Tuesday, December 18, 2012

Follow-up on the First Amendment license plate case

Last week, I discussed how North Carolina's "Choose Life" license plate program was designed in a way that ran afoul of the First Amendment.

Pro-choice politicians in other states with pro-life license plate programs are going to use the court decision as a platform to challenge their own state programs. A legislator in Georgia is on the case already.

Defenders of the pro-life-but-not-pro-choice-plate programs will try to distinguish their policies from North Carolina's, but I am skeptical. The key would be to argue that their program, unlike North Carolina's, does not discriminate within a government-created public forum (license plates) where 'private' speech takes place, but instead is a direct expression of a government viewpoint.

If other courts issue rulings that uphold other state programs, the issue is likely to end up at the United States Supreme Court.

Links:

Article in the Atlanta Business Chronicle (December 12, 2012): Georgia lawmaker may seek "Pro-Choice" license plate following NC decision

Monday, December 17, 2012

Did "tax-funded abortion pills" cause the Newtown tragedy?

Of course not. But this is the kind of nonsense we get when people shamelessly piggyback on a tragedy to score political or culture war points. We also get this kind of analysis when someone is paid to analyze events on cue but has nothing of substance to say regarding something terrible and complex.

Watch Mike Huckabee's statement here:



I understand Huckabee is trying to make a larger point about the culture, rather than drawing a direct line from the ACA's contraceptive mandate-- which does not mandate taxpayer funding of abortion pills, by the way-- to the Newtown massacre.

Still, this is what happens when a tragedy occurs:
  1. We extrapolate from an isolated event and determine that it encapsulates, or is the ultimate representation of, something about our society that must be addressed. It is possible, however, that an event is sui generis and cannot then serve as a platform for useful long-term policy reform. 
  2. We reduce the cause of a tragedy-- which may ultimately be an unexplainable, horrible, mysterious confluence of a dozen different macro- and micro-level variables-- to a single variable, such as guns, treatment of mental health, school security, violent video games, or, in this case, taxpayer-funded abortion pills and tolerance of homosexuality. 
  3. We take our already-existing beliefs regarding what is wrong with society and how to fix it, and see the tragedy as a validation of those beliefs, and therefore a validation of our already-existing policy proposals. 
We should not under-react to events. In addition to our normal and proper human response-- grief-- something that Barack Obama, in my opinion, has done very well as president-- we should heed societal signals to act and look for trends and how they fit into the larger fabric of society and its governance. 

We should not also overreact to events. Overreacting to events is a recipe for bad policy-making, especially if the events to which we are reacting cause a kind of myopia, where we forget to consider policy options in light of larger historical, cultural, and social contexts. 

So far, the best writing I've read reacting to the Newtown massacre have been two columns from  The New York Times, one by Ross Douthat, which addresses the mystery of human evil, and one by Nicholas D. Kristof, which offers very sensible and concrete proposals for regulating guns and ammunition. 

Links:

Column in The New York Times by Ross Douthat (December 15, 2012): The Loss of the Innocents

Column in The New York Times by Nicholas D. Kristof (December 15, 2012): Do We Have the Courage to Stop This?

Article about Huckabee's statement in The Raw Story (December 16, 2012): Huckabee attacks 'tax-funded abortion pills' in Newtown monologue

How to maintain the Japanese population?

This is a nice essay, by Alexandra Harney, on ways to address population decline in Japan. It goes a little sideways at the beginning-- it implies that the Japanese government could not focus on infrastructure projects and population maintenance at the same time, like they are mutually exclusive-- but makes standard and sound recommendations at the end.

Refreshingly, the author of the essay does not recommend reinforcing or returning to 'traditional family values'-- in other words, limited birth control and women out of the paid workforce-- as a means of addressing Japanese population decline. As the author and many others note, increased gender equity, supported through government policies, is good in and of itself and also tends to produce replacement-rate birth rates.

Links:

Essay in The New York Times (December 15, 2012): Without Babies, Can Japan Survive? 

Sunday, December 16, 2012

A holiday break

The politics of abortion, contraception, and family planning never stops. I, on the other hand, do stop occasionally and take a break! I will be away from my computer for much of the rest of December, so my postings will be intermittent until the first week of January, 2013.

Thanks for reading and responding. Enjoy the holidays. 

Thursday, December 13, 2012

The symbolism of coat hangers

The coat hanger made its appearance-- or reappearance-- in American culture this week in two odd ways.

First, the show American Horror Story-- which defies brief description-- recently featured a woman attempting to perform a self-abortion with a wire coat hanger. You'll have to read the Salon article about the episode, but, intentionally or not, the show's producers built a case for abortion-as-necessary so over the top that it almost undermines itself.

Second, the owner of a dry cleaning business in Ohio placed pro-life messages on the coat hangers that go back to customers with their clothes. The owner of the business seemed genuinely obtuse regarding the symbolism at work, although there is some evidence that people had been complaining about the hanger messages for a couple of years. A blogger who broke the story called this "the worst marketing decision ever." I posted a link to the article on a Facebook page I maintain for my students, and one of them said they checked The Onion web site to make sure this wasn't a hoax.

What is it about coat hangers? The coat hanger as the symbol of desperate, unsafe and illegal abortions has been part of the cultural imagination of Americans for 40 years.

