Ectopic Pregnancy Surgery / Abortion

[Wanna_B_Scutty]

This is usually in sync with what is taught in medical schools to medical students who are future physicians who each have their own personal systems of morals and values but are asked to learn the code of conduct of their new proffession and expected to behave within it when acting in a proffessional role.

We're just spinning in circles here, so this is going to be my last "code of conduct" post. No more!!!

But, as I've said multiple times, there does not exist a universal "code of conduct for my new profession" on a macro level. The AMA guidelines are set up as such, they will be taught to me as such, and I will test on them as such. However, it is not true that they really are what they claim to be-- particularly with regard to such complicated subjects as abortion.

So, yes, I will be taught a code of conduct that will mostly synch up to my medical licensing board most of the time. But I will not be taught a true "professional code of conduct."

---

Members don't see this ad.

 

[evade]

I'm going to assume that you do not think it is ok to terminate a (healthy) infant's life. How about an unborn child's life? If the mother had been pregnant very close to the end of the third trimester and now decided to have an abortion (let's say at 38 weeks). For the point of this question, let's assume that the baby could survive outside the womb if removed by C-section or induced vaginal birth. Would you think that such an abortion was ethical simply on the basis of the mother's decision? Would the mother's morals govern in this situation?

Of course they wouldn't. The law governs in that situation, and elective third-trimester abortions are not legal.

This hypothetical always seems to come up, so I'll run a little further with this. Even if they were legal, I doubt you'd ever find a doctor who'd do one. I've known a lot of abortion providers, and I promise you, they're not the heartless hacks you probably think they are. Not a single one would even consider taking on a case like this. I further doubt that any woman would just up and decide at 38 weeks to terminate her pregnancy, unless she's got some serious mental health troubles (which of course, would require treatment in their own right.

 

[Wanna_B_Scutty]

Here is an interesting article about ethics in the medical profession:

....

"Recent findings show that many medical students perceive that the current medical environment is abusive toward their personal, moral and spiritual growth.27 Many health professionals feel a threat to their "freedom of conscience" (a basic human right according to the UN Universal Declaration of Human Rights28) and report a type of moral or ethical distress29 when placed in a position of subordination to authorities who exert power to elicit choices that contravene personal values. Most health providers wish to maintain ethical standards, but it is unrealistic to expect that all individuals will act according to their principles if the cost or consequences are considered too high.30 Many practitioners are afraid to challenge authority or to seem defiant and out of step with prevailing professional wisdom. The risk of serious disciplinary action, including the inability to graduate from medical school or the loss of licence to practise medicine, has pushed health providers into reluctantly acquiescing. The prospect of facing such difficulty has also prompted many trainees to shun areas of medicine that may infringe on their ethics because they prefer to avoid the aggravation and possible consequences of dealing with issues likely to engender moral turmoil and ethical distress.

...

Great post, Onc!

 

[Gut Shot]

I thought this was an interesting read:

The Incidence of Abortion Worldwide
Stanley K. Henshaw, Susheela Singh and Taylor Haas
International Family Planning Perspectives, 1999, 25(Supplement):S30–S38

Context: Accurate measurement of induced abortion levels has proven difficult in many parts of the world. Health care workers and policymakers need information on the incidence of both legal and illegal induced abortion to provide the needed services and to reduce the negative impact of unsafe abortion on women's health.

Methods: Numbers and rates of induced abortions were estimated from four sources: official statistics or other national data on legal abortions in 57 countries; estimates based on population surveys for two countries without official statistics; special studies for 10 countries where abortion is highly restricted; and worldwide and regional estimates of unsafe abortion from the World Health Organization.

Results Approximately 26 million legal and 20 million illegal abortions were performed worldwide in 1995, resulting in a worldwide abortion rate of 35 per 1,000 women aged 15–44. Among the subregions of the world, Eastern Europe had the highest abortion rate (90 per 1,000) and Western Europe the lowest rate (11 per 1,000). Among countries where abortion is legal without restriction as to reason, the highest abortion rate, 83 per 1,000, was reported for Vietnam and the lowest, seven per 1,000, for Belgium and the Netherlands. Abortion rates are no lower overall in areas where abortion is generally restricted by law (and where many abortions are performed under unsafe conditions) than in areas where abortion is legally permitted.

Conclusions: Both developed and developing countries can have low abortion rates. Most countries, however, have moderate to high abortion rates, reflecting lower prevalence and effectiveness of contraceptive use. Stringent legal restrictions do not guarantee a low abortion rate.

 

[evade]

However, I profoundly disagree with you that the moral worth of a fetus is contingent only upon the value that a woman gives it. Why should this be so?

Because it is in her body. Because the very existence of that being is intimately and totally tied into the existence of the woman. Because she alone must face the risks in carrying it (which as we both know can range from minor to devastating). This is not discrimination, this is biology. No person can be forced to be life support for another.

Also, it's because no one else has the power or the right to determine the moral worth of a fetus. Not you, not me, not the President. No one can agree on its value, and no one can determine it. But sometimes, these calls must be made. Who better than the woman?

 

[snoozer]

Great post, Onc!

How easy for you and OncoCap to assume that it is the environment of medical school that brainwashes or threaten students into a new way of thinking when you have SO MUCH experience in these classes yourselves.

If the study is indeed true, which it may well be, I'm not suprised since such a large number of people didn't know what they were getting into. A lot of folks who go into medicine see only that wonderful moment that they help a patient and the patient says thank you. They don't realize that to get to that one patient, there are days they will have to see 26 others first who are disgruntled, angry to be kept waiting, looking/hunting for any flaw so they can sue you, or patients who just lie to their doctors' faces. And I think it does require some if not a large amount of restraint and beating about the head that you CANNOT react poorly to these patients even if you think their lifestyle or demeanor about their health is utterly appalling. (And turning them away is sort of abandonment, not to mention if you really did this w/ all those patients that fall into these categories, you might not generate enough income to support yourself)

And a lot of my classmates definitely felt angered that they would not be allowed to practice the way they thought, and felt they were being brainwashed when they were told simple things like "you cannot tell a patient it is their fault they are overweight". Because they didn't realize that there are guidelines and medicine is not exactly about expressing yourself. Politics sure is, but medicine needs this kind of standardization to protect patients and doctors and to keep our profession respectable. Politicians get to say whatever they want, and you know how much we all love them.

 

[psipsina]

We're just spinning in circles here, so this is going to be my last "code of conduct" post. No more!!!

But, as I've said multiple times, there does not exist a "code of conduct for my new profession" on a macro level. The AMA guidelines are set up as such, they will be taught to me as such, and I will test on them as such. However, it is not true that they really are what they claim to be-- particularly with regard to such complicated subjects as abortion.

So, yes, I will be taught a code of conduct that will mostly synch up to my medical licensing board most of the time. But I will not be taught a true "professional code of conduct."

We aren't going in circles. You are refusing to accept the reality of the situation. By the time you are on your own practicing you will have a clear understanding of what is expected of you, this is the code of conduct. They will start teaching it in ethics courses, then it will be taught to you on the floor, then it will be taught to you by residents. Because states license doctors, there is no national code that you can slip in your whitecoat pocket and always rely on. But within each state and each healthcare facility there is in fact a code of conduct that you need to follow if you want to remain a practicing physician. The end. It doesn't matter how this makes you feel. It doesn't matter if you wish it was another way. It doesn't matter if you don't think its a true code of conduct or not. They will still take your license away if you don't follow it. This is how it is. If you join the proffession you will be able to influence this code of conduct by joining ethics committees etc. Until then you are at its mercy.

I would pay to be a fly on the wall during your first ethics course by the way.

 

[psipsina]

How easy for you and OncoCap to assume that it is the environment of medical school that brainwashes or threaten students into a new way of thinking when you have SO MUCH experience in these classes yourselves.

I A lot of folks who go into medicine see only that wonderful moment that they help a patient and the patient says thank you. They don't realize that to get to that one patient, there are days they will have to see 26 others first who are disgruntled, angry to be kept waiting, looking/hunting for any flaw so they can sue you, or patients who just lie to their doctors' faces. And I think it does require some if not a large amount of restraint and beating about the head that you CANNOT react poorly to these patients even if you think their lifestyle or demeanor about their health is utterly appalling. (And turning them away is sort of abandonment, not to mention if you really did this w/ all those patients that fall into these categories, you might not generate enough income to support yourself)

And a lot of my classmates definitely felt angered that they would not be allowed to practice the way they thought, and felt they were being brainwashed when they were told simple things like "you cannot tell a patient it is their fault they are overweight". Because they didn't realize that there are guidelines and medicine is not exactly about expressing yourself. Politics sure is, but medicine needs this kind of standardization to protect patients and doctors and to keep our profession respectable. Politicians get to say whatever they want, and you know how much we all love them.

Maybe there should be an informed consent for entrance for medical school. We all sit down and first we determine that everyone currently has decision making capacity. Then we thouroughly explain the way its going to be, everything from the fact that you may only make 100k/year to the fact that your license will be taken away if you follow your own personal values instead of the code of conduct of wherevery you are practicing. Then every medical student signs on the dotted line. This all goes down before you take out your loan or move to the new city or quit your job. That way no one can get disgruntled when they are finally forced to face the reality of all the glory that being a physician can be.

 

[snoozer]

Great post, Onc!

We aren't going in circles. You are refusing to accept the reality of the situation. By the time you are on your own practicing you will have a clear understanding of what is expected of you, this is the code of conduct. They will start teaching it in ethics courses, then it will be taught to you on the floor, then it will be taught to you by residents. Because states license doctors, there is no national code that you can slip in your whitecoat pocket and always rely on. But within each state and each healthcare facility there is in fact a code of conduct that you need to follow if you want to remain a practicing physician. The end. It doesn't matter how this makes you feel. It doesn't matter if you wish it was another way. It doesn't matter if you don't think its a true code of conduct or not. They will still take your license away if you don't follow it. This is how it is. If you join the proffession you will be able to influence this code of conduct by joining ethics committees etc. Until then you are at its mercy.

I would pay to be a fly on the wall during your first ethics course by the way.

well I guess we're techincally going in circles because we're providing facts and examples and scutty is just turning herself Blue saying "La la la --I can't hear you -- La la la" or some such equivalent. But I agree with what you mean entirely.

I find it great that even after all the evidence, she's still finding a way to say "I'll get to follow my own values and still I'll be an ethical doctor, I always get my way!"

And it's just too damn convenient that everytime we mention a governing board or a large, well accepted group that hands down a code she can just sideline it claiming "they're just out for political power!".

 

[OncoCaP]

Of course they wouldn't. The law governs in that situation, and elective third-trimester abortions are not legal.

This hypothetical always seems to come up, so I'll run a little further with this. Even if they were legal, I doubt you'd ever find a doctor who'd do one. I've known a lot of abortion providers, and I promise you, they're not the heartless hacks you probably think they are. Not a single one would even consider taking on a case like this. I further doubt that any woman would just up and decide at 38 weeks to terminate her pregnancy, unless she's got some serious mental health troubles (which of course, would require treatment in their own right.

Ok, great. We agree on this. It's hard to know what someone on an anonymous board thinks, so I like to ask questions for clarification. Don't get me wrong. I don't think that physicians who perform abortions are "hacks." I don't agree with them, but I can understand why they do what they do.

Now, what about 21 weeks? "http://en.wikipedia.org/wiki/Late-term_abortion: The exact point when a pregnancy becomes late-term is not clearly defined. Three articles published in 1998 in the same issue of the Journal of the American Medical Association could not agree on the definition. Two articles chose the 20th week of gestation to be the point where an abortion procedure would be considered late-term.[2] While another article chose the third trimester, or 27th week of gestation.[3] The point at which an abortion becomes late-term is often related to the "viability" (ability to survive outside the uterus) of the fetus. Sometimes late-term abortions are referred to as post-viability abortions. However, viability varies greatly between pregnancies. Nearly all pregnancies are viable after the 27th week, and almost no pregnancies are viable before the 20th week. Everything in between is a "grey area".[3] ... In 1997, the Alan Guttmacher Institute estimated the number of abortions past 24 weeks to be 0.08% (approximately 1,032 per year).[6])

Let's say that a woman at 21 weeks broke up with her significant other and now wanted an abortion because she no longer wanted to be a parent of a child from that relationship. This isn't unreasonable ...(http://en.wikipedia.org/wiki/Abortion_in_the_United_States#Reasons_for_abortions :
Reasons for abortions
[A] study, in 1998, revealed that women reported the following reasons for choosing an abortion:[4]

25.5% Want to postpone childbearing
21.3% Cannot afford a baby
14.1% Has relationship problem or partner does not want pregnancy )

Here are the stats I have on abortion & when it occurs:

http://en.wikipedia.org/wiki/Abortion
In 2002, from data collected in those areas of the United States that sufficiently reported gestational age, it was found that 86.7% of abortions were conducted at or prior to 12 weeks, 9.9% from 13 to 20 weeks, and 1.4% at or after 21 weeks.

An abortion at 21+ weeks would be rare (~1.4 in a 100). However, it does happen, and it appears to be legal.
http://en.wikipedia.org/wiki/Abortion_in_the_United_States: According to the Centers for Disease Control, there were 854,122 legal induced abortions in the US in 2003.[2] So @ 1.4%, we are talking about ~12,000 abortions at 21+ weeks per year in the U.S. Discounting further for the relationship issue or partner who does not want the child (14.1%), we're talking about 1686 abortion per year in this category in the U.S. -- not an insignificant number.

Now on viability, http://www.abortioninfo.net/facts/development4.shtml :
In the fifties viability was reached about thirty weeks after conception. Modern medical technology changed that to twenty-five weeks in the seventies. Now viability continues to be pushed further and further back in the pregnancy and is now as early as nineteen weeks. Here are some examples of viable children: fetuses said to be only parts of their mothers who lived and grew into individual happy healthy people without their mothers:

Marcus Richardson - 19 weeks, 6 days - 780 gm - Jan. '72 - (University Hosp., Cincinnati)
Melissa Cameron - 20 weeks - 450 gm - Dec. '83 - (Sault Ste. Marie Hosp., Cincinnati Enquirer)
Kenya King - 21 weeks - 510 gm - June '85 - (Med. World News, Nov. 11, 1985, p. 119)
Suzanne South - 21 weeks, 2 days - 644 gm - July '71 -(Bethesda Hosp., Cincinnati)
Kelly Thorman - 21 weeks - 596 gm - March '71 - (St. Vincent Hosp., Toledo)
Melissa Murray - 22 weeks - 510 gm - June '83 - (Victoria, Texas - Houston Post)
Tracy LaBranch - 22 weeks, 1 day - 538 gm - March '72 - (Battle Creek Enquirer)
Ernestine Hudgins - 22 weeks - 484 gm - Feb. '83 - (San Diego, Washington Post)
Mimi Faulkner - 23 weeks - 484 gm - Nov. '78 - (San Diego, Boston Herald)
Tascha Hudson - 23 weeks - 580 gm - March '74 - (Brooke Army Hosp.)
Simmonne Jayette - 23 weeks - 595 gm - April '78 - (Montreal Jewish General Hospital)
Alicia Ponce - 24 weeks - 644 gm - April '74 - (Associated Press)

Twenty-one and twenty-two week premature babies are now supported routinely, and have a good chance of survival. By twenty-four weeks after conception, premature babies have a 40% chance of reaching adulthood without any major complications.2 By twenty-eight weeks, the chance is 90%.3 By twenty-nine weeks, survival is almost definite. (Note: These percentages are from reports written during the late 1980s. Current survival rates are most likely much higher.)

http://www.abortionfacts.com/online_books/love_them_both/why_cant_we_love_them_both_13.asp
One example is Baby Kenya King ...

