Should hospitals be required to perform abortions?

Great Debates
21

I’ve never heard of a hosipital, Catholic or otherwise that would refuse to do an abortion if the woman’s life depended on it (ectopic pregnancy, severe hemmoraging, etc.) assuming they had someone on call who felt qualified to do the surgery.

Now, I’m perfectly willing to debate the ethics of performing abortions for the health of the woman (but not an immediate life-threatening situation)compared with forcing her to transport to another hospital. Let’s just make sure we’re all debating the same topic.

Not every hospital has a Level III trauma center. Not every hospital has a maternity ward. Not every hospital is set up to do heart transplants. The debate over what hospitals should/must offer can’t be limited strictly to abortions.

22

Izzy, let’s carry on the debate without rephrasing people’s comments. oldscratch said life saving, not changing (and not skin grafts, sex changes, or pacifiers). I favor far more than simply life saving abortions. But within the context of the discussion I was having the other night, the topic was where it is needed to save the life (health?) of the mother. My understanding is that certain hospitals do not perform them even in such instances. As I said earlier, I need to check this out more. Not sure to what extent this occurs - how easily a hospital can turn down someone on their doorstep needing care.

In phrasing the debate, I’m saying, IF this is happening, and IF women are being practically denied access to abortion as a result, SOMETHING should be done about it. Specifically, I proposed requiring the performance of abortions. Many folk believe even in no abortion, even where the health of the mother is at risk. Let’s see if the situation I was presented with exists, and if so, debate it on these grounds. Then we can go as far afield as anyone wishes.

I agree with you that the distinction concerning hiring seems sophistry. What I am suggesting is that, historically religious denominations have played a significant role in providing health care. If they are refusing to provide legal care to individuals who lack realistic options, perhaps things should be changed. Whether this requires ordering the performance of abortions, ordering divestiture of hospitals by noncomplying denominations, gov’t purchase or subsidized purchase of noncomplying hospitals, (all of which certainly have problems) or something else, I don’t know.

Also, when a party chooses to enter into a highly regulated industry, they give up some control over the services they provide. Can an accredited hospital choose to serve only white folks? Only rich folks who can pay in cash? Can the Jehovah’s Witnesses buy a hospital and provide all health carew services that consist of praying over the afflicted? All interesting topics, but to what extent are they related to the OP. I’m not sure.

Now I’m talking about a run of the mill general service hospital, not some elite old folks’ facility, elective surgery boutique, or the like. The place Billy Bob gets rushed to after his arm is caught in the thresher. Could be County General or St Lukes, whichever happens to be nearest. What if St. Luke’s is 10 minutes away and County Gen is 30? And then what if Billy Bob’s sister needs an emergency abortion?

Like I said, I first have to check in more to see if what was stated as fact over my dinner table actually has any basis in reality. I consider myself kind of well read (the proverbial lake miles wide but inches deep) and was surprised I had not heard about this insidious plan by them nasty catholics! I’ll see if I can turn something up tomorrow. Or perhaps someone in the know will check in in the meantime.

23

Please reread oldscratch’s post, and retract this false statement. And let this be a lesson for you in the future, to pay more attention when posting, especially when making snide accusations to other people.

24

Okay, folks, help me define the parameters within which this will be the best debate. As a strong abortion advocate, I must admit I am woefully ignorant as to the proper terminology to describe the various distinctions. I had in mind what kunilou suggests - needed, but not an emergency. What I first said over dinner was, “I’m personally not that worried about the S.Ct., cause even if Roe v. Wade gets overturned, it goes to the states, I have $, and my kids will always be able to get an abortion if needed.” I can imagine a poor rural girl may not enjoy my (and my daughters’) luxury. How do we distinguish between life vs health threatening need for abortion?

Our dinner guest, who has lupus, said her understanding was that certain things could (or could have) gone wrong meaning that the need to take the time going to a farther hospital could make a serious difference to her health. I didn’t ask a whole bunch more questions about what specifically could go wrong, what types of procedures were necessary, and what the implications would be.