The coat hanger symbol is just that, a symbol-- it does not entirely track with reality but resonates emotionally because it captures a deeper truth about the world. First, the wire hanger was not and is not the implement of choice for unsafe abortions performed by illegal abortionists or for self-abortions. There are a wide range of methods used in unsafe abortions (an article in the Western Journal of Emergency Medicine has a table of various methods). The wire hanger is the type of implement that is sometimes used, along with knitting needles and other long, sharp objects that are easily available. Second, the use of something like a wire hanger has a little less to do with the proverbial 'back alley abortion' than with self-abortion.

The deeper truth here is that women attempt and have abortions regardless of their legality. One of the fundamental tenets of the pro-choice movement is that making abortion illegal (or legal but difficult to access) does not fundamentally reduce the number of abortions but makes the abortions that do occur unsafe and sometimes fatal.

Below are some links to articles that explore unsafe abortions in the United States before-- and after-- the Roe decision.

Links:

Article in Salon (December 13, 2012): "American Horror Story's" coat hanger abortion

Article at The Huffington Post (December 11, 2012):  Pro-Life Coat Hangers at Springdale Cleaners: 'Worst Marketing Decision Ever'

Essay in The Atlantic by Rebecca J. Rosen that discusses the symbolism of the coat hanger (August 23, 2012): Consider the coat hanger

Essay in The New York Times by a retired doctor about treating women who attempted to self-abort with various implements (June 3, 2008): Repairing the Damage, Before Roe

Article in the Western Journal of Emergency Medicine (November 2009 issue): The Back Alley Revisited: Sepsis after Attempted Self-Induced Abortion

Article in Slate that discusses the phenomenon of post-Roe self-abortions in the United States; the article also links to a couple of scholarly studies about self-induced abortions (January 18, 2011): The DIY Abortion

Wednesday, December 12, 2012

Public support for the contraceptive mandate

A new survey indicates that the contraception mandate is popular:
Most Americans support the Obama administration health reform mandate that requires business owners and faith-based non-profits to offer insurance coverage of contraception for employees, even when doing so conflicts with their [the employer's] religious principles, according to a recent survey by LifeWay Research. (Source: USA Today)
How popular?
-- 63% of American adults say businesses should be required to provide their employees with free contraception and birth control, even if it runs counter to the owners' religious principles.
-- 56% say nonprofits, such as schools, health facilities and charities should be required to provide the coverage.
-- 53% say Catholic and other religious schools, hospitals, and charities should be required to [provide the coverage]. (Source: USA Today)
LifeWay polled about 1191 people, so the margin of error is a little less than +/- 3%. Of the three results reported above, the only one that is close to being within the margin of error is the third result.

Regardless, these kinds of numbers should make the Obama administration and family planning advocates happy. Public support for a given policy does not always track with its constitutionality, of course, so we'll have to see how judges ultimately work out the religious freedom concerns of certain employers.

What I suspect, however, is that a majority of Americans support the contraceptive mandate-- or, don't have a serious problem with it-- for two main reasons:
  1. It strikes them as a good idea. It saves women and families money; it will allow women to use the most effective contraceptives without a concern for cost; and people largely believe that there is a positive correlation between increased use of effective contraceptives and lower rates of unintended pregnancy-- and abortion.
  2. The contraceptive mandate does not really impinge on the religious freedom of employers. In other words, many Americans just don't buy the narrative that this is a fundamental burden on religious employers. Except in rare circumstances, the connection between the employer and the free contraceptives that a woman would receive under her health care plan is distant and tenuous.  The ACA and its follow-up regulations, despite the objections of pro-life groups, are actually pretty good at creating a firewall between religious employers and the money that goes to purchasing contraceptives under ACA-regulated health care plans. 
I was a little curious about LifeWay Research. According to its web site, LifeWay exists "for the purpose of assisting and equipping church leaders with insight and advice that will lead to greater levels of church health and effectiveness." Given the comments of LifeWay's president in the USA Today article (excerpted from LifeWay's press release), one gets the sense that he is baffled and frustrated by the results of the survey:
"The religious freedom that the United States pioneered is not a freedom of belief, but a freedom to practice that faith," said Ed Stetzer, president of LifeWay Research. "The American public appears unaware or unconcerned that some religious organizations and family businesses indicate fear of losing the freedom to practice their faith under the new healthcare regulations."
People in the survey may "overlook the fact that more than 90 percent of businesses with employees are family businesses. Recent lawsuits contend that the religious freedoms of these families conflict with healthcare choices desired by individuals," said Stetzer.
Don't Americans get it? He seems to be asking. Actually, I think a majority of Americans understand things pretty well.

Links:

Article in USA Today-- note that there are some odd typographical errors in the article (December 3, 2012): Most Americans support contraception insurance for all

Home page for LifeWay Research; the home page also contains a link to pdf and ppt versions of the poll

Press release for the Life Way poll (November 30, 2012)

Tuesday, December 11, 2012

"Choose Life" license plates and the First Amendment

Like many states, North Carolina allows different groups to promote their view of the world by developing their own specialty license plate, thereby getting their message out and, through specialty plate fees, raising money for a favored charity. We have this program in Pennsylvania, where one sees many university-themed plates (Edinboro alumni, for example). In North Carolina, approximately 150 specialty plates have been authorized.

