Wednesday, October 22, 2003

"Partial-Birth" Abortion Is Propaganda

Or, "How to Become a Physician Without Going to Medical School."

Want to make your mother proud, by allowing her to refer to you as "My son/daughter, the doctor"? Or, perhaps you wish to impress your friends, or you think you care about the well-being of your fellow human beings?

In other words, do you want to become a physician, but don't really want to go to Medical School, spend 3 to 7 years as a virtual slave doing a residency, and begin your professional life with an average of $100,000 in student loans? Well, then have I got the solution for you. Get thyself elected a U.S. Senator or House Representative, and get ready to make medical decisions.

Regardless of what your personal preference/opinion is vis-a-vis abortion, the recent passage of Bill S 3, the Prohibition on Partial-Birth Abortions, should really scare you. Why? Because this bill has nothing to do with abortion. It has to do with unlicensed, unqualified individuals making religious/moral decisions about the quality of medical care you should receive. I was almost certain this is illegal in this country, but clearly I was mistaken.

First, let's examine the medical facts. Bill S 3 (to see all 5 versions, go here) states the following (emphasis added):

'(a) Any physician who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus shall be fined under this title or imprisoned not more than 2 years, or both. This subsection does not apply to a partial-birth abortion that is necessary to save the life of a mother whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself. This subsection takes effect 1 day after the date of enactment of this chapter.

'(b) As used in this section--

'(1) the term 'partial-birth abortion' means an abortion in which--

'(A) the person performing the abortion deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus; and

'(B) performs the overt act, other than completion of delivery, that kills the partially delivered living fetus;


This bill is not about abortion because THERE IS NO MEDICAL TERM OR PROCEDURE CALLED "PARTIAL BIRTH ABORTION". Abortions are classified in 2 ways: based on the mechanism of initiation; and based on abortion technique.

1. Classification based on mechanism of initiation: An abortion is either Spontaneous, or Induced.

A Spontaneous abortion is an abortion which "occurs without medical or mechanical means to empty the uterus" (p 856). The lay term for Spontaneous abortion is Miscarriage.

An Induced abortion is "the medical or surgical termination of pregnancy before the time of fetal viability" (p 869). A subset of the Induced abortion is the Elective (Voluntary) one, which is "the interruption of pregnancy before viability at the request of the woman but not for reasons of impaired maternal health or fetal distress" (p 869).

2. Classification based on technique: Abortion can be performed either Medically or Surgically.

Medical regimens involve the woman taking a drug, or combination of drugs which will cause labor to start.

The Surgical techniques are:

MENSTRUAL ASPIRATION-- The contents of the uterine cavity are manually aspirated using a small tube (5- or 6-mm Karman cannula) attached to a syringe. This is used within 1-3 weeks after a missed menstrual period.

DILATATION AND CURETTAGE-- The cervix (the bottom part of the uterus which protrudes partway into the vagina) is first dilated, and then the pregnancy is evacuated by scraping (sharp curettage), or vacuum aspiration (suction curettage) of the uterine cavity. Because the likelihood of intra-op complications increases after the first trimester, the technique of curettage is best used before 14 weeks.

DILATATION AND EVACUATION-- The cervix is dilated, followed by mechanical extraction (using an instrument called a forceps, which is introduced inside the uterus and is used to grasp POC tissue) and evacuation of fetal parts. This technique is used after 16 weeks, up to 24 weeks.

DILATATION AND EXTRACTION-- Same as above, except part of the fetus is first extracted through the dilated cervix, in order to facilitate the evacuation.

*Please note that this technique involves partial delivery of fetal parts through the cervix in order to facilitate EVACUATION (as in physical removal), not TERMINATION.

HYSTEROTOMY-- The pregnancy is evacuated via an incision made in the uterus (entry is via the abdomen, like in a Cesarean section). (This technique is only used in an emergency or when the other techniques are contraindicated.)

HYSTERECTOMY-- The entire uterus is removed. (This technique is only used in an emergency or if there's a medical indication.)

If you are interested, here's a step-by-step description of the surgical techniques. And here's a link to Williams Obstetrics, if you want to verify the accuracy of the medical information I used (the pages quoted are from the 21st edition). This is an expensive book, $139, so you might want to borrow it from the Library.

So, the medical classification, of the medical procedure of abortion does not include such a thing as "partial-birth abortion". This is because, BY DEFINITION, AN ABORTION CAN ONLY OCCUR BEFORE THE FETUS IS VIABLE.

Viability is the ability of the fetus to live independently of the mother. This usually occurs at 24 weeks (if you happen to live near a Level III, NICU hospital).

