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Partial Birth Abortion Ban Upheld By Supreme Court

Awww. Thanks, Miss Anthrope!

The feeling is mutual.

Now flattery IS something that might suck me into this. ;)

ETA: The other issue is that I accidentally deleted my connection to my hospital's library which would allow me to back up my assertions with more reliable statistics than what I'm finding on Google.

Awwww right back atchya.

Now....to flatter you back into the discussion.

Katana is smart. Katana is the best. Katana has razor sharp wit. Katana is super groovy. Katana will PWN this issue.

Is it working?:con2:
 
Thanks for the link, ponderingturtle.

ETA: I have some thoughts, but I'm debating whether to get drawn into another heated thread. Debating gun control AND abortion at the same time? Yikes. ;)

Well this is not the same as a general abortion debate. You can be against abortion and still think this law is bad because it forces dangerous procedures on mothers who still qualify because of health risks. Of course there are people who feel that health risks to the mother are no reason to abort a non viable fetus as well. I guess that would be the god ment for them to die arguement.
 
Thanks for the link, ponderingturtle.

ETA: I have some thoughts, but I'm debating whether to get drawn into another heated thread. Debating gun control AND abortion at the same time? Yikes. ;)

Well, if you extend 2nd amendment rights to the fetus, the issue becomes moot.
 
What about OB/Gyn organizations? Is that the opinion of them and not the AMA in general?

Looks like the American College of Obstetrics filed a brief in support of the challenges to the ban when the Act was signed.

[FONT=Arial, Helvetica][FONT=Arial, Helvetica]Over 95% of induced abortions in the second trimester are performed using the D&E method. The alternatives to D&E in the second trimester are abdominal surgery or induction abortion. Doctors rarely perform an abortion by abdominal surgery because doing so entails far greater risks to the woman. The induction method imposes serious risks to women with certain medical conditions and is entirely contraindicated for others. [/FONT][/FONT]
[FONT=Arial, Helvetica][FONT=Arial, Helvetica]The intact variant of D&E offers significant safety advantages over the non-intact method, including a reduced risk of catastrophic hemorrhage and life-threatening infection. These safety advantages are widely recognized by experts in the field of women's health, authoritative medical texts, peer-reviewed studies, and the nation's leading medical schools. ACOG has thus concluded that an intact D&E "may be the best or most appropriate procedure in a particular circumstance to save the life or preserve the health of the woman, and only the doctor in consultation with the patient, based on the woman's particular circumstances can make that decision." [ACOG Statement of Policy on Abortion (reaffirmed 2004)] [/FONT][/FONT]

They make a pretty convincing argument.
 
I recommend that those who wish to discuss the matter knowledgeably read the actual opinion. It is available on the Supreme Court's web site. Be wary of conventional news reports (many of which are notoriously bad in reporting the case) and stay away from the so-called pundits for the time being.

Justice Kennedy, writing for the majority, said:
We assume the following principles for the purposes of this opinion. Before viability, a State "may not prohibit any woman from making the ultimate decision to terminate her pregnancy." It also may not impose upon this right an undue burden, which exists if a regulation's "purpose or effect is to place a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability." On the other hand, "[r]egulations which do no more than create a structural mechanism by which the State, or the parent or guardian of a minor, may express profound respect for the life of the unborn are permitted, if they are not a substantial obstacle to the woman's exercise of the right to choose." [Planned Parenthood of Southeastern Pa. v.] Casey, in short, struck a balance. The balance was central to its holding. We now apply its standard to the cases at bar. (Citations omitted.)
This is an interesting choice of words. Certain rights to abortion are "assumed." Technically, Roe vs. Wade is still valid, and the Casey decision is still valid, too; but their validity is uneasy. The Court did not think it was necessary to overturn these cases (which would ordinarily be a last resort) in order to reach its decision. In a concurring opinion, Justice Thomas basically said that, given the chance, he and Justice Scalia would conclude that Roe and Casey and "the Court's abortion jurisprudence" have no basis in the constitution.

Justice Kennedy went on to declare that the statute was not vague (vague statutes pertaining to criminal conduct are constitutionally unenforceable), or overbroad. The vagueness analysis seemed to me to be shallow, and the overbreadth analysis was even moreso (Justice Kennedy saying the problem of arbitrary enforcement was "somewhat speculative.")