North Carolina legislators wanted to allow pro-life groups to use the specialty plate program to 'promote life'-- but not allow pro-choice groups the opportunity to promote their views. In opening up the specialty license plate program to pro-life groups, the North Carolina government explicitly banned pro-choice plates or the use of specialty plate fees for any pro-choice organization or activity.

For this reason, federal District Court judge James C. Fox placed a permanent injunction on the "Choose Life" plate program.

The First Amendment issues here are interesting. Like many free speech cases, this one comes down to how one frames the government's behavior.

The ACLU, and the ruling judge, framed the case as North Carolina promoting the speech of pro-life citizens while suppressing the speech of pro-choice citizens.  The problem in this case is not that North Carolina allowed for a "Choose Life" license plate, per se. Instead, problem was that people who were pro-choice were explicitly prohibited from creating their own speciality license plate. The state, then, allowed some people with a particular viewpoint to use the public medium of the license plate to express their political views while denying others the opportunity to do the same.

One could analogize this to having a publicly-owned concert space and allowing some acts to perform while banning others (like Marilyn Manson or Lady Gaga)  because they are 'inappropriate.' Courts clearly do not allow governments to selectively approve use of a public space based on the views of the potential speakers.

When the government opens up space that it controls to citizen speech, wild things can happen-- fringe viewpoints can be expressed, and people can be deeply irritated or offended by the views of others. But this is what happens in a democratic and free society, and, as responsible and critical self-governing adults, we are expected to take the good with the bad-- in fact, determine for ourselves what is good and what is bad, without government interference. In creating a specialty license plate program, so that private groups could express their personal views on their license plates and raise money for private charities, North Carolina must allow everyone an equal opportunity to use the medium. If North Carolina does not want pro-choice specialty license plates, it should not have authorized pro-life license plates.

Now, the alternative framing of the issue is that the "Choose Life" license plate program is the government of the State of North Carolina speaking for itself. Governments are allowed to promote their own viewpoint as a reflection of the views of the (majority of the) population. So North Carolina, qua North Carolina, can divert money to pregnancy care centers, and abstinence-only sex education programs, and say loud and clear that the official state position is that life begins at conception and that abortion is morally wrong-- so long as it does not prevent women from exercising their 14th Amendment right to terminate a pregnancy.

North Carolina asserted that the license plate program is not a form of "private" speech but rather government speech in the guise of a license plate program. When the government speaks for itself, it is not required to give equal time to alternative viewpoints.

The court rejected this position because of the overall structure of the current license plate program. The program does not exist solely or primarily to promote the state's view of life issues. Instead, it is a program designed to allow for a range of views on many issues, political and non-political, on a special kind of public bulletin board-- the automobile license plate. It is, in other words, a forum for private speech, not a program that exists solely to promote the singular view of North Carolina. Therefore, while the North Carolina government has a clear viewpoint on abortion, it is using its power to selectively grant access to a public forum for citizen speech to promote its views-- and that is impermissible.

While the court decision may be an irritant to pro-life advocates, it does not mean that the government of North Carolina has to get out of the business of promoting pro-life views. It just has to structure its efforts differently.

Links:

United States District Court opinion (December 7, 2012): American Civil Liberties Union v. Conti, No. 5:11-CV-470-F (E.D.N.C. 2012)

Article in USA Today (December 10, 2012): U.S. judge bans N.C. 'Choose Life' license plate

Article in LifeSiteNews.com (December 10, 2012): Judge: NC Choose Life Plates Invalid Because No Pro-Abortion Version

Monday, December 10, 2012

Higher contraceptive use and abortions in Russia

I haven't had a chance to read and analyze this study, but I wanted to pass it on to you in the meantime. The study, which compares contraceptive use and abortion rates in Belarus, Russia, and Ukraine, is making pro-life activists happy.

From what I can gather on a quick reading, the authors compared declining abortion rates in Belarus, Russia, and Ukraine, and noted that Russia's abortion rate is not declining as quickly as it is in the other two countries and remains high. They also determined that Russian women are more likely to use "modern" methods of contraception than women in Belarus and Ukraine.

These observations, taken together, appear to validate the pro-life assertion that more contraceptive use = more sexual activity = more contraceptive failure and unintended pregnancies = more abortions. In other words, the promotion of contraceptives, rather than abstinence as a means of preventing pregnancy, leads to more abortions.

Note that, from what I read, the authors do not conclude this. Instead, they appear to call for more study  regarding the divergence in abortion trends among the three countries. Also note that the LifeSiteNews.com article discussing the study does not mention that Russian abortion rates are in fact declining, though not as fast as they are in Belarus and Ukraine. It focuses instead on the fact that Russia's abortion rate continues to be relatively high.

Please read the article yourself and let me know what you think!

Link:

Article published in PLOS One (November 30, 2012): Divergent Trends in Abortion and Birth Control Practices in Belarus, Russia and Ukraine

Article in LifeSiteNews.com (December 6, 2012): Study: Higher contraception rates associated with higher abortion rates in Russia

Here is the abstract to another study, published in Contraception, that pro-lifers like to cite regarding the contraception-abortion link (June 17, 2010): Trends in the use of contraceptive methods and voluntary interruption of pregnancy in the Spanish population during 1997-2007

Sunday, December 9, 2012

Oklahoma ultrasound and drug laws struck down

The Oklahoma Supreme Court has surprised me.

