Monday, July 21, 2008

Civil Rights Roundup: 07/21/08

Your daily dose of civil rights and related news

The Boston Globe has a report on Democratic efforts to find an "anti-Scalia." Could Massachusetts Governor Deval Patrick, a former bigwig in the Civil Rights division of the Justice Department, be that guy?

A dissident Catholic group claims it has ordained three women as priests.

I missed this while I was in NY, but Connecticut is likely to file suit to mandate that the VA allow voter registration drives.

The Washington Post reveals how nannies organized themselves to get the first housekeeper protection law in the nation passed in Montgomery County.

The Post also has an op-ed about "career academies", which have demonstrated some success in improving the job prospects (though not the academic performance) of at-risk youth. Jonathan Kozol, as I recall, was skeptical about this programs, as they essentially track these youth away from any chance at joining the nation's elite, thus perpetuating class divides.

The Arizona Republic has an interview with By Any Means Necessary (BAMN) on the Arizona affirmative action fight.

Local religious leaders are rallying behind a Massachusetts synagogue which was again hit by vandals.

The Orlando Sentinel urges Florida to stop withholding civil rights for ex-felons just because they can't pay restitution to their victims. After all, no civil rights often means no jobs, which means the victims will never get paid.

South Dakota gives doctors a script to read when talking to women considering an abortion. The script says that abortion "will terminate the life of a whole, separate, unique living human being," and "informs" the women that she possesses "an existing relationship" with the fetus that is protected by the U.S. Constitution, that "her existing constitutional rights with regards to that relationship will be terminated," and finally, (falsely) tells her that "abortion increases the risk of suicide ideation and suicide."

Lemons into lemonade: School districts around the country are looking for ways to integrate in the wake of the Supreme Court's decision last summer severely limiting voluntary desegregation plans.

New Orleans residents wonder if the air of police entitlement that allows them to violate citizens rights with impunity is the exception or the rule.

Finally, hip-hop star Usher is launching a voter registration drive in Georgia.

6 comments:

PG said...

South Dakota gives doctors a script to read when talking to women considering an abortion. The script says that abortion "will terminate the life of a whole, separate, unique living human being," and "informs" the women that she possesses "an existing relationship" with the fetus that is protected by the U.S. Constitution, that "her existing constitutional rights with regards to that relationship will be terminated," and finally, (falsely) tells her that "abortion increases the risk of suicide ideation and suicide."

I'm in favor of the kinds of pre-abortion information that don't treat pregnant women like they're all mentally retarded. For example, if the state is willing to fund sonogram machines and procedures at abortion clinics, I have no problem with not merely offering a sonogram, but mandating that all women who request an abortion receive a sonogram and sign a form stating that they have viewed it and still wish to have an abortion. If a woman can't cope with seeing a sonogram, she's probably going to regret the abortion later and end up as the Kennedy-in-Carhart type who thinks the state should have protected her from having that option.

In contrast, the script a) infuses the government's beliefs about the fetus into what ought to be a medical, scientific fact-driven situation; b) makes a deeply muddled, uninformative statement about the Constitution; and c) as David notes, falsifies the data we have on abortion and suicide.

A sonogram gives real information that the woman may not already possess (indeed, women without a high school education may not know what a human fetus even looks like). "This is what the fetus in your uterus looks like. It will cease to exist if you have an abortion. Is an abortion what you want?"

The South Dakota script, in contrast, is just insulting. If the fetus is "whole and separate," does that mean it is independent of the woman's body? If it's pre-viable, of course not.

Also, this "unique" fetish of pro-lifers completely puzzles me. Uniqueness is neither necessary nor sufficient for personhood. Identical twins aren't unique, genetically speaking, but they're still people. If we are stupid enough to allow reproductive cloning, the clones MUST be treated as people even though they lack genetic uniqueness.

Anonymous said...

Oh brother. Yeah, 'cause what you propose isn't the least bit insulting: "mandating that all women who request an abortion RECEIVE a sonogram." Why sugarcoat it in polite "mandating...request...receive" leanguage? You're asserting that women should be FORCED to have and view a sonogram.

And what if they turn away, or close their eyes, for any of a myriad reasons adult rational human beings who aren't interested in being "protected from themselves" and aren't intersted in being patronizingly forced to undergo a medical procedure might have? Shall we trot out the equipment from A Clockwork Orange?

