There’s a lot of blogging today over a sensationalistic post at NRO by Shannen Coffin, a former Bush lawyer who was responsible for anti-choice litigation surrounding the so-called “partial birth” abortion ban. She He notes a 1996 memo from the files of the Clinton administration, predating Clinton’s veto of the anti-choice bill, in which Elena Kagan, then a Clinton legal advisor, recommended a change in language in the policy statement eventually issued by the American College of Gynecologists supporting their opposition to the bill. They originally stated that “in the vast majority of cases, selection of the partial birth procedure is not necessary to avert serious adverse consequences to a woman’s health”, and that they “could identify no circumstances under which intact D&X would be the only option to save the life or preserve the health of the woman”, but – on Kagan’s recommendation – clarified that by also noting that it “may be the best or most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman”. (Note that ACOG explicitly reaffirmed this policy, using the same language, at least three more times, in 1997, 2000, and 2003). That policy statement was later referred to by at least one federal judge, in litigation on the constitutionality of the ban later enacted by Bush.

Quelle horreur!

Coffin’s conclusions are that this is a “distortion of science”, that “language purporting to be the judgment of an independent body of medical experts devoted to the care and treatment of pregnant women and their children was, in the end, nothing more than the political scrawling of a White House appointee”, and that “Miss [sic] Kagan’s decision to override a scientific finding with her own calculated distortion in order to protect access to the most despicable of abortion procedures seriously twisted the judicial process” – naturally she he rolls this up into the ongoing Kagan Supreme Court confirmation hearings as well. The right-wing idiotocracy is all a-Twitter, too, natch: Powerline declares this is a “smoking gun” and “shocking”; Riehl calls it “misrepresenting science” and “dishonest”; the risible Betsy, of Betsy’s Page, reads this and concludes that “there was a doctors’ opinion that said that partial birth abortion was not necessary and she, with no medical background at all, drafted a statement that said the exact opposite”. Yuval Levin, the severely bioethics-challenged former staff manager of Bush’s Presidential Council on Bioethics, declares this to be a “war on science”, “astonishing”, and “easily the most serious and flagrant violation of the boundary between scientific expertise and politics I have ever encountered”.

This sort of nonsense is particularly astounding from Levin, who was a central player in the workings of an “ethics” commission that remains a watchword for right-wing distortion and duplicity, whose major policy statements drew dissenting opinions from its own most scientifically-qualified members, and which then censored, and later fired, those same members. Levin – a political scientist and former Bush White House policy staffmember who has spent his entire career crafting right-wing bioethics policy - also castigates Kagan for her lack of medical expertise and her involvement in healthcare policymaking. You really just can’t make this stuff up.

It’s especially disingenuous for people like Levin and Coffin – political hacks whose entire career consists of trying to influence policy to fit their ideological leanings, from both inside and outside the government – to claim that there’s something untoward in political policy staff conferring with the policy-making boards of professional organizations to shape language on statements issued in clearly political and legal contexts. That sort of thing goes on all the time, and it’s appropriate for such bodies of experts to confer with political authorities to ensure that their statements are effectively written and focused. It would be inappropriate for them to turn themselves over to the political authorities as tools of policy, and to issue statements they did not believe were true, but it’s not inappropriate to get guidance on language and emphasis in order to convey an effective message. (As Coffin herself notes, ACOG already opposed the anti-choice bill. Obviously they would want their policy statement to reflect the reasons why.) To suggest that a policy expert drafting language for a policy statement endorsed by a professional body is somehow scandalous – let alone unusual – is simply stupid. And to suggest, as Coffin and others have recklessly done, that ACOG is somehow compromised or tarnished in doing so, is not merely stupid and dishonest, but libelous.

Aside from the completely manufactured, and fictional, scandal that the right-wing noise machine is busily whipping up over this, there is also the simple fact that the language Kagan suggested does not replace or contradict the language previously present. The statement that there are “no circumstances under which intact D&X would be the only option” is entirely compatible with the claim that it “may be the best or most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman” (emphases added). It’s simple, really: the fact that something is never the only option in no way means that it is a bad option; the revised language not only implicitly acknowledges this but clarifies for the dim-witted (i.e., conservatives) the even more important point that it is in fact sometimes the best option. (Obviously, Intact D&X is never the only option: you can always perform an unnecessary Cesearean section or force the woman to deliver a fetus that may be dying and may possibly kill her - options that are much prefereable, for conservatives, than allowing a woman to choose the safest option on her own authority. ACOG’s point, which Kagan nudged them towards, is that there are often better  options – and that women should have the right to choose them.)

The fight over Intact D&X was particularly nasty because it encapsulates so much of right-wing misogyny, so clearly: it was not a ban on abortion, and it was not a ban on late-term abortions; in fact, it did not ban any abortions under any circumstances. It was only and entirely a ban on one particular procedure for performing abortions. It banned the procedure that was preferable in specific circumstances – leaving abortions entirely legal under those circumstances but forcing women to submit to a procedure that was less safe and more debilitating for them. It was straightforwardly an attempt to punish women by making them accept higher risks and a lower standard of care, as the price for choosing a procedure the right wing disapproved. And ACOG’s policy statement implicitly recognized this: it notes that there are always alternatives to the ID&X procedure, but that in some circumstances those alternatives are worse, and ID&X is, in those circumstances, the best or most appropriate procedure. Kagan’s contribution – appropriate, useful, and highly pro-woman – was to encourage them to clarify that distinction. (Note, again, that ACOG explicitly reiterated this policy, and the important distinction it makes, three times after Kagan supposedly “overrode” their scientific judgment in the matter by forcing them to include language that does not contradict that judgment.)