Baby Kenya King born in Plantation, Florida, 21 weeks (4 1/2 months) from the first day of her mother's last menstrual period; weighing 510 gm (18 oz) she was 10.5 inches (26.5 cm). She dropped to 370 gm (13 oz). She is shown at 2270 gm (5 lbs.) with her mother. (Miami Herald, Pam Smith photo)

A major center such as Johns Hopkins reported the following survivors:

- at 22 weeks = none

- at 23 weeks = 15%

- at 24 weeks = 56%

- at 25 weeks = 79%

The Limit of Viability, M. Allen et al., N. Eng. J. Med. 11/25/93: Vol. 329, No.22, pg. 1597

http://apnews.myway.com/article/20070220/D8ND49N01.html
Tiny Baby to Leave Florida Hospital

Feb 19, 7:45 PM (ET)

By MATT SEDENSKY

MIAMI (AP) - A premature baby that doctors say spent less time in the womb than any other surviving infant is to be released from a Florida hospital Tuesday.

Amillia Sonja Taylor was just 9 1/2 inches long and weighed less than 10 ounces when she was born Oct. 24. She was delivered 21 weeks and six days after conception. Full-term births come after 37 to 40 weeks.

"We weren't too optimistic," Dr. William Smalling said Monday. "But she proved us all wrong."

Neonatologists who cared for Amillia say she is the first baby known to survive after a gestation period of fewer than 23 weeks. A database run by the University of Iowa's Department of Pediatrics lists seven babies born at 23 weeks between 1994 and 2003.

http://www.msnbc.msn.com/id/17237979/
Earliest surviving preemie to remain in hospital
Doctors decide not to release infant girl who was born at 22 weeks

Baptist Children's Hospital via
Sonja Taylor is overjoyed to be taking baby Amillia home after four months in the NICU at Baptist Children's Hospital.

Updated: 7:44 p.m. CT Feb 20, 2007
MIAMI - A girl born after just under 22 weeks in the womb — among the shortest gestation periods known for a live birth — will remain in a hospital a few extra days as a precaution, officials said Tuesday.

Amillia Sonja Taylor, born Oct. 24 after just under 22 weeks in the womb, had been expected to be sent home from Baptist Children's Hospital on Tuesday.

However, routine tests indicated she was vulnerable to infection, said Dr. Paul Fassbach, who has cared for the baby since shortly after she was born.

(I wish I had a recent Journal article that better summed the above up. My point is that probable viability at 21 weeks is a reasonable assertion to make)

******

So, finally getting to the question: Would you believe that the mother's morals would govern in this case @ 21 weeks of an apparently healthy unborn child for the reason that the relationship broke up and do you personally would believe that such an abortion would be ethical? If you were not sure, what kind of questions or decision-making process would you go through to determine if it was ethical to perform an abortion in this case?

 

[Wanna_B_Scutty]

Because it is in her body. Because the very existence of that being is intimately and totally tied into the existence of the woman. Because she alone must face the risks in carrying it (which as we both know can range from minor to devastating). This is not discrimination, this is biology. No person can be forced to be life support for another.

Yes, it is in her body. However, no fetus has ever asked to be conceived and therefore "trapped" in her body. Rather, the mother conceived the fetus of her own free will, thus creating a living human organism with a temporary physiological need for a womb. Given that the mother created the needs of this human organism of her own free will, why isn't reasonable to view the provision of those needs as her responsibility? Given that the only other option is to kill the human organism- a unique and living being- isn't this more reasonable?

Also, it's because no one else has the power or the right to determine the moral worth of a fetus. Not you, not me, not the President. No one can agree on its value, and no one can determine it.

We may not be able to agree upon worth, but why not hold fast to our dictum of "first, do no harm"?

But sometimes, these calls must be made. Who better than the woman?

In all honesty, this is the one argument that has always profoundly perplexed me-- and for the record, I am a woman.

The thing is, I can't actually imagine anyone worse to make the decision than the women in question. I mean, talk about a conflict of interest! A woman with an unwanted pregnancy cannot possibly make an unbiased assesment of the moral status of her fetus if she views the presence of that fetus as adverse to her own self-interest.

 

[psipsina]

well I guess we're techincally going in circles because we're providing facts and examples and scutty is just turning herself Blue saying "La la la --I can't hear you -- La la la" or some such equivalent. But I agree with what you mean entirely.

I find it great that even after all the evidence, she's still finding a way to say "I'll get to follow my own values and still I'll be an ethical doctor, I always get my way!"

And it's just too damn convenient that everytime we mention a governing board or a large, well accepted group that hands down a code she can just sideline it claiming "they're just out for political power!".

Sometimes debates about ethics and values really have no resolution, these are the situations that can be stated to be going in circles. This isn't a discussion of what we believe, its a discussion of what is, so in fact it doesn't even need to be resolved. I guess I though that by discussing the way things are with people before they entered medschool we could help them not be those disgruntled third years chained to the proffession by their six figure debt. But alas, if they just don't want to hear it there is nothing to be done. Maybe some little premed is lurkin here and will learn something valuble as they make their decision about pursuing their sparkly dream of being a physician.

 

[kylek044]

Because it is in her body. Because the very existence of that being is intimately and totally tied into the existence of the woman. Because she alone must face the risks in carrying it (which as we both know can range from minor to devastating). This is not discrimination, this is biology. No person can be forced to be life support for another.

Well, until the child is 18 they are financially dependant on the father. If the father doesn't take care of them, they'd be dead. The very existance of the child is tied to the existance of both parents! Should the father have rights to kill it until its 18th birthday?

 

[snoozer]

Sometimes debates about ethics and values really have no resolution, these are the situations that can be stated to be going in circles. This isn't a discussion of what we believe, its a discussion of what is, so in fact it doesn't even need to be resolved. I guess I though that by discussing the way things are with people before they entered medschool we could help them not be those disgruntled third years chained to the proffession by their six figure debt. But alas, if they just don't want to hear it there is nothing to be done. Maybe some little premed is lurkin here and will learn something valuble as they make their decision about pursuing their sparkly dream of being a physician.

Oh how I pray to deter people like Wanna Be Scutty. reality is what it is. And still, your arguments are very well stated.

 

[psipsina]

Yes, it is in her body. However, no fetus has ever asked to be conceived and therefore "trapped" in her body. Rather, the mother conceived the fetus of her own free will, thus creating a living human organism with a temporary physiological need for a womb.

What about rape victims? What about a woman with an abusive husband who won't let her use birth control? What about a woman who uses birth control and it fails? It isn't a black and white issue of a woman deciding to make a fetus and then deciding to kill it because it isn't convienient for her. It isn't our place to judge these women because we aren't in their lives. The premise of your argument doesn't apply to many women who chose to abort.

 

[turkleton]

Sometimes debates about ethics and values really have no resolution, these are the situations that can be stated to be going in circles. This isn't a discussion of what we believe, its a discussion of what is, so in fact it doesn't even need to be resolved. I guess I though that by discussing the way things are with people before they entered medschool we could help them not be those disgruntled third years chained to the proffession by their six figure debt. But alas, if they just don't want to hear it there is nothing to be done. Maybe some little premed is lurkin here and will learn something valuble as they make their decision about pursuing their sparkly dream of being a physician.

One of the best lessons I've learned is that in these debates/forums no matter how loudly you speak, how much you underline, how much you bold or put everything in caps its not going to change anyone's beliefs. For some reason once we get started on expressing our views and how logical their basis is, you forget that they were generated over years and years of experiences- but that if we say it loud enough or be vocal enough about it, it will summarily change those same long standing beliefs in someone else. Pointless. Thank you psipsina

 

[OncoCaP]

What about rape victims? What about a woman with an abusive husband who won't let her use birth control? What about a woman who uses birth control and it fails? It isn't a black and white issue of a woman deciding to make a fetus and then deciding to kill it because it isn't convienient for her. It isn't our place to judge these women because we aren't in their lives. The premise of your argument doesn't apply to many women.

First, let's get one issue out of the way: many practicing physicians oppose abortion. To suggest that somehow medical students "know best" when it comes to medical ethics and are in a position to lecture premeds about the ins and outs of medical ethics is not serving anyone well. I would suggest that premeds (soon to be MSx's) and med students can have some interesting discussions and even enjoy them. One of the things that I am going to try hard to do as I go through medical education is to avoid acting like a physician is some kind of elite member of society. Will I have strong opinions? Sure, I have those now. However, I'll give opposing arguments weight even if I don't agree and the person has no medical qualifications. Yes, there are many things that physicians are solely entitled to do, but that doesn't mean that they have some kind of unquestioned authority when it comes to deciding what is ethical or how to resolve ethical conflicts. Here is a quick article on the ethics of abortion from a physician. I think we can agree that there are plenty more out there (look no further than the Physicians for Life organization):

http://www.dakotavoice.com/200610/Guest/20061016_DO.html
"Our opponents in this campaign would have you belief that if the law banning abortions in South Dakota is upheld doctors will go to jail and women in South Dakota will be left with no health care. Nothing could be farther from the truth. Currently no South Dakota doctors do abortions; therefore no South Dakota doctors would be prosecuted under HB1215 when it is upheld. The only abortions done in South Dakota are done by 4 physicians from Minneapolis brought in to SF by Planned Parenthood. The bill also specifically protects physicians doing a legitimate medical procedure to save a woman's life. It protects doctors doing a legitimate procedure where something goes wrong and a baby is inadvertently harmed. South Dakota physicians and South Dakota women have nothing to fear from this legislation.

"The overwhelming number of abortions done in South Dakota and across our nation are done for expediency or convenience. They are done on perfectly healthy babies and perfectly healthy mothers. They are not done for rape, not done for incest, not done for fetal anomalies, and not done to save the life of the mother. They are done because a pregnant woman feels hopeless or helpless. We as a society and especially a Christian community need to seek out these women and be instruments of God's grace and compassion.

******

Now, on to the question on what about rape. It's kind of like asking, is it ok to kill someone with a gun ... usually not, but there are exceptions. What are the reasons that women have abortions?

Here is some data as you can see, abortion for reasons of rape are rare, but they do occur. I'm not convinced that two wrongs make a right:

http://en.wikipedia.org/wiki/Abortion_in_the_United_States#Reasons_for_abortions

[edit] Reasons for abortions
In 2000, cases of rape or incest accounted for 1.0% of abortions.[3] Another study, in 1998, revealed that women reported the following reasons for choosing an abortion:[4]

25.5% Want to postpone childbearing
21.3% Cannot afford a baby
14.1% Has relationship problem or partner does not want pregnancy
12.2% Too young; parent(s) or other(s) object to pregnancy
10.8% Having a child will disrupt education or job
7.9% Want no (more) children
3.3% Risk to fetal health
2.8% Risk to maternal health
2.1% Other
According to a 1987 study that included specific data about late abortions (i.e. abortions "at 16 or more weeks' gestation"),[5] women reported that various reasons contributed to their having a late abortion:

71% Woman didn't recognize she was pregnant or misjudged gestation
48% Woman found it hard to make arrangements for abortion
33% Woman was afraid to tell her partner or parents
24% Woman took time to decide to have an abortion
8% Woman waited for her relationship to change
8% Someone pressured woman not to have abortion
6% Something changed after woman became pregnant
6% Woman didn't know timing is important
5% Woman didn't know she could get an abortion
2% A fetal problem was diagnosed late in pregnancy
11% Other

 

[OncoCaP]

One of the best lessons I've learned is that in these debates/forums no matter how loudly you speak, how much you underline, how much you bold or put everything in caps its not going to change anyone's beliefs. For some reason once we get started on expressing our views and how logical their basis is, you forget that they were generated over years and years of experiences- but that if we say it loud enough or be vocal enough about it, it will summarily change those same long standing beliefs in someone else. Pointless. Thank you psipsina

I agree with you. At the same time, I'm not under the impression that anyone is trying to change anyone's mind here. I do think this is an interesting topic, and I've learned a lot about the subject from listening to both sides. Chances are that people might want to talk about abortion more than say, which enzyme catalyzes a particular phosphorylation. It's a hot topic for people to talk about. Also, nothing helps me clarify my own perspectives and opinions more than when I try to explain them to someone else ... particularly someone who doesn't agree with me. In this way, if there is a falacy in my thinking, I can learn about it more quickly. If it's just a difference of opinion, I can learn about other opinions and why people hold opposing viewpoints, for the purpose of getting along better with them in real life. I seriously hope that everyone here is just doing this for fun and maybe to learn more about this issue. If someone does feel like they are being pressured to do something that they don't think is ethical, there have been some suggestions posted about that on this thread.

 

[snoozer]

First, let's get one issue out of the way: many practicing physicians oppose abortion. To suggest that somehow medical students "know best" when it comes to medical ethics and are in a position to lecture premeds about the ins and outs of medical ethics is not serving anyone well. I would suggest that premeds (soon to be MSx's) and med students can have some interesting discussions and even enjoy them. One of the things that I am going to try hard to do as I go through medical education is to avoid acting like a physician is some kind of elite member of society. Yes, there are many things that physicians are solely entitled to do, but that doesn't mean that they have some kind of unquestioned authority when it comes to deciding what is ethical or how to resolve ethical conflicts. Here is a quick article on the ethics of abortion from a physician. I think we can agree that there are plenty more out there (look no further than the Physicians for Life organization):

http://www.dakotavoice.com/200610/Guest/20061016_DO.html

I am not suggesting, nor do I think psipsina was, that med students or doctors even just know best. However, I am a little irritated that you would cite a random article claiming medical school environment causes oppression and claiming that this makes it fact for individuals such as psipsina or myself especially since, you have not yet experienced this environment which you READ about.

As for abortion, I have not stated my opinion on it and here it is: I think that whatever your decision is, is based in large part on whether or not you consider it to be a living organism (prior to 20 weeks) which is still debatable to me after having taken embryology. And so to me, I am still undecided but I believe that since this is an area where nothing has given me a DEFINITIVE answer, I am very comfortable with the law allowing for abortion, as long as we all recognize we are free not to have them for ourselves or perform them (unless it's standard of care and we're their doc).

And finally, I refrained from mentioning either your or Wanna Be's premed status for quite a while until it became relevant when the two of you pretended that you could chalk up psipsina's or my attitudes to the oppressive environment of medical school. And if you find it offensive that I discounted your opinion because you are not yet a med student, you should really consider the context in which you were attempting to express your knowledge.

 

[OncoCaP]

I am not suggesting, nor do I think psipsina was, that med students or doctors even just know best. However, I am a little irritated that you would cite a random article claiming medical school environment causes oppression and claiming that this makes it fact for individuals such as psipsina or myself especially since, you have not yet experienced this environment which you READ about.

As for abortion, I have not stated my opinion on it and here it is: I think that whatever your decision is, is based in large part on whether or not you consider it to be a living organism (prior to 20 weeks) which is still debatable to me after having taken embryology. And so to me, I am still undecided but I believe that since this is an area where nothing has given me a DEFINITIVE answer, I am very comfortable with the law allowing for abortion, as long as we all recognize we are free not to have them for ourselves or perform them (unless it's standard of care and we're their doc).

And finally, I refrained from mentioning either your or Wanna Be's premed status for quite a while until it became relevant when the two of you pretended that you could chalk up psipsina's or my attitudes to the oppressive environment of medical school. And if you find it offensive that I discounted your opinion because you are not yet a med student, you should really consider the context in which you were attempting to express your knowledge.

