From: eeb1@quads.uchicago.edu (e elizabeth bartley)
Subject: Re: Medical Enforcers? 
Reply-To: eeb1@midway.uchicago.edu
Organization: University of Chicago Computing Organizations
Distribution: na
Date: Fri, 13 Nov 1992 20:45:58 GMT

In article <1992Nov10.223901.14440@nas.nasa.gov>
dking@raul.nas.nasa.gov (Dan King) writes:
>In article <1992Nov9.231922.16381@midway.uchicago.edu>
>eeb1@quads.uchicago.edu (e elizabeth bartley) writes:
 
>>In an emergency, any doctor qualified to diagnose if a third-term
>>abortion is need and to perform one could go ahead and perform one but
>>might have to justify the abortion afterwards.  (Of course, if he
>>doesn't perform one and she dies, there's no "might" about him having
>>to justify his lack of treatment.)
 
>So you require medical approval prior to the abortion, but judicial
>approval after.

If full medical approval (two concurring opinions) is obtained prior
to the abortion, the judicial approval is presumed given -- and if
it's withheld, all that happens is that the doctors in question can't
presume judicial approval again....

>What I originally responded to was your comment 
>that you would require medical approval, not judicial approval.  
>No one can currently get a surgical abortion without medical approval,
>regardless of legality.  To have judicial review of medical
>decisions is forcing judicial approval on the decision making.  
>I can see no other reason for including the judiciary.

My suggested proposal potentially involves the judicial process, as
all laws potentially involve the judicial process; it is invoked if a
wrongdoing is charged.  If the full medical approval is given, the
judicial process is invoked only if there's a reason to believe
something's wrong.
 
>>In other cases, doctors who are certified qualified to diagnose
>>conditions which require an abortion (ask the AMA who; I would guess
>>all gynecologists and some others) can diagnose a needed abortion. 

>I think all doctors are qualified to diagnose a need for abortions,
>but I could be wrong.

I don't know.  I would think that a psychiatrist (who has an M.D.) who
hasn't practiced medicine in thirty years wouldn't be qualified to
diagnose a need for an abortion.  Similarly, a doctor who's worked
only as a podiatrist or only as an osteopath (some of those have M.D.,
though mostly a weird O.D.) for thirty years wouldn't be qualified.

>Is this some sort of new certification program you want to set up?

It might be.

>If it is, do you see the danger of politicizing this certification program?
 
Oh, yes.  That's why to the extent I made a suggestion, it was
automatically qualifying everyone whose specialization includes
diagnosing whether or not an abortion is needed.

>>Two opinions (one could be granted over the phone or after looking at
>>faxed information if need be) are needed for a legal abortion.
>>Barring having accepted a bribe or giving false information to another
>>doctor to secure a concerring opinion, the worst he could face (say,
>>for routinely certifying every case in which a woman says she wants an
>>abortion as a case in which an abortion is medically necessary) would
>>be losing his certification to perform or authorize an abortion (with
>>a second opinion) without any possibility of having it legally
>>questioned afterwards.
  
>Who is going to pay for the second doctor?

Hm.  That one actually takes some thought....  I guess I'd make the
taxpayers pay.  That's not a major problem; the tests really only need
to be performed once, so let's call it $200 for a visit to the doctor
(I think that's high; that's intentional) for the doctor to take any
needed personal observation and review the earlier tests -- 200
dollars per abortion * 100 abortions per year = $20,000 per year
nationwide.  I can live with that a lot easier than women thus denied
medically necessary abortions.

>Who is going to review all these abortion decisions?

No one unless wrongdoing is charged, with some facts to back the
charge up.
 
>Who is going to keep track of all abortions?

No one; doctors keep records anyway for fear of malpractice suits and
those records can be subpeonaed if there's a reason to presume
wrongdoing.  The records could of course be falsified, but so could
anything the doctors sent in.

>What you are going to end up with under your plan is a system much
>like the one that existed prior to RvW.  That a woman that can 
>afford your added bureaucracy, and could afford to make it worth 
>the government hassles for the doctor(s), will be able to procure
>safe and legal abortions.  The women that can not afford this,
>despite her abortion possibly being therapeutic, would end up 
>relying on illegal and possibly unsafe abortions.  Do you see the
>potential with your restrictions of this danger, and if so, do
>you really think the un-known gain is worth all this?

You're assuming a bureaucracy I'm not.

You are assuming the judiciary process reviews every single abortion
performed in the third trimester.  I'm assuming a system whereby
review is possible if there's reason to believe wrongdoing, but review
is not performed unless a credible charge of wrongdoing is made.

As an analogy, think about a decent system of laws against child
abuse.  If a charge is made, it's investigated and something is done
if it's found accurate.  But the police don't come to everyone's home
to see if if they're beating up their kids.

In the normal case, the added burden on the woman would be going to a
second doctor, and the taxpayers would pay the doctor's bill.  In a
medical emergency, the doctor would perform an abortion and justify it
after the fact.  That would be somewhat unpleasant, but if it's enough
of a medicial emergency that an abortion couldn't wait for a second
opinion, it shouldn't be all that difficult to prove that the abortion
was necessary.

-- 
Pro-Choice                 Anti-Roe                     - E. Elizabeth Bartley
            Abortions should be safe, legal, early, and rare.

Cthulhu for President -- when you're tired of voting for the lesser of 2 evils.
Newsgroups: talk.abortion