Raising this issue is simply another example of the right-wing’s reflexive insanity over sex and abortion, coupled with their inherent inability to read and comprehend basic logical statements. (Note “Betsy”‘s analysis: “there was a doctors’ opinion that said that partial birth abortion was not necessary [no, there simply wasn't] and . . . [Kagan] drafted a statement that said the exact opposite” [no, she didn't].) Honestly, the relationship between “not the only” and “sometimes the best” is really not that tricky. It’s too tricky, of course, for the average right-winger, and for people like Coffin and Levin, whose deficiencies were all too apparent back when they were writing policy for Bush, but to people of normal intelligence and reading comprehension, this entire farce is an obviously groundless, and all-too-familiar, political hackery.

The right wing is also up in arms over this because, as Scott Lemieux at Lawyers, Guns, & Money notes:

the only point of this feeble “smoking gun” is to allow Senate Republicans to mention the phrase “partial birth abortion” a lot [and] I should note once again that for reasons Judge Posner and Justice Stevens have explained the entire issue is a farce. The distinction between D&X abortions and other abortion procedures is wholly arbitrary, and for people who have supported irrational laws making such a distinction to pretend to care about rigorous medical science is nothing but comedy of the lowest form.

Mahablog was fast out of the blocks on this, in a post I wish I’d written:

if you actually understand the issue in question — which leaves out righties, naturally — you’d know there is no “there” there. . . . Somehow, in the fevered imagination of righties, a professional organization representing 90 percent of U.S. board-certified obstetrician-gynecologists was duped by Kagan into telling a lie, or something, and because this wording came from Kagan it must not actually reflect the views of ACOG. . . . no scientific finding was “overridden,” just clarified, and ACOG must have agreed with the statement or they wouldn’t have continued to repeat it in their position papers ever after.

Lemieux gets the content issue exactly right:

There’s no contradiction between the two drafts, because D&X abortions are, in fact, not medically necessary in a majority of cases. But this fact doesn’t mean that they are never medically necessary, and indeed the original statement implies that there are cases where D&X abortions are necessary or preferable for a protecting a woman’s health. Adding a statement to clarify what was implicit in the first draft doesn’t “distort” anything, and of course if ACOG didn’t think the statement was accurate Kagan had no power to get them to change it. There’s nothing here.

UPDATE: Corrected pronouns referring to Coffin; he’s a “he”, not a “she”. My apologies to Coffin for the mistake.

UPDATE: Another right-wing website breathlessly announces that Kagan “pressured a second group” on its wording of its pro-choice policy. That group was the AMA. Their claim: “Kagan discussed with other Clinton administration officials whether the AMA could reverse its policy saying there is not an identified situation in which partial-birth abortion is the only appropriate method of abortion. The AMA also noted ethical concerns with partial-birth abortions and said that it should not be used unless it is absolutely necessary.” Note that this repeats exactly the same mistake all the other commentators made about the first memo: the two positions described are not contradictory, and there is no “reversal” in evidence! And Kagan’s particular crime: she wrote an e-mail saying “We agreed to do a bit of thinking about whether we (in truth, HHS) could contribute to that effort . . . . Chuck and I are meeting with the AG on Tuesday; Donna offered to send over some doctors this week”. They don’t even identify who the e-mail was sent to (obviously it was internal), or whether any such meeting ever took place, let alone had any effect. (Apparently the AMA does the bidding of any government staff lawyer who offers to “contribute” to their policy development.) Truly, the stupid knows no bounds with these people.

This book review is excerpted from a detailed forthcoming review in the American Philosophical Association Newsletter on Medicine and Philosophy, v. 10, n. 1, Fall 2010.

Jonathan D. Moreno and Sam Berger (eds.)
MIT Press, Cambridge, 2010
286 pp., with Index
Foreword by Harold Shapiro
Introduction and Afterword by Jonathan D. Moreno and Sam Berger
ISBN: 9780262134880

Bioethics addresses issues shaped by abstruse empirical fact and the technical parameters of the technologized controversies of contemporary culture. It is tempting to imagine that our philosophy must be as technologically-informed as our understanding of our lives has now become – that human flourishing must be in some ways dependent upon technological problem-solving, that the range of values and possibilities accommodated within the morally good life is wider than previously imagined, and that these observations define a particular stance, critical but welcoming, toward the prospect of aggressive engagement with the future through the tools and products of science.

Something like that is the position ascribed to “progressive bioethics” by the authors of the just-issued essay collection, Progress in Bioethics: Science, Policy, and Politics. The volume collects almost 20 essays on questions of the nature of bioethics as a field, its relationship to progressive ideology, and the ways that relationship plays out in particular issues and controversies characteristic of the field now and in the past. The authors are a roll-call of respected and influential figures in contemporary bioethics, not all of them academics, subscribing to a wide range of perspectives on progressivism and the task of progressive bioethics. The impression they give is of a fluid and open-minded community, engaged in a searching and sometimes indeterminate discourse with itself and the wider world.

The Foreword, Introduction, and essays of both Section I: “Bioethics as Politics” and Section II: “The Sociology of Political Bioethics” investigate the nature of progressivism, the issues that are or should be of interest to progressive bioethics, and the practicalities of politics and policy that bioethics is often involved in. Section III: “The Sociology of Political Bioethics”, addresses questions of the professional identity of bioethics, and how progressive ideology meshes with other personal and professional values. Section IV: “Conflicting Views of Biotechnology” contains one unabashedly pro-technology piece, and another warning against an uncritical stance on science. The concluding Section V: “Progress Beyond Politics”, offers higher-level reflections on the field of bioethics in general. In the “Afterword”, the editors remark upon the prospects for progressivism and healthcare reform in the advent of the Obama administration – a question that could not be more timely.