Your argument about the article is fair. It is one article out of many. If you think it is off base -- simply say so (as you have done). I do think you have made an effort to make this as respectful a discussion as possible (and you have been respectful about the premed thing -- I'm not sure why psipsina made that statement). To be perfectly honest, I have been STUNNED by how respectful and civil this entire discussion has been. I would have expected the flaming to start within hours and the thread to be closed down. I also appreciate your opinion and your thoughts. It's been an interesting debate for me anyway. I don't find your posts to be oppressive in any way. My point in citing the article is simply to state that it was an issue for some med students. I think we can agree that any one person's (or even two people's) experience in medical school does not necessarily represent a trend ... we need to look at more macro studies if we want to determine if something is an issue in the more general case or not. In my personal work experience I have found that dealing with ethical issues even without any patients can get very complicated. Adding patients to the mix adds to the complexity, of course.

 

[evade]

Now, what about 21 weeks?

[[lots of stuff]]

So, finally getting to the question: Would you believe that the mother's morals would govern in this case @ 21 weeks of an apparently healthy unborn child for the reason that the relationship broke up and do you personally would believe that such an abortion would be ethical? If you were not sure, what kind of questions or decision-making process would you go through to determine if it was ethical to perform an abortion in this case?

Firstly, the vast majority of states (my own included) define the legal limit for terminating a pregnancy to be "at viability." There is no set date written into the law. Viability is currently medically recognized as twenty-four weeks' gestation. Gestation is determined via ultrasound before any abortion procedure, no matter how early or late (it's crucial to know the size of the fetus, and when you're doing second-trimester procedures, yes, it's crucial to know if they're under the legal limit. At twenty-four weeks, zero days, it is absolutely illegal to do an elective abortion.

Secondly, the earliest surviving infant off your list there is the most recent one, Amillia. She broke the world record for being the most premature baby to ever survive, at 21 weeks, 6 days. Anything earlier than that is 100% bunk. Best case, the dates were off (ie, mom never had an ultrasound, and she's guessing from her last menstrual period - this is not medically accurate, for obvious reasons); worst case, someone straight-up made them up. A search for "Marcus Richardson" only brings me to "pro-life" sites. Just like the one you cited. If you want me (or anyone, for that matter) to take you seriously, please cite from reliable sources.

Now, perhaps the survival of a few infants who were "pre-viable" will make people re-examine the cutoff for elective termination, but it likely won't. We're talking fractions of a percent here, in terms of survival. And of those extremely premature babies that do survive, many of them have serious problems later on (mental ******ation and other problems secondary to brain bleeds).

As to your situation, the woman in question would need some counseling to make sure this is really what she wants. It's not a matter of ethics, it's a matter of taking care of the patient. Has she gone from really wanting and looking forward to this baby to just wanting to end the pregnancy? If so, why? Is she depressed? Overwhelmed? In bad financial straits? These things need examining. Or has she always been really hesitant about this pregnancy, and encouraged (or told) to keep it by her boyfriend, and now that he's split, she's able to make her own choices?

Ultimately, though, if it's really what she wants, she has the right to choose to terminate her pregnancy.

 

[OncoCaP]

...
As to your situation, the woman in question would need some counseling to make sure this is really what she wants. It's not a matter of ethics, it's a matter of taking care of the patient. Has she gone from really wanting and looking forward to this baby to just wanting to end the pregnancy? If so, why? Is she depressed? Overwhelmed? In bad financial straits? These things need examining. Or has she always been really hesitant about this pregnancy, and encouraged (or told) to keep it by her boyfriend, and now that he's split, she's able to make her own choices?

I'm really glad that these questions are being asked. That should certainly cut down on some unnecessary abortions.

Ultimately, though, if it's really what she wants, she has the right to choose to terminate her pregnancy.

Yes, that's the current law. It seems unethical to me (ending the life of a viable fetus for a non-medical reason), but that's the way it is. I wish that adoption was provided as an option in these situations; in this way, the mother could go on with her life (waiting a mere 16 more weeks from 21 to 37) and another family could have the child that they always wanted. I consider the unborn child to be a patient as well because his or her life is also profoundly affected in an abortion. We don't simply terminate the life of a 21-year-old woman who is expected to recover after 16 weeks of life support just because her mother or significant other finds taking care of her burdensome or because she might have a brain injury. We shouldn't terminate the life of a healthy 21-week-old female human inside a healthy mother either. I personally wish we had more respect for human life of the unborn child in our legal and medical system and would balance the decision of the mother with a more humane ethical standard for all lives impacted. It is ironic that a person who kills a pregnant mother (or even just the fetus) can be charged with the death of the child (in addition to harming the mother), but when the mother terminates her pregnancy for "convenience reasons (doesn't want any (more) children, etc.)," she is legally untouchable.

 

[psipsina]

First, let's get one issue out of the way: many practicing physicians oppose abortion. To suggest that somehow medical students "know best" when it comes to medical ethics and are in a position to lecture premeds about the ins and outs of medical ethics is not serving anyone well. I would suggest that premeds (soon to be MSx's) and med students can have some interesting discussions and even enjoy them. One of the things that I am going to try hard to do as I go through medical education is to avoid acting like a physician is some kind of elite member of society. Will I have strong opinions? Sure, I have those now. However, I'll give opposing arguments weight even if I don't agree and the person has no medical qualifications. Yes, there are many things that physicians are solely entitled to do, but that doesn't mean that they have some kind of unquestioned authority when it comes to deciding what is ethical or how to resolve ethical conflicts. Here is a quick article on the ethics of abortion from a physician. I think we can agree that there are plenty more out there (look no further than the Physicians for Life organization):

http://www.dakotavoice.com/200610/Guest/20061016_DO.html
"Our opponents in this campaign would have you belief that if the law banning abortions in South Dakota is upheld doctors will go to jail and women in South Dakota will be left with no health care. Nothing could be farther from the truth. Currently no South Dakota doctors do abortions; therefore no South Dakota doctors would be prosecuted under HB1215 when it is upheld. The only abortions done in South Dakota are done by 4 physicians from Minneapolis brought in to SF by Planned Parenthood. The bill also specifically protects physicians doing a legitimate medical procedure to save a woman's life. It protects doctors doing a legitimate procedure where something goes wrong and a baby is inadvertently harmed. South Dakota physicians and South Dakota women have nothing to fear from this legislation.

"The overwhelming number of abortions done in South Dakota and across our nation are done for expediency or convenience. They are done on perfectly healthy babies and perfectly healthy mothers. They are not done for rape, not done for incest, not done for fetal anomalies, and not done to save the life of the mother. They are done because a pregnant woman feels hopeless or helpless. We as a society and especially a Christian community need to seek out these women and be instruments of God's grace and compassion.

******

Now, on to the question on what about rape. It's kind of like asking, is it ok to kill someone with a gun ... usually not, but there are exceptions. What are the reasons that women have abortions?

Here is some data as you can see, abortion for reasons of rape are rare, but they do occur. I'm not convinced that two wrongs make a right:

http://en.wikipedia.org/wiki/Abortion_in_the_United_States#Reasons_for_abortions

[edit] Reasons for abortions
In 2000, cases of rape or incest accounted for 1.0% of abortions.[3] Another study, in 1998, revealed that women reported the following reasons for choosing an abortion:[4]

25.5% Want to postpone childbearing
21.3% Cannot afford a baby
14.1% Has relationship problem or partner does not want pregnancy
12.2% Too young; parent(s) or other(s) object to pregnancy
10.8% Having a child will disrupt education or job
7.9% Want no (more) children
3.3% Risk to fetal health
2.8% Risk to maternal health
2.1% Other
According to a 1987 study that included specific data about late abortions (i.e. abortions "at 16 or more weeks' gestation"),[5] women reported that various reasons contributed to their having a late abortion:

71% Woman didn't recognize she was pregnant or misjudged gestation
48% Woman found it hard to make arrangements for abortion
33% Woman was afraid to tell her partner or parents
24% Woman took time to decide to have an abortion
8% Woman waited for her relationship to change
8% Someone pressured woman not to have abortion
6% Something changed after woman became pregnant
6% Woman didn't know timing is important
5% Woman didn't know she could get an abortion
2% A fetal problem was diagnosed late in pregnancy
11% Other

Ummmmm, I never said that medstudents know about best about ethical dilemmas. I think its really fun to debate ethics which is why I'm on this forum. I enjoy the mental exersize and think that the best way to solidify my own personal values and beliefs is through debate with people who have a different perspective on things.

I do think we might be more informed about issues like current medical code of conduct and licensing, simply because you don't get taught this stuff until you are in medical school. The things I think we may be more informed about are just facts about how the current medical system operates that no one bothers to explain clearly until you have been inducted into the fraternity of medicine.

onward with the debate:
My examples were of women who didn't actively decide to become pregnant. I was pointing out a fallicy in the other posters logic. I was providing examples of women who became pregnant not through their own volition or their own irresponsible planning but through forces outside their control.

I never proposed that rape victims make up a large percentage of women seeking out abortions, which is the point you went on to refute. In fact rape victims who seek medical care are offered the morning after pill in the ER as standard of care so this would probably skew your stats a bit anyway.

Anyway, what I was trying to show is how difficult it is to pass sweeping judgements on when you are dealing with individuals with individual circumstances. If we make elective abortions illegal we are making the sweeping judgement that all abortions are wrong, but I don't think this is the case. I don't think that simply because we may find some of the reasons that women get abortions to be morally reprehensible (such as the woman who uses it as her only birth control method who is always brought up in these discussions) we can prohibit all women in all circumstances from having that option. Instead I think we should put our efforts into sex education, accessibility to birth control, better options for mothers who would keep their children if their life circumstances were better, improving the adoption and foster care system etc.

 

[OncoCaP]

Ah, ok, psipsina -- your explanation makes a lot of sense, and I enjoy these discussions for the same reasons that you do. I also like this idea of yours:

"... we should put our efforts into sex education, accessibility to birth control, better options for mothers who would keep their children if their life circumstances were better, improving the adoption and foster care system etc."

 

[evade]

I wish that adoption was provided as an option in these situations

I am curious, what makes you think it isn't?

 

[OncoCaP]

I am curious, what makes you think it isn't?

Perhaps what I mean is that adoption should be promoted rather than given as an ethically equivalent option to terminating a healthy pregnancy. This is a reasonable spot for ethics to come into play, much as it would if a mother wanted to end life support for her 21-year-old daughter who is expected to recover with life support after 16 weeks. The mom may say, look, this is going to cost me a mint; I don't want to pay for all this care. Or,having to care for my daughter is going to interfere with my job. The hospital would come back and say that pulling her daughter off life support for financial or job reasons in this case is not an option for legal, moral, and ethical reasons.

Adoption addresses the most common reasons for which women have abortions. If you place your unborn child up for adoption, none of these things is an issue in the usual case:

(see wiki article source above in a previous message)
25.5% Want to postpone childbearing
21.3% Cannot afford a baby
14.1% Has relationship problem or partner does not want pregnancy
12.2% Too young; parent(s) or other(s) object to pregnancy
10.8% Having a child will disrupt education or job
7.9% Want no (more) children

The fact that these are the main reasons women are having abortions provides evidence that adoption is inadequately promoted in crisis pregnancies. Otherwise, the reasons for having an abortion would be reasons that could not be addressed by adoption. If the (hopefully false) counterclaim is that women are not logical about this, then I would say terminating a life must be addressed with logic. Abortion should never be done for irrational or illogical reasons; if there is a logical solution to a crisis and a human life hangs in the balance, that logical solution should be at the very least strongly promoted or, better yet, legally required.

 

[kelaskov]

I'm really glad that these questions are being asked. That should certainly cut down on some unnecessary abortions.
.

If you are truly committed to reducing the number of abortions perhaps you shouldn't be so quick to support or quote the physicians for life site.

They routinely post false medical information (abortion causes breast cancer) on their site and offer suggestions to medical students that may increase the number of unplanned pregnancies.

TAKEN FROM PFL WEBSITE:

[Below are some suggestions from physicians for a particular medical student which may or may not be of help to others. They are simply offered as food for thought and as a starting place...]

Dear Physicians For Life,

I am a 3rd year medical student and was wondering if anyone could give me advice on how I could avoid having to give contraception to patients during my clinicals. My classmates tell me that they are instructed to give prescriptions for the pill to patients. I believe contraception is immoral and unhealthy.

RESPONSES:

Tell this student that…slavery ended with the Civil War. He MUST be well aware of ALL the contraceptives and their actions, but he can defer prescribing them to someone else. He is never solo as a student. Tell him to know the contraceptives so well that he can answer any questions, but also know…the evils of artificial contraception. It comes up in my Emergency Practice and I just say NO, I don't write the pill. You cannot right a wrong with another wrong. This is my religious belief and it is protected. Charles H, MD FAAEM

Contraception is a difficult issue…For me I don't prescribe OCPs to unmarried women unless it is for a medical problem. OCPs are a license to get pregnant for most teens.
Scott L, MD

........

I know of no easy answer to that 3rd year medical student's dilemma. But I would encourage him/ her to stand by his/her beliefs and just say no! There are certain situations where hormonal replacement may benefit the patient such as a woman with polycystic ovary syndrome or a young anorexic woman who doesn't ovulate and doesn't have menstrual periods. Unfortunately, most of the prescriptions for birth control pills are for contraception.
.......

Furthermore, when hormonal contraception fails to block ovulation, it is an abortifacient (aborting drug) because it changes (thins) the endometrium so that the embryo is unable to secure a good implant and is thus aborted/killed. I believe this is how the morning after pill Preven [and Plan B] works.

Birth control pills also fail to prevent pregnancy 18% of the time according to a study. I would recommend that the 3rd year student read NEJM article "Timing of sexual intercourse in relation to ovulation" December 7,1995 Volume 333 No. 23 pp 1517-1521. For most people, I believe NFP is the safest method of "family planning". ....

Dear 3rd year medical student,

My best advice is to be up-front with the physician who is in charge of that rotation for the month, even at the risk of getting a lower grade. Pray before you speak to that person and then tell him/her how you feel that you can't prescribe them because of moral and ethical reasons. Be prepared to offer an explanation b/c that may happen and you may have to speak to more than one director. From my own experience, don't just wait and try to get around it every time the issue comes up by making another student write the rx., etc. Just be up-front from the start- you may be persecuted; but Christ is with you, take comfort.
Best wishes, Maria M, M.D.

 

[OncoCaP]

If you are truly committed to reducing the number of abortions perhaps you shouldn't be so quick to support or quote the physicians for life site.

They routinely post false medical information (abortion causes breast cancer) on their site and offer suggestions to medical students that may increase the number of unplanned pregnancies.
...

I agree that they should not provide false information. That is wrong. There is no excuse for that. I'm all for providing accurate information. Also, I'm 100% in favor of contraception to avoid unwanted pregnancies ... it doesn't always work, but it's much better than no contraception.

 

[trustwomen]

Secondly, the earliest surviving infant off your list there is the most recent one, Amillia. She broke the world record for being the most premature baby to ever survive, at 21 weeks, 6 days. Anything earlier than that is 100% bunk. Best case, the dates were off (ie, mom never had an ultrasound, and she's guessing from her last menstrual period - this is not medically accurate, for obvious reasons); worst case, someone straight-up made them up.