Like many conservative state governments, Oklahoma passed laws making it more difficult for women in the state to obtain abortions. While pro-life advocates and analysts, in public statements, push for additional abortion regulations as a way of gumming up the abortion process, state officials have to pitch the regulations in a different way.

The 1992 U.S. Supreme Court case Casey v. Planned Parenthood allows states to regulate abortions if the intent of the regulations are a) to express respect for potential life, and/or b) assist women in making an informed choice regarding whether to terminate or continue a pregnancy.

At the same time, abortion regulations are not allowed to create an "undue burden" on women attempting to obtain an abortion, meaning that any law that, by design or effect, creates substantial obstacles to obtaining an abortion is unconstitutional. In applying the Casey decision, the Supreme Court and other courts have looked to the state's motive in creating various challenged regulations: does the regulation exist to actually enhance a woman's informed decision making over abortion, or is the regulation an attempt to make the process burdensome enough that some women will be unable or unwilling to go through the process?

The debate over abortion regulations reminds me of debates over voter ID laws in the 2012 election cycle. Voter ID laws and regulations regarding abortion-- 24-hours waiting periods, mandatory ultrasounds, etc.-- work similarly in that the more procedural obstacles one places in a person's way, the less likely they are to act. Comparing the enactment of voter ID laws with historical attempts to regulate voting (for example, in the south before 1965), it was pretty clear that political elites, at least, were motivated primarily by a desire to suppress the votes of a certain section of the political spectrum.

But on the surface, voter ID laws and the like had a parallel and legitimate justification-- to fight voter fraud, for example. In order to prevent public backlash-- and also avoid having the laws struck down as unconstitutional-- legislators had to maintain the public fiction that the laws were high-minded attempts to improve the electoral process.

One sees a similar dynamic with anti-abortion regulations, and pro-life states have had a pretty good run in recent years regulating abortions. In particular, laws requiring women to undergo ultrasounds before abortion, and TRAP laws (targeted regulations of abortion providers)-- i.e., regulating the abortion providers out of business-- have been pretty popular.

Ultrasound laws are pitched as a means of helping women make a more informed choice about abortion: women should be able to see what it is that they are going to abort. The drug regulations in Oklahoma, like other TRAP laws, are framed as attempts to ensure the best possible medical care of women having abortions.

Many pro-lifers genuinely believe that anti-abortion laws are about helping women-- although that may be from the perspective that women are helped the most if they do not go through with abortions, which are seen as physically, mentally, and spiritually dangerous. Setting that aside, the primary motive of these kinds of laws is to make things a little tougher on women and abortion providers. One hallmark of a "substantial obstacle" type of law is that it regulates the abortion process in a way that is not required with similar medical procedures in similar settings.

I have always wondered why more anti-abortion regulations have not been struck down as obviously unconstitutional under Casey. Well, I guess the Oklahoma Supreme Court and I agree.

In two decisions issued on December 4, the Court struck down two Oklahoma laws:
Oklahoma laws requiring women seeking abortions to have an ultrasound image placed in front of them while they hear a description of the fetus and that ban off-label use of certain abortion-inducing drugs are unconstitutional, the state Supreme Court ruled Tuesday.
The state’s highest court determined that lower court judges were right to halt the laws. In separate decisions, the Oklahoma Supreme Court said the laws, which received wide bipartisan support in the Legislature, violated a 1992 U.S. Supreme Court case. (Source: Washington Post)
The vote counts were unanimous. In addition, each decision was issued per curium-- a short, unsigned opinion issued by the whole court (rather than authored by a single judge with other judges signing on) with little analysis. Sometimes courts will issue a per curiam opinion for strategic reasons, but the general purpose of a per curium opinion is to signal that the law and its application to the given facts are so clear that the court does not need to provide a detailed analysis.

The main statement of each decision was that a) Casey governs review of these kinds of laws, and b) the Supremacy Clause of the Constitution requires state courts to act consistent with federal constitutional doctrine.

I imagine that the decisions will be appealed to the United States Supreme Court. I also imagine that the trend of states enacting waves of anti-aboriton regulations will continue for now. Regardless, these decisions stand as a blunt rebuke of the practice from an unlikely source.

Links:

Article in The Washington Post (December 4, 2012): Oklahoma court rules anti-abortion laws pertaining to ultrasound, drugs are unconstitutional 

Article in LifeSiteNews.com (December 5, 2012): Oklahoma Supreme Court strikes down abortion restrictions as 'unconstitutional'

Oklahoma Supreme Court decision (December 4, 2012): Nova Health Systems v. Pruitt, 2012 OK 103, ___ P.3d ___

Oklahoma Supreme Court decision (December 4, 2012): Oklahoma Coalition for Reproductive Justice v. Cline, 2012 OK 102, ___ P.3d ___

Friday, December 7, 2012

Should teens be given emergency contraception in advance of sex?

In late November of this year, the American Academy of Pediatrics (AAP) published a policy statement on emergency contraception that is sure to be rejected outright by the pro-life community.

