There is much discussion these days of banning abortion with exceptions for rape, incest, and life of the mother. Setting aside the issue of whether this can possibly be true given the right's support for “personhood” amendments, I want the right to explain what the process would be to seek an exception from a ban on abortion.
If efforts to criminalize abortion succeeded, would it be a medical, legal, or theological authority that would make the determination as to whether a woman qualified to have the banned procedure? If I was raped, would I have to prove it beyond a reasonable doubt, or might a preponderance of the evidence standard suffice? Would I make my case to a doctor? A judge? A police officer? An ethics committee?
And on what basis would the appointed entity make the decision? The embrace by many politicians of an exception for the life but not the health of the patient would presumably require legislation that would then leave authorities in the position to determine, for example, whether a delay in beginning cancer treatment would be considered a threat to my life or merely a risk to my health.
And how would the exception-seeking process work in an emergency? Reports from doctors seeking to comply with the Catholic Healthcare Directives suggest not well:
I'm on call when she gets septic, and she's septic to the point that I'm pushing pressors on labor and delivery trying to keep her blood pressure up, and I have her on a cooling blanket because she's 106 degrees. And I needed to get everything out. And so I put the ultrasound machine on and there was still a heartbeat, and [the ethics committee] wouldn't let me because there was still a heartbeat. This woman is dying before our eyes. She was so sick she was in the [intensive care unit] for about 10 days and very nearly died. Her bleeding was so bad that the sclera, the white of her eyes, were red, filled with blood...
Imagine if this doctor also needed to comply with a statute and seek the approval of a governmental authority while his patient was “dying before [his] eyes.” Would he need to get an emergency court order or is the idea that the legislated “exceptions” would work as a defense should he be sanctioned or prosecuted for having performed an abortion without approval or sufficient cause?
The nebulousness of the exception concept is also relevant to the debate over the contraceptive coverage mandate. Opponents of the HHS mandate claim they are not opposed to insurance coverage for contraception in general, but only when it is used to prevent pregnancy. So what they want is an inquiry into the reasons my doctor writes me a prescription and the authority to rule on whether it is justified.
Will someone please explain how this inquiry would work? Congressman Paul Ryan? Cardinal Dolan? Anybody? We don’t know what conditions would qualify for treatment, how severe they must be, what evidence would be required, and to whom we would make our cases for treatment. To my boss? My plan administrator? A priest? Would there be an appeals process? Insurance plans and health facilities that currently purport to have health exceptions demonstrate that they just don’t work and have harmed women. Given that this problem has received national attention but opponents of contraception have offered no solutions, it seems they are fine with the occasional woman taking prescription painkillers unnecessarily or losing her ovary.
Existing “exceptions” to prohibitions on insurance coverage for abortion don’t work either. Many women who have been raped are currently paying for their abortions out of pocket. We can expect that if abortion is outlawed, even with exceptions, some women will be forced by the state to carry unwanted pregnancies that result from rape to term.
The right wing regularly argues we need less government because government doesn’t do much right. We need to know why and how they think government could be an effective arbiter of whether my particular circumstances are dire enough to justify my contraceptive use or my being exempted from an abortion ban. I find the proposition that I might not be entitled to make these medical decisions myself dehumanizing, but if that is the world I live in, I would at least like to know the specifics.
No politician or pundit should get away with claiming he supports any “exception” without facing the obvious follow-up question: “How would it work?”