Actually, even Amillia's dates were the standard misinterpretation/exaggeration by the press. In the articles, it is explained that Amillia was a "test-tube baby" who was implanted in her mother's womb 21w6d before birth, i.e. her birth was 21w6d post-"conception". Considering that pregnancy weeks (and abortion weeks) are counted from last menstrual period, i.e. 2 weeks before conception, Amillia was 23w6d LMP at birth. And since this is the earliest-ever surviving preemie (and she's not out of the woods yet, her much-vaunted return home was delayed due to respiratory problems), our 24 week limit seems acceptable.

Everyone, please keep in mind that 90% of abortions are done before 12 weeks of pregnancy, and only 1% are done after 20 weeks. Those which are done later, are much more likely to be for "therapeutic" reasons (fetal anomaly, maternal health) and the "elective" reasons are not so elective when you really speak to the women involved - high proportion of young teens, abused women, women with planned pregnancies facing unforeseen personal disasters, addicts, psychiatric issues, etc. There is a small subgroup of so-called "ordinary" women who get abortions over 20 weeks also - women who could not access one earlier due to financial or legal barriers. (In Canada, for instance, where the barriers to early abortion are far less prevalent, only 6% of abortions are later than 12 weeks, compared to 10% in the US).

Beyond 24 weeks, as a rule, only therapeutic abortions (fetal anomaly, maternal health) are performed, of which there only a few hundred a year - done in abortion clinics, anyway. (Private OBs and hospitals sometimes also induce labour early or perform a hysterotomy for these women and their tragedies, and the stats are not collected). There are a few clinics which "advertise" that they go to 26 weeks, but really they just use a different fetal measurement scale which adds a few weeks to the gestational age determination, i.e. if you got turned away from a standard 24 week clinic you'd also get turned away from there.

I worked for many years as a counselor at clinics where the upper limit of abortion services was 23w6d. I can testify to the following: the later the abortion, the more compelling and serious the reason for it.

 

[trustwomen]

Perhaps what I mean is that adoption should be promoted rather than given as an ethically equivalent option to terminating a healthy pregnancy. This is a reasonable spot for ethics to come into play, much as it would if a mother wanted to end life support for her 21-year-old daughter who is expected to recover with life support after 16 weeks. The mom may say, look, this is going to cost me a mint; I don't want to pay for all this care. Or,having to care for my daughter is going to interfere with my job. The hospital would come back and say that pulling her daughter off life support for financial or job reasons in this case is not an option for legal, moral, and ethical reasons.

Adoption addresses the most common reasons for which women have abortions. If you place your unborn child up for adoption, none of these things is an issue in the usual case:

(see wiki article source above in a previous message)
25.5% Want to postpone childbearing
21.3% Cannot afford a baby
14.1% Has relationship problem or partner does not want pregnancy
12.2% Too young; parent(s) or other(s) object to pregnancy
10.8% Having a child will disrupt education or job
7.9% Want no (more) children

The fact that these are the main reasons women are having abortions provides evidence that adoption is inadequately promoted in crisis pregnancies. Otherwise, the reasons for having an abortion would be reasons that could not be addressed by adoption. If the (hopefully false) counterclaim is that women are not logical about this, then I would say terminating a life must be addressed with logic. Abortion should never be done for irrational or illogical reasons; if there is a logical solution to a crisis and a human life hangs in the balance, that logical solution should be at the very least strongly promoted or, better yet, legally required.

Nope, adoption is well-known to be an option by all women who seek abortion. I was a counselor for many years, I always checked that they had thought about their other options, and they all looked at me like I was insane whenever I mentioned adoption. Now, you have a point inasmuch as: if all women (black women especially) knew that their babies would BE adopted rather than live their lives in foster care, there might be somewhat fewer abortions, but not enough to actually put a dent in the numbers (you need fewer unplanned pregnancies for that!). And please recall that any father can block an adoption and take the child to raise himself, so the mother's desire to place for adoption will not necessarily be respected.

Plus, having a baby and giving it up, in her context (family, work, whatever), could mean:
-losing her family (lots of parents/spouses would not accept this)
-losing her job/financial stability (pregnancy and recuperation time, plus most maternity leave is unpaid)
-losing her mind ("rationality" is all well and good, but ask 100 women whether they could give up a baby they brought into the world. Then ask them whether they could have a first-trimester abortion. If the numbers are remotely similar, they're lying to you.)

You say "terminating a life must be addressed with logic". Most lives that humans terminate have nothing to do with logic - they're all about dinner. Hell, even most human lives that we terminate have nothing to do with logic - or, rather, they involve the logic of brute egoistic survival. I do not believe that a fetus has rights - it is insentient and non-viable, and has much less individual "life"/rights than an enemy combatant or even a cat. Even if it did have rights, it cannot survive without using the body of another person and she has the inviolable, overriding right to restrict her body to her own private use if she wishes.

And as for your analogy: if the daughter's life support, say, required the mother to donate blood for some reason, the mother would have the right to refuse - even if her daughter died as a consequence. If she can't be forced to donate blood, she can't be forced to lend her uterus to the life-support mechanism either.

Don't want to be all negative here, so here are some tested and proven ways to reduce the number of abortions in the US:
-better contraceptive information, accessibility of contraception, and sex ed
-less moral censure of sex - it leads kids to contracept poorly because only "sluts" or "sinners" plan to have sex, and they don't want to be the "type of person" that has condoms on them or takes the pill
-a better social safety net so that unplanned childbearing is less of a disaster
-better working conditions for parents (parental leave, flextime, etc.)
-free and accessible health care (leads to better contraception and better health information)
-affordable education so that young people have a reason to plan their lives and families better and not wind up with an unplanned pregnancy

And all these things are what the pro-choice movement supports and promotes! They are trying to put themselves out of business, how about that...

 

[da8s0859q]

I am a 3rd year medical student and was wondering if anyone could give me advice on how I could avoid having to give contraception to patients during my clinicals. My classmates tell me that they are instructed to give prescriptions for the pill to patients. I believe contraception is immoral and unhealthy.

oh damn.

Yeah, I think I'll just beg to differ and not shoot off my mouth.

 

[trustwomen]

oh damn.

Yeah, I think I'll just beg to differ and not shoot off my mouth.

You know it isn't kelaskov who feels that way, right? He's quoting an anti-abortion website.

 

[OncoCaP]

Nope, adoption is well-known to be an option by all women who seek abortion. I was a counselor for many years, I always checked that they had thought about their other options, and they all looked at me like I was insane whenever I mentioned adoption.

That's good that adoption is at least being mentioned. Since you don't view the fetus as an organism that has any rights or deserves any respect beyond what the mother decides it deserves, adoption is just another option. However, if you viewed the fetus as a human child that did have dignity and inherent worth ... a worth beyond the convenience of the mother, you would obviously look at this matter quite differently (protecting the unborn child would be worth some extra effort).

Now, you have a point inasmuch as: if all women (black women especially) knew that their babies would BE adopted rather than live their lives in foster care, there might be somewhat fewer abortions, but not enough to actually put a dent in the numbers (you need fewer unplanned pregnancies for that!). And please recall that any father can block an adoption and take the child to raise himself, so the mother's desire to place for adoption will not necessarily be respected.

So what you are really saying is that black women are really not worried about if their children would be adopted or not. When the show up at the abortion clinic, they just have a problem that they want solved right away ... their way, that is. I'm also a little surprised as to the following: Why would the mother care if the father raised the child if the main reason that she is having an abortion is because she doesn't want a child (or more children)? She doesn't seem to care whether the child lives or dies ... why would she care if the father raises it?

Plus, having a baby and giving it up, in her context (family, work, whatever), could mean:
-losing her family (lots of parents/spouses would not accept this)
-losing her job/financial stability (pregnancy and recuperation time, plus most maternity leave is unpaid)
-losing her mind ("rationality" is all well and good, but ask 100 women whether they could give up a baby they brought into the world. Then ask them whether they could have a first-trimester abortion. If the numbers are remotely similar, they're lying to you.)

Yes, these are valid concerns. These are some of the reasons I was pro-choice for many years. (in addition to my prior thinking that some lives were just not worth living, e.g., severely disabled, children who are not wanted, etc. -- only lives "worth living" should be carried to term). However, I decided that killing a young child isn't justified when it means losing a family or job, so it isn't justified before the child is born either. Since you don't consider the fetus to be a child (or at least a child with any rights), you don't have this concern, obviously.

You say "terminating a life must be addressed with logic". Most lives that humans terminate have nothing to do with logic - they're all about dinner. Hell, even most human lives that we terminate have nothing to do with logic - or, rather, they involve the logic of brute egoistic survival. I do not believe that a fetus has rights - it is insentient and non-viable, and has much less individual "life"/rights than an enemy combatant or even a cat. Even if it did have rights, it cannot survive without using the body of another person and she has the inviolable, overriding right to restrict her body to her own private use if she wishes.

I'm talking about the medical field, not warfare. If you want to withdraw a feeding tube or stop some life-preserving treatment, you'll need a lot of logical reasons to back up your decision (person in a coma with no hope of recovery, person did not want this kind of life-sustaining treatment, etc.). In Travis County (where Austin, Texas is) 33% of pregnancies end in abortion. Few of those abortions require anything more than a simple desire not to have a child.

And as for your analogy: if the daughter's life support, say, required the mother to donate blood for some reason, the mother would have the right to refuse - even if her daughter died as a consequence. If she can't be forced to donate blood, she can't be forced to lend her uterus to the life-support mechanism either.

She would have a right to refuse, but she would not have a right to refuse that her daughter get that blood transfusion (unless her religion prohibited that). You are correct, she can refuse to use her body to save her daugher's life. At the same time, she must allow for alternate arrangements. If a mother does not want to breast-feed an infant, she can provide formula or give the baby up entirely for adoption. She does not have the right to have a physician inject the child with a lethal dose or to crush the body of the child and then dispose of the body parts. All I'm suggesting is that the child's right to life trumps the mother's right to convenience or other problems that result from a unwanted pregnancy. She should make reasonable accommodation for the child to live its life, even if she is unwilling to raise it.

Don't want to be all negative here, so here are some tested and proven ways to reduce the number of abortions in the US:
-better contraceptive information, accessibility of contraception, and sex ed
-less moral censure of sex - it leads kids to contracept poorly because only "sluts" or "sinners" plan to have sex, and they don't want to be the "type of person" that has condoms on them or takes the pill
-a better social safety net so that unplanned childbearing is less of a disaster
-better working conditions for parents (parental leave, flextime, etc.)
-free and accessible health care (leads to better contraception and better health information)
-affordable education so that young people have a reason to plan their lives and families better and not wind up with an unplanned pregnancy

Yes, I agree with these things. The number of abortions seems to be going down, so many of these steps appear to be working.

And all these things are what the pro-choice movement supports and promotes! They are trying to put themselves out of business, how about that...

Amazing indeed. Keep up the good work of eliminating the need for abortions! That's really the best strategy.

 

[snoozer]

That's good that adoption is at least being mentioned. Since you don't view the fetus as an organism that has any rights or deserves any respect beyond what the mother decides it deserves, adoption is just another option. However, if you viewed the fetus as a human child that did have dignity and inherent worth ... a worth beyond the convenience of the mother, you would obviously look at this matter quite differently.



Why would the mother care if the father raised the child if the main reason that she is having an abortion is because she doesn't want a child (or more children)? She doesn't seem to care whether the child lives or dies ... why would she care if the father raises it?

1. of course adoption is being mentioned, and hopefully women and men everywhere just generally know about its existence. the public I would hope, is not THAT ignorant. But I think mentioning it as an option (as a care provider) reflects a restraint from imposing moral values on your patient's decision because currently there is no absolute on when a fetus (less than 20 weeks) is = to an infant. (As demonstrated by the massive number of sites shouting both messages)

2. I don't think the whole father raises the kid thing is that simple. If the father of the child was a deadbeat and he showed up at the hospital right after the labor claiming "I'm the father! I have rights!" He can actually just refuse to let the woman put it up for adoption, I don't believe the father actually needs to make PROVISIONS for that child, till he gets dragged into court and forced to pay child support. (which sometimes isn't paid anyway). Current laws seem to require that there A. Be no father (nowhere in the picture, isn't coming back or dead) or B. that he also consent to giving it up for adoption.
I think this process makes it actually very difficult for a woman to bear the 9 month pregnancy and hope to God that either the father doesn't show up or will be willing to sign the form and leave her alone. That's probably a more significant barrier than what you claim to just be "inconveniencing the woman."

 

[OncoCaP]

1. of course adoption is being mentioned, and hopefully women and men everywhere just generally know about its existence. the public I would hope, is not THAT ignorant. But I think mentioning it as an option (as a care provider) reflects a restraint from imposing moral values on your patient's decision because currently there is no absolute on when a fetus (less than 20 weeks) is = to an infant. (As demonstrated by the massive number of sites shouting both messages)

I'm really glad that it is being mentioned. I think the public isn't always doing the brightest things. I could give you some examples if you need proof.

Yes, if you think the fetus has less of a right to live than a stray dog, then adoption is just another option. When you realize that, hey, this is a human individual who is very young, like I once was and deserves to be protected just like any other human individual, that's when your thinking changes. This is a human with his or her own DNA and who is very much alive and distinct from the mother. It is neither the mother nor the father. The unborn child is a unique human -- a unique person.

The cells in this human and in the mother are doing what they can to help this tiny creature grow up to develop so that it become a human adult eventually. Maybe this is just an Austin and Houston thing, I have noticed that the SPCA has gone from "kill" animal shelters to "adopt" animal shelters (I realize that some dogs are still put down). Maybe they are doing the same thing in your city for stray (unwanted) animals. Maybe Bubba looks at you like you're insane when you suggest that he should put his unwanted mutt up for adoption instead of shooting it or injecting it with a lethal cocktail. However, just like Bubba can learn about dog adoption, the public can learn about human adoption as a more humane alterantive to abortion. Maybe we can do the same thing for the really young humans as well.

It's a new frontier that we could explore. There was a time when Blacks weren't considered humans with rights either. That was wrong, just like our thinking about fetuses is wrong now. Let's do the humane thing here. Let's not "kill" the fetuses; let's place them for adoption, giving them at least the same right to life as a stray dog or cat. I'm not suggesting that equating unborn humans to stray dogs or cats is where we want to be, but it would be a step up from where we are today. Not everyone wants an abused and abandoned Rottweiler, but there are groups that seek these animals out and place them in loving homes. Same thing for the tiny humans. There are groups that want to take these unwanted little tykes and place them into loving homes.

2. I don't think the whole father raises the kid thing is that simple. If the father of the child was a deadbeat and he showed up at the hospital right after the labor claiming "I'm the father! I have rights!" He can actually just refuse to let the woman put it up for adoption, I don't believe the father actually needs to make PROVISIONS for that child, till he gets dragged into court and forced to pay child support. (which sometimes isn't paid anyway). Current laws seem to require that there A. Be no father (nowhere in the picture, isn't coming back or dead) or B. that he also consent to giving it up for adoption.
I think this process makes it actually very difficult for a woman to bear the 9 month pregnancy and hope to God that either the father doesn't show up or will be willing to sign the form and leave her alone. That's probably a more significant barrier than what you claim to just be "inconveniencing the woman."

