abortion information France

Planned Parenthood ban in Texas stopped

The fighting over funding Planned Parenthood continues.

In an earlier post, I observed that these fights over taxpayer funding of Planned Parenthood are being won less over grand constitutional principles and more on legislative and regulatory arguments.

In this case, Planned Parenthood in Texas is attacking the state ban (on federal funds going to organizations that provide abortions) on two fronts. First, they have filed a federal lawsuit alleging that the ban violates the free speech rights of Planned Parenthood. The case is going to go to trial in federal court but Planned Parenthood lost its request to have a temporary injunction on the funding ban while the trial goes on.

Second, Planned Parenthood argues that a provision of Texas's administrative code prevents the state from doing anything that costs the state federal funds:
Under the Texas Human Resources Code, which governs the women’s health program, any provision is “inoperative if it causes Texas to lose federal matching funds” for that program, Planned Parenthood said in an e-mailed statement. “The rule will cost Texas taxpayers nearly $200 million over five years." (Source: Bloomberg News)
On this claim, Planned Parenthood won a temporary injunction.

Unlike other contraception and abortion related issues, I think that funding fights will remain essentially political in nature: I just don't see Planned Parenthood keeping taxpayer money flowing through constitutional claims. (Feel free to let me know if and why you disagree.) Texas may lose the battle on funding in the short term, but nothing prevents the state from changing its regulatory code to harmonize it with the state government's clear desire to defund abortion-providing organizations.

Links:

Article in Bloomberg News (October 27, 2012): Planned Parenthood Gets Texas Clinic Funding Ban Halted

Article in the Los Angeles Times (October 26, 2012): Planned Parenthood battles Texas in court over funding

Link to the federal Fifth Circuit decision (pdf): Planned Parenthood of Hidalgo County vs. Suehs, No. 12-50377 (5th Cir., August 21, 2012)

Friday, October 26, 2012

Planned Parenthood and mammograms

Pro-life groups like Live Action love to charge Planned Parenthood with lying when it comes to whether the organization provides women with mammograms.

Does Planned Parenthood provide mammograms? The literal answer appears to be "no," they do not. That being said, Planned Parenthood provides a) many breast exams a year (according to The Hill, 750,000), and b) referrals to organizations that do provide mammograms, much like many basic health care organizations.

As with negative political advertising, then, the activists attacking Planned Parenthood are indulging in myopia, which allows them to focus on something that is literally true while failing to see the bigger and more relevant picture. The larger and more relevant picture in this case is that Planned Parenthood provides, among other preventative and primary care, access to breast exams and mammograms for women. If those women are poor and in areas (like in rural Texas) where Planned Parenthood is one of the only places to access affordable care and referrals, then cutting off the organization's funding will deny women important health care wholly unrelated to abortion.

This controversy over mammograms is just one battle in a larger campaign to set an image in the public mind of what Planned Parenthood is, fundamentally. Is Planned Parenthood an organization that provides a range of health care services to women, or is Planned Parenthood a profit-driven abortion industry?

Which image seems more convincing depends in part on what statistics one cites about the organization. Planned Parenthood, in absolute numbers and in proportion to other abortion providers, provides a lot of abortions. Abortions, however, only make up a small proportion of Planned Parenthood's overall activities-- about 3%. It is in the eye of the beholder, I suppose, but I think it is fairest to say that while Planned Parenthood is a major abortion provider it is also primarily a provider of basic health care for women.

If one concludes that its overall body of work is valuable, then one will support continued funding of Planned Parenthood, in particular its work providing free and low-cost health care for poor women. If one sees Planned Parenthood's abortion work as unacceptable regardless of what else it does, then one will likely object to taxpayer funding of the overall organization, as it appears to indirectly subsidize the abortion side of the business.

Note that, in terms of adopting one perspective or the other, whether Planned Parenthood directly or indirectly provides mammograms is simply irrelevant.

Links:

Article in The Hill about Planned Parenthood and mammograms (October 25, 2012): SBA List blasts Obama for saying Planned Parenthood provides mammograms

Article in the National Review Online that is a good example of the focus on the mammogram question and the emphasis on Planned Parenthood's provision of abortions (October 17, 2012): Celebrating Planned Parenthood's Birthday with a Mammogram Myth

Another article in the National Review Online (October 17, 2012): Planned Parenthood Staff: The President is Wrong, We Don't Provide Mammograms

Thursday, October 25, 2012

De-funding of Planned Parenthood blocked

An Indiana law that attempted to block all federal and state Medicaid funding of Planned Parenthood (or any organization that provides abortion as one of its services) was struck down by the Seventh Circuit Court of Appeals.

The importance and scope of the decision should not be overstated. While supporters of Planned Parenthood are touting this (correctly) as a victory, the grounds on which the law was struck down were fairly narrow.

Federal law requires that Medicaid money be given to any organization that is able to provided quality medical services to Medicaid recipients. Planned Parenthood meets the threshold definition of a qualified medical facility; therefore, it can't be denied Medicaid money by a Medicaid-participating state like Indiana.

Here is a relavant excerpt from the decision (via Politico):
"The defunding law excludes Planned Parenthood from Medicaid for a reason unrelated to its fitness to provide medical services, violating its patients' statutory right to obtain medical care from the qualified provider of their choice," the ruling said.
Indiana can still prevent state money from paying for abortions, just as the federal government does (with exceptions). It just can't deny funding for non-abortion services.

In short, while poor patients will benefit from the decision, it does not establish some kind of broader constitutional right. If Mitt Romney becomes president, it is feasible that the President and Congress could simply modify the language regarding Medicaid funding to allow states to cut off funds for any organization that provides abortions, even for non-abortion services.