Justice Kennedy's opinion about vagueness and overbreadth has some serious practical problems, and these are problems that ought to be obvious to all citizens in light of present accusations against the Bush "administration" pertaining to prosecutorial abuse. Justice Kennedy asserts that doctors will not be criminally liable if they lack the requisite criminal intent. This may be correct, but that will not stop a prosecutor from bringing charges. After all, intent is proven by conduct, and if the doctor committed the forbidden act, it will be little comfort to him/her to say that there was no criminal intent. In effect, this procedure will be effectively banned even in cases where there is no criminal intent (and therefore no crime). Either that, or doctors who perform this procedure will have to make video recordings of the event to show that they act for legitimate purposes and without criminal intent. But would you want a jury to see that gruesome footage, even if it shows you were--technically speaking--innocent?

The key issue was whether there was an "undue burden" on the woman seeking an abortion. Justice Kennedy concluded the purpose of the statute was not to place such a burden, but his reasoning struck me as a little strange. Basically he concluded that the government had good reasons for the statute (namely preserving fetal life and regulating physicians). Justice Kennedy at times writes like the author of a pro-life pamphlet, suggesting that women have to be protected from themselves, as many of them are distressed by abortions and come to regret them later. There was no suggestion that any of these justifications might be pretexts.

Justice Kennedy acknowledged that there was a disagreement among professionals as to whether the prohibited procedure might indeed be the safest procedure in some cases. Where there is disagreement, the Court deferred to the Congress. Also, the Court seemed to say that there were always safe alternatives to the procedure, so there was no need for a "health exception" that would allow the procedure to be used if the woman's health (but not her life) was endangered.

There are a lot of puzzling aspects to the opinion, but Justice Kennedy acknowledged that it is the nature of the lawsuit that dictated the analysis. The lawsuit alleged that the statute's restrictions were unconstitutional on their face. Justice Kennedy specifically allowed that the result might be different if a suit was brought showing that the statute was being applied in an unconstitutional manner:
The Act is open to a proper as-applied challenge in a discrete case.
The majority opinion also contains a nice potshot at a popular assertion by those opposed to "judicial activism," namely that the Court must defer to the facts that the legislature finds:
On the one hand, the Attorney General urges us to uphold the Act on the basis of the congressional findings alone. Although we review congressional factfinding under a deferential standard, we do not in the circumstances here place dispositive weight on Congress' findings. The Court retains an independent constitutional duty to review factual findings where constitutional rights are at stake.
 
A few words about the dissent in Gonzales vs. Carhart:

Four justices dissented: Justices Ginsburg (who wrote the dissent) along with Justices Stevens, Souter and Breyer. The following paragraph sums up the dissent, and seems to be often quoted by the media:
Today's decision is alarming. It refuses to take Casey and Stenberg [v. Carhart] seriously. It tolerates, indeed applauds, federal intervention to ban nationwide a procedure found necessary and proper in certain cases by the American College of Obstetricians and Gynecologists (ACOG). It blurs the line, firmly drawn in Casey, between previability and postviability abortions. And, for the first time since Roe, the Court blesses a prohibition with no exception safeguarding a woman's health.
The lack of a safeguard for a woman's health is the dissent's most potent objection, and Justice Ginsburg goes right to it. The Stenberg case seemed to say that such an exception was crucial, and without it, a statute could not survive constitutional scrutiny:
In Stenberg, we expressly held that a statute banning intact D&E was unconstitutional in part because it lacked a health exception. We noted that there existed a "division of medical opinion" about the relative safety of intact D&E, but we made clear that as long as "substantial medical authority supports the proposition that banning a particular abortion procedure could endanger women's health," a health exception is required.... (Citations omitted)
Further, when there is a disagreement about safety (as Justice Kennedy said there was), then Stenberg required erring on the side of requiring the health exception, not omitting it. Quoting Stenberg:
The word 'necessary' in Casey's phrase 'necessary, in appropriate medical judgment, for the preservation of the life or health of the [pregnant woman],' cannot refer to an absolute necessity or to absolute proof. Medical treatments and procedures are often considered appropriate (or inappropriate) in light of estimated comparative health risks (and health benefits) in particular cases. Neither can that phrase require unanimity of medical opinion. Doctors often differ in their estimation of comparative health risks and appropriate treatment. And Casey's words 'appropriate medical judgment' must embody the judicial need to tolerate responsible differences of medical opinion.
Justice Ginsburg also expanded upon a point (touched upon by Justice Kennedy) that much of the "factfinding" done by the legislature was flat-out wrong. The district court, which took evidence (the Supreme Court does not take evidence but relies upon the record made in the district court), concluded that the reasons given by Congress were unsupported by evidence, and the procedure in question could in some cases be the best for the patient's health. Typically, the most "conservative" judges would consider such evidence and conclusions important, but here, the "conservatives" making up the majority did not do so. Since the facts of the case show that the procedure is the safest in some cases, should there not be an exception to allow it to be used in those cases?