Great points. Adoption law is really complicated. Adoption isn't the only legal issue that parents can face. A common one (unfortunately) is divorce. I wish that parents could get along, but that's not always possible. When you have a divorce you can't just put your kids down like a stray dog when you don't want them anymore or you don't want your (soon to be ex) spouse meddling in their affairs. You have to go through the court system, which can be inconvenient, expensive, and painful. The kids have rights too, including the right to life. The legal system the best system we have, and we can work to improve it. In the meantime, we need to work within the legal system that we have. On the plus side, there are many crisis pregnancy agencies that will work with mothers who have unplanned children and will cover all their expenses. There are no guarantees it will all work out, but it's worth a try in my opinion. Abortion is a lot more convenient, just like lethal injection or crushing is a lot more convenient than going through divorce court to figure out who gets the kids; the most convenient or pain-free way isn't necessarily the most ethical or moral way. We need to respect all lives, including the lives of children, unborn and born.

 

[snoozer]

I'm really glad that it is being mentioned. I think the public isn't always doing the brightest things. I could give you some examples if you need proof.

Yes, if you think the fetus has less of a right to live than a stray dog, then adoption is just another option. When you realize that, hey, this is a human individual who is very young, like I once was and deserves to be protected just like any other human individual, that's when your thinking changes. Maybe this is just an Austin and Houston thing, I have noticed that the SPCA has gone from "kill" animal shelters to "adopt" animal shelters (I realize that some dogs are still put down). Maybe they are doing the same thing in your city for stray (unwanted) animals. Maybe we can do the same thing for the really young humans as well. It's a new frontier that we could explore. There was a time when Blacks weren't considered humans with rights either. That was wrong, just like our thinking about fetuses is wrong now. Let's not "kill" the fetuses; let's place them for adoption, giving them at least the same right to life as a stray dog or cat.



Great points. Adoption law is really complicated. However, when you have a divorce you can't just put your kids down like a stray dog when you don't want them anymore or you don't want your (soon to be ex) spouse meddling in their affairs. You have to go through the court system, which can be inconvenient, expensive, and painful. The kids have rights too, including the right to life. The legal system the best system we have, and we can work to improve it. However, in the meantime, we need to work within the legal system that we have. On the plus side, there are many agencies that will work with mothers who have unplanned children and will cover all their expenses. There are no guarantees it will all work out, but it's worth a try in my opinion. Abortion is a lot more convenient, just like lethal injection or crushing is a lot more convenient than going through divorce court to figure out who gets the kids; the most convenient or pain-free way isn't necessarily the most ethical or moral way. We need to respect all lives, including the lives of children, unborn and born.

1. The reason why things are presented as OPTIONS, and not 1 > 2 are simply because at this point in time, your idea that the fetus has a right to life is a belief you hold, rather than a stated fact that pre 20 week fetus = to another person. This is why if you were counseling a patient the 1st thing to do would be present the options: there are in this example 2: abortion and adoption.
Just like it would be wrong for a care provider to say: well it isn't alive so you should have the abortion
It would also be wrong to say: it's clearly alive so you should just suck it up and give it up for adoption.

My point here is just that: what you think the fetus' rights are shouldn't be imposed upon the patient. They have to make their own decision.

2. In a divorce, and the situation you are talking about: you already have kids, talking, walking around, pooping in diapers, whatever. It's not like there'd be any argument to how to split the kids in half once you're getting a divorce. When a woman is 6 weeks pregnant, and she doesn't want to support a potential life, I don't think it's as clear cut.

 

[OncoCaP]

1. The reason why things are presented as OPTIONS, and not 1 > 2 are simply because at this point in time, your idea that the fetus has a right to life is a belief you hold, rather than a stated fact that pre 20 week fetus = to another person.

Yes, I do have this belief. Yes, it's true that pre-20 weeks, humans have no rights. That's why adoption is only presented as an option. I don't like it, but it makes sense.

Humans clearly have their own DNA and cells that are replicating and developing into the placenta, fetus, etc. very early on. It is true that this pre-20 week human does not legally have the right to live apart from the mother's wish. It's a sad state of affairs.

This is why if you were counseling a patient the 1st thing to do would be present the options: there are in this example 2: abortion and adoption.
Just like it would be wrong for a care provider to say: well it isn't alive so you should have the abortion
It would also be wrong to say: it's clearly alive so you should just suck it up and give it up for adoption.

Err, wait. Are you saying that a healty, developing, growing fetus isn't alive? What is your definition of "alive"? Are you saying the fetus is "dead"?

I'm quite sure that "alive" means possessing life. There are many formal definitions of life wiki lists several of them, which the fetus seems to satisfy quite nicely (at least to the extent it doesn't, I'll show you an "alive" human being that has a similar limitation).

Here is a common definition:http://en.wikipedia.org/wiki/Life
"There is no universal definition of life; there are a variety of definitions proposed by different scientists.To define life in unequivocal terms is still a challenge for scientists [1][2].

Conventional definition: Often scientists say that life is a characteristic of organisms that exhibit the following phenomena:

Homeostasis: Regulation of the internal environment to maintain a constant state; for example, sweating to reduce temperature. -- check, the fetus and placenta perform regulatory functions (along with the mother, of course). The heart is pumping to supply nutrients to the growing tissues. The fetus is doing a lot chemically and physiologically to sustain its life.

Organization: Being composed of one or more cells, which are the basic units of life.
Metabolism: Consumption of energy by converting nonliving material into cellular components (anabolism) and decomposing organic matter (catabolism). Living things require energy to maintain internal organization (homeostasis) and to produce the other phenomena associated with life. -- check. No question here.

Growth: Maintenance of a higher rate of synthesis than catalysis. A growing organism increases in size in all of its parts, rather than simply accumulating matter. The particular species begins to multiply and expand as the evolution continues to flourish. -- check.

Adaptation: The ability to change over a period of time in response to the environment. This ability is fundamental to the process of evolution and is determined by the organism's heredity as well as the composition of metabolized substances, and external factors present. -- check. The fetus clearly adapts to its environment in the womb (much as the mother's body does things to sustain the child's life). The child will "grow" in a particular direction (to stay in the uterus, for example, as opposed to penetrating through it). Some of these adaptive processes are rather slow, but they take place.

Response to stimuli: A response can take many forms, from the contraction of a unicellular organism when touched to complex reactions involving all the senses of higher animals. A response is often expressed by motion, for example, the leaves of a plant turning toward the sun or an animal chasing its prey. -- Check. The fetus certainly doesn't respond to stimuli like an adult human. However, there are nerves developing very early on, and they can certainly respond to stimuli:

BMJ 1996;313(7060):797 (28 September),
http://www.bmj.com/cgi/content/full/313/7060/797
"The development of the human spinal cord is a highly orchestrated process in which neurone and glial specific genes are induced in a manner closely similar to that in experimental animals.5 It becomes functional early in fetal life, and reflex movements to somatic stimuli can be evoked between 7.5 and 14 weeks while at the same time the fetus begins to move spontaneously in the absence of any obvious external stimulation. It is important to emphasise the reflex nature of these movements even though they may involve extensive body regions and therefore intersegmental and brain stem connections. They occur (in abnormal patterns) in anencephalic fetuses at 16-35 weeks even when only parts of the spinal cord are intact.6

Reproduction: The ability to produce new organisms. Reproduction can be the division of one cell to form two new cells. Usually the term is applied to the production of a new individual (either asexually, from a single parent organism, or sexually, from at least two differing parent organisms), although strictly speaking it also describes the production of new cells in the process of growth. -- Check. Well, the cells are certainly dividing, so there is that element of reproduction. However, sexual maturity is not reached until the teenage years, and no one is suggesting that a 4-year-old immature human female is not alive.

So it seems that the fetus is very much alive. It isn't fully developed, but neither is a 4-year-old human.

Thus, it would be factual to say:
"Your fetus is alive, and an abortion would kill this fetus."

... and appropriate to ask: "Are you willing to respect his or her life by choosing to carry your child to term and then place this boy or girl up for adoption?"

My point here is just that: what you think the fetus' rights are shouldn't be imposed upon the patient. They have to make their own decision.

Yes, you describe the situation as it is. I'm suggesting that we do better. For example, the situation as it is today may be that some people have very limited access to healthcare (no insurance, etc.). This is what we have. I'm suggesting that we do better.

 

[stiffany]

Yes, true. There is a big difference though between the adoption of 13-year-olds and newborns (don't you agree?). After all, we have security in the maternity wards because people steal babies ... they are valuable. We could use many more.

I agree. Although I still question why some children (like toddlers) get stuck in the foster care system. What happens if mom doesn't abort for whatever reason and then later realizes she can't handle the child after a period of time and the child becomes neglected and abused? Or, what happens if mom never gives up the kid and the cycle continues, as is often the case with 14 year old children of 28 year olds (with 42 year old mothers themselves) having children. Is that the better outcome? I'm not sure myself actually having come from and known people who had crappy childhoods but are now respectable, well-educated adults and also having known people who never got over theirs.

The good thing is that most abortions are for children of an ethnicity that people want (arrg -- I don't like that this is such an issue) and for children with parents without a history of mental issues. So, most mothers/ children would qualify.

Okay. I still question whether or not the desire to go outside of the country for children and the inability of some people to find "suitable children" (agree with you on the term nastiness) has to do with a lack of babies for adoption or some other issue. For one, adoption is easier in some other countries than the United States.

Well, we all have issues, and, when it comes to abuse and neglect, that's what the foster care system is there for. I lived next to a family with ~8 foster kids (biological parents were in jail or had drug habits). It was really sad, but the kids did get excellent care.

True, but what about the crappy foster care families?

Well, it's the breakup of the family. Not a good thing. I guess it's not valued like it used to be.... Do you think we should promote families with both parents present or do you have another idea?

I think two parent families or large families with lots of caregivers (like aunts and uncles, grandparents nearby) should be encouraged. However, I do not think that marriages should stay together for the "sake of the children." I very vaguely remember reading some news article once about how seeing one's parents go through divorce is actually easier on children than being in a stressful home situation with dueling parents. Still, I think having parents who are around and supportive (no matter what gender mix or remarriage/relationship status) is something that's really needed.

I don't think that people are wondering about contraception these days. People are using abortion as a method of contraception. I agree that there are better ways, and I plan to educate my children about contraceptives.

People are using abortion as a method of contraception because they're either A. lazy, B. uninformed, C. unable to get the emergency contraception, birth control pills, or condoms they need to protect themselves both against HIV/STIs and pregnancy, and D. because *&%$ happens. I still think there is a general lack of understanding and availability of contraception. Many HMOs don't cover it and they're not required to by law in several states(Anecdotally, when I decided on my contraceptive method of choice after many attempts to find something that didn't make me have awful side effects, my insurance wouldn't cover it. However, they would cover my entire pregnancy, labor and delivery, and the future healthcare of my new dependent. I was fortunate enough to be able to pay the $500 up front, but otherwise I would have been stuck). Also, individual pharmacists aren't required to sell you emergency contraception even though it's an FDA approved substance for general use (being over-the-counter! in some countries) so what happens if you've forgotten your birth control pill or the condom breaks and you don't want to have a child? You can either hope your pharmacist lets you have it or you can silently pray that the EPT test you take at the end of the month comes back negative (Definitely not fun).

I still think there are grave barriers to effective means of contraception. We have an abstinence only education policy in our public schools. When I was in middle school and high school (granted this was in the mid-90s and in Texas), our education about sex consisted of a discussion about the fact that you could get HIV and then called STDs from having sex, not to mention that more frightening thing called pregnancy (At least back when I was a teenager I was more worried about pregnancy than anything else - still not worried enough to not have sex though). There was no discussion about birth control pills, nor one of those banana demonstrations about how to use a condom or even where one could get them. Fortunately, I had grandparents who, while not open to discussing my actual sex life with me, were willing to discuss contraception, protecting myself against STDs and pregnancy in the abstract (aka, she's not having sex of course but she still needs this info for the future...). However, parents being willing to talk about contraception (and help kids get forms other than condoms) and admit their kids are having sex really hinders what I consider the safety of many a 16 year old. I think much more openness is still needed and I'm hoping that's something that changes in the next presidential administration regardless of whether a conservative or liberal person heads the White House.

Nice chatting in this thread though - while a bit of the banter got annoying for a bit with people just antagonizing each other, it's a very well thought out topic. Maybe being in allo versus pre-allo helps that a bit...

 

[stiffany]

Err, wait. Are you saying that a healty, developing, growing fetus isn't alive? What is your definition of "alive"? Are you saying the fetus is "dead"?

Here is a common definition:http://en.wikipedia.org/wiki/Life
"There is no universal definition of life; there are a variety of definitions proposed by different scientists.To define life in unequivocal terms is still a challenge for scientists [1][2].

So it seems that the fetus is very much alive. It isn't fully developed, but neither is a 4-year-old human.

Thus, it would be factual to say:
"Your fetus is alive, and an abortion would kill this fetus."

... and appropriate to ask: "Are you willing to respect his or her life by choosing to carry your child to term and then place this boy or girl up for adoption?".

So, as the wiki article cited states, there's no decided upon definition of life. Your definition is different from snoozers, which is different from mine. I don't think it's fair to argue about the definition of life and tell someone they're wrong when clearly there's no definitive consensus. It's your opinion versus someone else's opinion on something that comes down to belief once you get in that gray zone. Clearly a four year old is alive - they can run and talk and there are thought processes going on up there that we know about. A 2 or 7 or 20 week old fetus is different than that. Where you draw the line within that period before viability as an independent person (or even once viability happens but before birth when I think it's acknowledged in many, but not all cultures that the baby has a right to live) I think comes down to personal beliefs about what it means to be a person and an individual.

I actually think that asking a mother about whether or not she's willing to respect the fetus' life is a completely loaded question and that stating that the fetus is alive not only pushes an agenda, but also disrespects the fact that the mother could have a differing opinion that's perfectly acceptable since society hasn't decided uniformally when life officially "starts". If the mother doesn't think that the fetus has what I'll term personhood, then I don't think it's possible to disrespect it. Instead, I think by asking someone that, as a physician, you're allowing your personal beliefs to directly affect your advice for your patient. I think it is perfectly legitimate to provide your patient with all her options matter of factly (adoption, termination, keeping the child) and then express your personal opinion IF she asks for it, but only as long as you openly admit your biases and don't try to hide behind science, which clearly as the wiki article lays out, hasn't formed an official stance on the issue.

 

[psipsina]

Err, wait. Are you saying that a healty, developing, growing fetus isn't alive? What is your definition of "alive"? Are you saying the fetus is "dead"?

I'm quite sure that "alive" means possessing life. There are many formal definitions of life wiki lists several of them, which the fetus seems to satisfy quite nicely (at least to the extent it doesn't, I'll show you an "alive" human being that has a similar limitation).

Here is a common definition:http://en.wikipedia.org/wiki/Life
"There is no universal definition of life; there are a variety of definitions proposed by different scientists.To define life in unequivocal terms is still a challenge for scientists [1][2].

Conventional definition: Often scientists say that life is a characteristic of organisms that exhibit the following phenomena:

Homeostasis: Regulation of the internal environment to maintain a constant state; for example, sweating to reduce temperature. -- check, the fetus and placenta perform regulatory functions (along with the mother, of course). The heart is pumping to supply nutrients to the growing tissues. The fetus is doing a lot chemically and physiologically to sustain its life.

Organization: Being composed of one or more cells, which are the basic units of life.
Metabolism: Consumption of energy by converting nonliving material into cellular components (anabolism) and decomposing organic matter (catabolism). Living things require energy to maintain internal organization (homeostasis) and to produce the other phenomena associated with life. -- check. No question here.

Growth: Maintenance of a higher rate of synthesis than catalysis. A growing organism increases in size in all of its parts, rather than simply accumulating matter. The particular species begins to multiply and expand as the evolution continues to flourish. -- check.