Links:

Article, by the Associated Press, in Politico (October 23, 2012): Court blocks defunding of Planned Parenthood in Indiana

Link to the Seventh Circuit decision: Planned Parenthood of Indiana v. Comm. of the Indiana State Dept. of Health (October 23, 2012)

Wednesday, October 24, 2012

Mourdock, abortion, and 'God-intended' rape

Question: How many candidates for office can make incendiary remarks about abortion in a single election season?

Answer: One more than we expected, apparently.

From The Hill:
Republican Indiana Senate candidate Richard Mourdock said Tuesday night that pregnancy caused by rape can be "something God intended to happen."  
"I struggled with it myself a long time but I came to realize that life is a gift from God, that I think even when life begins in that horrible situation of rape that it is something that God intended to happen," Mourdock said during a debate with Rep. Joe Donnelly (D-Ind.). 
Mourdock attempted to clarify later:
"God creates life, and that was my point. God does not want rape, and by no means was I suggesting that he does. Rape is a horrible thing, and for anyone to twist my words otherwise is absurd and sick," he said.
Even if one accepts this modification, Mourdock's statement is contemptible. What is Mourdock saying? Does he mean that God does not intend a given rape to occur, but in select cases of sexual assault, decides to impregnate the rape victim out of a love of life?

One of the reasons why so many people, even self-identified pro-lifers, support a rape exception to a general abortion ban is that having to endure a rape-induced pregnancy would compound the trauma of the rape victim. Therefore, the idea that God would in essence try to make lemonade out of lemons is offensive.

The larger issue that this raises is one of theology: Assuming the existence of a God who makes things happen in the world, why does that God allow evil to occur? It is so common for people to say, "everything happens for a (God-driven) reason." Taking that trite phrase and applying it rigorously leads to offensive and absurd statements like Richard Mourdock's.

UPDATE: Pro-lifers back Mourdock.

UPDATE II: Ross Douthat, columnist for The New York Times, notes that this is just standard Christian theology, and wonders why pro-choice politicians aren't pressed on their similarly out-of-the-mainstream positions on abortion (like abortion on demand in the second trimester of pregnancy).

Links:

Article in The Hill (October 23, 2012): Mourdock: Pregnancy from rape can be 'something God intended to happen'

Catholic views on abortion

Despite the Catholic Church's strong stance on abortion and contraception, American Catholics are not all that different from other Americans regarding these issues.  Polls tend to show that Catholics have a diversity of opinion on abortion and contraception that is not all that different from everyone else.

The clarity and absolutism of the official Church position prompts heated fights between a) those that see the Church teachings on the family and sexual behavior as organically linked to all other social justice issues and central to what it means to be Catholic, and b) those who appreciate many other aspects of Catholic doctrine (like its teachings on social justice) and wish there could be less of an emphasis on abortion and contraception.

Three recent news items illustrate this.

First, a poll just released by the Public Religion Research Institute reveals that a majority of Catholics would like to see the Church focus more of its attention on social justice and poverty issues, rather than right to life issues. This makes sense, given that Catholics are just not all that different from other Americans when it comes to assessing the morality of contraception and abortion, and in their behavior regarding contraceptive use.

Second, the Catholic Church and affiliated pro-life activists are pushing in the opposite direction. This is illustrated by a recent interview of Philadelphia archbishop Charles J. Chaput:
Abortion, Archbishop Chaput says, “is very serious issue that requires absolute adherence on the part of Catholics,” Chaput explains. “And if we don’t stand united on this issue, we’re bound to failure — not only in the area of protecting unborn human life but in maintaining our religious freedom,” he continues.
The third recent news items is an example of how sparks fly when these divergent views clash. LifeNews.com reports that the Sunday bulletin of the Holy Trinity Catholic Church (in Washington, D.C.) contained the first part of an article that argued that universal health care trumps other considerations-- in essence, suggesting support for Obamacare despite concerns over the contraceptive mandate. As you might imagine, this was not received well.

If you want to explore the differences between American Catholics and non-Catholics on contraception and abortion, the links below from the Guttmacher Institute, Gallup, and the Public Religion Research Institute provide a lot of great information.

Links:

Article in LifeNews.com about a Georgetown Church with a 'pro-Obamacare' article in the Sunday bulletin (October 22, 2012): Catholic Church Uses Bulletin to Promote Pro-Abortion Obamacare

Holy Trinity Catholic Church bulletin (October 21, 2012): Citizens of Faith-- Bringing Morality into the Voting Booth, Part One

Article from Reuters analyzing the 2012 American Values Survey (October 22, 2012): Catholics want more focus on poverty than abortion: survey

Public Religion Research Institute (October 22, 2012): The 2012 American Values Survey

National Review Online The Corner blog (October 23, 2012): The Issue of Abortion 'Requires Absolute Adherence on the Part of Catholics'

Guttmacher Institute Report (April 2011) comparing sexual behavior and contraceptive use among women of various faith backgrounds: Countering Conventional Wisdom: New Evidence on Religion and Contraceptive Use

Gallup poll (May 22, 2012): Americans, Including Catholics, Say Birth Control is Morally OK

Gallup poll (March 30, 2009): Catholics Similar to Mainstream on Abortion, Stem Cells

Tuesday, October 23, 2012

Is Planned Parenthood too political?

The Washington Post published an article that suggests that all of the partisan wrangling over Planned Parenthood funding might have fatally damaged the public legitimacy of the organization. The article is informative. However, assuming its thesis is accurate, the author subtly seems to assign fault to Planned Parenthood itself for this current condition:
Planned Parenthood has become so embroiled in partisan politics that its mission to provide health care and family planning services to women is threatened.
I don't see how Planned Parenthood's quest to maintain government grants or to locate alternative forms of government funding by appealing to a political party that supports its mission is an improper foray into "partisan politics." Planned Parenthood only seems to be partisan because one political party has focused a lot of negative attention on them. If you ran an organization that became a bete noire of one political party, what would you do? Would you react defensively and look for love from the other major political party?  This is wrong?

