Required ViewingOklahoma's gallingly paternalistic ultrasound law.
Posted Wednesday, Oct. 22, 2008, at 6:30 AM ET
For many pregnant women, ultrasounds are like candy—there can't be too many of those grainy black-and-white images of the fetus napping or kicking in the womb. But if you're pregnant and don't want to be and are considering an abortion, an ultrasound image could be an object of dread. It might force you to think about the fetus as having a separate identity or as the baby it could become.
PRINT
DISCUSS
E-MAIL
RSS
RECOMMEND...
Facebook
MySpace
Mixx
Digg
Reddit
del.icio.us
Furl
Ma.gnolia
Sphere
StumbleUponDread is the emotion pro-life groups look to instill when they push states to pass laws that make an ultrasound part of the abortion procedure. It should also be said that women may, in fact, react otherwise: They could shrug off the ultrasound as a matter of indifference or even greet it with relief, because an image taken during the first trimester may look much more like a blinking light, or a newt, than a baby. I've never seen a study measuring how many women feel what, but abortion opponents believe that if women see the physical evidence of their pregnancy on the screen, at least some of them will decide not to end it.
Accordingly, 14 states have passed abortion-related ultrasound laws. Some of these statutes merely instruct clinics to offer an ultrasound to each abortion patient. Since many clinics do this anyway to help determine the week of the pregnancy, these laws don't intrude all that much on the doctor-patient relationship. And as William Saletan has pointed out in Slate, it's hard to argue that women deciding whether to have an abortion should be shielded from accurate scientific information, which is what ultrasounds are, after all.
But what if a woman doesn't want an ultrasound, and there's no pressing clinical reason for her to have it? Four states—Alabama, Louisiana, Mississippi, and Oklahoma—have taken the galling step of requiring her to have one regardless of need. They recently passed laws that go beyond offering ultrasounds to mandating them. Oklahoma's new statute dictates that either the doctor performing the abortion or a "certified technician working in conjunction" with that doctor do the ultrasound, "provide a simultaneous explanation of what the ultrasound is depicting," and also "display the ultrasound images so that the pregnant woman may view them." The law goes so far as to specify the doctor's script: The physician must describe the heartbeat and the presence of internal organs, fingers, and toes. The patient then has to certify in writing that the doctor or technician duly did all of this before the abortion. She can avert her eyes from the screen, the statute allows. Maybe the legislators should have also thought to mention putting her hands over her ears.
The Oklahoma law, scheduled to go into effect on Nov. 1, has other objectionable provisions. Its confusing rules about medical abortions (drugs) would force the clinic bringing suit to stop offering that procedure entirely, says Stephanie Toti, a lawyer for the Center for Reproductive Rights, a public-interest law group that challenged the statute in court earlier this month on behalf of one of the state's abortion providers. Forty percent of the women who come to the clinic choose medical abortions, but the law talks about administering the drugs and follow-up care in a way that doesn't jibe with standard practice, so doctors would be stuck practicing medicine in a way that doesn't make sense to them. The law would also prevent women from recovering damages from any obstetrician-gynecologist whose "act or omission contributed to the mother's not having obtained an abortion"—in other words, women cannot bring suit against a doctor who failed to tell her about a detected birth defect.
This means the law is forcing one kind of information upon women, via ultrasound, while preventing them from successfully suing a doctor who withholds other, possibly more salient information from them, as CRR points out. And this, finally, is what makes Oklahoma's law stand at the top of the heap of paternalism that Justice Anthony Kennedy started climbing two years ago, in his opinion in Gonzales v. Carhart, the decision that banned one method of late-term abortion.
How Did Blocking Traffic Become Argentina's Favorite Way To Protest?
The Ridiculous Arguments Against Trying Khalid Sheikh Mohammed in Open Court
How Did They Calculate That Tiger Did $200 Damage to That Tree?
My Ill-Fated Winter Fling With Alicia Keys
Can All of Architecture Be Reduced to 253 Patterns?
The Latest Updates From Barack Obama's Facebook Newsfeed
On so-called partial birth abortion, I think Bazelon makes a mistake in saying the court is substituting its judgment for the woman and her doctor. They did not write any law on the matter, but Congress did. I don't think this is an entirely innocent mistake either, as I feel pretty certain that she prefers to think that if such "mistaken" policies exist then it becomes the responsibility of judges to overturn them. If she doesn't think the law is any good, then elect different legislators to repeal or modify it. Likewise she complains about the paternalism of the Oklahoma law. Evidently, that's the way that Oklahoma voters have liked it. Move to Oklahoma and get politically active if you think this is such a bad thing.
--Ed_of_La_Mancha
(To reply, click here.)