Necessarily, there are gaps: the definition of progressivism needs further exploration, and it remains unclear why progressivism should have any of the content suggested for it; at times the content or scope of bioethics also seem taken for granted. Even the role of science in progressive bioethics awaits further examination. These are not faults in a collection of diverse viewpoints; however, much remains to be discussed. This volume opens that discussion insightfully, searchingly, and provocatively.

Progress in Bioethics is must-reading for political progressives interested in biomedical issues, bioethicists who identify as political progressives, bioethicists in general who are interested in the conceptual landscape of contemporary biomedical policy and cultural controversy, and for those who seek to develop a humanitarian pro-science viewpoint, whether on biotechnology or other complexities of our technologized modernity.

Dr. Jack Cassell, in Florida, is getting press today for the cranky, obnoxious note he posted on his office door:

If you voted for Obama . . .
seek Urologic care
elswhere

Changes to your healthcare
begin right now
not in four years

He apparently also fills his waiting room with anti-Obama literature, signs about what “the morons in Washington have done to your healthcare” (NB: nothing has changed about any of his patients’ healthcare; he is the only one who has done anything so far), and explicit instructions on who they should vote for.

In response to concerns that he might be politicizing his care just a tad, he argues “I’m not turning anybody away — that would be unethical. But if they read the sign and turn the other way, so be it.” So of course he’s not actually doing anything to make patients feel uncomfortable by explicitly telling them to leave his practice because he disapproves of their politics; they just happen to choose to seek another doctor for reasons unrelated to his behavior or his treatment of them.

There’s been commentary over whether this infringes any laws or principles of medical ethics. His supporters claim he is justified in behaving this way because doctors, like everyone, have a right of free speech. There’s a lot to be said about that – most notably that the whole point to medical ethics is that professional practice and the professional relationship impose standards more stringent than those  incumbent on ordinary citizens. Simply having a right of free speech does not justify acting like a jerk toward your patients; the treatment relationship is one-sided, predicated upon the doctor’s commitment to service of the patients’ needs, not their approval of the patients’ politics; admission as a professional is predicated upon acceptance of those standards, and a willingness to put one’s personal inclinations aside in the professional arena.

But aside from that, what strikes me about this situation is the general attitude it reveals. Not only does this doctor fail in the face of any of the above standards, but it seems obvious he simply conceives of medical practice as something that does not in fact entail the authority of such standards or commitments. Doctoring is apparently a job, to him – something he can do if and as he chooses, and which does not impose on him any obligations he does not happen to want to meet. He is – to all appearances – essentially the doctor in Ayn Rand’s Atlas Shrugged, who joins with the amoral capitalist runaways to form a free-market society founded on hard money and ethical egoism. Being a doctor does not require him to do anything for anyone if he doesn’t feel like it, and it doesn’t require him to accept as a patient – or even keep as a patient anyone he has already accepted – who does not personally agree with him on any matter of his choosing.

What I fear, but perceive, is that this attitude is becoming more widespread. Doctoring is just a job, it seems, in the minds of more and more doctors, and in the minds of the right-wingers who are so afraid that Obama is going to destroy healthcare by making it less capitalist. (As usual, facts are of no moment to the right-wing panic apparatus: it is this doctor himself who is “changing” healthcare for his patients – his own sign says so  – but he still manages to blame it on Obama. And it is this doctor who has made healthcare hostile and unwelcoming for his own patients – he is, not a death panel exactly, but a one-man jerk panel to his personal caseload – but they deserve it, he seems to think, because they voted wrong.) Whatever the consequences of Obamacare, I fear that it will be simply impossible to destroy medicine in the US because there will be no medical profession left to destroy – just a bunch of entitled, self-absorbed jobsworths whining about how much less they like their jobs now that the glamor and remuneration has started to fade and they’re left with nothing more than providing better care to more people, which is such an imposition.

Democratic Congressmember Alan Grayson, who represents that district, was notorious for (accurately) characterizing the Republicans’ healthcare policy as “Die quickly”. He notes about Dr. Cassell: “Maybe he thinks the Hippocratic Oath says, ‘Do no good.’” That’s about the size of it.

The latest entry in the “creepy personified fetus” category: the “Feti” – weird/cutesy Christmas-tree ornaments shaped like tiny embryos at about the 6-8 week stage (bulbous head, no digits, visible tail). As is usual with this genre, they sport adult-appropriate personal characteristics, including clothes, personal possessions, and in one case a moustache. You can buy Santa fetuses, “happy” fetuses, candy-cane-carrying fetuses, and an “Adam Lambert” fetus displaying a punk hairdo and clutching a Star of David – a cultural mishmash that I refuse to attempt to understand.

Happy Fetus

Feto Incognito

Adam Lambert Embryo

The purveyor of the site insists that “Feti is just for fun, no political statements being made here.” I’m tempted to believe that in her case, but the thing still strikes me as weird,  and indicative of a mindset that is worth noting.

The vendor suggests these are intended as gifts for expectant parents, as appropriate additions to the “Baby’s First _____” category of remembrances. (Exactly how, I’m not sure: “Baby’s First Disembodied Hanging on a Christmas Tree”?) In that vein, they play off the very common and understandable practice of many expectant parents in personifying their fetus as it develops – talking to it, playing music, naming it before it is born, and so on. They also seem to accept as a cultural commonplace the fetishizing – literally, in this case! – and personifying of the fetus that is a mainstay of anti-choice propaganda. (Anti-choicers often wear gold-plated fetal-footprint jewelry, and they are forever trying to force abortion patients to look at pictures or sonograms of the fetus.)