Put another way, the Republican Party waged public war against Planned Parenthood and politicized it and then criticized the organization for defending itself against its public war and for being politicized. 

I do think that the head of Planned Parenthood, Cecile Richards, should not have temporarily joined the Obama campaign as an adviser. Beyond that, however, I don't blame an organization for aligning primarily with the political party that supports its efforts-- the National Rifle Association, or the AFL-CIO, for example.

An official with the Planned Parenthood Action Fund (the political action wing of the organization) put it well:
“We’re not on the side of a party,” she said. “We’re on the side of policy. And there’s just a clear, dramatic distinction between what President Obama has been committed to and delivered and what Mitt Romney and Paul Ryan have promised to destroy. So we don’t have a choice.”
A counterargument of sorts was made in the summer by Campbell Brown, who detailed in a New York Times op-ed what she saw as a pattern of self-destructive partisanship by Planned Parenthood even before the major Republican push to pull funding from the organization. I think Brown is persuasive in arguing that the political wing of Planned Parenthood has not always made the best tactical decisions and has overreacted to the behavior of potential allies. But these are not the actions that have caused Planned Parenthood to be publicly labeled as "politicized" and "controversial." Instead, primary blame lies with Republicans, who have themselves overreacted to the relatively small part of Planned Parenthood's work (3%) that focuses on abortion, to the detriment of many women who don't care as much about abortion as they do cancer screenings and family planning.

Links:

Article in the Washington Post (October 20, 2012): Planned Parenthood's funding is targeted in partisan debates

Op-ed in The New York Times by Campbell Brown that criticizes Planned Parenthood for being partisan (June 23, 2012): Planned Parenthood's Self-Destructive Behavior

Monday, October 22, 2012

Medically necessary abortions: The battle of the experts

Apparently, Representative Joe Walsh is not entirely alone! The assertion that an abortion is never medically necessary has been floating around in the pro-life universe for at least a little while.

We are now witnessing a battle of the experts.

One the one side is Joe Walsh and friends.

Walsh himself released a pdf document with quotations from several doctors-- including some historically prominent pro-choice doctors, like Alan Guttmacher-- making the 'never medically necessary' claim seem quite reasonable.

Also on Walsh's side are several doctors who particpated in a recent "International Symposium on Maternal Health" in Dublin. Ireland, despite a European Court of Human Rights ruling in 1992, has a total ban on abortion. Irish pro-lifers want the country's politicians to resist pressure to implement even a life exception, so the question of medical necessity is directly relevant there.

The "Dublin Declaration," released after the September symposium (organized by a doctor directly involved in the pro-life movement in Ireland) reads quite similarly to Walsh's statement, especially his clarification of his views.

Two features of these statements continue to bother me.

The first is the lack of clarity regarding what they regard as "a fundamental difference between abortion, and necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of life of her unborn child." The difference appears to me to be the following: Terminating a pregnancy is itself never a medically indicated treatment, yet there may be times that another type of treatment of a pregnant woman may incidentally terminate her pregnancy.

Is there in fact a fundamental difference, and could the people that support this view provide some concrete examples to demonstrate the difference? Apparently the "International Symposium on Maternal Health" did that, but I can't find any online information. I don't like having to guess at what this means in practice, because it is then difficult to evaluate the empirical validity of the statement.

The second feature is the focus on abortions that occur in late pregnancy, after the fetus is viable (in other words, capable of living outside of the mother's womb, assuming all other conditions are favorable). What Walsh and others seem to be asserting is that, post-viability, terminating the fetus is never itself medically necessary, because at that point, the fetus can simply be "delivered" and "born" rather than "aborted." In other words, it is no less safe to deliver the fetus early (through, for example, a C-section) than to kill the post-viable fetus.

Well, okay (assuming my understanding of their argument is correct). But what about pre-viable fetuses and embryos? Are there first- and second-trimester, non-ectopic pregnancies that exacerbate or bring on  a dangerous medical condition, such that continuing the pregnancy creates a risk to the mother of death? If so, then those conditions would seem to point to abortions that are medically indicated.

So that's the one side. On the other side is the American College of Obstetricians and Gynecologists (ACOG) and other prominent doctors.

ACOG released a statement on October 19 directly refuting Representative Walsh: "Despite all of our medical advances, more than 600 women die each year from pregnancy and childbirth-related reasons right here in the US."

What is not clear from this statement is how many of these 600 women have died due to complications from ectopic pregnancies or from some other medical problem. As with the "Dublin Declaration," I would have liked some concrete examples.

A more detailed defense of the concept of abortion-as-medical-necessity is from Dr. David Grimes, an OB/GYN who has performed abortions, teaches at the University of North Carolina at Chapel Hill, and has worked at the CDC (see Los Angeles Times article):
In his practice, he said, he’s often cared for women who are newly diagnosed with breast cancer or leukemia whose oncologists refuse to administer treatment until the pregnancy is over. Type 1diabetes can be severely aggravated by pregnancy, and an abortion may be necessary to save a patient’s eyes or kidney function. And in some severe cases of pre-eclampsia, the liver can begin to die — and the only treatment is ending the pregnancy.
This seems to refute the Dublin Declaration doctors, yet even here some more detail might help: Are these pre- or post-viability pregnancies, or both? And what about the claim that late-term pregnancies can simply be ended with delivery rather than abortion?

If you have additional sources of information from the experts, please send them to me or post in the comments, and we'll discuss further!