Adaptation: The ability to change over a period of time in response to the environment. This ability is fundamental to the process of evolution and is determined by the organism's heredity as well as the composition of metabolized substances, and external factors present. -- check. The fetus clearly adapts to its environment in the womb (much as the mother's body does things to sustain the child's life). The child will "grow" in a particular direction (to stay in the uterus, for example, as opposed to penetrating through it). Some of these adaptive processes are rather slow, but they take place.

Response to stimuli: A response can take many forms, from the contraction of a unicellular organism when touched to complex reactions involving all the senses of higher animals. A response is often expressed by motion, for example, the leaves of a plant turning toward the sun or an animal chasing its prey. -- Check. The fetus certainly doesn't respond to stimuli like an adult human. However, there are nerves developing very early on, and they can certainly respond to stimuli:

BMJ 1996;313(7060):797 (28 September),
http://www.bmj.com/cgi/content/full/313/7060/797
"The development of the human spinal cord is a highly orchestrated process in which neurone and glial specific genes are induced in a manner closely similar to that in experimental animals.5 It becomes functional early in fetal life, and reflex movements to somatic stimuli can be evoked between 7.5 and 14 weeks while at the same time the fetus begins to move spontaneously in the absence of any obvious external stimulation. It is important to emphasise the reflex nature of these movements even though they may involve extensive body regions and therefore intersegmental and brain stem connections. They occur (in abnormal patterns) in anencephalic fetuses at 16-35 weeks even when only parts of the spinal cord are intact.6

Reproduction: The ability to produce new organisms. Reproduction can be the division of one cell to form two new cells. Usually the term is applied to the production of a new individual (either asexually, from a single parent organism, or sexually, from at least two differing parent organisms), although strictly speaking it also describes the production of new cells in the process of growth. -- Check. Well, the cells are certainly dividing, so there is that element of reproduction. However, sexual maturity is not reached until the teenage years, and no one is suggesting that a 4-year-old immature human female is not alive.

So it seems that the fetus is very much alive. It isn't fully developed, but neither is a 4-year-old human.

I think we are all well aware of the definition of life (or we should be if we managed to do moderately well on the MCAT). The thing is that the embryo isn't doing this stuff on its own. Its kindof like a virus that fits all of the above qualifications but it can't replicate without a host cell, because it lacks its own reproductive machinery, so many scientists claim that they aren't alive, or if they are we certainly don't say they have a right to live in the host cell. Even once the rudimentary organs are in place the embryo can't ventilate its blood supply. An embryo can't live on its own, even with every medical intervention known to man until about 23wks, which pretty much everyone agrees is the logical cut of for elective abortions. Also many people equate humaness not with the genetic code held within a cells nucleus but with self awareness and an wired limbic system which are also events in late fetal development. I think the culmination of these ideas is why science hasn't defined the early embryo and fetus as "alive".

I also understand that spiritual issues play a large role in this debate, as many people are concerned more with the presence of a soul than some definitive biological moment that we've defined as alive. But the understanding of what a soul is and when a person recieves it are going to vary far and wide amongst people. My personal belief is that the universe wouldn't invest a soul at the moment of conception because so many early embryos are spontaneously aborted (medline says 50% before a woman even knows that she's pregnant and then 10% more before week 12) . . . it just doesn't make any sense to me that a something as special as a soul would be invested in something that is likely going to cease to exist shortly afterwards. I'm giving my belief as an example of how widely spiritual beliefs can vary, and who are we to determine who's spiritual belief has more or less value. If we impose one person's beliefs on everyone else we are essentially devaluing every other belief.

Because science hasn't been able to definively rule on the life status of a fetus before it is viable outside the womb, and because so much of the definition rides on personal beliefs that vary widely, we can't make the procedure illegal in a country that was founded on religious freedom. To do so would be declaring that one belief system had more inherent value which goes against everything this country was founded upon.

It is also equally troublesome for a physician to advocate one option over another when the only reason for their opinion is their personal values. We are supposed to respect the patients autonomy in all our actions, and their right to value their personal beliefs as much as you value yours is part of this. If I was your patient and you devalued my beliefs in an attempt to make me change my beliefs I would be very hurt, and embarrased, and would feel intimidated. These aren't emotions physicians tend to try and inspire in their patients.

 

[OncoCaP]

I agree. Although I still question why some children (like toddlers) get stuck in the foster care system. What happens if mom doesn't abort for whatever reason and then later realizes she can't handle the child after a period of time and the child becomes neglected and abused? ...

It's a huge leap to assume that a child who is not aborted will become abused or wind up in a foster home (any more than a child who was not considered as a potential abortee). Until you can provide some information that this is actually the case, you'll have to forgive me for pointing out that this is mere speculation.

Yes, there are bad parents out there who abuse or neglect their children. The first problem is that we don't know which parents are going to abuse or neglect their children. The second problem is even if we think that a certain demographic abuses children, we can't stop them from having kids.

You do make a great point though. If we have parents who do not want their children, we need to make sure that we have someplace for them to go. I would argue that we do. The foster care system is not where all the kids who should have been aborted wind up. My experience with foster care is that there are many reasons why children wind up there that have nothing to do with whether the children were wanted or not, including substance abuse of the parents, financial problems that came about after the child was born, or just plain evil parenting (that the parent thinks is perfectly ok), etc.

Okay. I still question whether or not the desire to go outside of the country for children and the inability of some people to find "suitable children" (agree with you on the term nastiness) has to do with a lack of babies for adoption or some other issue. For one, adoption is easier in some other countries than the United States.

Yes, U.S. legal adoption issues are one factor, but you'll find that that is only one of several issues, and the supply of newborns available for adoption (particularly the 'desirable' ones that are most frequently aborted) is a big issue:

http://www.prb.org/Template.cfm?Sec...tManagement/ContentDisplay.cfm&ContentID=7951
"One reason for the rise of international adoptions is the dwindling supply of adoptable children within the United States.1 Increased access to contraception, the availability of legal abortion, decreases in the teen birth rate, and reduced social stigma surrounding unmarried parenting are among the reasons that there are fewer U.S.-born children available for adoption. Some demographers also point to the postponement of marriage and childbearing as fueling the demand for adopted children. Women in their 30s or 40s are more likely to encounter problems getting pregnant and carrying a pregnancy to term than younger women, and some turn to adoption to have the child they want.

"Unmarried American mothers are no longer a common source of children for adoption. Although the percentage of births to unmarried women has increased dramatically since the 1970s, and accounted for one-third of all U.S. births in 2000, many unmarried mothers now keep their children or transfer their children's legal custody to relatives rather than put them up for adoption. Young teenage mothers are less likely to keep their babies, but the birth rate for young teens has fallen steadily since 1991, according to the National Center for Health Statistics.

"Another reason why many parents are looking abroad for children is that adopting within the United States is legally complicated, slow, and costly. Public adoptions through the foster care system are less prone to legal snarls but are much slower, making it difficult to adopt children while they are still infants. Less than 2 percent of children adopted through the foster care system in 1998 were infants, compared with 46 percent of children adopted from abroad.2

True, but what about the crappy foster care families?

Do you have information that foster care is worse than non-foster care? It seems to me that children in foster care are closely monitored for potential abuse. If anything, there appears to be more potential for abuse of non-foster children than of foster children (although I don't have any data). I'm not saying that foster care is a great thing, but let's recognize that newborns are more easily adopted than the 10-year-old girls and boys that wind up in foster care.

In any case, I question your assertion that kids who are not aborted have a greater chance of winding up in foster care than any other kid (until you show me some data anyway).

I think two parent families or large families with lots of caregivers (like aunts and uncles, grandparents nearby) should be encouraged. However, I do not think that marriages should stay together for the "sake of the children." I very vaguely remember reading some news article once about how seeing one's parents go through divorce is actually easier on children than being in a stressful home situation with dueling parents. Still, I think having parents who are around and supportive (no matter what gender mix or remarriage/relationship status) is something that's really needed.

There are complex family issues here. If the child can be raised by its mother, that's ideal. However, it isn't always possible, and that's where adoption comes in.

People are using abortion as a method of contraception because they're either A. lazy, B. uninformed, C. unable to get the emergency contraception, birth control pills, or condoms they need to protect themselves both against HIV/STIs and pregnancy, and D. because *&%$ happens. I still think there is a general lack of understanding and availability of contraception. Many HMOs don't cover it and they're not required to by law in several states(Anecdotally, when I decided on my contraceptive method of choice after many attempts to find something that didn't make me have awful side effects, my insurance wouldn't cover it. However, they would cover my entire pregnancy, labor and delivery, and the future healthcare of my new dependent. I was fortunate enough to be able to pay the $500 up front, but otherwise I would have been stuck). Also, individual pharmacists aren't required to sell you emergency contraception even though it's an FDA approved substance for general use (being over-the-counter! in some countries) so what happens if you've forgotten your birth control pill or the condom breaks and you don't want to have a child? You can either hope your pharmacist lets you have it or you can silently pray that the EPT test you take at the end of the month comes back negative (Definitely not fun).

Yes, life is complicated, and not everyone is very good at it. Contraception has issues, but it works well for those who want to make the effort. When things go wrong, we don't need to kill the unborn child. There are other solutions.

...
Nice chatting in this thread though - while a bit of the banter got annoying for a bit with people just antagonizing each other, it's a very well thought out topic. Maybe being in allo versus pre-allo helps that a bit...

Yes, it has been a nice discussion. I appreciate your opinions and thoughts.

 

[OncoCaP]

I think we are all well aware of the definition of life (or we should be if we managed to do moderately well on the MCAT). The thing is that the embryo isn't doing this stuff on its own. Its kindof like a virus that fits all of the above qualifications but it can't replicate without a host cell, because it lacks its own reproductive machinery, so many scientists claim that they aren't alive, or if they are we certainly don't say they have a right to live in the host cell.

So, if I understand you correctly, a fetus is best compared to a virus, which doesn't even have organelles is smaller than any of the cells in a fetus and never develops into a multicellular organism? Somehow that doesn't seem like a very good analogy at all.

Actually, the fetus is doing a great job of replicating its cells. It has many of the functions we find in a human, like a pumping heart, for example. In fact, there are elective abortions taking place where the child *could* survive outside the mother's womb. If you'll grant me that no child that is viable outside the womb of the mother should be aborted except if it endangers the life of the mother, I'll consider that a huge step forward. Pro-choice advocates will never grant this. In fact, late-term abortion procedures *require* that the child be *killed* by lethal injection or other means prior to delivery (delivering the baby alive poses a problem).

Even once the rudimentary organs are in place the embryo can't ventilate its blood supply. An embryo can't live on its own, even with every medical intervention known to man until about 23wks, which pretty much everyone agrees is the logical cut of for elective abortions. Also many people equate humaness not with the genetic code held within a cells nucleus but with self awareness and an wired limbic system which are also events in late fetal development. I think the culmination of these ideas is why science hasn't defined the early embryo and fetus as "alive".

Well, a patient in the hospital may have trouble ventilating its blood supply as well, and we don't consider that a reason that an issue of convenience gives physicians an excuse to give that animal a lethal injection either. Also, what many people twist so that they can kill another human doesn't really serve anyone well. It's a human. It's alive. It can respond to stimuli. It's growing. Give it time and it will eat, cry, and poop.

I also understand that spiritual issues play a large role in this debate, as many people are concerned more with the presence of a soul than some definitive biological moment that we've defined as alive. But the understanding of what a soul is and when a person recieves it are going to vary far and wide amongst people.

Well, I think aborted babies go to Heaven, so it's not a problem for me when it comes to their soul. I could see how this might be a problem for some people, however. I also agree that there are cases where we have done everything reasonable to help save a person's life and we just can't do any more. In other cases, we just cannot allow a life to continue because it will threaten another more viable life.

What I am asking is that we provide accommodation for the lives of the unborn. I'm not suggesting that women be required to raise every child they conceive. I am suggesting that when they have a child in their womb, they should respect that life, even if they don't need to legally.

Because science hasn't been able to definively rule on the life status of a fetus before it is viable outside the womb, and because so much of the definition rides on personal beliefs that vary widely, we can't make the procedure illegal in a country that was founded on religious freedom. To do so would be declaring that one belief system had more inherent value which goes against everything this country was founded upon.

I would argue that the issue here is not a limitation of science, it's simply a reflection of the selfishness of some women, who value their convenience above the life of another human being. Again, I would consider a grant that viable fetuses should not be subjected to abortion (as in if it stays alive when we deliver it, we don't kill it, but try to save it) an enormous step forward. If you grant this, you pro-choice friends will not agree with you.

It is very difficult to question that a fetus is alive. It takes some real twisting of the definition to suit one's desired end result to come to that conclusion that the fetus is not alive. We know that we have a human being at conception. It is one cell. That's where it starts. The cell is alive. Moreoever, that cell is not a frog cell, lizard cell, or chimp cell. It is uniquely human and a unique human at that. Anyone who questions this is misrepresenting the facts that we do know about life from science. Also, to the extent that we have questions or doubts, we need to err on the side of safety. If we have a patient and we don't know if they are alive or no, we continue to do what we can for them. It is not until they are confirmed dead (heart not pumping, no brain waves, etc.), that we stop trying.

I'm all for religious freedom as long as it doesn't involve elective abortion of a fetus that is we have plenty of reasons to suspect is alive. We can have a humane, civil society without killing our very you so that men and women don't need to be embarrassed about an unwanted pregnancy. Yes, we should be supportive and encouraging, but not if it involves killing another human so that someone won't feel bad.

It is also equally troublesome for a physician to advocate one option over another when the only reason for their opinion is their personal values. We are supposed to respect the patients autonomy in all our actions, and their right to value their personal beliefs as much as you value yours is part of this. If I was your patient and you devalued my beliefs in an attempt to make me change my beliefs I would be very hurt, and embarrased, and would feel intimidated. These aren't emotions physicians tend to try and inspire in their patients.

You know, it was troublesome when some people questioned the prevailing belief that black people were subhuman. It probably hurt some white people's feelings for someone to group them with those people. No only that, but hundreds of thousands of men died because some people questioned the status quo -- talk about a disadvantage. It was troublesome when people questioned why women didn't have the right to vote or the right to contraception. It probably embarrassed and made some men and women very angry.

There is good kind of troublesome and bad kind of troublesome. Good kind of troublesome fights for what is right. It protects the weak or very young from injury or death, even at the expense of hurting, embarrassing, or intimidating someone. I wish it didn't have to come to that, but when you are dealing with someone who wants to kill a young human, it can lead to conflict. When you have a ped patient who has a black eye and a ruptured spleen, you don't worry about whether the parent might be embarrassed or hurt about you asking about what happened and that you don't agree that this could happen from the child just falling over. You ask the tough questions about the potential child abuse even if you could be wrong because you care, not just for the parent, but the child as well. Bad kind of troublesome devalues human life on the basis of convenience. It caters to the status quo without questioning it. It supports a system that injuries and mains millions of innocent human children just so that someone doesn't need to be embarrassed. Just because there are cases where abortion is justified, doesn't mean that we should just let the unjustified cases "slide." Sometimes trouble is a good thing.

 

[stiffany]

It's a huge leap to assume that a child who is not aborted will become abused or wind up in a foster home (any more than a child who was not considered as a potential abortee). Until you can provide some information that this is actually the case, you'll have to forgive me for pointing out that this is mere speculation.

In any case, I question your assertion that kids who are not aborted have a greater chance of winding up in foster care than any other kid (until you show me some data anyway).

Yes, it has been a nice discussion. I appreciate your opinions and thoughts.