I don’t know if the anti-choice movement has so far succeeded in turning the fetus into a fetish object that you can now literally market them to the general public as holiday ornaments, or if the common desire to see fetuses as sort of reverse-extensions of babies simply makes this a natural marketing move, like Cabbage Patch dolls or those weird Anne Geddes photographs of babies in flower petals, and the right wing has merely piggybacked off that common emotional trope for their own purposes. The former would scare me a bit, the latter is merely infuriating. Either way, this sort of thing leaves me with a creepy feeling.

I’m happy for people to be happy about their pregnancies, and to embue their future offspring with emotional valence or even a somewhat overgrandiose sense of promise or accomplishment. In the same way that all parents think their kids are smart and talented, and I wouldn’t quarrel with that, expectant parents can and should go ga-ga over the cute little buns in their respective ovens. There is no point, in the case of people’s emotional experience of the events in their lives, to go around insisting to them “you know it has no functional higher nervous system, right?” . . . “that’s not a ‘person’ you’re carrying, in any meaningful sense of the term – just wanted to let you know” . . . “don’t get too close to it – there’s about a 1-in-12 chance you’ll lose the pregnancy”. But when it comes to law and policy-making, clear distinctions do have to be made – and at that point, the conflict between stark reality and parents’ expectations may be uncomfortable.

Regardless of parental beliefs, not all kids are smart or talented, and thus some won’t make it into selective academic or sports or art programs. And regardless of the fervent, desperately dishonest myth-making of the anti-choice right, the early fetus is not a person and does not make moral claims on a woman’s body and life sufficient to override her autonomy. It is unfortunate to have to disappoint people emotionally invested in believing otherwise, but it is far worse to make policy based on wishful thinking in defiance of the truth.

By all means, have yourself a merry little Christmas, and hang a smiling Adam Lambert Jewish punk fetus upon the highest bough. But let’s keep the “personified fetus” myth firmly in its place when we go to making important decisions about real issues in real people’s lives.

So, much has been made this week of the fact that the Republican National Committee, throughout its longstanding berserker campaign against women seeking control of their own bodies, has in fact been providing comprehensive healthcare insurance to its own employees – including female employees – for almost 20 years. Many fingers were pointed over the hypocrisy of attempting to prohibit abortion access for all women in America by every means possible, while covering abortion care for its own employees under their internal health insurance plan. (This in fact is in keeping with right-wing approaches to the issue generally: their values legendarily evaporate when it’s their personal interests at stake, and stories of women’s clinics providing abortion care to the same women who were picketing those clinics before and after the procedure are legion.)

Predictably, Michael Steele, the hapless RNC head, announced less than 24 hours after the story broke that that coverage provision had been rescinded unilaterally. The usual right-wing hysteria has erupted, with demands that people be fired and angry denunciations that donors to the RNC had not been allowed to deny healthcare to its female employees as they wanted to do. As Ben Smith rightly points out, not one female employee of the RNC – the ones whose coverage has now been stripped without their consultation (and presumably without any reduction in their premium contributions) – has been quoted or consulted in this move.

I note also that pro-choice ideology within the Republican party has run at about a steady 35-38% for most of a decade (a recent poll shows it down somewhat among Republicans, but is widely regarded as an outlier). I presume the large majority of those are women. Assuming further that women are half the GOP membership, that would mean that roughly two-thirds of GOP women are pro-choice (I suspect they’re actually less than half the membership, which would push the prevalence of pro-choice ideology even higher within that smaller female group). Now, I don’t know if the RNC employee base is representative of the Republican Party generally, but if it is, that would mean that about a third of its staff, and about two-thirds of all its female staff, are in favor of abortion rights. There are other factors to be considered, for which we don’t have data (what percentage favor having abortion covered in their health plan, as opposed to its just being legal; to what degree the RNC staff skew even crazier on abortion than the rank and file; what percentage of the staff are female; and so on), but any way you slice it it seems inevitable that there is at least some considerable degree of support for abortion services among the RNC’s staff, to say nothing of the GOP generally. Yet the RNC leadership revoked their own staff’s coverage without consultation, and without the slightest apparent consideration for that staff’s wishes, needs, or rights.

The message is clear enough, and, I suppose, fair and consistent in that peculiar GOP way: for Republicans, hurting women is more important than anything else – certainly more important than providing real healthcare for an entire nation, but more important also than seeing to the needs of their own membership. The Republican National Committee – a body that exists solely to cater to the interests and welfare of registered Republicans – stripped healthcare services that had been available for almost 20 years away from Republican women employed in the service of that body and their party, without the slightest hesitation or apparently without even talking to them.  Within the highest levels of the Republican Party itself, your lack of status as a woman trumps your preferential status as a Republican.

Michael Steele could have just made it much more simple and direct:

Goldman Sachs has just issued a helpful report for the insurance industry, identifying the profit potential for them in various likely outcomes of the current healthcare access reform initiative. Their conclusion: the best thing for the insurance companies is no reform at all, followed by the weakest possible reform; the worst thing for them is real reform with universal access and a publicly-backed plan option.

In other words: the current disaster of a system is the one that provides the greatest possible profit potential to the insurance industry; any effort at increasing access to care is against that industry’s interests, and a robust and successful reform effort is the worst possible thing from an industry whose profits are entirely dependent on charging the highest possible premiums and delivering the least possible care.

The Senate Finance Committee bill, which Goldman’s analysts conclude is the version most likely to survive the legislative process, is described as the “base” scenario. Under that legislation (which did not include a public plan) the earnings per share for the top five insurers would grow an estimated five percent from 2010 through 2019. And yet, the “variance with current valuation” — essentially, what the value of the stock is on the market — is projected to drop four percent.