Links:

Los Angeles Times article in which a doctor provides specific examples of where abortion is indicated as a means of preventing a potentially life-threatening problem (October 19, 2012): Doctors dispute 'inaccurate' abortion claim from Rep. Joe Walsh

Article from Politico that provides a link to a Walsh-created pdf document of a list of quotes from medical professionals that suggests that abortions are in fact never medically necessary (October 19, 2012): Walsh walks back abortion comments-- a bit

Link to the American College of Obstetricians and Gynecologists (ACOG) web site that contains their official response to Representative Walsh

Article from Live Action News, about the "Dublin Declaration" (September 10, 2012): Dublin Declaration: Abortion Is Not Medically Necessary

International Symposium on Maternal Health home page

Abortion in Latin America

This article, from Time, is an excellent short review of abortion conditions in Central and South America, in the context of Uruguay's modest attempts to liberalize its abortion laws and the recent difficulty of an Argentinian woman to obtain a legal abortion after being raped.

When it comes to abortion, contraception, and family planning, Central and South American countries are a bundle of sorry contradictions. While strongly Roman Catholic in culture, this region has very high abortion rates compared to the U.S. and Western Europe and high numbers of unsafe abortions. Would this be, in part, because of cultural and socioeconomic conditions that make effective use of contraception difficult?

Those that support total bans on abortion-- like American House member Joe Walsh-- should consider the experience of women in the countries that have 'no exceptions' laws: "El Salvador, Nicaragua,  Honduras, the Dominican Republic, and Chile." El Salvador perhaps goes the farthest, as the women there who have abortions are themselves declared criminals and jailed. This is odd, legally speaking, even for restrictive abortion regimes. Those-- again, like Representative Walsh-- should consider the stories of women who have not received necessary medical care because doctors in these countries were wary of being punished if they gave medical care to a pregnant woman who needed it, for fear of being prosecuted.

Links:


Time article (October 19, 2012): Uruguay Diverges from a Continent Where Abortion Is Worse than Rape

Article from the Washington Post that explains Uruguay's political culture and how it helps to explain the how and why of its liberalization of abortion law (October 21, 2012): Legalizing abortion the Uruguayan way: through painful compromises and concessions

Sunday, October 21, 2012

Representative Walsh's alleged backtrack

Representative Joe Walsh, after his recent statement that abortions are never medically necessary, has supposedly "backtracked." I'm not so sure.

Read his "backtrack" (from CBS News):
"When it comes to having an abortion to save the life of a mother, I will say again that, outside of the very rare circumstances such as ectopic pregnancies, during which both the mother and baby will die if the baby is not aborted, and other rare health issues, the research is pretty clear that with the advances in modern medicine, an invasive and traumatic procedure like an abortion is not necessary to save the life of a mother.
"In those very rare cases where a mother's life may be in danger past the point of viability for the baby, today's doctors work to induce labor or perform a caesarean section in an attempt to save BOTH lives," the statement continued. "These cases are extremely rare, and they unfortunately are used by the militant pro-choice movement to justify every single abortion. 

"...While, I do not support abortion, I do of course support medical procedures for women during their pregnancies that might result in the loss of the unborn child. When such an occurrence takes place, that decision on whether to perform that procedure is a very difficult one and one that should be left up to the mother and her family."
Does that sound like a backtrack to you? In the first paragraph, he corrects himself when it comes to ectopic pregnancies, but otherwise essentially repeats his primary and controversial assertion: "an invasive and traumatic procedure like an abortion is not necessary to save the life of the mother."

In the second paragraph, Representative Walsh acknowledges that pregnancies may be life-threatening, but that doctors should work to save "BOTH" mother and unborn child.

Okay, but what happens if doctors have to make a choice between one or the other? Well, according to his statement in the first paragraph,  abortion "is not necessary to save the life of the mother." He seems to suggest that this dilemma is factually impossible-- it does not occur.

But wait a minute-- here comes the third paragraph of his statement: "I do of course support medical procedures for women during their pregnancies that might result in the loss of the unborn child."

Did you get that? While abortions are never medically necessary, there are apparently other "medical procedures" that might in fact be necessary to save the mother that might incidentally kill the unborn child. In these cases, a woman and her doctor should have the discretion to determine whether to undergo the potentially life-saving medical procedure.

Regarding this special category of other medical procedures, is not clear what Representative Walsh is talking about. Is he talking about medical procedures that do not save a pregnant woman's life by terminating her pregnancy, but, in attempting to address the mother's condition, accidentally put the life of the fetus at risk? Or is he talking about abortion-- in other words, abortion is okay when it is done only as a means to save the mother's life, rather than as an end in itself (so that abortion is done, but, in purpose, is incidental to the primary purpose of saving the mother's life)? 

I don't think it can be the latter, because of Walsh's reiteration that (apart from ectopic pregnancies) abortion is never medically necessary. Therefore, it has to be the former-- medical procedures that do not save the mother's life by killing the fetus but, in execution, accidentally kill the fetus anyway.

If that is the case: I don't know enough about medicine to know if this is a valid-- and very subtle-- distinction, or if this is just doubletalk.

Factually, I think doctors will disagree with the assertion that ending a pregnancy by terminating the pregnancy is never the best method by which to preserve the life of the mother. A recent article in USA Today seems to confirm this. The American College of Obstetricians and Gynecologists (ACOG) does not agree with Representative Walsh, either.

Regardless, what is clear-- after reading Representative Walsh's statement-- is that he did not in fact backtrack on his statement, apart from ectopic pregnancies. News outlets like CBS that report that he backtracked on his statement are allowing him to avoid being held accountable for what I think is a very dubious assertion. 

