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=> yet one more article about abortion

yet one more article about abortion
Posted by Habibi (Guest) - Tuesday, August 10 2004, 0:04:52 (CEST)
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Also, I forgot to add the word "spontaneous" in front of abortion in the titles of some of my posts below.
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The Lancet
Volume 362, Issue 9395 , 8 November 2003, Page 1509
Editorial

USA continues war over abortion

Available online 7 November 2003.

Even before US President George W Bush had a chance to sign the partial-birth abortion Act of 2003, opponents had filed court challenges to block its implementation. Supporters claim the Act outlaws a "gruesome and inhumane" procedure that is "never medically necessary". Opponents say the Act will deny a woman access to a rarely performed but medically accepted procedure that may be necessary to protect her health. In addition, opponents charge, the Act is so vaguely worded it could be used to prosecute physicians who perform the most common abortion procedure in the second trimester—dilatation and evacuation.

On first reading, the Act's language seems precise. It defines partial-birth abortion as an abortion in which the physician "… 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 fetus".

The Act was drafted after similar state laws were struck down by the courts. Since its landmark 1973 Roe v Wade decision that legalised abortion, the US Supreme Court has repeatedly ruled that a woman has a "fundamental" right to decide to terminate a pregnancy. Because it is a fundamental right, the state must demonstrate "a compelling state interest" to restrict abortion, the Courts have ruled, and the state's interest in protecting the fetus did not become compelling until the fetus can survive independently of its mother, the point of viability. Then, at the point of viability, the Court has said, the state could "go as far as to proscribe abortion except where it is necessary, in appropriate medical judgement, for the preservation of the life or health of the mother". In 2000, the US Supreme Court reaffirmed the tenets of Roe v Wade and struck down a partial-birth abortion law enacted by the State of Nebraska noting that the wording of the law was so vague that it could apply to dilatation and evacuation, which is commonly used in abortions of pre-viable fetuses, and because the law made no exception for procedures done to protect the mother's health.

To get around these objections, Congress refined its definition of a partial-birth abortion but opponents point out that the description could still apply to a dilatation and evacuation procedure at any stage of gestation. As written, the ban could apply to procedures done at any point in a pregnancy and makes no mention of fetal viability. Congress could easily have clarified this issue by using the more precise and medically accepted term for the procedure, intact dilatation and extraction, and by adding a sentence to note that the ban did not apply to dilatation and evacuation. The fact that the drafters did not include this language suggests that opponents of the law are correct that the intent of the law is indeed to intimidate all physicians who provide abortion services. To address the Court's insistence that any ban must have a "health" exception, Congress included in the law legislative findings from Congressional hearings that the Congress says indicate the procedure is never necessary to protect a woman's health. This conclusion runs counter to the opinion of the American College of Obstetricians and Gynecologists, which holds that while it can identify no circumstances under which intact dilatation and extraction would be the only option to protect a woman's health or life, the procedure "may be the best or most appropriate procedure in a particular circumstance".

It seems unlikely that the new Act will satisfy the Court's objections and will only serve to further divide the USA over the issue of abortion. Rather than trying to legislate around Roe v Wade, Congress should instead work on providing US citizens with better access to contraceptive services. Currently, about one half of pregnancies in the USA are unintended and half of these end in abortion. If Congress passed legislation to provide comprehensive contraceptive services to the poor and to sexually active teenagers, and required health insurers to cover contraceptives, it would do more to reduce abortion than passing bans that, if they withstand court challenge, will only succeed in driving abortions underground.



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