And what if the pregnancy was the result of rape? How do we feel about forcing the woman to contemplate the result of her assault then? If our answer is different, is that because the pregnancy is then not her "fault"? Does that not suggest this whole "protect you from yourself" business has just a wee bit of a poorly-hidden moralistic agenda? Does a rape or incest victim somehow have a more privileged understanding of what it REALLY means to be pregnant, and thus can opt out of the patronizing twaddle that you propose?

Because that's exactly what it is: Yes, dearie, you say you understand what pregnancy is, and that you know what you want, but do you really? Because I, in my smug, elevated position, knowing nothing about the set of circumstances that brought you to make this difficult choice, don't think that you do.

Either we regard women as rational actors, or we don't. Either we give them credit for knowing that that widdle bump in their belly is somehow related to the production of a human infant, or we don't. A script is odious, insulting, and appalling. A forced viewing of a sonogram is odious, insulting, and appalling.

PG said...

"Mandate" is polite language? who knew? in law & politics, it's usually treated as a dirty word (particularly when it comes to the feds' unfunded mandates on the states).

I am in favor of treating abortion as much as possible like any other medical procedure. Other medical procedures require informed consent, in some cases including watching a video that describes and pictures potential consequences of the procedure.

For example, when I got my wisdom teeth removed, I had to watch a video about the possibility that the surgery would leave my face paralyzed. The video on exactly what laser surgery on my eyes entailed was even more fun. (And they didn't offer anything during the procedure to block the odor of the flesh of my eyeballs getting burned.)

There are women seeking abortions who haven't received even basic health information about how pregnancy occurs and what a fetus looks like. Indeed, part of the reason that some women have to seek abortions is that they weren't informed on how to avoid pregnant. We know from the "abortion regret" movement that some women get abortions lacking fundamental facts.

The *facts* -- not philosophy, religion or opinions -- on abortion should be known to someone obtaining the procedure, just as the facts on other medical procedures are known to people who receive them. A sonogram is an excellent way to provide particularized information about the condition that the abortion is intended to address. Although abortion prohibitionists hate this analogy, it would be stupid for an oncologist to try to describe how a tumor was progressing without showing the scan. Is it hard for the patient and her family to see what is happening to her body? Sure. But she can't make the most informed decision on what is best for her without particularized information, in both verbal and visual form.

Wanting women to get abortions, without as much factual information as feasible, isn't empowering women. So long as the mandatory sonogram places no financial or significant time burden on the patient, there's no constitutional reason for it not to be used. If seeing a sonogram keeps someone from having an abortion, then why the hell is she having an abortion in the first place?

There's no reason to treat informed consent differently for women whose pregnancy is thought to have resulted from non-consensual sex. People who need to get their wisdom teeth pulled due to getting hit in the face during an assault have to give informed consent just as much as I did when I got mine pulled before they were even slightly impacted. The only cases in which standards for informed consent can be lowered is if the procedure occurs in an emergency where even the extra 15 minutes would risk the patient's health or life. In line with my general policy of treating abortion like a medical procedure, I would require any mandatory sonogram to have an exception for emergency abortions.

Anonymous said...

Informed consent is about the communication of risks.

A sonogram tells you nothing about risks.

To make abortion consistent with other medical practices, of course risks should be communicated. This is, I understand, already done -- not to do so, obviously, would violate medical ethics.

If you would care to amend your position to mandate that a physician offer a sonogram, I would have no problem with that. Surely, if a woman comes in for an abortion and lacks basic information about what's going on or how she got that way, the offer of a sonogram would solve that problem. Ditto for relieving physician culpability (of which there ought to be damned little in the first place) should the woman later experience regret. More importantly, to my mind, this scenario allows women who do understand how getting knocked up works, and who have made their own personal decision to stick with just the stuff needed for informed consent and be treated as if they actually have dignity and agency. And are not, as you put it, mentally retarded, or something.

Going back to the "consistency with other medical practices" idea, I've never heard of an uncontested instance in which a doctor was able to refuse a procedure based on a patient's declining to participate in some piece of ritual not associated with medical necessity or the accepted rules of consent. My own anecdote, to counter yours: in the first of a recent series of tumor removals, the doctor offered -- not forced, mind you, but offered -- to show me the scan. Out of curiosity, I accepted. The second removal -- different doctor, different office, blank slate -- I explained I knew the drill, didn't wish a viewing, and just get the damn thing out, please. And there were no problems -- just as if you, for whatever reason, declined to watch the video. The risks would have been communicated as necessary for consent (perhaps by a doctor cranky at having to spend the extra time), and off you go.