Links:

CBS News: Walsh backtracks: Abortion to save a mother's life is up to her

USA Today article on the medical necessity of abortion (October 19, 2012): Doctors say abortions do sometimes save women's lives 

UPDATE: Article from Politico that provides a link to a Walsh-created pdf document of a list of quotes from medical professionals that suggests that abortions are in fact never medically necessary: Walsh walks back abortion comments-- a bit

Saturday, October 20, 2012

Abortions are never medically necessary?

There are a few things about abortion that I think are simply inarguable. Here's one: Performing an abortion is sometimes necessary for saving the life of a pregnant woman.

I stand corrected! Joe Walsh, a member of the House of Representatives from Illinois, wants to criminally ban abortions "without exception." What about abortions that are required in order to save the life of the pregnant woman? No problem: Rep. Walsh asserted that abortions are never medically necessary due to "modern technology and science."

What? Does anyone besides Rep. Walsh believe this?

Now, resisting an explicit life exception to a general abortion ban is not all that unusual (although still on the extreme end). Pro-life activists make two arguments. First, they think that performing an abortion in order to save a woman's life falls under the criminal defenses of self-defense and/or necessity (i.e., the choice of evils defense). Therefore, a life exception is implicit in any abortion ban. Second, the term "life" is so vague that it will allow many women to obtain abortions that are not life-preserving in the strictest sense.

Walsh does think that exceptions are generally abused, which is not a unusual pro-life claim. But I suspect that other pro-life politicians and activists will decline to defend him, because saying that abortions are never medically necessary is just not supportable.

Links:

Article on the NPR web site (October 19, 2012); includes a statement from ACOG: Life of the mother: never a reason for abortion, Congressman says

Brief article in Politico (October 19, 2012): Rep. Joe Walsh: Abortion never saves mom's life

Article from New York Magazine (October 19 2012) that contains some information from the CDC on deaths due to ectopic pregnancy : Congressman Joe Walsh is the latest Republican to say ridiculous thing about abortion

Friday, October 19, 2012

Abortion clinic opens in Northern Ireland...

...to general confusion.

If nothing else, Marie Stopes pushing forward with a modest offering of abortion services (medical abortions within the first nine weeks under limited circumstances) is going to force the government to do something about the legal confusion that seems to reign in Northern Ireland.

Links:

Associated Press article, reprinted in the New York Daily News: Ireland's 1st abortion clinic opens to protests in the mostly Catholic and Protestant country

Op-ed in the Belfast Telegraph that summarizes the issues nicely and calls for government action: Time to clear up legal position on abortions

Free contraceptives and STDs

An essay by Jennifer Fulwiler in the National Catholic Register criticizes the recent Obstetrics & Gynecology study (the St. Louis study) on the connection between free contraceptives and pregnancy and abortion rates.

Her critique does not focus on the methodology of the study or its specific results. Instead, she focuses on the possibility that using certain types of contraception may increase STD rates.

She does not describe the causal links, but she is implicitly floating two hypotheses:
  1. Women who rely on IUDs or hormonal implants are less likely to use condoms during sex and therefore are more likely to be exposed to STDs.
  2. Some studies indicate that hormonal implants increase the likelihood of contracting an STD. Therefore, use of hormonal implants makes STD contraction all the more likely, given hypothesis 1. 
Given what Ms. Fulwiler cites as high rates of STD contraction in the study area (St. Louis), she thinks the researchers were ethically irresponsible for promoting IUD and hormonal implant use. She does not acknowledge that the researchers did not push these methods of contraception; the women in the study were free to choose from a range of contraceptive methods.

Links:

Essay in the National Catholic Register (October 10, 2012): The Shocking Ethics Behind the Contraceptive Choice Project

Abortion law in Uruguay

The process of liberalizing abortion law in Urugruay continues. This article, in The New York Times, does a little comparing of Uruguay with other South American countries.

Uruguay's law tracks what I think is the general American consensus on abortion: abortions in early pregnancy generally allowed, abortions in middle-and-later stage pregnancy generally prohibited with exceptions for rape and health concerns. (Americans would also likely endorse a right to choose abortion in cases of incest or severe fetal deformity.)

Its regulations 'around' abortion (a five-day waiting period of reflection, for example), however, would be strongly opposed by pro-choice groups in the United States.

Another difference is how the language of the law frames abortion. The original version of the bill indicated that abortion in the first trimester was a 'right.' The modified bill removes that reference to cast the change in abortion law more as a form of 'decriminalization.' This may be playing semantics, but culturally this might ease the transition a bit. Legislators and constituents may be more comfortable with resignation to a reality than assertion of a right.

For additional analysis, see my earlier post on Uruguay. Note that the law that was passed by the lower legislative chamber appears different than the one passed by the Senate. I don't know if that reflects inaccurate reporting or genuine modification of the lower house bill by the Senate.

Links:

Article in New York Times (October 17, 2012): Uruguay Senate Approves First-Trimester Abortions

Article in The Huffington Post (October 17, 2012): Uruguay takes historic step legalizing abortion

Thursday, October 18, 2012

The economics of contraception

University of Massachusetts economics professor Nancy Folbre, in an Economix (New York Times) blog post, nicely combines several observations about the benefit of providing women with free contraceptives.

Her observations?
  1. "[U]nintended pregnancy costs American taxpayers roughly $11 billion each year."
  2. The cost of unintended pregnancies affect poor young women more than others and exacerbates the cycle of poverty for the mother and her child(ren). 
  3. Insights from the field of behavioral economics suggest that simply expecting women/couples to engage in perfectly strategic behavior when it comes to preventing unintended pregnancy-- in particular, securing and using contraception effectively-- is unrealistic. 
  4. 'Pre-emptive' birth control, like LARCs (long-acting reversible contraceptives), that have very low use error (i.e., people don't mess up using it properly), overcome this problem. 
  5. As a result, it is not surprising that the recent St. Louis study published in Obstetrics & Gynecology shows that free distribution of LARCs to women who ask for them correlates with a decline in unintended pregnancy, teen pregnancy rates, and abortion rates. 
  6. Government spending on family planning, therefore, is a good "investment." 
Why don't Republicans, she asks, buy into government-sponsored family planning, given that they "typically embrace cost-benefit analysis"? This she leaves to the reader's imagination. 