As for Justice Kennedy's reference to the government's "legitimate interest ... in protecting the life of the fetus that may become a child," Justice Ginsburg pointed out the absurdity of this assertion in light of the majority opinion, namely that Justice Kennedy's rationale doesn't protect fetuses at all:
The law saves not a single fetus from destruction, for it targets only a method of performing abortion. And surely the statute was not designed to protect the lives or health of pregnant women. In short, the Court upholds a law that, while doing nothing to "preserv[e] ... fetal life," bars a woman from choosing intact D&E although her doctor "reasonably believes [that procedure] will best protect [her]." (Emphasis in original, citations omitted.)
Justice Ginsburg also points out the obvious anti-abortion language in Justice Kennedy's majority opinion, particularly the appeal to "moral concerns" and the anti-abortionists' propaganda:
Revealing in this regard, the Court invokes an antiabortion shibboleth for which it concededly has no reliable evidence: Women who have abortions come to regret their choices, and consequently suffer from "evere depression and loss of esteem."
...
The Court's hostility to the right Roe and Casey secured is not concealed. Throughout, the opinion refers to obstetrician-gynecologists and surgeons who perform abortions not by the titles of their medical specialties, but by the pejorative label "abortion doctor." A fetus is described as an "unborn child," and as a "baby"; second-trimester, previability abortions are referred to as "late-term"; and the reasoned medical judgments of highly trained doctors are dismissed as "preferences" motivated by "mere convenience." (Citations omitted.)
And Justice Ginsburg found concern in a word I mentioned earlier:
And, most troubling, Casey's principles, confirming the continuing vitality of "the essential holding of Roe," are merely "assume[d]" for the moment, rather than "retained" or "reaffirmed." (Citations omitted.)
In addition, Justice Ginsburg lobs several legitimate criticisms of Justice Kennedy's shallow legal analysis. But she says:
If there is anything at all redemptive to be said of today's opinion, it is that the Court is not willing to foreclose entirely a constitutional challenge to the Act. ... Surely the Court cannot mean that no suit may be brought until a woman's health is immediately jeopardized by the ban on intact D&E. A woman "suffer[ing] from medical complications" needs access to the medical procedure at once and cannot wait for the judicial process to unfold. (Citations omitted.)
 
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From another thread:
But make no mistake, Judge Alito thinks Roe was wrongly decided. If the issue is properly presented to him, he would probably vote to narrow or overrule Roe.
Justices Alito and Roberts did not issue any separate opinions in the Gonzales v. Carhart case.
 
Thanks for the analysis, Brown.

I am particularly troubled by the use of "late term". When most people think late term, I suspect they are thinking of something like this:
the pro-choicers untroubled by the killing of a baby in the womb while premature babies at earlier stages of development are being saved in the same hospital.

The dissent indicates that this actually refers to second trimester abortians, before the fetus becomes viable (Wikipedia tells me the legal definition of viability is "at least 50% chance of survival"). I wonder if that affects anyone's opinion in this thread.
 
I have read estimates that they represent somewhere between your figure, LawnOven, and 1% of all abortions in this country.

What is disturbing about the ruling is more in what it will lead to.
Yep.

Between .17% and 1% of the camel is now in the tent.
 
OK. Miss Anthrope and Lonewulf, you're too cute. I couldn't resist. :D

Like others, I appreciate your info and thoughts, Brown.

From what Brown posted:

Revealing in this regard, the Court invokes an antiabortion shibboleth for which it concededly has no reliable evidence: Women who have abortions come to regret their choices, and consequently suffer from "evere depression and loss of esteem."


