 |
 |
|
|
By Hugo van Dooren, M.D.
Last week, watching the news on television in the doctor's lounge at a local hospital, I caught a blurb about "domestic violence." A lady discussing the problem and listing available services reported that every 15 seconds in this nation some form of domestic violence is committed against a spouse or significant other. It struck me as a dramatic presentation of the extent of violence in this country. Looking at another aspect of violence, I was reminded of the bill to ban partial birth abortions that President Clinton vetoed--a veto the House and Senate failed to override in September 1996.
It is incredible to me how both Clinton and the media have distorted and misrepresented this procedure as a medical necessity. The women who testified against banning the procedure did not need it to save their lives, but chose to have it for reasons that were not life threatening. A more recent public television broadcast, and subsequent newspaper reports, exposed the flagrant lies about data supporting this procedure as a so-called "rarely used" and "much-needed" procedure. The fact is that the procedure has been used excessively and not just for rare cases when the life of the mother was at stake.
The AMA's Council on Judicial Affairs labeled it a procedure that had no medical necessity.
What is the alternative to that procedure? Obstetricians inform me that Caesarean section or hysterotomy are the answer. The risk to the mother by those procedures is less than the former one, so why not use that procedure? My opinion is that it has to do with both the physician's and the pregnant mother's feelings. The alternate procedures would produce a live child, likely viable considering the state of gestation. My guess is that both the physician and the woman want the child to be dead. It seems that we achieve that goal, to dispose of the child for whatever reason, by utilizing partial birth abortion.
This whole issue has been revived in Congress, and again President Clinton threatens to veto a ban unless the bill permits exceptions for saving the life of the mother or because of the health of the mother. The notion of the mother's "health" is always liberally interpreted and can include emotional distress.
I think APA should be vocal in strongly supporting the ban against partial birth abortions and recognize that they are not an essential or justifiable medical procedure.
The callousness toward violence has, I believe, gradually permeated all of society since the Supreme Court, in Roe v. Wade, allowed abortions "at any time" during the pregnancy as a woman's right, disregarding and relegating the right of "personhood" of the unborn fetus to some future date. Consequently, thousands of abortions are done each day in this country--one abortion every 2.16 seconds, almost seven times more frequently than domestic violence.
As Francis Schaeffer and C. Everett Koop pointed out in Whatever Happened to the Human Race? and How Then Shall We Live?," the permissive attitude toward abortion is the beginning of a progressive trend of increasing violence, in part because of a numbing of our conscience about killing people. Evidence for the validity of their prediction that euthanasia and infanticide will be the logical consequences and sequences to abortion can be seen in countries such as China and the Netherlands, where this is already happening. In the U.S., we are awaiting the Supreme Court's decision on physician-assisted suicide.
Realizing that the abortion issue has been a point of serious controversy in APA, taking either one of the opposite positions will leave a large percentage of the membership feeling alienated from and disregarded by the organization. Therefore, as long as APA takes a formal position, there will be serious discontent among many members. The option of rewriting the position statement on abortion is not likely to satisfy either side.
So what is the solution? Does APA really need to take a position in this emotional and political controversy? It is not an organization whose purpose is to decide on moral issues, unless they affect the practice of psychiatry and the care of psychiatric patients. I do not see why abortion would fall under the purview of psychiatry. Yes, as psychiatrists we deal with patients in whose lives abortion might play a role. However, we need to deal with that in our role as physicians who have an opinion about these matters based on our personal value system. This is not a psychiatric issue. To me, it makes more sense for APA to withdraw its position on abortion and to leave it to each member to decide.
APA would benefit by not being burdened with the intense feelings among its membership on this issue and by focusing its energies on what is important to psychiatric patients and to psychiatry.
Dr. Van Dooren is a psychoanalyst and medical director of psychiatric services at Puget Sound Hospital in Tacoma, Wash.
(Psychiatric News, May 16, 1997)