Sidenote, she also said her health care provider would not authorize birth control pills, even tho the meds she was on for her lupus at the time pretty much guaranteed that her becomeing pregnant would be disastrous for her and the fetus. When she convinced them of the expense they would face, compared to the pills, the compassionate insurance company paid for the pills.

25

only on women…

26

I’ll try and look up the issue, but I believe it was Goodhousekeeping or Redbook.
There was an article about these CAtholics buying up a lot of hospitals, and abortion and birth control not being provided. And one woman’s doctor said that she would be in severe trouble if she didn’t have an abortion. (not quite death, but if she did have the child, her situation would get worse). I forget the exact problem. Anyways, her local hospital covered by the insurance wouldn’t do it. They said they had to wait until it was ABSOLUTELY NECESSARY. WTF?
They wouldn’t tie a woman’s tubes, or give out birth control for women who suffered um, oh…what was it, endotrimosis (spelling is wrong, I know!)
The point was, it was fucking scary. Probably another reason why I haven’t gone to church in the last couple weeks: I’m sick of seeing the church being so controlling, even when someone’s life hangs in the balance…

27

Whereas you have no problem with the goverment killing people?

The answer is NOT requiring the hospitals to do anything but letting the doctors do the abortions after the hostpitals refuse to. This is a case where someone will do the abortions and if the hospitals refuse someone else will do them.

28

In short, no.

However, any hospital that refuses to perform abortions in order to save the mother’s life should either have the ability and the willingness to get such patients to another hospital in short order, or they shouldn’t be any sort of trauma center at all.

Dr. J

29

If you’re saying that it is simply a given, since it’s legal, that abortion has the same status as any other medical procedure, then I’d say you’re begging the question.

Shodan’s point wasn’t crap at all. If pro-choice means it’s up to the individual to decide whether or not abortion is taking another human’s life (and isn’t that what I keep hearing?–it’s up to the individual), that choice must apply to anyone who provides medical care as well. Otherwise we are completely ignoring what makes this procedure uniquely problematical.

And how can we argue that an organization that believes abortion is murder (again, their choice) is ethically “off the hook” if they merely allow their facility to be used for abortion (but don’t perform it themselves). Surely this distinction is specious if we allow the organization the right to decide if abortion is murder. Your right to choose to have an abortion (if that right exists) does not equate with a right that someone else MUST perform or aid it.

30

It is not true that catholic hospitals will let a woman die rather than perform an abortion. It is true that catholic hospitals will not perform abortions on demand.

I don’t understand how the state can compel a doctor to perform abortions that they do not feel are medically neccesary. Yes, if you allow a woman to die because you refused to perform a procedure that would save her life that is malpractice. But most abortions are not performed to save the life or health of the mother, most are performed because the woman doesn’t want to become a mother.

Any Catholic priest would understand that in the case of an ectopic pregnancy, the mother will die and the baby will die. There is no ethical dilemna for catholics here, since we can either save the mother’s life while the baby dies, or both the mother and the baby will die. It is not against catholic principles to allow the termination of an ectopic pregnancy.

There is an ethical dilemna present if there is a situation where the mother would die, but the baby would live. But catholics believe that the life of the mother should come first, since she probably has obligations to her other children. Even catholics believe that the life of the mother comes before the life of the unborn baby. What catholics are opposed to are abortions where both the mother and baby would live.