Thanks. I guess I wasn't trying to imply that children who are considered for abortion and then aren't aborted are more likely to end up in foster care. Sorry for not being clear. I was saying that, since the people against abortion argue for adoption as a viable option, they need to consider what happens for children that are adopted. Certainly many foster parents are wonderful, but there are still cases where it doesn't work out or where kids aren't adopted into permanent homes. Rates of kids in the social welfare system have actually been fairly steady over the past seven years (although I don't know what that trend looks like pre-2000). Plus, I think if a woman is considering abortion, there is something in her life that she feels limits her ability to take care of a child. While I'm sure there are plenty of cases where these circumstances are overcome, not being able to afford raising a kid is definitely one of them that is difficult to fix, especially with recent cuts in food stamps, WIC aid, and the "mother back to work" phenomenon - In a large number of cases, with the money mom makes from work, she can barely cover child care, much less anything else.

I think we're on somewhat of the "same side" in terms of foster care/adoption. However, I think I continue to hold a lot more skepticism about the system. As someone with friends who work for NY child welfare system, the reality of their day to day interactions and case files startle me.

 

[stiffany]

Just because there are cases where abortion is justified, doesn't mean that we should just let the unjustified cases "slide." Sometimes trouble is a good thing.

The problem with this statement is the fact that the two sides of the abortion debate differ in terms of what they consider unjustified abortions. As I've maintained throughout, something that flat out angers me about the pro-life stance is that they consider women who do not want to have children as somehow being deviant or lazy because they can't go through the process of pregnancy/raise the child that they AND A PARTNER created. As I said above, it first takes two to tango and I don't see a lot of people on O'Reily taking about where the men are in many of these equations. I also don't like the fact that pro-lifers think that these babies should be "saved from the horror, immoral thing that is abortion", but many don't bother to do things to help support mothers who can't support their babies or support moves for contraceptive options and education in our schools. Instead, women are damned if they have sex and end up pregnant and also damned for seeking contraception or receiving sex education. It can't go both ways and since 90+ percent of people have sex before marriage instead of abstaining as they're encouraged to do by the gvt (being the only option officially allowed to be taught), it's an awful irony. I guess to lay my own "agenda" out on the line, I think abortion is bad and is a really crappy alternative for the WOMEN who have to undergo it. It shouldn't be seen as a form of contraception as you mentioned it is earlier. And, there should be more social support for poorer women or women who are not in stable relationships or able to support children on their own instead of general scapegoating about the sin of abortion. At the end of the day, I believe unless it's your body and your life, no one has a right to make decisions that affect you forever. I realize that people may retort with "well, we say murder is wrong" and if they believe abortion is murder, so be it. However, until scientists and lay-people and the government can agree on the definition of personhood and until we provide women with alternatives other than carrying an unwanted child to term and potentially raising it without help or having a back-alley abortion, my personal belief is that abortion should be considered a personal choice.

Oh, on a different note if you're interested since you said you believe aborted babies go to heaven, there are some great rituals in Japan for women who miscarry (and also for some women who abort, mostly due to genetic issues since abortion is somewhat stigmatized) to get closure through these official ceremonies that honor the life of their lost children. You could probably find out more info on a google search if you're interested. There are beginning to be some movements in the United States for similar things, especially within the infertility support movement for women who have trouble carrying pregnancies to term.

 

[snoozer]

So, if I understand you correctly, a fetus is best compared to a virus, which doesn't even have organelles is smaller than any of the cells in a fetus and never develops into a multicellular organism? Somehow that doesn't seem like a very good analogy at all.

Actually, the fetus is doing a great job of replicating its cells. It has many of the functions we find in a human, like a pumping heart, for example. In fact, there are elective abortions taking place where the child *could* survive outside the mother's womb. If you'll grant me that no child that is viable outside the womb of the mother should be aborted except if it endangers the life of the mother, I'll consider that a huge step forward. Pro-choice advocates will never grant this. In fact, late-term abortion procedures *require* that the child be *killed* by lethal injection or other means prior to delivery (delivering the baby alive poses a problem).



Well, a patient in the hospital may have trouble ventilating its blood supply as well, and we don't consider that a reason that an issue of convenience gives physicians an excuse to give that animal a lethal injection either. Also, what many people twist so that they can kill another human doesn't really serve anyone well. It's a human. It's alive. It can respond to stimuli. It's growing. Give it time and it will eat, cry, and poop.



Well, I think aborted babies go to Heaven, so it's not a problem for me when it comes to their soul. I could see how this might be a problem for some people, however. I also agree that there are cases where we have done everything reasonable to help save a person's life and we just can't do any more. In other cases, we just cannot allow a life to continue because it will threaten another more viable life.

What I am asking is that we provide accommodation for the lives of the unborn. I'm not suggesting that women be required to raise every child they conceive. I am suggesting that when they have a child in their womb, they should respect that life, even if they don't need to legally.



I would argue that the issue here is not a limitation of science, it's simply a reflection of the selfishness of some women, who value their convenience above the life of another human being. Again, I would consider a grant that viable fetuses should not be subjected to abortion (as in if it stays alive when we deliver it, we don't kill it, but try to save it) an enormous step forward. If you grant this, you pro-choice friends will not agree with you.

It is very difficult to question that a fetus is alive. It takes some real twisting of the definition to suit one's desired end result to come to that conclusion that the fetus is not alive. We know that we have a human being at conception. It is one cell. That's where it starts. The cell is alive. Moreoever, that cell is not a frog cell, lizard cell, or chimp cell. It is uniquely human and a unique human at that. Anyone who questions this is misrepresenting the facts that we do know about life from science. Also, to the extent that we have questions or doubts, we need to err on the side of safety. If we have a patient and we don't know if they are alive or no, we continue to do what we can for them. It is not until they are confirmed dead (heart not pumping, no brain waves, etc.), that we stop trying.

I'm all for religious freedom as long as it doesn't involve elective abortion of a fetus that is we have plenty of reasons to suspect is alive. We can have a humane, civil society without killing our very you so that men and women don't need to be embarrassed about an unwanted pregnancy. Yes, we should be supportive and encouraging, but not if it involves killing another human so that someone won't feel bad.



You know, it was troublesome when some people questioned the prevailing belief that black people were subhuman. It probably hurt some white people's feelings for someone to group them with those people. No only that, but hundreds of thousands of men died because some people questioned the status quo -- talk about a disadvantage. It was troublesome when people questioned why women didn't have the right to vote or the right to contraception. It probably embarrassed and made some men and women very angry.

There is good kind of troublesome and bad kind of troublesome. Good kind of troublesome fights for what is right. It protects the weak or very young from injury or death, even at the expense of hurting, embarrassing, or intimidating someone. I wish it didn't have to come to that, but when you are dealing with someone who wants to kill a young human, it can lead to conflict. When you have a ped patient who has a black eye and a ruptured spleen, you don't worry about whether the parent might be embarrassed or hurt about you asking about what happened and that you don't agree that this could happen from the child just falling over. You ask the tough questions about the potential child abuse even if you could be wrong because you care, not just for the parent, but the child as well. Bad kind of troublesome devalues human life on the basis of convenience. It caters to the status quo without questioning it. It supports a system that injuries and mains millions of innocent human children just so that someone doesn't need to be embarrassed. Just because there are cases where abortion is justified, doesn't mean that we should just let the unjustified cases "slide." Sometimes trouble is a good thing.

1. Psipsina was not saying that the fetus is a virus, I think she is trying to say it is similar in that, without a host organism it cannot replicate. I don't recall any stories where a doctor suctioned out a tiny embryo, put it in a petri dish and it became an infant that later grew into an adult. You're right, embryos do a great job of replicating ... in the PROPER environment when being GIVEN the right amount of stuff and the right kind of stuff.

2. Yes there are abortions taking place where the fetus could be viable outside of the womb, but please remember that these are a very small % of all abortions taking place and that these may also encompass cases where women's lives are at risk. Of course there must be instances where the women's lives are not truly "at risk", they're "depressed" or whatever the abortionist can scramble into the slot to justify collecting an unduly large sum for the procedure. These, however, are not what psipsina is advocating for.

3. your statement about pro-choice advocates is very narrow minded, a sweeping generalization that is most likely untrue. This would be the standard of another person saying to you "all pro-life people are against Plan B because it's abortion." Pro-choice and pro-life are broad categories that are terms for how people generally label themselves, but unlike a professional code, it's a LOT more flexible.

4. Your statement about the selfishness of women seems to convey that all women KNOW it's alive and human and therefore are just in denial. Yet there are many women and men, in fact, who believe it is NOT alive and are not just in denial.

5. Novel Human DNA =/= a human being in my definition. Although it may be in yours, you cannot pretend that this is universally accepted as fact. Frankly, a tumor (another analogy you may have a bad emotional reaction to) is often a sort of novel DNA in a person, and that new cell w/ its mutated DNA is indeed alive and replicating (w/in a host of course) but it isn't a new human being, is it?

6. I don't think that it's so cut and dry that a 5 week or 6 week fetus = a person w/ rights. Anencephalic (dramatic example here) babies are not exactly alive ever, but they feed and grow into full term if you don't catch it early and they do die upon exiting the womb.

 

[OncoCaP]

Thanks. I guess I wasn't trying to imply that children who are considered for abortion and then aren't aborted are more likely to end up in foster care. Sorry for not being clear. I was saying that, since the people against abortion argue for adoption as a viable option, they need to consider what happens for children that are adopted.

Yes, ok. I would be fine with identifying what potential adoptive parents are out there, what exactly they are looking for, and then, when a mother comes for an abortion, saying, "By the way, there are many couples out there who want a child. Here is the list. If I understand your situation correctly, there are 100 couples in this area that would like a child like yours. Would you consider carrying it to term rather than having an abortion?"

That would be a nice start. However, for many women there are some real embarrassment or intimidation reasons for not taking the pregnancy to term. There are some women whose parents would be very angry if they found out that their daughter had an out-of-wedlock pregnancy. A young woman who babysat my kids had such a pregnancy and lost her job as a teaching intern at a religious school because of that pregnancy. If she had an abortion instead, she would have been able to keep that job. Her boyfriend also pressured her to have an abortion. He left her when he found out that she was going to carry the baby to term. Many women have abortions because of pressure or perceived threat of pressure from people around them. This is a serious problem, and one of the reasons I was pro-choice for many years. I thought it was hypocritical to on the one hand say "don't have an abortion" and on the other hand, fire someone for their job because they chose to take an unplanned pregnancy to term. Even as difficult as it is, I'm never going to excuse killing a very young unborn child because people are going to say and do mean things to you. I wouldn't accept such excuses for abuse and/or killing of a 2-year-old child anymore than for a 20-week-old child.

Certainly many foster parents are wonderful, but there are still cases where it doesn't work out or where kids aren't adopted into permanent homes. Rates of kids in the social welfare system have actually been fairly steady over the past seven years (although I don't know what that trend looks like pre-2000). Plus, I think if a woman is considering abortion, there is something in her life that she feels limits her ability to take care of a child.

Certainly it would make sense to start with those cases where adoption looks like a great option. In those cases, where adoption seems unlikely and the mother does not want the child the situation is more difficult. If we could agree that at least doing something about those cases where there are plenty of adoptive parents or where some counseling or other support could help the mother take care of the child would be possible, then that would be a great place to start. The more difficult cases could be postponed until we have something we could do there.

While I'm sure there are plenty of cases where these circumstances are overcome, not being able to afford raising a kid is definitely one of them that is difficult to fix, especially with recent cuts in food stamps, WIC aid, and the "mother back to work" phenomenon - In a large number of cases, with the money mom makes from work, she can barely cover child care, much less anything else.

I'm all for starting with the easier situations and then working on alternatives to the more difficult abortion situations.

I think we're on somewhat of the "same side" in terms of foster care/adoption. However, I think I continue to hold a lot more skepticism about the system. As someone with friends who work for NY child welfare system, the reality of their day to day interactions and case files startle me.

It's not a perfect system. I don't think it's necessary to link abortion and foster care. Most adopted babies don't wind up in foster care ... they wind up in loving homes.

 

[psipsina]

So, if I understand you correctly, a fetus is best compared to a virus, which doesn't even have organelles is smaller than any of the cells in a fetus and never develops into a multicellular organism? Somehow that doesn't seem like a very good analogy at all.

Actually its a really good analogy since science can't decide if either a blastula or a virus is alive. Thats the point I was making, that the definition of life that you provided doesn't proove that an embryo is any more alive than a virus because neither can perform these functions that define life on their own. Trying to apply the scientific definition of life to an embryo is as shaky as applying it to a virus, which is why science has never definitively stated that either is alive.

Actually, the fetus is doing a great job of replicating its cells.

When did I say it wasn't . . .

It has many of the functions we find in a human, like a pumping heart, for example.

the functional word here being "many". many doesn't = human. A cat has many of the functions that we find in humans, but most people would not argue that a cat is equally protected under the law as a human. The things that separate lower species from humans are the other qualities like a CNS capable of higher thought, self awareness, complex emotions etc that you never addressed the fetus not having.

In fact, there are elective abortions taking place where the child *could* survive outside the mother's womb. If you'll grant me that no child that is viable outside the womb of the mother should be aborted except if it endangers the life of the mother, I'll consider that a huge step forward. Pro-choice advocates will never grant this.

I think most states require that elective abortions not take place after week 23 unless the health of the mother is at risk (didn't an earlier post from trustwoman discuss this?). I think you'd be hard pressed to find a physician willing to abort a 28wk fetus simply because the mom had decided she didn't want it anymore. There would have to be much more compelling reasons.

Well, a patient in the hospital may have trouble ventilating its blood supply as well, and we don't consider that a reason that an issue of convenience gives physicians an excuse to give that animal a lethal injection either.

A person on a vent in a hospital has already attained their human potential and have all the other variables intact such as a CNS with higher cortical function and a soul. They are alive by scientific and religious definitions whereas an embryo/early fetus is not.

It's a human. It's alive. It can respond to stimuli. It's growing. Give it time and it will eat, cry, and poop.

No, the point is that by scientific definition, and many spiritual definitions it is not alive. It has the potential to attain life but it is not alive by any definition other than those that rest entirely on personal beliefs which can't legally be imposed on any one else.

What I am asking is that we provide accommodation for the lives of the unborn. I'm not suggesting that women be required to raise every child they conceive. I am suggesting that when they have a child in their womb, they should respect that life, even if they don't need to legally.

You are asking that every woman define life according to your spiritual belief system. You are thereby devaluing the belief systems of others that don't define life the same way. Because spiritual beliefs are so important to people it can be deeply hurtful to have them devalued by others. As a layperson you can do whatever you please in this arena, but when put into a position of power and trust as a physician you should try not to be hurtful to your patients by devaluing their deeply held spiritual beliefs like this. If you try to impose your definition of life (which is only based on your spiritual beliefs) upon your patients you will only hurt them, and probably make them very defensive, which will make them more likely to go against your advice anyway.

I would argue that the issue here is not a limitation of science, it's simply a reflection of the selfishness of some women, who value their convenience above the life of another human being.

I think we already discussed situations where the woman might not be making the decision to abort for her convienience and why making blanket judgements like this of individual situations can be wrong. I think its hurtful to imply that all women who make this choice are simply being selfish. If I were raped I would definitely abort, having the rapists dna proliferating within me would surely destroy any remaining mental stablity that I may posess. I would also abort if my husband were abusive as he could prevent the baby from being adopted. These are just two examples of many permutations of situations that may make the decision to have an abortion about more than selfish convienience.

It is very difficult to question that a fetus is alive.