Your statement that if a woman can't cope with seeing a sonogram then she probably shouldn't have an abortion is neither a factual nor scientific judgment -- it's a moral one, and one that neither you nor I am qualified to make about a stranger's life.

There are all kinds of perfectly valid reasons someone might have for not wanting to view a sonogram. She might, for instance, be pathologically squeamish (personally, I always decline the offer of an angled mirror during gyn exams. Should I then not be entitled to a pap smear?). Much more importantly, she might believe -- and be utterly rational in thinking so -- that an abortion is absolutely the right thing to do given her current circumstances and the likely physical/mental/life consequences of carrying the pregnancy to term. And yet, the forced viewing of a sonogram under already stressful conditions might cause her to abruptly abandon a considered and wise decision for an impulsive and emotional one that has disastrous consequences for her, for the future she might have otherwise had, for the child, and, potentially, for the innocent people that ill-raised child may go on to affect.

You speak of regret as if it's a one-sided coin. What about the regret of a woman who sacrifices a brilliant future to be the unhappy and unprepared parent she never intended to be?

You also speak about sonograms as if they're context-free god's received truth. They aren't. (Which is, I think, precisely why they aren't used to attempt to communicate risk.) When I, an overeducated person, looked at my tumor scan, I saw abstract and baffling patterns of light and dark. What does a woman who doesn't understand how pregnancy works see when she looks at a sonogram? For that matter, what does an educated person see? Very likely not the actual biological organism in its correct and highly limited developmental stage. If it doesn't communicate risk, and it doesn't communicate accurate information, what use does a forced sonogram have other than as a crude brickbat of emotional propaganda?

PG said...

I said, "I have no problem with ... mandating that all women who request an abortion receive a sonogram," not that it is my position that a sonogram SHOULD be mandatory. I don't think it should be mandatory. I am saying that one can plausibly argue that a sonogram would assist informed consent, not that a sonogram is necessary to my conception of informed consent for an abortion. The suggestion of a mandatory sonogram was intended to contrast with the religious/ philosophical twaddle that South Dakota is mandating.

A mandatory sonogram can be rationally linked to informed a consent; I don't think that would have trouble getting past someone like O'Connor, and it would be cheered by Kennedy. You agree that a sonogram can serve a purpose in informed consent and that it would be OK for doctors to be required to offer one. The only point of disagreement is on whether it could made mandatory.

A doctor certainly can refuse to provide a procedure, especially one that is not medically necessary, if a patient refuses to sign a form 1) accepting the risks of the procedure, 2) stating that she has been informed of those risks and understands them, and 3) limiting her ability to sue for malpractice (especially with regard to jurisdiction).

However, informed consent is not just about the communication of risks, although that is the malpractice-lawsuit-avoiding, sign-this-form aspect of it. The ethical aspect is ensuring that the patient understands the nature and purpose of the medical intervention. The purpose of an abortion is to end an unwanted pregnancy; the nature of an abortion is to remove the fetus from her uterus.

If someone has had a limited education regarding human reproductive biology, simply offering a sonogram will hardly remedy that shortage. For one thing, the patient may not even know what a sonogram is (I didn't know what one was until I was in high school). This is particularly important because reproductive health is the exception to the general rules regarding minors and medical care. Normally a parent would be guiding, if not outright choosing, a minor's medical choices. For abortion, minors can decide for themselves.

Moreover, your idea that a sonogram necessarily creates an emotional (and impliedly irrational) bias against having an abortion that otherwise is the right choice is unsupported. Did you look at your first tumor scan and think, "Hmm, maybe I'll keep it after all"? A sonogram could just as easily harden someone's resolve to be free of an intrusion in her body that will only grow worse.

A sonogram has context, but it's the context of the viewer's own preferences, unlike SD's speech for doctors.

You speak of regret as if it's a one-sided coin. What about the regret of a woman who sacrifices a brilliant future to be the unhappy and unprepared parent she never intended to be?

I speak of abortion regret with regard to women who say they regret having abortions, rather than not having them, because I don't know of anyone who wishes she'd had an abortion instead of completing a pregnancy that resulted in a live birth of a viable child. (I'm sure some women who didn't find out before it was too late to abort that their kid had a fatal birth defect would have preferred to abort rather than go through the physical and emotional pain of delivering a baby who will die quickly and in some cases painfully.)

Whether it's hormones or love, very few women seem to wish that their offspring had never existed.