Things are much worse, Goldman estimates, for legislation that resembles what was considered and (to a certain extent) passed by the House of Representatives. This is, the firm deems, the “bear case” scenario — in which earnings per share for the top five insurers would decline an estimated one percent from 2010 through 2019 and the variance with current valuation is projected to be negative 36 percent.

What the firm sees as the best path forward for the private insurance industry’s bottom line is, to be blunt, inaction.

The study’s authors advise that if no reform is passed, earnings per share would grow an estimated ten percent from 2010 through 2019, and the value of the stock would rise an estimated 59 percent during that time period.

The next best thing for the insurance industry would be if the legislation passed by the Senate Finance Committee is watered down significantly.

Coincidentally, no doubt, the report arrives from Goldman Sachs – recipient of uncountable billions in public bailout dollars for their executives’ bonuses, from the Obama administration – just as the healthcare access reform plan being pursued right now by that same administration is nearing its final legislative conflict. Goldman helpfully notes in a disclaimer that the firm “does and seeks to do business with companies covered in its research reports.”

All you have to do to see how utterly repulsive the healthcare insurance industry is is to simply watch how they talk about their own business. It is impossible to be disgusted enough by an industry that – uniquely in the industrialized world – treats people’s bodies, health, and lives as saleable commodities in a free market in misery.

The AP reports that Scott Roeder, the terrorist who killed Dr. George Tiller, publicly and in cold blood, last May, has openly confessed to the crime and justified it with the usual religious-radical gibberish about “unborn children”. In the article, he explicitly equates fetuses with independently-living persons and claims that killing to prevent abortion is justified if at least one forced pregnancy results; he encourages others to perform similar terroristic murders, and states he intends to base his legal defense on an argument for a religious-political justification for murder. None of this is new, except possibly that he has stated all this on record now.  It confirms what we knew about him, anyway.

The real question is whether those who are so agitated about real or imagined terrorism of other kinds (especially by Muslims), and who have been so complacently accepting of anti-woman terrorism in the US for decades, will condemn or even acknowledge an open statement of Christian religious-terrorist ideology in the case of yet another anti-choice fanatic.

Just this week we’ve seen a terrible mass murder committed by a Muslim military officer who was apparently distraught over the war in Afghanistan and his possible deployment. Literally before the bodies were cool, various right-wingers jumped in to denounce “Muslim terrorism” and to cite vague links between the suspect and Al Qaeda (he visited a mosque which was also visited by someone who knew someone who was connected with Al Qaeda); however, it is not clear that the apparent perpetrator’s motives were intended for a political end at all – as opposed to merely an outburst of personal anxiety – and there is little to suggest that it was terrorism in any reasonable sense. The murders of doctors by anti-choicers, beyond any question, are defined by the features of terrorism found in most of the commonly-used definitions: they are acts of violence committed against civilians for the purpose of inciting fear in other, third-party individuals, to promote a particular political end. We heard nothing of this at the time of Dr. Tiller’s death (nor of any of the previous murders and other acts of violence); will we hear it acknowledged now that the terrorist has so openly proclaimed his murderous religious ideology?

Anti-choice terrorism is intended to prevent women from exercising a legal and moral right involving their bodily health and autonomy, by terrorizing those women and their healthcare providers – it is violence intended not merely against its chosen (often random) targets, but to terrorize and thus paralyze a larger group, to further the religious and political ideology of the perpetrators and their vast army of supporters and admirers within the religious right. Yet it has never been acknowledged as such, and the large subculture on the right wing who have made a profession of terrorism scare-mongering have never acknowledged the persistent anti-choice terrorism ongoing in the US. (Nor has the FBI: fake anthrax attacks had been staged on almost 700 abortion clinics in the US in the days before 9/11 – not one of them resulted in an arrest, or any obvious urgency about the issue, and they were not treated as domestic terrorism. One person was charged with terrorism for fake anthrax attacks on clinics in the wake of 9/11 and the Congress anthrax mail attacks – the first and only such charge in the entire history of anti-choice terrorism. None of the anti-choice murderers, including Roeder, have been charged as terrorists.)

Now we have an admitted terrorist openly advocating further political killings to promote his religious obsessions. If Roeder were a Muslim and his targets were not women and their healthcare providers, the shrieking loons of the right would be off their heads screaming about his crime, his religious beliefs, his unrepentant stance, his advocacy and rationalization of violence, and his links to other extremists with similar religious and political beliefs. Will we see even the slightest acknowledgment of Christian anti-choice religious terrorism and its dangers in this blatant case?

At this moment, debate is proceeding on the House votes on the landmark healthcare bill. I haven’t blogged about it, because, frankly, it was overwhelming and I didn’t know what I could say that would help. (The Democrats’ stealth approach to bill-crafting, while possibly politically astute, made it hard to get a clear handle on the thing, too.) This will be, without question, one of the most important legislative events of my lifetime; if the bill passes the Senate and is finally voted into law in a reasonably intact form, it will be the most significant development in American history that I will see. More importantly, it will be – largely, though not entirely – an end to crippling insecurity and lifelong anxiety for hundreds of millions, and of irremediable pain and suffering for tens of millions who now live in the only affluent country that permits its business class to sell life itself for profit.

The bill on offer is far from optimal. It locks in the profiteering on death and misery that the vast majority of the country is burdened with, and is needlessly complicated and limited in what it offers to the rest. It deliberately cripples its own modest offering by restricting it only to those whom the profiteers have absolutely refused to serve at any price, prohibiting the rest of the country from accessing healthcare organized on any saner and more humane basis. But worst of all, the bill is being held hostage by the insane and vicious anti-choice army that infests the right wing and has wholly captured the Republican party. And, too predictably, the omnipresent contingent of grandstanding asshole Democrats is giving them exactly what they want, as they always do.