She is making a rhetorical point, of course. 

That being said, I don't think this is so hard to understand. Identifying the policy that best gets us from point A to point B is only part of the lawmaking calculus. In this case, two competing considerations trump policy efficacy: Moral opposition to contraception and ideological opposition to a large social welfare state. 

Links:

The New York Times Economix blog: Contraceptive Economics

Wednesday, October 17, 2012

Contraception and the second presidential debate

During the second presidential debate, President Obama promoted the idea of requiring most employee health care plans to offer free contraception. Mitt Romney's response was as follows (from The Washington Post):
“I’d just note that I don’t believe that bureaucrats in Washington should tell someone whether they can use contraceptives or not,” Romney said. “And I don’t believe employers should tell someone whether they could have contraceptive care of not. Every woman in America should have access to contraceptives.”
This just does not compute. In what way does the ACA's contraception mandate require women to use contraceptives or give the government the power to deny women access to contraceptives? In what way do employers under the ACA gain the power to deny women contraceptive care?

As a way of ducking an issue, this was a nice flip-around: I'm going to pitch the contraceptive mandate as an example of government and employer coercion of women. In reality, however, the contraceptive mandate is the opposite of what Mitt Romney implied about it.

The contraceptive mandate simply requires health care plans to offer women the option to access free contraception. The contraceptive provision, therefore, enhances the ability of women to freely decide whether or not to use contraceptives.

Regarding employers, Romney's statement is actually an argument for the contraceptive mandate of the ACA. As things stand now, employers can refuse to provide a health care plan to employees that provides free coverage of contraception. That sounds a lot like an employer telling "someone whether they could have contraceptive care or not"-- or, at the least, it leaves it up to women to access contraceptives on their own dime. By forcing employers to allow women to get contraceptives for free through their health care plan, the ACA prevents what supposedly worries Mitt Romney.

Links:

Washington Post recap of the second presidential debate (October 16, 2012): Obama goes on offensive, turns debate into argument with Romney

Tuesday, October 16, 2012

Romney's new abortion spot

Yes, I would call this tacking back on abortion.



The question is, what would Romney really do as President? I was talking to a colleague about this the other day, and our speculation is the following: Given Romney's 'evolution' on the issue over time, what might drive his agenda on abortion is less his own personal view than what his allies in Congress and activists within the party might want him to do-- which would be to sign conservative abortion legislation, nominate anti-Roe/Casey judges, etc.

So, if we assume that Romney's view on abortion has 'evolved' to become more conservative, then he will do conservative things as President. If his views on abortion at any given time are more a matter of political expediency, then he will act as an agent for others among his allies and constituents who see abortion as of primary importance. The result is the same, given that he is allied with people want to take a very conservative line on abortion.

In short, despite this gesture toward some kind of centrism on abortion, I would predict that President Romney will make people with a pro-life agenda very happy. 

A post-Roe world

Among all of the policy areas where Barack Obama and Mitt Romney clash, their views on abortion present some of the starkest contrasts, despite what some see as an attempt by the Romney campaign to dial back its conservatism on abortion.

(UPDATE: Just as I posted this, I came across this article on a new Romney ad. So much for "what some see." It's what it is.)

The New York Times published an editorial predicting what would happen if the U.S. Supreme Court reversed Roe v. Wade (actually, Casey v. Planned Parenthood). In short, around half of the states would enact much more restrictive abortion laws within a legislative session after the undoing of Roe/Casey.

One thing that I wonder about in a post-Roe/Casey landscape is how states would attempt to ban medical abortions, in particular self-abortions by women using drugs like Cytotec, which is an anti-ulcer medication but is also effective in causing a miscarriage early in pregnancy. (The active ingredient in Cytotec is misoprostol, which one of two standard drugs used in medical abortions, the other being mifepristone, or "RU-486.")

Traditionally, American states did not make criminals out of the women who actually obtained an abortion, treating them instead as victims of rapacious abortionists and/or coercive husbands, boyfriends, fathers, etc. In many countries, and among many pro-choice organizations, medical abortions are the future. How would states abortion laws deal with women who could get their hands on Cytotec and self-abort?

Links:

Editorial in The New York Times (October 15, 2012): If Roe v. Wade Goes

The Caucus blog in The New York Times (October 16, 2012): In New Ad, Romney Stresses Moderat Positions on Reproductive Issues

What do Catholic women think about contraception?

The organization "Women, Faith, and Culture" intends to tell us:
Our preliminary report, What Catholic Women Think About Faith, Conscience, and Contraception, probes the views of church-going Catholic women and analyzes their knowledge, beliefs, and attitudes about the Catholic Church and her teachings on family planning. This Preliminary Report is part of a larger research effort, the Women, Faith, and Culture Project, that explores the perspectives of church-going Catholic women on a wide array of issues related to faith, sexuality, and reproduction. 
The preliminary report can be found on the Women, Faith, and Culture web site. It takes a little bit of hunting around, but you can download a pdf copy of the report from there.

Links:

Women, Faith, and Culture web site

Monday, October 15, 2012

HPV vaccine and promiscuity

The journal Pediatrics just published a study about the HPV vaccine. Human papillomavirus virus (HPV) is a sexually transmitted disease that can make certain types of cancer more likely. There is a vaccine to prevent one from getting it.

The vaccine itself is not controversial, but the federal government's recommendation that tweens (age 11 and up) receive it-- i.e., at an age before the onset of sexual activity- was. Some parents are worried that giving their children the vaccine will encourage them to go out and have sex.