Emergency contraception (EC) is just that-- various pharmacologic methods of preventing pregnancy up to 120 hours after unprotected or under-protected sex. Plan B and ella are two well-known brands of emergency contraceptives; there are three major chemical methods for achieving the desired result.

As it is now, most states require that adolescents under the age of 17 get a doctor's prescription to obtain emergency contraception. Given that EC works best the earlier it is taken, the prescription requirement could delay its effective use, or prevent a teen from accessing it altogether.

As a result, the AAP published its policy statement as part of an attempt to continue to lower the teen birth rate in the United States. Their major recommendations are
  1. "encourage" doctors to engage in "routine counseling" of teenagers regarding emergency contraception, how it works, safety questions, etc.; and 
  2. prescribe emergency contraception to teenage patients in advance of sexual activity, so that they will already have the emergency contraception product and know how to use it, in the event that they have unprotected or under-protected sex.  
Four pieces of information jumped out at me as I read the policy statement:
  1. 80% of teen pregnancies are unwanted. This is extremely high; in contrast, among all American women aged 15-44, 49% of pregnancies are unwanted. Furthermore, 27% of teen pregnancies are ended through abortion. Access to EC, therefore, could reduce the number of abortions in the United States. Consider also how many teenagers are having unwanted children-- 27% of the 80% of unwanted pregnancies are aborted, so a significant number of young women and families every year are dealing with the short-term and long-term disruptions of a new baby.
  2. Teenagers are more likely to be sexually assaulted than adult women, so they are more likely as a cohort to need access to EC. Given the trauma of sexual assault, many women do not report being sexually assaulted right away, if at all. Having to obtain an EC prescription from a doctor within a day or two of being sexually assaulted may be traumatic for a young woman and prevent her from stopping a rape-caused pregnancy. 
  3. The three most common contraceptive methods of teenagers are condoms, withdrawl, and the pill, in that order. The first two methods are not the best in terms of preventing pregnancy, especially where subject to imperfect use. If teenagers under the age of 17 are having sex, my guess is that the failure rates of condoms and withdrawl are even higher than they are among the general population. 
  4. Adolescents are more likely to use EC if prescribed in advance.
Given these facts, the AAP recommends that teens under 17 are given EC in advance, along with information and advice.

So why are pro-lifers opposed to the AAP recommendation?

First, pro-life groups argue that, in rare cases, emergency contraceptives do not prevent fertilization but instead prevent the implantation of an already fertilized egg, making Plan B and other emergency contraceptives abortifacients.

Second, it is a common belief among pro-lifers that providing contraceptives to teens, and giving them information and advice on their use, essentially encourages them to have sex. The reasoning is of at least two types:
  1. If you give a teenager EC and show her how to use it, aren't you implicitly suggesting that you expect her to have sex, which she will take as a form of permission?
  2. If a teenager knows that she can access emergency contraception, then sex to her will be consequence-free. As a result, access to EC would increase the number of teens having sex.
The 'permission to have sex' line of argument has a common sense appeal but is empirically doubtful. A certain percentage of teens are having sex, regardless of what their parents, teachers, and doctors tell them. There appears to be little empirical evidence to show, for example, that sex education programs that discuss contraceptive use result in more teens having sex than abstinence-only sex education curricula.

If one accepts that a certain percentage of teens will have sex regardless of parental views, etc., then withholding access to EC and contraceptive information in sex education programs is an unnecessary and ineffective disincentive. Put another way, teenage pregnancy as a 'punishment' for having sex is ineffective, disproportionate, and harmful. In this light, the American Academy of Pediatrics recommendation makes a lot of sense. 

Links:

Policy statement by the American Academy of Pediatrics, published in Pediatrics (November 26, 2012): Policy Statement: Emergency Contraception 

Article at ABC News (November 26, 2012): Pediatrics Group Calls for Easier Access to Emergency Contraception 

Article at National Review Online (December 3, 2012): Care for a Plan B? 

Article by Bloomberg News, reprinted in the San Francisco Chronicle (November 26, 2012): Teens Need Contraception Prescriptions in Hand, U.S. Doctors Say

A different article by Bloomberg News, reprinted in The Seattle Times (November 27, 2012): Doctors: Teens should have access to emergency contraception 

Heritage Foundation editorial published at LifeSiteNews.com (December 3, 2012): Teens need parental involvement, not 'emergency contraception'

Thursday, December 6, 2012

Should Secretary Clinton talk about abortion in Ireland?

Irish expatriates living in the United States want Secretary of State Hillary Clinton to talk abut abortion when she meets with Irish government officials and gives a scheduled speech in Ireland today.

I'm not sure what they think is to be gained. Generally speaking, I think it is bad strategy for someone to attempt to get involved in producing an outcome-- here, first-step liberalization of abortion laws-- when that change is already in process, albeit in fits and starts. There is little potential upside and lots of potential downside.

Despite being very personally popular in Ireland, Secretary Clinton is an outsider. She is also, like a majority of Americans, much more liberal on abortion laws and rights than Irish lawmakers. If she attempts to use her public platform to push the Irish government forward, it could give ammunition to liberalization opponents, who could argue that any attempt to open up Irish abortion law is really setting the country on a slippery slope to an American style 'abortion on demand' system. It would also put hesitant pro-liberalization government officials in the position of looking like they are responding to Clinton, which may actually impel them to distance themselves from whatever comments she might make. In short, a public American push could actually stall the process or cause a backlash.