For you, with your personal beliefs, it is. For others with differing beliefs it may not be. You are judging others from your perspective and need to aknowledge that other valid perspectives might exist.

Anyone who questions this is misrepresenting the facts that we do know about life from science.

So the majority of the scientific community is misrepresenting scientific facts when they refuse to define a fetus as alive. But you with your BS know infinitely more than the majority of trained scientists? Really. Your absolutely confident of this?

Also, to the extent that we have questions or doubts, we need to err on the side of safety. If we have a patient and we don't know if they are alive or no, we continue to do what we can for them. It is not until they are confirmed dead (heart not pumping, no brain waves, etc.), that we stop trying.

As I discussed before the struggling already alive having attained human status with a functioning cortex patient is not equateable to a fetus who is not by scientific definition alive and does not have higher cortical function. The only thing that makes these equal in your mind are your personal beliefs, which you can't impose upon others legally or under the code of conduct.

I'm all for religious freedom as long as it doesn't involve elective abortion of a fetus that is we have plenty of reasons to suspect is alive.

You have plenty of reason to suspect based on your personal beliefs. "We" don't necessarily share these beliefs. Your beliefs do not guide the nation precisely because of religious freedom. You don't get to make exceptions to suit your personal beliefs, thats the whole point.

We can have a humane, civil society without killing our very you so that men and women don't need to be embarrassed about an unwanted pregnancy. Yes, we should be supportive and encouraging, but not if it involves killing another human so that someone won't feel bad.

There are plenty of reasons that women choose to abort other than avoiding "feeling bad". See the discussion above.

The only reason you can define the act of an elective abortion as "killing another human" is because of your personal beliefs. You can not impose those beliefs on your patients, because it is unethical not to respect patient autonomy (one of those code of conduct things).

You know, it was troublesome when some people questioned the prevailing belief that black people were subhuman.

Last time I checked science has prooved that black people are in fact human so this is a false comparison to the "is the fetus alive with equal status as a postnatal human debate"

There is good kind of troublesome and bad kind of troublesome. Good kind of troublesome fights for what is right.

Its only right according to your individual belief system which I and many other americans do not share with you. You don't have the right to impose that belief system upon the rest of us.

You really need to be able to separate your beliefs from facts. I know that my beliefs about karma and reincarnation are not fact for many others, I would never attempt to impose my beliefs on everyone else because I recognize this. I believe that every animal has a soul that is equal in every way to the human soul and should be valued as such. The current system that is used in america to raise and process animals as food is probably as revolting to me as the idea of aborting a blastula is to you, but I would never impose this on anyone else, especially my patients. I don't have the right to judge others. I'm not morally superior to anyone else and my beliefs aren't more valuable than anyone elses. Your assumption that your beliefs are more valuable and therefore the truth devalues everyone else around you. When you take on the role of the physician you take on the responsibility not to do this to your patients.

 

[OncoCaP]

1. Psipsina was not saying that the fetus is a virus, I think she is trying to say it is similar in that, without a host organism it cannot replicate. I don't recall any stories where a doctor suctioned out a tiny embryo, put it in a petri dish and it became an infant that later grew into an adult. You're right, embryos do a great job of replicating ... in the PROPER environment when being GIVEN the right amount of stuff and the right kind of stuff.

There are at least two issues here: (1) Just because you consider the fetus to be a parasite doesn't mean it isn't alive. There are plenty of parasites that are very much alive. There are also parasites that need a very specific host and a very specific location within that host. The difference, of course is that this parasite is a human and this human is going to leave the mother unharmed in the cases we are talking about here. There are plenty of stories of abortions where the child had to be killed before being delivered. If you would just grant me those, I would consider it a huge step forward in this debate. (2) There are plenty of patients that need blood transfusions, liver transplants, etc. etc. Just because they need these things and cannot survive without them doesn't mean they are not alive. In fact there are people in comas that are considered alive. There may be a decision to terminate life if there is no hope for recovery, but no hospital is going to terminate the life of a neonatal patient that is expected to make a perfect recovery in 38 weeks.

2. Yes there are abortions taking place where the fetus could be viable outside of the womb, but please remember that these are a very small % of all abortions taking place and that these may also encompass cases where women's lives are at risk. Of course there must be instances where the women's lives are not truly "at risk", they're "depressed" or whatever the abortionist can scramble into the slot to justify collecting an unduly large sum for the procedure. These, however, are not what psipsina is advocating for.

Oh really? So she agrees that elective abortions of viable fetuses (one that survive outside the womb by proving it, not by some time standard) should not be done? That would be a pleasant surprise for me. I'm not saying that I agree that fetuses that need more nurture in the womb are automatically ok for abortion for any reason. I'm just saying that stopping all elective abortions of viable fetuses (as in they prove they can survive by trying it) would be a major breakthrough here (even if this is only 200 or so cases per year).

3. your statement about pro-choice advocates is very narrow minded, a sweeping generalization that is most likely untrue. This would be the standard of another person saying to you "all pro-life people are against Plan B because it's abortion." Pro-choice and pro-life are broad categories that are terms for how people generally label themselves, but unlike a professional code, it's a LOT more flexible.

Ok, tell me about a national pro-choice advocate on the record who thinks that elective abortions of viable fetuses should only be done if the mother's life is in danger (she is going to bleed to death), and I'll stand corrected.

4. Your statement about the selfishness of women seems to convey that all women KNOW it's alive and human and therefore are just in denial. Yet there are many women and men, in fact, who believe it is NOT alive and are not just in denial.

Here is the breakdown from a poll:

http://www.harrisinteractive.com/NEWS/allnewsbydate.asp?NewsID=94
When Does Life Begin?

"People have different views about when human life beings. Listed below are some points at which people might say life begins. Which best describes your views about when life begins?

47% believe that life begins at conception
12% believe that when brainwaves or motion is observed from the fetus
24% believe at the point of viability.

*********
Women know these fetuses are alive. They aren't wondering about it.

5. Novel Human DNA =/= a human being in my definition. Although it may be in yours, you cannot pretend that this is universally accepted as fact. Frankly, a tumor (another analogy you may have a bad emotional reaction to) is often a sort of novel DNA in a person, and that new cell w/ its mutated DNA is indeed alive and replicating (w/in a host of course) but it isn't a new human being, is it?

There you go, twisting what I said. Go back and read my message. I listed the definition of life the way you would see it in a textbook. I showed you how a fetus meets all the criteria. Go back to the definition and prove to me beyond a reasonable doubt that the fetal patien is not alive and thus we can remove it. You can't do it because the fetus is alive. The only thing you can show is that it needs nurture and it is not fully developed. That's it; that's all you can show. Give it time, and if it is healthy, it will develop into a normal human. I never said that novel DNA makes a human. You and I both know enough about DNA to know that a tumor cell does not have the right DNA in the right form in the right situation to ever make another human being naturally. You don't wake up one morning after sunbathing and find a baby growing out of your back. Your tumor cell has a damaged version of *your* DNA. It's a damaged version of you, not another human being. I don't mind you having a different opinion, but let's not twist scientific facts, like what we understand life to be. Even if there are some doubts, we can't just "abort" a patient who shows some signs of life but not others (unable to breath on own, needs blood transfusions, cannot reproduce, etc.).

6. I don't think that it's so cut and dry that a 5 week or 6 week fetus = a person w/ rights. Anencephalic (dramatic example here) babies are not exactly alive ever, but they feed and grow into full term if you don't catch it early and they do die upon exiting the womb.

[/QUOTE]

If the baby dies on its own from natural causes, so be it. I can accept that. I find it unethical to kill a healthy child in the womb because it would embarrass the mother to carry it to term.

 

[snoozer]

There are at least two issues here: (1) Just because you consider the fetus to be a parasite doesn't mean it isn't alive. There are plenty of parasites that are very much alive. There are also parasites that need a very specific host and a very specific location within that host. The difference, of course is that this parasite is a human and this human is going to leave the mother unharmed in the cases we are talking about here. There are plenty of stories of abortions where the child had to be killed before being delivered. If you would just grant me those, I would consider it a huge step forward in this debate. (2) There are plenty of patients that need blood transfusions, liver transplants, etc. etc. Just because they need these things and cannot survive without them doesn't mean they are not alive. In fact there are people in comas that are considered alive. There may be a decision to terminate life if there is no hope for recovery, but no hospital is going to terminate the life of a neonatal patient that is expected to make a perfect recovery in 38 weeks.



Oh really? So she agrees that elective abortions of viable fetuses (one that survive outside the womb by proving it, not by some time standard) should not be done? That would be a pleasant surprise for me. I'm not saying that I agree that fetuses that need more nurture in the womb are automatically ok for abortion for any reason. I'm just saying that stopping all elective abortions of viable fetuses (as in they prove they can survive by trying it) would be a major breakthrough here (even if this is only 200 or so cases per year).



Ok, tell me about a national pro-choice advocate on the record who thinks that elective abortions of viable fetuses should only be done if the mother's life is in danger (she is going to bleed to death), and I'll stand corrected.



Here is the breakdown from a poll:

http://www.harrisinteractive.com/NEWS/allnewsbydate.asp?NewsID=94
When Does Life Begin?

"People have different views about when human life beings. Listed below are some points at which people might say life begins. Which best describes your views about when life begins?

47% believe that life begins at conception
12% believe that when brainwaves or motion is observed from the fetus
24% believe at the point of viability.

*********
Women know these fetuses are alive. They aren't wondering about it.



There you go, twisting what I said. Go back and read my message. I listed the definition of life the way you would see it in a textbook. I showed you how a fetus meets all the criteria. Go back to the definition and prove to me beyond a reasonable doubt that the fetal patien is not alive and thus we can remove it. You can't do it because the fetus is alive. The only thing you can show is that it needs nurture and it is not fully developed. That's it; that's all you can show. Give it time, and if it is healthy, it will develop into a normal human. I never said that novel DNA makes a human. You and I both know enough about DNA to know that a tumor cell does not have the right DNA in the right form in the right situation to ever make another human being naturally. You don't wake up one morning after sunbathing and find a baby growing out of your back. Your tumor cell has a damaged version of *your* DNA. It's a damaged version of you, not another human being. I don't mind you having a different opinion, but let's not twist scientific facts, like what we understand life to be. Even if there are some doubts, we can't just "abort" a patient who shows some signs of life but not others (unable to breath on own, needs blood transfusions, cannot reproduce, etc.).

1. I never said it was a parasite, I said it could be LIKE one in that it needs a host. If the embryo didn't need a host, there'd be no abortion debate at all.

2. I did grant you those that there are abortions where that occur w/ abortionists and viable fetuses, but I don't advocate for those, plus I think they're most likely illegal. However I do think that if a woman goes in for her 6 mth ultrasound and her baby has NO SKULL and the doctor has to dismember it to take it out or otherwise the birthing compromise the woman's uterus, I think it's acceptable because the woman's fertility is being preserved so that she can have children later since her current fetus is NOT viable by medical standards.

3. My point was that pro-choice and pro-life are just labels, not set rules and that by labeling yourself pro-choice or pro-life does not necessarily mean you will claim all the tenets of a prochoice/prolife organization to be your own.

4. Much like I am not certain the fetus is alive, I am also not certain it is not alive. If I could prove EITHER way without a reasonable doubt, I wouldn't have a debate with anyone cause I'd know the answer.

5. Your statement about waking up after sunbathing seems to say something like "if you get cancer from sunbathing, it isn't your fault" but If you get pregnant, that's your fault. See how that makes it sound like you're punishing the woman? I'm not sure that's your intent but your stance seems to be that women are just at fault and unwilling to accept responsibilty. Again, I'm NOT SURE that's your intent but IF IT WERE: that would be a terrible judgement to just make about women you DON'T KNOW.

6. Scientific facts do not tell us what defines "life". This is, like what psipsina said, confusion of beliefs for facts.

7. I read that article and a large number of pro-choice think that life begins after viability. Of course, when you look at the overall (which incorporates pro-lifers who are obviously unlikely to GET AN ABORTION) it seems like most people think life begins at conception. But the women who show up at the clinic to go and get an abortion are unlikely to fall into the category of prolife so you can't really just say: they all know its alive. A large number of them: 78% when I summed it up in fact, think life begins after brain waves. 61% think they are not sure or its after viability. So I think it'd be safe to say that AS MANY AS 61% of pro-choice women who MAY or may not seek an abortion do NOT KNOW it is alive.

 

[vtucci]

Because it is in her body. Because the very existence of that being is intimately and totally tied into the existence of the woman. Because she alone must face the risks in carrying it (which as we both know can range from minor to devastating). This is not discrimination, this is biology. No person can be forced to be life support for another.

Also, it's because no one else has the power or the right to determine the moral worth of a fetus. Not you, not me, not the President. No one can agree on its value, and no one can determine it. But sometimes, these calls must be made. Who better than the woman?[/QUOTE

For those of you who have been looking for a woman to take up the OP's cause, well here you go. I do not believe you need a womb to have an opinion on abortion so gentlemen, I welcome your thoughts. Also, I think the OP should be applauded on thinking about these tough ethical dilemmas before he is smack dab in the middle of rotations.

Ladies- for all of you who are gung ho pro-choice advocates who believe that the woman has the ultimate right to decide the moral worth of the fetus as it resides in her body, I must respectfully disagree. Except in the cases of rape and incest, the woman decided to participate in an act that she knew (or should have known) could result in pregnancy. This is a question of responsibilty and two lives are involved. We do not get to abdicate our responsibilities when we engage in sexual intercourse and say well gee it was an accident and I don't want a child. As adults, we should have thought about that before. If you cannot handle the results of intercourse, you are not mature enough to have it. Society should get a right to say how it values life and if that means banning abortion, so be it. Being opposed to abortion does not merely mean that we are not educated sufficiently on the issues.

The reason abortion is such a hot-button issue is that we cannot all agree on when "life" begins. As a former attorney, please let me tell you that Roe v. Wade is undoubtedly the worst written decision in Supreme Court history, not because of the decision permitting abortion, but because it did not appropriately address both sides of the issue. Moreover, the lines in the sand that the Court drew on this issue keep being whitled away (e.g., viability- with advances in technology and medications, the number of weeks a fetus is viable is different in 2007 than it was in 1972). For those of you interested, overturning Roe v. Wade would result in a patchwork quilt of laws with some states permitting abortion and others forbidding it. That is not something I think would be in our nation's interest either.

Every law we have is based on larger ethical or moral frameworks (e.g., thou shalt not kill- statutes against murder, thou shalt not steal-statutes against larceny, fraud etc). Whether it is religion or natural law, it is not as simple as to separate it out and say we should not bring our own opinions into the hospital when treating patients. The laws are already set up forcing us to do this (i.e., reporting certain diseases and not others in the public interest, reporting suspected child abuse).

For those of us who believe that life begins at conception, abortion is murder (however, you can think of abortion in the ectopic scenario like self-defense killing instead of murder). Also, as has been mentioned, pregnant women represent two patients. Consider the case where there is a pregnant woman who does not want to abort her fetus but who is addicted to drugs and as a result, her fetus is addicted to drugs. Would it be in everyone's best interests to forcibly detox her or imprison her for child endangerment even though it is her body?

Additionally, there is no law (political or religious) that prohibits abortions in cases where the mother's life is in danger so even the most staunchly opposed to abortion physician should be amenable to perfoming this procedure when necessary to preserve life.

I plan to go into emergency medicine and while I object to elective abortions on ethical and religious principle, I would gladly perform an abortion in the case of an ectopic pregnancy and do everything I could to save the life of the mother.