But is this true? USA Today reports:
Preteen girls who received the HPV vaccine were no more likely than unvaccinated girls to get pregnant, develop sexually transmitted infections, or seek birth-control counseling, finds the latest study to discount concerns that vaccination against the human papillomavirus encourages promiscuity.
The logic that leads people to resist the HPV vaccine is similar to that used by people who argue against sex education that includes information about contraceptives. The idea appears to be that giving a boy or girl the HPV vaccine or teaching adolescents how to put a condom on a banana is a signal that sexual activity is permissible and/or inevitable.

An additional possible logic is that withholding the HPV vaccine and knowledge about contraception provides an additional disincentive to engaging in sexual activity: If you have sex, there is the risk of getting an STD or getting pregnant (or getting someone pregnant), so you will be scared off having sex.

As it turns out, it doesn't work that way. Sexual education programs that include birth control information do not increase adolescent sexual activity, and neither does giving girls, at least, the HPV vaccine.

This should be good news for parents who are worried about sending the wrong message to their kids, but it is hard to overcome 'common sense' concerns with scientific evidence.

Links:

Pediatrics home page: See links to abstracts under "eFirst Pages (early release articles)"

Article in USA Today (October 15, 2012): HPV vaccine not tied to increased promiscuity for girls

Article in The New York Times (October 15, 2012): Vaccine Doesn't Alter Sexual Behavior, Study Finds

Abstract to an earlier study with similar results, published in the American Journal of Preventative Medicine (January 2012): Human papillomavirus vaccine and sexual behavior among adolescent and young women

"Arlen Specter is a jerk, but he's our jerk."

So said Paul Weyrich.

His career was remarkable in that, while doing something at one point or another to make everyone across the political spectrum angry with him, he had incredible staying power.

One of the stranger things about Arlen Specter was that he was a pro-choice Republican in a state that has many pro-life Democrats (e.g., Governor Casey and Senator Casey).

Farewell, Senator.

Links:

The New York Times article: Arlen Specter, Pennsylvania Senator, Is Dead at 82

Cytotec and medical self-abortion

I just came across this August 2012 article in The New York Times. It describes how women in Mexico and the U.S. purchase Cytotec, and anti-ulcer drug, to self-abort. (Cytotec is misoprostol, which can effectively induce abortions in early pregnancy.) There are few barriers to obtaining the drug in Mexican pharmacies. For Mexican women, this may be their only option to abort-- relatively safely-- given that abortion is largely illegal outside of Mexico City. For women who live in Texas, Cytotec from a Mexican pharmacy may be an attractive option given increased regulations on abortions in Texas and the reduction of state funding for family planning clinics.

One problem is that pharmacists are reluctant to provide instructions on how to use Cytotec to effectively self-abort.

Links:

The New York Times article on Cytotec and Mexican pharmacies: Looking to Mexico for an Alternative to Abortion Clinics


Sunday, October 14, 2012

Doubling down on the Catholic focus on contraception

Janet E. Smith, Chair of Life Ethics at Sacred Heart Seminary and defender of Humanae Vitae, thinks that part of the gap between Catholics and the Church on contraception has to do with not enough discussion of the topic during the homily.

Smith thinks that more Catholics would turn against contraception (beyond 'natural family planning') if the seamless nature of the Church's life views and its social justice views were emphasized. She also asserts that Catholics would find a renewed emphasis on "moral issues" strange at first but ultimately admirable and refreshing. 

Are you skeptical? 

It seems implausible that the reason why most Catholics reject the Church's teaching on contraception is ignorance of the theological argument against it. 

Links:

Essay in the National Catholic Register (October 7, 2012): Contraception, the Election and the New Evangelization


DesJarlais presides over congressional session?

Honestly. What in the world is John Boehner thinking? If you can think of a single reason why Boehner thinks this is a good idea, please let me know.

Links:

From The Huffington Post (October 12, 2012): Scott DesJarlias Presides Over Congress Pro Forma Session Despite Abortion Scandal 

Saturday, October 13, 2012

Implementing exceptions to abortion bans

Around the world, countries that are slowly moving away from very restrictive abortion bans are struggling to implement legally-mandated exceptions (for example, for rape). In several countries their judiciaries are the prime movers, requiring more exceptions to general prohibitions on abortions.

The struggle then becomes drafting of rules to govern the exceptions and their implementation.

For example, in Argentina, the country's supreme court held that women must be allowed to obtain abortions in cases of rape. Provincial and city governments are apparently in charge of developing their own rules to effect the exception, and are struggling to do so in the face of pro-life opposition.

Recently, a Buenos Aires woman who was raped while a victim of human trafficking has had her abortion delayed due to activist outcry and a local judge's order. Anti-abortion activists shamed themselves by protesting outside the woman's home. The reason her case became public at all was because the mayor of Buenos Aires, who is pro-life, publicly announced that someone was going to get an abortion due to rape.

In Northern Ireland, Marie Stopes plans to open the first abortion clinic in the territory, in Belfast. Unlike in the U.S., where clinics are the primary venue for abortions, clinics are highly unusual in European countries. Northern Ireland is different from the rest of the UK in having highly restrictive limits on abortion. (While the rest of the UK has restrictive limits on paper, in practice abortion is generally available and accessible under broadly interpreted exceptions.) Hospitals in Northern Ireland are technically able to provide abortions for life-or-health reasons, but an absence of specific legal guidelines on abortions have deterred doctors from performing abortions (beyond strong political and cultural deterrents).

The Marie Stopes clinic looks as if it is intended to force the question of when abortions are permitted and to provide genuine access to abortions early in pregnancy (they will provide medical abortions for women pregnant up to nine weeks)-- which, of course, is why it is drawing such strong negative attention.