Right now, the “Stupak amendment” is being debated: an amendment that will prohibit any person enrolling in the government-backed “healthcare exchange” – which is to say, the poorest and most desperate, who are the only ones eligibel to enroll in that plan – from being offered a full range of healthcare services in cases of unwanted pregnancy. For those people, the “public options” will be forced pregnancy, death in childbirth, or an abortion that she likely can’t afford and the right-wing terrorists have likely made unavailable anyway. The Republican House caucus has already stated explicitly that they will refuse to vote for the healthcare bill in any form. But they – with their unconscionable Democratic allies – are holding up the bill to demand the anti-choice amendment in a bill they will not support even if they get it. And enough Democrats are equally indifferent to women’s lives and women’s needs to help them do it.

Democratic women are putting up a good fight – and their male allies deserve thanks, too. The Republicans have shrunk from merely legislative misogyny to outright thuggery, as they so commonly do. Michele Bachman led crowds of right wingers through the Congressional office buildings earlier today, invading offices and screaming at people to, in her words, “scare” them away from supporting women and healthcare for all. House Republicans staged an organized disruption on the floor today, systematically interrupting Democratic women as they spoke in favor of women’s interests and full healthcare coverage. The healthcare debate is being conducted the same way the Florida recount was in 2000: in the face of Republican assaults and intimidation, and without regard for the truth or significance of the actual substantive issue.

I have little to say about the whole thing. I feel helpless – particularly frustrating in the face of an issue so central to my personal and professional concerns – and am waiting as on election night for the outcome of votes that will – with great good luck – mean so much to so many, and move American one huge step closer to the decency and commitment to humanity that has been so sadly lacking in so much of our history. I can only wait and hope, like everyone else. In the meantime, there is an organized, vicious, and relentless minority that is fiercely dedicated to their own hostility to any notion of a decent regard for others, and to the freedom of others to live their own lives unconstrained by that minority’s backward and reactionary values. They are fighting – in the most literal sense – right now to keep tens of millions of people at the mercy of any illness they may suffer, to keep hundreds of millions at the mercy of an insurance system that rivals only those reactionaries themselves in its hostility to the needs of the people they nominally serve, and to keep every woman in America at the mercy of the nasty and bitter men who despise them and their bodies.

I can’t stand watching this unfold. And I can’t say, can’t express even fractionally, how much, how gut-wrenchingly much, I hate and revile these disgusting creeps.

UPDATE: Rayne at Firedoglake reports “Stupak Amendment Passes: 64 Dems Ask for Primary Opponents“. That’s exactly how I feel about it. I had already promised myself that I would contribute to the primary opponents of any misogynist Democrats; I’m saddened, and shocked, that there are so many of them. I will certainly target all that I can afford to. Read the rest of the post; it’s exactly right.

UPDATE: The final bill has passed, 220 – 215. Exactly one Republican voted in favor – 39 Democrats voted to withhold healthcare from over 40 million Americans. This is a great – but very partial – victory. There still remains the Senate bill – which will be a far tougher fight, with looser rules and a larger percentage of heartless and misogynist Democrats in the mix – followed by the conference committee and the final vote. The Republicans and reactionaries will do everything they can to destroy other people’s hopes for a decent life, and their control over their own bodies and life plans – the rioting, disruption, demagoguery and thuggery seen today are just a taste of what is coming. And this step, momentous as it is, comes bitterly. The discussion in the followup post at Firedoglake captures it perfectly; as one commenter put it: “It’s like winning a huge battle, but half of your friends were killed or wounded.”

UPDATE: I’ve added the reference to Democrats in the headline. I didn’t make it clear above that Bart Stupak, who led the charge to destroy healthcare reform for over 300 million Americans if they didn’t let him destroy autonomy for 150 million female Americans, is a Democrat. Along with 63 other misogynist traitors, he put the people’s party against 51% of the people, to indulge their personal medieval religious obsessions. Fuck him and all of them.

UPDATE: Scott Lemieux at Lawyers, Guns, and Money gets the power dynamic exactly right: “Certainly, there are many potential criticisms of how Democratic leadership has dealt with health care, although when you actually care about expanding access to health care it’s hard to negotiate with the Stupaks of the world who don’t, but want to use other people’s progressive impulses to attack women.”

Today is National Coming-Out Day (one day after President Obama promised yet again to repeal the “Don’t Ask Don’t Tell” policy and work toward fuller equality for all people, and yet again did nothing tangible about it).

I don’t have much to say about that, except to offer support and the wish that the homophobia that infects our society, among other lingering forms of discrimination and prejudice, will soon fade, and “coming out” can be the act of celebration and affirmation that it should be, rather than an act of courage and risk-taking in the face of dangers that should not be allowed  to exist.

I’ll note, by way of parochial hyper-focus, that the pressures and threats that impede coming out and living openly in one’s chosen orientation have health consequences as well as many other harmful impacts; they cause stress and depression, create barriers to healthcare access, often result in abusive or discriminatory treatment in emergency care, and not infrequently result in violence. And of course the pervasive legal discrimination LGBTQ people face, in particular regarding health insurance, visitation and decision-making rights for gay couples, and barriers to assisted fertility and adoption, are also health and family-rearing issues as well as being rank discrimination in the basic sense.

Ending homophobia for reasons of good health is an odd and circumlocutory approach to the problem, but it’s one reason among many. Simple moral necessity is a better one. It’s long past time.