The only upside is if Irish public opinion is actually more open to wider liberalization than reported. Then Clinton, as someone working outside of the constraints of the Irish party system (and Catholic Church pressure), would be the rare elite figure who could speak truth to power on behalf of the population. But I'm not sure that's where Ireland is as a country-- yet.

As it is, the sad death of Dr. Savita Halappanavar seems to have been a sufficient catalyst for the Irish government to do what is long overdue. A group of medical and legal experts has already issued a draft report suggesting various ways to incorporate a life exception into Irish laws, including guidelines for medical practitioners (which I will analyze in a later post). Secretary Clinton should let the process play out.

UPDATE: It seems that Secretary Clinton talked about other things. The Irish Times reports that Clinton "said ensuring the human rights of women and girls were respected was the 'unfinished business of the 21st century.'" Pretty safe and appropriate.

Links:

Article in The Hill (December 6, 2012): Clinton faces pressure to address abortion law on Ireland trip

A copy of the open letter can be found at this web site (December 5, 2012)

Wednesday, December 5, 2012

Planned Parenthood as top campaigner

The Planned Parenthood Action Fund (PPAF) was more effective in spending its money and getting positive results than any other political action group in the 2012 election. "Over 98 percent of its spending was in races that ended in the desired result, according to an analysis by the Sunlight Foundation" (Washington Post).

One might conclude that they were effective because the election swung to the Democrats in many key races and that Planned Parenthood money was simply chasing winners. Sarah Kliff of The Washington Post, who analyzed how and why PPAF used its money and resources, instead concludes that Planned Parenthood actually moved the meter in races, one example being John Tester's unexpected reelection to the U.S. Senate from Montana.

If you accept Kliff's analysis, one of the reasons why there was such a tremendous gender gap this election cycle is that PPAF saw that reproductive politics issues were registering as important for women (particularly after repeated conservative gaffes). They then spent money to a) work up carefully framed talking points and b) amplify those messages through targeted advertising. All of the pundits who were amazed that so many speakers at the Democratic convention were talking about reproductive rights missed what Planned Parenthood saw and was doing.

The article and the Sunlight Foundation report is a fascinating look into how effectively money can be spent-- especially in contrast to the millions of dollars wasted by supposed gurus like Karl Rove, whose own political action group spent in the neighborhood of $100 million with almost nothing to show for it.

Links:

Article in The Washington Post (December 5, 2012): Inside Planned Parenthood's campaign strategy

Sunlight Foundation analysis (last accessed December 5, 2012): Planned Parenthood Votes

Tuesday, December 4, 2012

Abortion and the CRPD

Another example of how abortion affects every aspect of American politics:
A United Nations treaty to ban discrimination against people with disabilities [the Convention on the Rights of Persons with Disabilities, or CRPD] went down to defeat in the Senate on Tuesday in a 61-38 vote.  
The treaty backed by President Obama and former Senate Majority Leader Bob Dole (R-Kansas) fell 5 votes short of the two-thirds needed for confirmation as dozens of Senate Republicans objected that it would create new abortion rights and impede the ability of people to home-school disabled children. (Source: The Hill)
Note that 61-38 means 61 Senators voted for confirmation of the CRPD. (Treaties, by constitutional requirement, must be passed by a two-thirds vote in the Senate.) The treaty was signed by President George W. Bush, and President Barack Obama, and has been signed by more than 150 countries and ratified by more than 120. Seven Republican Senators, including John McCain, also voted for the treaty.

Yet... it was too controversial. The purpose of the CRPD is to "require the rest of the world to meet the standards that Americans already enjoy under the 1990 Americans with Disabilities Act" (The Hill).  The treaty created a United Nations committee that would make recommendation to member countries regarding the rights of the disabled. The committee's recommendations would be non-binding on signatory countries (unless, I assume, countries choose to bind themselves to its recommendations, something the United States would not have done). Signing the treaty, according to supporters, "would allow the United States to serve on the committee to advocate for the rights of U.S. veterans and citizens living or traveling abroad" (The Hill).

Sounds pretty good. Why was it rejected, then?

Opponents, despite the clear non-binding nature of the U.N. committee's recommendations, see the treaty as an infringement on American sovereignty. Pro-lifers (and religious conservatives) have a history of being suspicious of international institutions, so a treaty of this kind sets off alarm bells. They think, apparently, that the international committee's recommendations will be forced upon them legally.

This concern reminds me of objections to the advisory panels that are part of the Affordable Care Act (ACA). Somehow these advisory panels, charged with making recommendations about preventative care, enhancing efficiency, and controlling medical costs, were transformed into "death panels" with the power to deny specific individuals medical care.