I grew up in Oklahoma, and while a student at OU, had an abortion at one of those 3 clinics in the state, with hastily borrowed money. While it was definitely a difficult decision, it allowed me to complete my education in a timely manner and go on to a successful career and happy marriage (in another state). If this law had been in effect when I needed the procedure, I don't know if I could have scraped together the cash to pay the additional cost. Who knows where I might have ended up. Perhaps it's not a case of the smart people leaving, but those who stay being subjected to the backward intentions of a powerful and dominant right wing. No wonder their overall statistics on health, education, and poverty are so dismal. Despite the low cost of living, you couldn't pay me to move back.
--denverdani
(To reply, click here.)
This is not paternalism. It's just bullying from those with one political view over those with another. The legislators are anti-abortion, and have just found a way to impose their view without actually "preventing" abortions. It's inaccurate to call it paternalism--although I'll agree that the Kennedy decision mentioned has paternalistic connotations.
I just don't think there's anything to be gained by misusing the term "paternalism," which is loaded with quite specific political and social meaning. This is not a result of legislatures suggesting they "know what's best" for people. It's simply state legislatures trying to evade supreme court decisions.
--StevieN
(To reply, click here.)
I find it exceedingly hard to believe that any woman who has scheduled an abortion would not understand the fact that what she is aborting is in fact a fetus. If this tactic proves unsuccessful, perhaps the next step for the anti-choice fanatics would be to let her know the procedure will be performed without anesthesia and that after the procedure is done, she'll be forced to name and bury the aborted fetus, and the newspaper will be notified so an obit can be published. At some point I am hopeful that even if a minority in the state agree that abortion is a medical procedure, they will not be forced by the majority into having the government intrude so profoundly into a personal decision. I have the utmost respect for any physicians who are able to stand up to the mobs and continue to practice in such a hostile environment.
--marecee
(To reply, click here.)
What the author views as "paternalistic" restrictions can also be viewed as giving women a fuller and more accurate view of their situation. It is telling that she states the restrictions "might force you to think about the fetus as having a separate identity or as the baby it could become." Why is this a bad thing? Does she want the doctor to deliver only the information that conforms to her views on the matter? She also says overturning the law would be "sparing them from a procedure that women would reject as too gruesome if they only knew the details". We wouldn't withhold details for other medical procedures, so why for abortion procedures? My conclusion: because it supports the aims of those who promote abortion, not what is in the best interests of the mother.
--shells
(To reply, click here.)
A paternalistic law would be one that shielded women from accurate information about what it was they were about to do. If women are capable of making decision to terminate the life of their child, they should be capable of receiving information. And the doctor doesn't have any "free speech" rights. They are a professional performing a service in which they are obliged to provide complete information to their patients. If we saw more pictures of war, we would be pacifists. If we saw more pictures of slaughterhouses we would be vegetarians. If we saw more pictures of poverty we would be more generous. If we saw more pictures of the unborn (not even abortions) we would be pro-life. It's long past due that those of us committed to social justice become completely committed to a just society in which all of its members are protected.
--Anduril23
(To reply, click here.)
When I worked in a Louisiana abortion clinic ten or so years ago […] we had the even more paternalistic 24-hour waiting period between the initial assessment and the termination procedure, and we very rarely had anyone change their minds in between. So knock yourselves out, waste time and paperwork if you must, but the net result will probably just be that abortions will become more expensive, so a woman who doesn't have $400 for an abortion will now have a much more expensive pregnancy and an exponentially more expensive child.
This has never been about actual children. If it were, these same people who are so desperate to save the fetuses wouldn't immediately cry "socialism" when any attempt is made to provide welfare assistance for the resulting infant.
Anybody who genuinely wants to save innocent babies should leave these women alone and adopt a couple of minority foster kids.
--loula
(To reply, click here.)
Planned Parenthood League of Massachusetts, where I proudly worked for many years, required, as part of its policies and protocols, that all women choosing an abortion have an ultrasound. There are sound medical and liability reasons for doing so.
However, that's very different from forcing women to look at the ultrasound image, or forcing her to listen to a script prescribed by law from provider to patient. At the clinic where I worked, women could certainly look at the image if they wanted to. Not many women particularly wanted to look at the ultrasound, but those that did want to, certainly could.
Never once in my years of experience did a woman change her mind after looking at an ultrasound. To suggest that she would is an insult to all women's intelligence and our ability to make our own decisions. By the time a woman gets to a clinic, she's already gone through her decision-making process, sometimes a painful one. She's considered all the options, talked to her family and friends and doctor, and made the phone call to make the appointment. Apparently the right wingers/pro-lifers have the misguided and insulting idea that women have abortions on a whim, or without thinking it through, and that simply flashing an ultrasound picture in front of them will help clarify their thinking. Talk about condescending!
--ellewilson
(To reply, click here.)
(10/28)