And, in an earlier post, I discussed how a life exception (yes, a life exception) for abortion was judicially imposed in the Republic of Ireland in 1992 and has not resulted in clear access to abortions for this narrow exception in the decades since.

One apparent difference between these countries and the United States is the speed and finality with which a judicial order in the U.S. is implemented. While there is a lot of scholarly literature about how judicial orders are implemented imperfectly in the U.S., when it comes to reproductive rights the judiciary does not make women wait for legislatures and bureaucratic agencies to come up with regulations. It is important to have democratic buy-in and utilize legislative and bureaucratic expertise when making fundamental changes in a sensitive policy area. But I think the U.S. system is clearly superior in allowing women much quicker access to their rights.

Links:

Article from Reuters about Argentina (October 12, 2012): Rape victims struggle to get legal abortions in Argentina

Article from the Washington Post (October 11, 2012): Belfast to open Ireland's 1st abortion clinic in test for murky anti-abortion laws on island

Article from LifeSiteNews (October 12, 2012): Marie Stopes situation in Belfast 'grim' unless politicians act swiftly: SPUC

Marie Stopes International web site

Friday, October 12, 2012

The VP candidates on abortion

Overall, I thought that Martha Raddatz did a good job moderating the VP debate. The question she asked on abortion, however, was a big nothing sandwich and could have wasted an opportunity for the voters to learn more.

I know that candidates themselves like to personalize policy, telling heartfelt or tragic stories about individuals they've met on the campaign trail, etc. But generally I think we are better served by learning about what candidates propose, specifically, to do in a given policy area. Raddatz asking the candidates to speak about their personal, rather than policy, views on abortion was the softest of softball questions.

Ironically, both candidates actually pivoted over to policy! Biden used the question to focus on Catholic "social" policy and Ryan, clearly prepared to be challenged on 'daylight' between him and Romney on abortion, gave the answer to the question he thought he was going to be asked.

This was one of the least contentious parts of the debate, in part because both candidates made a distinction between what they believe personally and what they support in policy.

For Biden, he articulated a Cuomo-like position: I agree with the Church that life begins at conception, but it is not my place to impose the implications of my belief on people of other faiths, so let's leave the decision to a woman and her doctor.

The general Biden position is often derided by pro-life activists, but it is a position that many Catholics take: A majority of American Catholics, consistent with a high majority of Americans, believe in a right of abortion, at least early in pregnancy.

Ryan in the past has harmonized his personal beliefs with his policy proposals, wanting abortion to be banned without an exception for cases of rape and incest. Since signing on with Mitt Romney, he's had to agree to those exceptions.

A lot of Democrats saw this as an opening to pit Romney and Ryan's views against each other, but how could Biden do that? Instead, his basic argument (which Raddatz suggested, too) was that, whatever the Romney/Ryan position is, it is anti-abortion.

And how could Ryan criticize Biden's position? Ryan is advocating (from his perspective) for more 'liberal' abortion laws than his personal beliefs allow.

So, in a lively and entertaining debate, abortion turned out to be the issue that produced the least heat and only a little light.

Links:

Washington Post On Faith column (October 12, 2012): Biden and Romney debate abortion and the role Catholicism plays in their positions 

Amy Davidson's Close Read column at The New Yorker (October 12, 2012): Ryan and Biden: The Abortion Question

Do pro-life activists get abortions?

I've read several accounts of abortion doctors and clinic workers who state that they have performed abortions on pro-life activists (or their wives, girlfriends, etc.).

Here is an example of a pro-life Republican Member of Congress who pressured his mistress into having an abortion, in order to avoid the breakup of his marriage. The allegation seems to be confirmed by a phone recording taken by the Congressman himself. Jeesh. 

Link:

Thursday, October 11, 2012

Did Romney say something new about abortion?

Not really, although you would think he had, given the coverage of one rather innocuous remark he made about his agenda.

Romney, in an interview with the DesMoines Register, did not state any change in his views on abortion-- he's already done that enough times in the past. Instead, he appears with this remark to be placing abortion farther down on his list of priorities. This just looks to me like a fairly typical dodge-controversy maneuver in the weeks before the election:
“There’s no legislation with regards to abortion that I’m familiar with that would become part of my agenda,” the GOP presidential candidate told The Des Moines Register’s editorial board during a meeting today before his campaign rally at a Van Meter farm.
Some news coverage is treating this like a big deal. Really?

Martin Bashir suggested that this 'flip flop' was going to make things difficult for Paul Ryan in the vice-presidential debate tonight. It won't. Ryan and Romney already have substantive policy differences on abortion (whether there should be an exception for rape, for example), and Ryan is adept as papering over those differences.

One interesting bit of news to come out of this was that he head of Planned Parenthood, Cecile Richards, is taking a leave of absence to "officially" help the Obama campaign fight Romney (see Daily Beast article). I know it is obvious that Democrats and Republicans have sorted largely into the pro-choice and pro-life parties, but this strikes me symbolically as a little much. On the one hand, it makes more sense than ever, given that Romney, like many Republicans, wants to de-fund Planned Parenthood. Perhaps for that very reason, however, having the head of Planned Parenthood take off her non-profit hat and put on a campaign hat for the Obama campaign seems like a step too far.

Links:

Article from the DesMoines Register (October 9, 2012): Romney says abortion isn't part of his agenda

Article from The Daily Beast (October 11, 2012): 'Proudly Pro-Life' Romney's Wriggle on Abortion Seen as 'Pragmatic'

MSNBC News' Martin Bashir (October 10, 2012): Romney abortion flip-flop complicates Ryan's debate 'Jell-O'

Los Angles Times editorial (October 10, 2012): Romney's latest fudge on his abortion agenda