Someone who believes she will be unhappy and unprepared as a parent can opt to have her child adopted at any stage, whether before birth or at age 16. If she never intended to be a parent, and is white and likely to have a "brilliant future," she probably can sell the newborn to someone who doesn't want to go to Ireland for him. Even in prohibitionist countries, no one is forced to be a parent. The right to abortion is necessary because no one ought to be forced to be pregnant, either.

Anonymous said...

You agree that a sonogram can serve a purpose in informed consent...

Er, no. No, I really don't. In fact, I kinda baldly spelled it out in the first two sentences of my last reply, which I tried to keep short and declarative especially for the purpose of establishing that I didn't agree. Let me try again: informed consent is about the communication of risk. A sonogram says nothing about risk.

Why, then, do I say that I don't object to a physician being required to offer a sonogram? Because I wouldn't object to a physician's being required to offer a toothbrush with every abortion, either -- which isn't to say that I think improved dental hygiene is part of informed consent. Simply: The offer does no harm. I think medical consumers ought to be able to choose from as wide a palette of tools that might help them conceptualize their experience as is practicable.

But the unbelievably important key word here is choice. And "choice" + "mandatory" = not so much a good combination, just like "mandatory" + "being assumed to be a rational and competent adult."

A doctor certainly can refuse to provide a procedure, especially one that is not medically necessary, if a patient refuses to sign a form 1) accepting the risks of the procedure, 2) stating that she has been informed of those risks and understands them, and 3) limiting her ability to sue for malpractice (especially with regard to jurisdiction).

Well, duh. We've already established -- and you have not argued against -- the fact that, under normal circumstances (eg, barring breech positioning), a sonogram does not communicate anything about risk.

However, informed consent is not just about the communication of risks...The ethical aspect is ensuring that the patient understands the nature and purpose of the medical intervention. The purpose of an abortion is to end an unwanted pregnancy; the nature of an abortion is to remove the fetus from her uterus.

Y'know, I think we can safely establish that even if a woman doesn't understand the mechanics of what's about to happen, she understands that an abortion will cease her pregnancy, not make her a little bit less pregnant.

Otherwise, why would she have made the appointment? Surely, if she accidentally wandered in seeking prenatal vitamins, that's something a good receptionist can clear up without State intervention.

If someone has had a limited education regarding human reproductive biology, simply offering a sonogram will hardly remedy that shortage. For one thing, the patient may not even know what a sonogram is.

Here's a thought:
Doctor: "Would you like to see a picture of what's happening in your tummy?"

Moreover, your idea that a sonogram necessarily creates an emotional (and impliedly irrational) bias against having an abortion that otherwise is the right choice is unsupported. Did you look at your first tumor scan and think, "Hmm, maybe I'll keep it after all"? A sonogram could just as easily harden someone's resolve to be free of an intrusion in her body that will only grow worse.

I didn't take the bait in your earlier response, because I thought you must be being deliberately obtuse. Now that you've raised it again, however:

A fetus isn't a tumor. Or a wisdom tooth, as you analogize it in your barbaric answer about rape victims and forced sonograms. We are wired to respond to infants (and just about anything cueing neoteny) differently than to tumors and wisdom teeth, which is easily demonstrable (and has amply been, in the psychological literature) by any number of physiological measures. The thing is, we respond this way even when what we're seeing isn't actually an infant -- as a sonogram, seriously magnified and not conveying information about developmental stages, can easily and erroneously imply.

And that's what I mean by context. You tautologically and self-servingly assume that any decision moving from aborting to not aborting is right. It clearly is not, and we ought to be suspicious about any deeply-considered conclusion that's thrown over in an emotional fit spurred by a misleading image.

Whether it's hormones or love, very few women seem to wish that their offspring had never existed.

What a lovely, rainbow-clad world you live in. Do you expect to find mothers declaiming it from the rooftops? This is an empirical question, unbelievably bulldozed by social desirability concerns, dealing centrally with the most extreme end of what remains one of the most taboo topics for women -- rejection of motherhood. Might I suggest that the survey sample ought be other than your circle of friends?

Even in prohibitionist countries, no one is forced to be a parent. The right to abortion is necessary because no one ought to be forced to be pregnant, either.

Or forced to undergo a patronizing and wholly unnecessary procedure with no parallel in the less morally-fraught medical world, which has no apparent purpose other than being a misleading and emotional attempt to derail a personal and considered decision.