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):
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
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
Comments
From a Catholic perspective, I would think that even if abortion were ever to be shown to be medically necessary, it would still be morally illicit to procure one by means of an intended direct effect of a medical treatment.
We live in a soft world. No matter how good maternal care gets, some people will not want to do anything to make a pregnant woman's life more difficult if she doesn't also agree to the difficulty, even when the cost of her avoiding the difficulty is the life of the child of her womb, and the difficulty for the mother in comparison is negligible, neither life nor health threatening. When the difficulty rises to the level of threatening the life or health of the mother, how much less are we able to make the case that the woman should be required by law to act with heroic self-sacrifice.
But for the Catholic, if the moral law requires such self-sacrifice, then it seems to me that the positive law should also require it, for the sake of the justice due to the child. What do you think?
regards
yan
yan
I think you are right about Catholic doctrine re: medical necessity. A medical treatment is okay if it attempts to resolve the medical issue but has an incidental and unintended effect of ending the pregnancy. But abortion itself as the means by which to address the medical problem would be immoral.
Regarding positive law, I'm less certain. It seems like Catholic doctrine would require the unborn to be given the same consideration as the born in the positive law. I've read elsewhere, however, that one can vote for a candidate who supports abortion so long as one is not voting for the candidate for that reason AND the candidate is advocating other policies that might reduce the incidence of abortion.
All that being said, a lot of American Catholics do not hold beliefs or act consistent with official Catholic doctrine.