You know what? I know many women who have experienced this after having children. Perhaps we should mandate contraception for everyone. It would probably do the planet a lot of good.

Also, what does this have to do with the method of abortion that women choose? As has been pointed out, this doesn't prevent abortions from happening. It doesn't save any fetuses.

What this does do is give us some scary insight into the minds of some of our Supreme Court justices.

The Court's hostility to the right Roe and Casey secured is not concealed. Throughout, the opinion refers to obstetrician-gynecologists and surgeons who perform abortions not by the titles of their medical specialties, but by the pejorative label "abortion doctor." A fetus is described as an "unborn child," and as a "baby"; second-trimester, previability abortions are referred to as "late-term"; and the reasoned medical judgments of highly trained doctors are dismissed as "preferences" motivated by "mere convenience." (Citations omitted.)

Pathetic. I just want to throw something when I read this. Supreme Court justices are supposed to be above this, aren't they? I just picture Bush, upon hearing the news, with a weasily expression, hands together Mr. Burns-style, saying "Eeeexcellent." At least one thing that he's meddled in is coming together for him.

Dick. :viking1
 
I guess in my mind, the crux of the abortion discussion is 'viability':

Are abortions performed to viable fetus's? The pro-life side would have us think that women in labor with full term fetus's are aborting.

Then, re: alternatives, are they any more hazardous to the women than a ceasarean? And again, viability is the key point.

The alternative methods are 'induction' and 'abdominal'. Suppose that a woman who dragged her feet, then decides to abort at later term. She just doesn't want to have go through labor, nor have a c-section scar. Are those valid 'womans health' concerns? I guess 'Intact D&C' is sure cheaper than those alternatives.
 
In a sense, the outcome of Gonzales v. Carhart is not a surprise, if one applies a very simplistic analysis. Such a simplistic analysis would go like this: Justices Scalia and Thomas would always vote to restrict abortion rights, regardless of the facts, the precedents or the statutory language. So would Justices Roberts and Alito, because that is precisely why little Bush named them to the Court in the first place.

And as for Justice Kennedy, he was a dissenting voice in Stenberg v. Carhart, which the Act in issue was created to address. In Stenberg, which dealt with a Nebraska statute, Justice Kennedy wrote:
The political processes of the State are not to be foreclosed from enacting laws to promote the life of the unborn and to ensure respect for all human life and its potential.
...
The State's brief describes its interests as including concern for the life of the unborn and "for the partially-born," in preserving the integrity of the medical profession, and in "erecting a barrier to infanticide." ... A review of Casey demonstrates the legitimacy of these policies. The Court should say so.
...
States also have an interest in forbidding medical procedures which, in the State's reasonable determination, might cause the medical profession or society as a whole to become insensitive, even disdainful, to life, including life in the human fetus.
...
A State may take measures to ensure the medical profession and its members are viewed as healers, sustained by a compassionate and rigorous ethic and cognizant of the dignity and value of human life, even life which cannot survive without the assistance of others.
...
Nebraska was entitled to find the existence of a consequential moral difference between the procedures [D&X and D&E].
...
Substantial evidence supports Nebraska's conclusion that its law denies no woman a safe abortion.
If these remarks sound familiar, it is because Justice Kennedy sounded similar themes in both Stenberg and Gonzales v. Carhart: a governmental interest in fetal life, a governmental interest in regulating physicians, a governmental interest in morals. These are things that the anti-abortionists have had wet dreams about, and now they are part of a majority Supreme Court opinion.

What had changed since Stenberg? Was the federal statute really drafted better, so as to avoid constitutional difficulty? That's a difficult argument to support. The Congressional shenanigans designed to get around Stenberg were exposed by the lower courts and were acknowledged even by the Gonzales v. Carhart majority. The Congressional action designed to avoid constitutional infirmity was arguably a sham.

What has changed is the Court's personnel. Justice O'Connor, who concurred with the Stenberg majority, is now gone. Justices Roberts and Alito are there, and their silent votes with the majority have produced the result.

Although the anti-abortion forces have reason to be dancing in the streets, there are a few points of note. First, Justice Kennedy does not seem to be inclined to overrule Roe or Casey. If overruling had been the crucial issue, the case would probably have gone the other way. It may be tempting to say that Roe and Casey are one step from being overruled, but that step is a mighty big one.