Regarding the CRPD, the treaty is seen as infringing on the prerogatives of American parents to raise their children, particularly disabled children, as they see fit, including using home schooling. Former presidential candidate and U.S. Senator Rick Santorum's statement is illustrative:
“Now, that CRPD is defeated, we know that United Nations won’t have oversight of how we care for our special needs kids. This treaty would have given the U.N. oversight of the healthcare and education choices parents with special needs kids make. Had it passed, CRPD would have become the law of the land under the U.S. Constitution’s Supremacy Clause, and would have trumped state laws, and could have been used as precedent by state and federal judges,” he said. (Source: LifeNews.com)
In addition to concerns over parenting rights, some pro-life advocates read the language of the CRPD, especially the use of the term "reproductive health," as "open[ing] the door to promoting abortion on an international scale" (LifeNews.com):
The International Right to Life Federation says pro-life groups oppose this legislation because it leaves open the potential for the international community to permit sterilization or abortion for the disabled. The  terminology, found in Article 25, requires, “free or affordable health care including the area of sexual and reproductive health and population-based health programs." . . . Tony Perkins, the head of the Family Research Council, has previously noted the pro-life concerns. . . “Translation: the global community could force America to sanction sterilization or abortion for the disabled–at taxpayer expense” he said. (Source: LifeNews.com)
From an earlier article in LifeNews.com:
The inclusion of the phrase “reproductive health” affords an opportunity for abortion advocates to interpret the terms as a euphemism for “abortion rights” and push for nations to legalize abortion based on the treaty. Indeed, this interpretation of “reproductive health” is the position of the Obama Administration. Secretary of State Hilary Clinton has testified before the House Foreign Affairs Committee to this effect, stating “We happen to think that family planning is an important part of women’s health, and reproductive health includes access to abortion.”
Unwilling to be explicit and clear about its objectives, the pro-abortion faction within the UN has used the realm of disability rights to provide cover for an attempt to interject the right to abortion into an international treaty. If the US ratifies it, the treaty becomes the law of the land, providing a potential abortion back-up for the day the Supreme Court finally overturns Roe v. Wade.
Again, there are echoes of the debate over the ACA and the contraceptive mandate, where any remote connection between taxpayer dollars and abortion was policed strictly and opposed strongly.

Beyond stated concerns about funding for abortion and threats to home schooling and American sovereignty, opponents to the treaty may be worried about the soft power of the treaty. The battle over abortion is as much a battle over public opinion as it is over legal requirements. It could be that pro-life activists are worried that a United Nations committee (with an American representative) with the power to engage in empirical research and issue science-based recommendations would a) shift public opinion away from the pro-life beliefs of the treaty opponents, and b) affect policy in ways pro-life activists oppose in other countries besides the United States.

As Michelle Goldberg recounts in her book The Means of Reproduction, pro-life organizations and politicians made strong efforts to oppose and alter the conclusions and recommendations of the United Nations at its 1994 International Conference on Population and Development in Cairo, and its 1995 Beijing Women's Summit. The recommendations and resolutions of the Cairo and Beijing summits are similarly non-binding on member countries, but have had a strong effect on public and expert opinion and therefore on public policy around the world.

The CRPD, then, for all of its good intentions, is collateral damage in the global culture war over family planning.

Links:

Article in The Hill (December 4, 2012): Senate rejects UN treaty for disabled rights in 61-38 vote

Article in LifeNews.com (December 4, 2012): Senate Defeats CRPD Treaty That Would Promote Abortion 

Earlier article in LifeNews.com that raised concerns about the treaty (July 20, 2012): Hidden Abortion Agenda in UN Convention on Disability Rights

Article in The Washington Post (December 4, 2012): Senate rejects treaty to protect disabled around the world

Monday, December 3, 2012

Update on family planning in the Philippines

The debate in the Philippines continues over a proposal for government-subsidized contraception and sex education. The Catholic Church is going all out to prevent the government from approving the program. Kathy Zeh, writing in The Huffington Post, discusses and refutes the argument of a Catholic archbishop that the legislation would spell doom and gloom for the country.

In an earlier post, I noted that Church representatives in the Philippines argued that increasing the population is the key to reducing poverty, a rather counterintuitive argument. In the most recent speech discussed by Ms. Zeh, the Catholic representative argues that government corruption, not lack of access to family planning, exacerbates poverty. This theme-- that there is nothing wrong with a large family, per se, only in the context of poverty that is caused by something else, namely, bad politics-- is one promoted by population control skeptics, like the Population Research Council. For a review of their arguments, see this post.

Government corruption and politics does exacerbate poverty. It is also true that large families that are wealthy are happy and not a problem for a country. Still, these observations largely miss the point. People in countries like the Philippines-- and in many parts of the United States-- are suffering under poverty. Many studies show that when women and couples have access to family planning information and resources, good things happen economically and developmentally. Addressing government corruption and the unjust distribution of resources in the world is one piece of the poverty puzzle, but family planning is equally important.

Also, the contemporary family planning movement is based on women's rights-- that it is not just pragmatic but right that women should have control over their fertility, the size of their families, and the spacing of their children. Advocates for orthodox Church teaching and advocates for family planning are going to talk past each other on this point, as the position of the Church is that a woman's fertility is not ultimately in her control but in the hands of God, so the basic premise that Catholic women can or should engage in family planning cannot be accepted.

Links:

Sunday, December 2, 2012

Concern that 'abortion may widen in Ireland'

I saw this headline as I was reading the news about reproductive politics: "Bishop, pro-lifers concerned that abortion may widen in Ireland."

