The problems exposed in Florida's fight over abortion clinics — state neglect, pro-choice denial, and the relegation of abortion to the shadows of medicine —didn't end there. They have surfaced in other states, too.
On Sept. 2, 1989, two weeks before the Miami Herald exposé in Florida, the Boston Globe disclosed that Dr. Howard Silverman, the owner of Massachusetts' biggest chain of abortion clinics, had admitted to sexual misconduct with a female patient. Based on the patient's complaint, Silverman had lost his authority to admit patients to nearby hospitals in the event of complications. Despite this, he continued to perform abortions. Unlike other providers in the area, Silverman used dubious advertising tactics, refused Medicaid patients, and apparently reaped huge profits. Although his three clinics handled more than 10,000 abortions per year, he disguised them as doctors' offices, thereby evading the state's abortion clinic regulations.
Like the exposed clinic operators in Florida, Silverman portrayed his unmasking as an attack on abortion rights. And, as in Florida, the Globe found that colleagues had known of his misconduct, as well as his generally bad reputation, but had kept it secret. "The question was: Who was going to tell?" an anonymous source in the pro-choice community told the Globe. "Do we go public with it and hurt the whole movement or do we keep quiet and deny women the chance to make an informed choice about who does their abortion?" A spokeswoman for Mass Choice, the state affiliate of the National Abortion Rights Action League, was outraged at the secrecy:
"The fact that he is still practicing after he's admitted assaulting a woman is frightening. And I certainly want to know more about who knew and why they didn't say anything. If they think they were protecting the abortion rights movement, they could not have been more wrong. They certainly were not protecting the women of this state."
A few days later, Chicago abortionist Arnold Bickham was arrested for practicing medicine less than a year after losing his license for gross malpractice. In the malpractice case, a woman had hemorrhaged and gone into shock after an abortion at Bickham's clinic. According to testimony at his license revocation hearing, Bickham, calling the woman "lazy," had shoved her out the door in a wheelchair. Before that, the state had suspended Bickham's license for performing abortions on women who weren't pregnant, and sometimes without proper anesthesia. No one could be sure how rare these offenses were, since abortion clinics in Illinois hadn't been regulated or inspected for four years, thanks to a court injunction like the one in Florida.
Another horror story surfaced in Maryland a week after the fight in Florida began. A woman lapsed into respiratory trouble while under anesthesia for an abortion at the Hillview Women's Medical Surgical Center. Despite having no anesthesiologist on hand, the clinic's medical director continued the operation. The patient went into cardiac arrest and died. A year later, a similar crisis developed. Again, there was no anesthesiologist. This time, clinic workers tried to revive the woman with the wrong drug and couldn't get the clinic's emergency oxygen equipment to work. The woman was left paralyzed, unable to walk or talk. Three years later, she died.
The clinic's owner, Barbara Lofton, blamed reports of her recklessness on the pro-life views of the local paramedic chief. He denied that he held such views. Months later, on 60 Minutes, Lofton's former employees and patients alleged that she had practiced medicine without a license and had nearly killed a patient by botching her abortion. CBS correspondent Meredith Vieira reported that "many pro-choice leaders knew about problems at Hillview but didn't want them publicized. National Abortion Federation head Barbara Radford admitted she was just hoping we would go away."
Nor were these leaders eager to address the underlying problem: Maryland had no laws for abortion clinics or outpatient surgery centers. Anesthesia and emergency medicine in these facilities were unregulated. That was why Lofton had moved her clinic to Maryland when the District of Columbia ordered her to stop performing abortions without a clinic license. A pro-choice legislator in Maryland had sought to regulate clinics but had met resistance from her colleagues. "There's only so much of a willingness to try to push ... the pro-choice movement to do what I think is the responsible thing to do," the lawmaker lamented, "because they then treat you as if you're the enemy."
Over the years, similar cases have turned up in other states. Pennsylvania's Kermit Gosnell scandal may be the latest and biggest of these regulatory failures, but it isn't the only one. On Wednesday, the attorney general of Delaware, Beau Biden, filed five complaints against two Delaware doctors and a clinic owner for impersonating a physician, prescribing controlled substances without a license, and failing to report what they knew about Gosnell. And three weeks ago, the Philadelphia Inquirer reported:
"Pennsylvania's system of oversight—or lack of it, in the grand jury's view—may not be unusual. For five months last year, New Jersey regulators received complaints that abortion doctor Steven Brigham, 54, was running a secret, cash-only, late-term abortion business using a risky interstate scheme—one for which he was disciplined in the 1990s. Just as in the Gosnell case, regulators took no public action against Brigham—until a police raid forced them to."
The Gosnell and Brigham cases, according to the Inquirer, "illustrate a host of problems, including a feeble complaint system, spotty clinic inspections, poor communication among oversight agencies—and the reluctance of doctors to punish their own."