The Huffington Post today breaks an original story on a long-running scandal at Columbia University Hospital, in New York, regarding lack of informed consent on a risky blood-volume-expander study. Heart-surgery patients were recruited into a study involving a new formulation of a volume expander that had been known to cause severe bleeding in its existing form; minimal information was provided in the consent form, some patients did not speak English, some were recruited in the ER under stressful circumstances, and the hospital IRB apparently did not adequately review the existing literature indicating the level of risk potentially involved. (Frustratingly, the story does not say what stage this experiment was conducted at, but it appears to have been a Phase I trial.)

The consequences:

At least two patients in the study died shortly after receiving the fluid and more than two dozen others required transfusions, according to documents submitted to the federal government by the hospital and obtained by the Huffington Post Investigative Fund.

There were attempts to rein in the problem as it developed:

In November 2000, two Columbia anesthesiologists – Marc Dickstein and Mark Heath- sought out the head of the institutional review board, Paul Papagni, a lawyer. They told Papagni that they had been in the operating room when a number of patients had hemorrhaged. They feared the study’s design virtually guaranteed that there would be more who would suffer hemorrhaging

However, their objections were derailed by internal politics. Columbia did later act decisively to crack down on the lead investigator, Dr. Elliott Bennett-Guerrero and report the breaches of protocol to the HHS, but they also downplayed the severity of the consequences, in part by reporting only a narrow range of outcomes from selected patients, not including the most severe adverse outcome, the bleeding that was the most important known side effect. The hospital also ignored advice from the HHS that it contact patients from the study and apprise them of the truth. Dr. Bennett-Guerrero has now been dismissed from the hospital (he landed in a Directorship and medical-school professorship at Duke – guess they’re OK with all this). Columbia has now been ordered by HHS to contact its former patients.

So, all in all, a serious problem plagued by misbehavior at every level, and an apparent partial coverup.

That’s all very worrisome, but it is the investigator’s attempted defense that particularly caught my attention:

Bennett-Guerrero . . . said in e-mails: “It is hard to imagine that an unbiased expert in cardiac surgery clinical trials could conclude that subjects were harmed in this study, since with only 50 patients per group the study was not designed or powered to prove any differences in major complications including death.”

What he’s saying is that because the sample size was so small, the statistical error in the results is necessarily mathematically too large to be able to show that the deaths or other events that resulted are clearly more numerous that would be expected by chance in such a group of patients.

There are a couple of real problems with this.

First, with a sample size of 50 and, as the article notes, varying dosages of the expander given, up to “three times the level recommended by the manufacturers”, this appears to have been a Phase I Ascending Dose trial. Phase I trials are conducted expressly for the purpose of monitoring safety and adverse side effects of the experimental treatment – they are intended to weed out unsafe treatments before they are tried on large groups of patients. In such trials, safety monitoring is paramount; the first sign of harm to patients should bring the trial to a halt. It’s true that such trial sizes are often too small for statistical significance, but the whole point is to gain confidence before exposing a larger sample size – so empirical monitoring is vital. In this trial, two patients died and numerous others suffered serious hemorrhaging – severe-enough outcomes that experienced clinicians complained directly to the IRB – but the lead investigator never reported a problem or stopped the trial.

(It is possible this was a Phase II or combined Phase I/II trial – though again the facts still seem to suggest Phase I. But if so, the sample size should have been large enough to be likely to return statistically significant results. The trial would be worthless without them.)

Another concern is that no early-Phase trial is supposed to be conducted on patients receiving conventional therapy or in lieu of conventional therapy, where such therapy exists. They are conducted on healthy volunteers. Partly this is to ensure that participation is truly voluntary (i.e., that patients are not being enticed into trials because they see it as a requirement for receiving other therapy), partly precisely to avoid this problem of contaminating apparent adverse consequences of the experiment with the patients’ underlying pathologies.

So it is difficult to see how this trial could have been appropriately designed, aside from the question of informed consent. Either it was a safety trial conducted on patients whose health was already compromised to the point that adverse effects could not be identified as the results of the experimental medication, or it was a dosage-efficacy trial conducted on a sample size too small to provide reliable results, either positive or negative. And in either case, clinical judgment seems to have been dispensed with as patients died but – because of the built-in lack of confirmatory mathematics – no suspicion was entertained about a possible link to the experiment they were participating in.

That raises questions of the investigator’s intent. At this point, I want to step away from this particular incident, and make it clear I am not making insinuations about Dr. Bennett-Guerrero or others from the Columbia trial. Clearly things went badly there but I don’t know what was going through his mind or what his intentions were. I want to use this situation to illustrate ways in which clinical trial design can be (again, I am saying nothing about this particular case) manipulated to  evade ethical protections for subjects.

If a trial is deliberately designed with a sample size too small to return significant results, then by definition no negative results can ever be discerned (nor can any positive results, either, of course). At the Phase I level, where harm is the only reported result, lack of positive results is not a problem, but the impossibility of negative results means that the candidate drug will automatically pass the screening. (Since you can’t find any statistically significant negative results, there will be no statistically significant negative results to report, thus the drug can never be proven to have failed the test. And since, at Phase I, “not failing” is a good-enough result to justify further research, the lack of a robust experimental design can, paradoxically, be a very useful feature.) With a lax IRB focusing only on the mechanics of the informed consent procedure, and not the possible pathways for harm or the mathematical intricacies of the results testing, one can easily get permission to conduct a “drug test” that no drug can possibly fail.

