Editor’s Note, July 8th, 2008: In response to the recent flurry of news coverage concerning Barack Obama’s statements on late term abortion, the federal abortion ban, and health exceptions for pregnant women, RH Reality Check is republishing relevant articles that we hope
will focus the debate and add the crucial voices of those who are directly affected by these laws – women and physicians.
The Supreme Court dealt a stunning blow to doctors last Wednesday, when they upheld a federal law banning a particular abortion method. As a board member of Physicians for Reproductive Choice and Health (PRCH), I’ve spoken with many abortion providers in the days since the ruling. They are full of questions, concerned about their patients and confused about the language of the ruling. Most of all, the physicians I’ve spoken with are asking how this ruling affects the way they practice medicine and the safety of the treatments their patients receive.
As physicians, we have a responsibility to act in our patients’ best interests—but the Supreme Court has just allowed Congress to override doctors’ expert opinions and ban a specific abortion method. This decision endangers women’s health and makes it harder for physicians to provide the best possible care to women. The doctors I’ve spoken to are angry and upset that they can no longer use a method they consider safest and best for many patients.
Dr. Christopher Estes shared a story with PRCH about a patient he treated last year. In an op-ed he wrote for The Daily News, Dr. Estes recalls treating a woman he calls Lisa. She was pregnant with her third child, and suffering from a heart condition that developed during her last delivery.
"Her condition had worsened substantially within the last week, and we were not sure how much longer her heart could withstand the strain of her pregnancy," he says. Dr. Estes believed the safest treatment for Lisa was an abortion using the method Congress has banned. "I will have to think long and hard about what I will do the next time I take care of a patient like Lisa. What am I supposed to say to her? ‘I’m sorry, but you’re part of the small fraction of women our laws ignore?’"
It is absurd to think that politicians know more about medicine than the physicians who care for women every day, yet that is just what this decision says. Even as Justice Kennedy acknowledged that some of Congress’ findings were "factually incorrect," his opinion upheld the law as written.[img_assist|nid=3187|title=undefined|desc=|link=none|align=right|width=150|height=190]
The Supreme Court’s decision asserts many things that are simply not true. For instance, the ruling contends that because some women might regret having an abortion if they knew what was involved, the state should anticipate that and protect them. Essentially, this ruling says that untrained politicians can make medical decisions for all of America—even when doctors vehemently disagree with Congress’ supposed findings.
The language used in both the law and the Court’s decision troubles physicians. PRCH member Dr. Amy Autry notes that so-called "partial birth abortion" isn’t even a medical term: "That’s just a lay term," she says. "What they describe could be actually almost any abortion procedure."
Though Kennedy’s opinion refers to the procedure as intact dilation and evacuation, many physicians I’ve spoken to still aren’t clear about which abortion methods they can legally use. Dr. Deborah Oyer, another PRCH member, spoke to National Public Radio about the ban. "How to define exactly where the line is between legal and illegal in the procedures we do isn’t clear to me," she notes. "If I interpret it as drawn in one place and the courts interpret it somewhere else, I may have crossed the line."
Doctors are rightfully concerned about crossing that legal line. According to the act, we face up to two years in jail and hefty fines if convicted of violating the law.
We’ve heard from legal experts that the ban will go into effect 25 days after the Supreme Court decision, which gives doctors a tiny window to puzzle through the legalese and make plans to continue providing quality care to women. In the meantime, physicians are consulting with their lawyers—and with other colleagues and professional organizations—to make sense of the ruling.
Ultimately, this decision won’t change the need for abortion in America, or the desire of pro-choice physicians to care for our patients based on the best medical evidence. What we must do now is speak up about the dangerous effects this decision could have: fewer options for patient care, no legal protections for women’s health, and a wide-open door for further restrictions on abortion and other medical procedures. What’s next? Will Congress ban every medical procedure they personally oppose?
I have no doubt that the Supreme Court’s ruling on the federal abortion ban will have repercussions for years to come. As doctors, we are angry and outraged at this intrusion into women’s personal healthcare decisions. But we are also getting organized to fight back against the next wave of incursions on reproductive health. The Supreme Court may not think women’s health is paramount, but we do and we’re not backing down.