31

Catholic teaching does allow the termination of an ectopic pregnancy,possibly in part because it’s impossible for the fetus to survive, but also because, in a way, an abortion is not what’s intended and the fetus is not directly terminated. What is intended is to save the life of the mother by removing the affected Fallopian tube.The abortion is considered to be a unintended side effect,as it would be if the mother were to take medication for an illness that caused a miscarriage.I’m not sure what Kunilou meant about severe hemmoraging. If he meant hemorraging after a miscarriage, that’s not an induced abortion,(although the same procedure might be used) and a Catholic hospital certainly should provide the treatment,as Catholic teaching allows it. ( miscarriage=no more fetus=not an induced abortion}

Catholic teaching ( as opposed to practice) not only does not state that the life of the mother comes first,it states that **neither** can be sacrificed to save the other.That is, you can neither directly cause the baby to die  to save the mother,nor directly cause the mother to die to save the baby. You must **try** to save both (this particular dilemma would come up around the issue of birth, not abortion, as that's when it's possible for the mother to die and the baby to survive).
32

IIRC, longer-term follow-up research was turning up indications that the gender realignment was NOT significantly helping people to improve their QOL, in terms of emotional adjustment.

33

Doreen – Thank you, that was very well stated. There are, yes, a few fanatics who would rather everyone die than perform an abortion, but they are an insignificant minority.

When I worked at (Sisters of) Mercy Hospital, the pharmacy would dispense the Pill for medically-mandated conditions (endometriosis, e.g.).

Anyway, with politics being what they are, your chances of a life-saving abortion in the hospital are worse if it’s up to the Government to dictate what is or is not provided. I can easily imagine a government bureaucracy letting you die while going through 5 approval levels and filling ten triplicate forms. Or enforcing an ironbound set of rules that does not bend even in a life-or-death situation.

JRD

34

There are medical centers that specualize in [http://www.bloodlessmed.com/"]bloodless]( [url) surgery. Should they be forced to do vampire surgery as well?

35

quote from dinsdale:

Also, when a party chooses to enter into a highly regulated industry, they give up some control over the services they provide. Can an accredited hospital choose to serve only white folks? Only rich folks who can pay in cash? Can the Jehovah’s Witnesses buy a hospital and provide all health carew services that consist of praying over the afflicted? All interesting topics, but to what extent are they related to the OP. I’m not sure.

reply:

Don’t confuse Jehovah’s Witnesses with Christian Scientists, please. Some of them are doctors who do much, much more than prayer to treat patients. I ought to know, I was treated by one for years, bless his soul. Their abstinence from blood is not done in a vacuum. It helped spurred a strong bloodless surgery movement, and many surgeries in general result in little blood loss.

36

Should doctors have to perform abortions?

No.

Should a hospital have to hire someone who won’t perform an abortion?

Again, no, if you can’t/won’t perform any certain medical procidure then you aren’t qualified for the position. There are plenty of qualified doctors who WILL perform abortions, and you either find a new carreer or suffer. You knew what you were getting into when you entered the medical profession.

It’s like being a vegetarian and saying “Hmmm… this meat cutting factory sounds like an ethical place to work.” Then saying “Why did you fire me for not cutting the meat?”

Very simply put: If you can’t/won’t do your job, then you will get fired.

37

Izzy, hey, I’ll retract whatever you want me to. I read oldscratch’s initial saving/changing clause as modified by her other numerous and I thought consistent references to saving. And I typed my comment to you in a joking mood. Sorry I didn’t include a smilie and my non hostile intent did not come across.

capacitor, sorry for my confusion and ignorance. As I was typing that, I was unsure which of the 2 to write, and clearly relied on a bad coin flip. Besides pointing out my clear error, do you have any response to the examples I advanced?

Bob, I’m not sure phrasing it that way begs the question. Or perhaps it begs a question somewhat different than the one I am asking. I’m going to be pretty busy for the next few hours, but will try to check in later expanding my views. Do you consider it inappropriate, inaccurate, invalid, to consider it “a given, since it’s legal, that abortion has the same status as any other medical procedure.” Why? What is the hierachy of medical procedures? Could hospital X simply decide to stop treating strep? This probably gets close to where the difference will lie, between those who consider abortion essentially an elective procedure, and those who don’t.

What is the value in declaring a woman has a right to any specific procedure, if she has no realistic access to it? (Man, I’m really displaying my ignorance and naivete here. And I was complaining about exceeding the OP!))