Once the fetus reaches viability, an abortion, either spontaneous (miscarriage), or elective (induced) can not occur. Instead, a PRETERM (PREMATURE) DELIVERY (birth) happens. (A pregnancy is considered full term after 37 weeks.)

Bill S 3 defines partial-birth abortion as follows:

'(1) the term 'partial-birth abortion' means an abortion in which--

'(A) the person performing the abortion deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus; and

`(B) performs the overt act, other than completion of delivery, that kills the partially delivered living fetus;

Medically, this definition is nonsensical:

-- performing the abortion...delivers a living fetus

By definition, an abortion can only occur before fetal viability. If you are performing an abortion you can not have a "living" fetus. During an abortion, there is no "living" fetus: the fetus does not have functional lungs. Of course, the fetus has the POTENTIALITY for viability. However, the potentiality for being alive at some point in the future, and actually being alive and living are not one and the same. Two points. First, just because a fetus has the potential for viability, nothing, and I mean NOTHING known to man, can actually insure, or even predict with certainty that said fetus will be delivered as a living neonate (newborn). Second, the language of the bill makes no mention of "potential" viability. It states as a given that the person "delivers a living fetus", a medically impossible fact. (A pre-viable fetus can not be a living fetus.)

-- for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus and performs the overt act, other than completion of delivery, that kills the partially delivered living fetus

Since an abortion occurs before fetal viability, THE DELIVERY OF A PRE-VIABLE FETUS WILL TERMINATE THE PREGNANCY. In other words, a pre-viable fetus, by definition, can not exist/survive independent of the mother (i.e., outside the uterus). Once a delivery has been initiated, the delivery will terminate the pregnancy. Medically, the delivery is the "overt" act in this case.

Second, let's look at the non-medical aspects of this bill.

Any physician who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus

I am not a legal expert, but what does interstate or foreign commerce have to do with performing medical procedures? The only possible explanation I could think of is a patient who crosses state lines to have a procedure performed. But, if she doesn't have any money, how is that "commerce"? Moving on, legally, how can you kill something which is not alive?

' (c)(1) The father, if married to the mother at the time she receives a partial-birth abortion procedure, and if the mother has not attained the age of 18 years at the time of the abortion, the maternal grandparents of the fetus, may in a civil action obtain appropriate relief, unless the pregnancy resulted from the plaintiff's criminal conduct or the plaintiff consented to the abortion.

Again, this is a legal issue, but it appears that Bill 3 gives a woman's husband and/or her parents a legal claim to her body. I shall abstain from making any sarcastic comments here, out of respect for the American men and women who are fighting and dying in foreign lands. While they are working towards bringing about freedom and rights to the women of Afghanistan and Iraq, our own legislators see fit to go the opposite direction, and treat women as property.

"This is very important legislation that will end an abhorrent practice and continue to build a culture of life in America," he said in a statement. "I look forward to signing it into law."

The above is President Bush's statement. Specifically, what is the "abhorrent" practice? (The legislation doesn't contain any reference to a known medical practice.) In general, when and why is it appropriate to characterize an/any established, approved medical procedure as "abhorrent", and what are the criteria used? Why is legislation used to "build a culture of life in America" and, more importantly, what is the meaning of a "culture of life" in this context?

Senate Majority Leader Bill Frist, R-Tenn., a heart surgeon, said the ban could save the lives of thousands of soon-to-be-born babies.

And daily reality in American hospitals says the ban could doom the lives of thousands of actual, live women.

And last, but not least:

"Today we have reached a significant victory as we continue to build a more compassionate society and a culture that values every human life," said Sen. Rick Santorum, R-Pa., the bill's sponsor.

Except, of course, the human life of over 60 million U.S. women considered by Sen. Santorum incapable of making a responsible decision, too "weak-minded" to be trusted with important issues. And, also except the life work of hundreds of thousands of dedicated healthcare professionals, viewed by Sen. Santorum as incompetent buffoons.

Some time ago, Andrew Sullivan criticized Sen. Santorum's comments on homosexuals as "an expression of a bleak future, in which tolerance and privacy are subject to the approval of "moral" majorities". Yesterday, Steven Den Beste had a post supporting the rights of men accused of rape, and Armed Liberal had a post in support of women taking responsibility for their own actions. I hope they take the time, and use their considerable talent to strongly condemn the passage of Bill 3, a piece of legislation based, not on science, but on the approval of "moral" politicians, on the premise that medical professionals have less rights than accused rapists (the accused rapist is innocent until proven guilty; the medical professional is guilty for practicing medicine), and on the assumption that women are infantile, second-class citizens.

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1 Comments:

At 3:06 AM, Anonymous Anonymous said...

disgusting

 

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