The Corral: Medical Practice

This is the first post in the Corral – the space for my thoughts on certain matters that go round in circles, are related to ethics, and are not ultimately going to go anywhere, but may be useful.

There is a medical procedure that I find revolting to even think about.  It is one I can’t see why anyone would actually want, but some do and others even go so far as to fetishise.  It is regrettably medically necessary and even life saving for some, but commonly leads to depression in those who have it.  And I would expect almost all decent people to agree with me that we should work together to try to wipe it out.  Unfortunately if we try to ban it, those who desperately need it will perform it on themselves.

I refer, of course, to limb amputation.  What did you think I was talking about?

The parallels to abortion are close.  Abortion is a procedure that is medically necessary and that I find squicky.  It is also a procedure that the poor unfortunate women who need will give themselves if they find it necessary.  Like the trap mentioned that would force someone to cut their own arm off, there are two jaws: Unwanted Pregnancy and Impossible Circumstances.

Unwanted Pregnancy

Unwanted pregnancy is the obvious factor.  Abstinence only sex education doesn’t work. (That’s studies from six successive years – I can’t be bothered to go back further).  And people aren’t going to stop having sex – before the 20th Century, Foundlings (abandoned babies) were a fact of life – and in its first four years, the Foundling Hospital in London accepted 15,000 foundlings.  There always has been unwanted pregnancy.

The main thing known to lower the rate of unwanted pregnancy, the simplest, and the most effective is contraception.  Preferably free contraception.  (Banning abortion has no effect on the abortion rate).  And almost all contraceptive methods that say may prevent implantation say so on the “may contain nuts” principle.  They might but no mechanism has been proven that they do and the known methods account for what happens.

Yes, that includes the Combined Pill (which inhibits ovulation and thickens the lining of the mucus – this being sufficient to account for all the effectiveness of The Pill), the IUD/Copper Coil (which makes the environment toxic for both sperm and egg), the hormonal coil (which is just the Pill delivered another way), and even Plan B/Levonorgestrol (the “Morning After Pill” prevents ovulation which is why it isn’t always reliable) and Ella/Ulipristal Acetate (prevents both ovulation and when that fails prevents the egg opening to receive the sperm for five days – long enough for the sperm to die off which is why it’s more effective than Plan B but also makes the person who took it fertile late in the cycle).  The only method that actually prevents implantation is the copper coil used as emergency contraception after the fertilisation has already occurred.

So to prevent the jaw of Unwanted Pregnancy being closed, the method is obvious.  Contraception for all, free at point of delivery.  (And that includes the Morning After Pill and Ella).  But this brings us to the other jaw.

Impossible Circumstances

As a man, I’m glad I will never be pregnant.  Something growing inside me for nine months, using my bodily resources, upsetting my balance and everything else, and then coming out in a painful way, stretching parts of my anatomy to the limit in an intense physical process that as often as not requires a hospital stay (I may work in a hospital but that doesn’t mean I want to be a patient!)

The most obvious impossible circumstance to carry a pregnancy to term is when it would kill the mother – even Roman Catholic doctrine says to abort in this case.  Yes, I know the official reasoning is that you can remove the fallopian tube and the baby is only incidentally aborted.  And?  It’s still an abortion; this justification is obvious sophistry.

The next most obvious is economic circumstances.  Even if the baby is given up for adoption, a pregnancy is expensive – and physically constraining.  (For all I’m saying about the Roman Catholic Church, I’ll give credit where it’s due on this point ).  Most women who seek abortions do so because they do not believe they can afford to keep the baby – a fact born out by over three quarters of those refused abortions being on the dole a year later as against under half of those who have abortions, despite initially similar circumstances.

Further, social circumstances are also a tie; having to look after someone dependent on you makes you more likely to be dependent on someone else, and gives other people a hold over you, making you more likely to stay in an abusive relationship.  The above links all are empirical findings on what actually happens with a sample of a thousand, comparing those accepted and denied abortions.

To open this jaw of the trap and prevent the poor woman cutting off her arm to save herself, the answer should be obvious.  Better protection and provision for the poor and the abused.  Social justice all the way actually lowers the abortion rate.

The Elephant in the Room

We’ve already been through the fact that banning abortion doesn’t actually lower the abortion rate.  We’ve been through the fact that contraception and real (i.e. not “abstinence only”) sex education works. We’ve been through that social justice works to lower the demand.

But the opposition to abortion comes from one claimed source.  Opposition to killing babies.  Unfortunately this doesn’t stack up – there appears to (as Fred Clark pointed out) be literally no attempt to save the foetuses that would spontaneously abort.  It’s likely that 75% of all pregnancies miscarry which makes this far and away the greatest killer the world has ever seen.  Cancer?  Nothing.  Small pox?  Small change, more like (even if it wasn’t the one disease we’d cured).    AIDS?  Only a little help.

Far and away the largest killer in the world if you believe that a foetus is a baby.  If life begins at conception, flood the research labs with money to cure this killer.  And support contraception – it divides the death rate by forty when used – or could prevent more than two thirds of worldwide deaths.

But this doesn’t happen. Those “pro-life” don’t seem to care for what they claim are babies at all – they merely focus on one very minor cause of death.  As the opposition to abortion therefore can’t be about saving babies lives, the reason must be something else.

Edit: Apparently British pharmacists can deny emergency contraception.  Because they labour under the belief it’s abortion.  (via)

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