And indeed, overruling could have been the crucial issue, but it was not. In other words, the majority might well have said that Roe, Casey and Stenberg would require that the Act be struck down, unless these cases were overruled ... and then proceeded to do just that. Such a ruling would have been far more straightforward than Justice Kennedy's shallow and quirky analysis BUT it might not have had majority support. It would therefore seem plausible that Justice Kennedy could not bring himself to join the "overrule" camp, but neither could he bring himself to say that abortion rights have been "re-affirmed"; as a result, he used the awkward "assumed" wording.

In other words, if Justices Thomas, Scalia, Roberts or Alito had written the opinion, there is a pretty good chance that they wouldn't have gotten Kennedy's vote.

Also of interest is that Justice Kennedy in Stenberg was pretty keen on deferring to legislative factfinding. But in Gonzales v. Carhart, he backpedaled, perhaps appalled by the shameless dishonesty of the Congressional "factfinding." Congress "found" that no medical schools provided instruction on the prohibited procedure, and that the procedure is never medically necessary. Both of these "findings" are flat-out false. (Justice Ginsburg's dissent pointed out additional "findings" that were bogus.)

Justice Scalia has gone on record as saying that the Court's jurisprudence should not change merely because its personnel have changed. But in this case, he apparently saw nothing to which to object.
 
I guess in my mind, the crux of the abortion discussion is 'viability':

Are abortions performed to viable fetus's? The pro-life side would have us think that women in labor with full term fetus's are aborting.

Then, re: alternatives, are they any more hazardous to the women than a ceasarean? And again, viability is the key point.

The alternative methods are 'induction' and 'abdominal'. Suppose that a woman who dragged her feet, then decides to abort at later term. She just doesn't want to have go through labor, nor have a c-section scar. Are those valid 'womans health' concerns? I guess 'Intact D&C' is sure cheaper than those alternatives.


Despite what the anti-abortion folks would like everyone to think, it would take an extraordinary set of conditions to convince any doc to abort a full-term (or viable) fetus. If Mom is in distress from a medical standpoint, and ending the pregnancy is the fix or would help, the quickest way to deliver the kiddo is a c-section (done one open to close in 19 minutes myself). You can have the babe out in minutes.

To do an intact D&E, you need to wait a good long while for the cervix to dilate before you can even start. More, you need to find a doc who is willing and able to do it. I didn't train in the technique, and only one senior physician in my program had ever even been exposed to the technique (and that was as a resident). It is not required that residents learn to do this, so even those who have the opportunity to learn it may not take it.

There's a reason why it is done so infrequently. While it may be best in certain circumstances (and I find it despicable that the court and congress feel that they are better able to decide), it is fundamentally unpleasant to do, difficult to do, and not every ob/gyn is trained in it.

I realize I'm digressing from Beeps original issue. No, I think you'd be hard-pressed to find an ob/gyn who would perform an abortion on a viable fetus just because Mom changed her mind about the pregnancy. In fact, we have involved law enforcement (in addition to mental health professionals) in cases where we suspected the mother was trying to harm the fetus in utero.
 
Thanks for the analysis, Brown.

I am particularly troubled by the use of "late term". When most people think late term, I suspect they are thinking of something like this:


The dissent indicates that this actually refers to second trimester abortians, before the fetus becomes viable (Wikipedia tells me the legal definition of viability is "at least 50% chance of survival"). I wonder if that affects anyone's opinion in this thread.

Also I do not think there is any talk about abortions of non viable fetus's in any stage vs viable ones.
 
I guess in my mind, the crux of the abortion discussion is 'viability':

Are abortions performed to viable fetus's? The pro-life side would have us think that women in labor with full term fetus's are aborting.

Then, re: alternatives, are they any more hazardous to the women than a ceasarean? And again, viability is the key point.

The alternative methods are 'induction' and 'abdominal'. Suppose that a woman who dragged her feet, then decides to abort at later term. She just doesn't want to have go through labor, nor have a c-section scar. Are those valid 'womans health' concerns? I guess 'Intact D&C' is sure cheaper than those alternatives.

That would make some sense if the sponcers of the bill specificaly did not prevent it from dealing with only vaible fetus's. So the point, while one most people would agree with is not relevent to the law.
 

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