The headline is from an article in the Catholic News Service. The pro-life activists and Catholic religious leaders quoted in the article say all of the things one would expect. In particular, they take the position that the recent controversy over Ireland's abortion law and concomitant guidelines for physicians are clear enough as is and therefore do not need to be revised-- and were not the cause of Dr. Savita Halappanavar's death from a miscarriage.

Like many people, I've been watching and analyzing events in Ireland with close interest, and perhaps we are getting to diminishing returns in discussing it. Still, it seems to continue to yield insights about reproductive politics generally.

For example, the situation in Ireland shows how the terms of the debate over reproductive politics can differ so widely from country to country, even countries that have surface similarities. The center point of the discussion in Ireland is over how to limit abortions to a life-saving procedure for pregnant women. How incredibly different this is from the United States, for example. It is also remarkably different from many European Catholic countries-- France, for one, and Luxembourg, for another, which just recently liberalized its abortion laws.

While these countries appear so different legally, politically, and culturally, however, it is less clear that these differences result in as stark a divergence in the actual occurrence of abortion as we might presume. The pro-life activists quoted in the article a) act like no Irish women are getting abortions now, and b) no Irish women are getting abortions in Ireland now.

It is very clear that many Irish women travel to the UK every year for abortions. So the question in Ireland is not so much whether Irish women will be able to obtain an abortion. Instead, the question is where the abortion will occur and how much more difficult and expensive it will be. The phenomenon of women traveling to obtain an abortion is not at all unusual-- in fact, it happens in the United States, where the problem isn't legality-- the problem is access to a clinic near where one lives.

Now, among Irish women who don't have the money, time, and support to travel to the UK on short notice, there may be a higher ratio of births-to-terminations. Put another way, for many women, the hassle of getting an abortion in a safe facility in the UK may be enough to cause them to carry their pregnancies to term. Still, a well-known fact about abortion in human history is that many, many women will have abortions-- or die trying-- regardless of what the legal regime prohibits. I doubt Ireland is much different in that regard. For poor women, especially, abortion being illegal does not mean it doesn't occur. It just may occur surreptitiously under awful conditions (the proverbial 'back alley abortion'). The history of abortion in the United States before Roe is instructive.

In short, Ireland is held up as this model pro-life country, in part because of its laws, but Ireland and its people are not abortion free. No society is. Therefore, the danger that pro-life activists are worried about is not that "abortion may widen in Ireland." Instead, the danger is that the abortions that Irish women already have will happen openly, in safe facilities, in Ireland.

Links:

Article in the Catholic News Service (November 29, 2012): Bishop, pro-lifers concerned that abortion may widen in Ireland

Article in LifeSiteNews.com (November 23, 2012): Luxembourg legalises abortion on demand

Saturday, December 1, 2012

Does America need more babies?

Ross Douthat, in his latest The New York Times column, offers a fairly balanced view of why birth rates might be declining in the United States (outside of the immigrant population) and what can be done about it.

He raises the familiar alarm about the dangers of declining populations, and worries that the United States, normally reliable for having a birth rate at or above replacement level, might start to go the way of countries such as Germany and Japan. We have been buoyed in recent years by the higher birthrates of immigrants, but falling rates in Latin America might spell trouble for us as well.

There are problems when a population shrinks, particularly when older people live longer and a society provides expensive healthcare and some kind of taxpayer-funded retirement income to its aging population.

That being said, in the United States, the developing problems of Social Security and Medicare are not primarily due to the increasing size of the retirement population relative to younger working Americans. Instead, the problem is primarily political in nature-- an unwillingness to adopt the three or four tweaks to Social Security and Medicare that would extend the life of these programs and enhance their affordability, even if the population of younger Americans remained the same or even shrunk a bit.

As for the birthrate itself, another primary problem is a continuing lack of gender equality matched with a lack of true societal support for working mothers-- in other words, the promise and encouragement of careers outside the home without the support necessary to prevent the combination of mothering and career from being a dilemma. Ironically, in many countries, Italy for example, there is just enough feminism to cause birthrates to decline.

Credit Douthat for recognizing this problem in the United States:
Government’s power over fertility rates is limited, but not nonexistent. America has no real family policy to speak of at the moment, and the evidence from countries like Sweden and France suggests that reducing the ever-rising cost of having kids can help fertility rates rebound. Whether this means a more family-friendly tax code, a push for more flexible work hours, or an effort to reduce the cost of college, there’s clearly room for creative policy to make some difference.
He also asserts economic and cultural explanations that are rather less plausible: a current lack of "a more secure economic foundation" and "late-modern [cultural] exhaustion." If these were important variables, then we would expect to find uniformly lower rates in peer countries that have, or have had, similar economic and cultural conditions. I'm not sure the evidence is there.

At any rate, it is a thought provoking read and I recommend it.

Links:

Ross Douthat column in The New York Times (December 1, 2012): More Babies, Please

Pew Research Center report (November 29, 2012): U.S. Birth Rate Falls to a Record Low; Decline is Greatest Among Immigrants

For a previous Pew Research Center report that concludes that economic downturns affect birth rates, see the following report (October 12, 2011): In a Down Economy, Fewer Births