04 June 2010

to be or not to be

that's a question

"On the other hand, most of the regulation being pushed by abortion opponents seems pointless; it will burden the health care system while hardly affecting the incidence of abortion."

This has been my point for a long time. If you actually seriously oppose abortion as a problem, then you'd want to support laws that purport reduce the incidence of it rather than things that are paperwork and regulation speed bumps along the way. It suggests that there is a pretty low opinion of doctors et al who provide them and a rather lower opinion of people who demand them. Without at all looking at why they did so (in both cases) and a lot of focus on the how, in particular with late term abortions which are much rarer. Asking "why" tends to get you a lot closer to determining how to arrive at "why, not" more often, certainly more so than presuming that gruesome how is an impacting feature or that you already know what the answer to "why" is (as we do/did with terrorism, "they hate us for our freedom!").

I suppose it would make some sense to allow states to competitively regulate (or not) abortion procedures (although it makes no sense to try to control interstate activity to that end from the state level), in that it would be more obvious which approaches are utterly useless and which have some effect on the underlying demands, both for and against. But I'm not sure that people who are pushing against abortion are usually all that concerned about whether they are pursuing rational policies that reduce demand for abortions instead of symbolic gestures that make it clear they don't want (other) people to have them. So the entire states as laboratories or competitive market approach might look a little silly here. That's typically a feature rather than a bug of that approach though.

Plus this is one issue that I'm a little more persuaded that the 14th Amendment positive rights guarantee matters more so than the states rights approach (less so here than with gay marriage). I'm very sympathetic to the dilemma of these choices, and to the argument that creating new life is important and perhaps special, but I'm also sympathetic to a concept that caring for such life in a planned or appropriate way might be important to fostering "good" lives and that there are therefore strong negative outcomes and consequences to creating new life, for the people involved, that can be easily put off for future consideration. Most of these consequences and situations can also be avoided by taking steps to avoid such undesirable pregnancies and dilemmas in the first place, as it seems pretty clear most upper crust people try to do. If we had some laws that reflected and adapted this thought process, most everyone else would be in a position to try to avoid the problem as well. But, as was pointed out, most anti-abortion laws and advocates do not advance that thought process at all.

4 comments:

Anonymous said...

Perhaps, a better way to regulate abortion procedures with the patient in mind would be to require all non-emergency patients to undergo four weeks of psychological therapy/evaluation before the proceedure and continueing eight weeks after the proceedure. It would then be possible to assess emotional risks such as guilt or depression, quickly. It would also provide psychological data for assessing and critiqueing such laws and evaluations. In my opinion this would be better for everyone than prohibiting it after an arbitrary number of days or weeks since inception of pregnancy or some of the other laws they're making which show virtually no concern for the pregnant woman.

Sun Tzu said...

They already do stuff like that in various states. Giving people an extra month to think it over is an example of speed bump regulation rather than an actual impediment that would reduce abortions in a significant manner. Many, if not most, people have already agonized over the decision prior to walking in and more delays are likely to put the procedure itself into a point where it is more harmful to either mother or the fetus. Early term abortions are pretty easy, basically like inducing a miscarriage. Later it gets, the messier and more complicated the procedure. I don't think another month is a very good idea at all for that reason.

Post-abortion depression exists, but I think its a tad overblown if you're pushing a mandatory followup period. The rate of depression looks about comparable to that of post-partem depression and is probably less common than that experienced after a miscarriage (or even an adoption). I don't think most people like doing it. So it's expected that some level of guilt is experienced. But the idea that it's a public health menace AFTER the procedure is kind of one of those pro-life mythologies that doesn't seem backed up by studying women involved. Access to post-op followup care would be useful, probably appreciated, but I don't see why that should be mandated.

Sun Tzu said...

(one note: the harm to the fetus is a sop to anti-abortion advocates. I'm not sure this exists, particularly in the most common forms of abortion, other than that the specific fetal embryo is terminated)

Sun Tzu said...

Here's basically the issue: Regulating abortion procedures is a supply side approach. That's what we've done for decades with drugs. It doesn't seem to have had any impact (cocaine prices have even gone DOWN for example). What you want in this case is an approach that will lead to fewer inputs (demand-side). Most anti-abortion advocates want such an input because they view the abortions themselves as immoral, which is a view I think they are entitled to have and even to try to convince others of, peaceably at least (presumably women who might want or have abortions or doctors that perform them). I want such a result because I view abortion as a last resort and agonizing solution usually only existing after often a series of bad decisions. If you can break that chain somewhere, I think you'll get somewhere. So far as I can tell, that's more or less what has happened in the upper crust solution. Those are kids and adults who are delaying sex slightly, using protection and/or forms of birth control once they do it, and so on and as a result, have far fewer abortions on demand than people in lower educational or socioeconomic settings. So, if there was a strong anti-abortion movement which advocated for the proper use of birth control and condoms, I'd be a little more understanding of it. That's not, by and large, what we have.

I agree that a better focus on the health and status of women, and indeed pregnancies in general not merely those up for abortions, in this equation would be beneficial, but the suggested approach won't do much of anything about actually reducing abortions and doesn't seem like it's warranted from a public health perspective.

I'll give you an example here: would it be useful to mandate for maternity leave (for both/either men and women), such that everybody who has a kid has to take 6 weeks or whatever off? I suggest that people probably should take maternity leave if it is offered, and especially if their employer is willing to pay them (perhaps at a slightly reduced salary as might normally accompany a "disability" payment), but I don't see how this should be mandatory, nor a set time frame. Some people take years off to raise children, others a couple weeks might be enough. The same problem arises at death and the depression surround grief and bereavement. It's certainly appropriate to lobby for social/employer attention and resources to be used on these problems, but I don't see how they can be resolved with clean regulatory requirements that people are obligated to use, whether they want/need them or not. That seems like it's been a major problem with the health care system we have already (that many resources are made available whether we actually need them or not, and at no visible cost to the consumer/patient).