Also, I put health care providers in a somewhat unique position. They serve a vital public need. It is in the government interest that everyone have some level of access to certain level of health care. In some areas, religious organizations have assumed reponsibility for doing so. Do they operate these facilities as a loss, or do they try to make a profit? If they provide such services, should they not have to provide all necessary services. I can imagine proposing that, if a hospital refuses to provide necessary health care – which I consider abortion and much other family planning to be, necessary aspects of gynecological practice – they should either get out of the hospital business, or the state should set up shop to provide the services the hospital lacks. Believe me, I don’t expect you all to agree with me.

Powerpuff, the permutation you did not address is, should hospitals be required to hire someone who will be able to perform abortions. I say yes. Hospitals are a little different from garages. Aamco can choose to do only transmissions, Midas only brakes (I know!) I say by their unique function, hospitals should be required to be full service providers.

I’ll check back later when I have a few more minutes.

38

Dinsdale, the question first posted (I think) could be re-worded, “Should a health care provider be forced to perform/provide/aid in a procedure they feel is morally reprehensible?” That’s the essence of the dilemma, correct? That’s what I meant by saying if we offer as a given that any procedure that’s legal ought to be regarded as any other medical procedure, it ignores the central debate here. The legality is not in question. This is a real unusual procedure from an ethical perspective.

That’s also what I meant by saying that the right to decide whether or not abortion is murder can’t apply only to those seeking them (I’m sure you can tell I would argue that right doesn’t exist, at least not as an absolute). If the central issue is “can a facility be forced to act in a manner that contradicts their own moral conclusions,” then recognize that by answering in the affirmative, you’ve created a slippery slope for those seeking abortions as well. I would argue that this conclusion renders the “right to choose” an illusion–i.e., there is only one morality that “counts.”

And even if the right to have a procedure is not meaningful if access doesn’t exist, that right still does not override my right (in this case, as health care provider) to act in accordance with my own conscience.

39

Dinsdale, you asked on whether or not hospitals are required to perform certain procedures shuch as abortion. I will answer that directly.

No, I don’t believe that a hospital should be required to perform every procedure, or even any, in its premises. With your logic, someone from another culture can demand that a hospital perform female circumscision on his daughter. The topic of abortion is still way too controversial to do such an end run of making mandatory its availability in every hospital.

Besides, making abortion procedures a requirement raises a lot of other questions: What if ob-gyns with abortion skills are very rare in the area, or non-existent? Should the hospitals be required to teach non-ob-gyns of the procedures against their will, on penalty of termination for refusal to learn? What if due to budget cuts, pre-natal services have to be cut, due to the abortion requirement severly curtailing the hospital’s budget flexibility? Will there be a quota on the number of abortions performed in that hospital? If so, what would happen if they are not met? What if hospitals lose patients and staff because of abortions performed there, or because of huge and demonstative but legal protests there every day, and lose money as a result? What recourse do hospitals have? These questions and others will have to be resolved.

Now, if it turns out that The Catholic Church is buying up all of the hospitals in the area so that abortions may not be performed in those hospitals, then there might be a case of violation of anti-trust laws.

40

This is a little overstated.It’s not true everywhere, but in my area there are a number of hospitals which specialize in particular areas ( only eye and ear surgery, only cancer treatment,only children }.I don’t think hospitals that are restricting services in this way are really what we are ( or should be )talking about.I think what we’re talking about is hospitals that do provide ob/gyn care but exclude abortions.I don’t even know that that would be a problem in all situations. To use my own area as an example, there are at least six hospitals within ten miles of my house.It doesn’t make sense to require the two Catholic ones to perform abortions in that situation,and in fact, it’s really not an issue here. That’s a different situation than one where the nearest general hospital is Catholic and the next is a significant distance away and there are no clinics or doctor’s offices which provide abortions either.

Dinsdale, I don’t understand certain what your friend was talking about regarding an abortion being an emergency.I’ve never heard of a situation where delaying an abortion by a few hours would make a difference ( not that one doesn’t exist,i’ve just never heard of it}and it makes a difference to the discusssion whether it could be an emergency.