Doing so, of course, requires that you suspend judgment as to the empirical/clinical course demonstrated by the subjects. With no mathematical test for success/failure, an ethical researcher must rely on careful clinical monitoring to detect problems with individual patients or the trial as a whole. Starting with healthy subjects makes such problems obvious, since they aren’t supposed to die at all, but conducting the trial on subjects already sick (or, in fact, pulled directly out of the ER into heart surgery) creates a ready explanation why some of them may die, if in fact they do. So, again, there is an incentive to conduct the trial in what would otherwise be a scientifically invalid manner, essentially building in negative outcomes from the beginning (if the patients already have life-threatening illnesses, you’re going to get some bad outcomes no matter what) as a screen for the negative outcomes that may arise from the experimental procedure. This makes it difficult to honestly answer the question whether the procedure harmed the subjects, but makes it easy to argue that it did not provably harm them.

Thus, for an unscrupulous researcher (and again, this part of the discussion is hypothetical; it is not aimed at a particular individual), it may be possible to design a trial that cannot deliver honest and reliable results, but which also cannot fail to provide the preferred result from the point of view of a drug manufacturer or funding source. Doing so requires conducting a trial that is both scientifically non-decisive by intention and which lacks the ability to identify clear harms to subjects. It may also require deliberately enticing patients into the trial for whom better and safer therapies are available, precisely to use their pathologies as a ready excuse for adverse clinical outcomes which the trial may produce in them. And, it necessarily requires vacating the professional obligation to use vigilance and judgment to monitor and protect patients in all circumstances, and especially the experimental environment – and to instead rationalize patients’ outcomes away in order to avoid public knowledge, and possibly self-knowledge, of the harms inflicted upon them.

Convenient rationalizations are not an acceptable mindset for those who take vulnerable others into their care. The fact that a trial design cannot determine whether its subjects have been harmed is not an acceptable exculpation of those whose obligation was to watch for, detect, and ameliorate such harms. It is a reason why such trials must not be conducted in the first place.

The announcement yesterday that Elizabeth Blackburn has won the Nobel Prize in Physiology or Medicine was no surprise, but surely a much-deserved recognition. Her work on the function of telomerase was a breakthrough in molecular genetics, and she had long been among the informal class of Laureates-in-Waiting.

It cannot but bring to mind, however, the shameful episode in which Blackburn was hounded off the Bush-era President’s Council on Bioethics by its erratic right-wing chair Leon Kass. Blackburn was one of the few voices of sanity on that board (along with ethicist William May, also purged at the same time). She had distinguished herself by filing a “minority opinion” to the Council’s first official position paper; after that, minority opinions were no longer allowed, and eventually she and the other dissenter were replaced by pliable right-wingers (notable for their ravings about “ejecting God from the public square” and the coming wave of “forced abortions”). Kass himself, of course, is well-known for his flamboyantly idiosyncratic reactionism (he’s against, among other things, dating, virtually every form of reproductive technology including ones that don’t exist yet, and, infamously, eating ice cream cones in public*).

As Kass finally fades into his richly-deserved irrelevance, and even with the right-wing anti-science circus still in full cry, it’s refreshing to see one of science’s stars – and, for her forthrightness in the face of the intellectual debacle that was the Kass Council, one of its heroes – acknowledged for pursuit of the truth by means of reason and fact. Whatever distortions the right clings to, and whatever political means they use to deny science’s truths and withhold its benefits from those who choose to make use of them, truth is what it is and science reveals it. Blackburn, in a peculiar and distinctive way, exemplifies both the majesty of the search for truth and the dangers of its repression. Though her prize is based on the scientific importance of her work, her personal story gives it particular salience, and makes her success particularly triumphant, in these darkling times.

* Yes, really.

There is a considerable component of right-wing blather, on healthcare and other topics, that is not seriously intended from the outset. To be sure, actual right-wing policy proposals are often offensive and addle-headed – withholding healthcare from women for religious reasons, or prohibiting factual information on contraception for teens are too-familiar examples – but often enough the most outrageous statements the wingnuts make are intended only to generate controversy. The ensuing agitation inflames the right-wing base constituency and feeds their self-aggrandizing notion of themselves as “under siege”, while the attention the controversy gins up raises the wingers’ profile and generates book sales and speaking fees. Rush Limbaugh, Ann Coulter, Michael Savage, and their cretinous ilk have made a profession of making factual claims that are indefensible in morals or truth, then evading responsibility by claiming they were joking; nominally more respectable right-wing pundits are not above the tactic, either. (George Will’s incompetent blundering into the issue of global warming continued long after his lack of knowledge had been thoroughly exposed in his own paper; the incident did him no harm among his target readership, for whom truth is an incidental feature of their reading material.)

For this reason, I felt less shock than merely tired recognition at this week’s reports from the right-wing “Value Voters” conference, in particular the much-remarked insanity of anti-choice provocateur Lila Rose’s demand that abortions be “done in the public square” (“maybe then we might hear angels singing as we ponder the glory of conception”*). Of course it’s idiotic, outrageous, and unhinged; of course it’s meaningless as a serious policy proposal. But it was never intended to be otherwise. It was intended to do exactly what it did – get more attention for a serial attention-seeker whose stock in trade is saying provocative things on video so she can enjoy the reaction, as well as create yet another controversy to make anti-choice theater seem important by generating press.

But it’s worth taking a moment, not to combat this nonsense as if it was to be taken seriously, nor even to condemn the continual offensiveness and provocation of the anti-choice movement (a singularly unlikely complaint, since without that the anti-choice movement wouldn’t even exist), but to note the ways in which anti-choicers choose to offend.

What does it mean to imagine – even if only to create offense – that women should be forced to have their abortions in public? As crazed as the suggestion is, it is not as extreme, from the right-wing perspective, as it would seem from any decent point of view. Mandatory public display of intimate gynecological procedures in order to diminish the legal availability of those procedures is nothing more than the literal instantiation of the basic presuppositions of the anti-choice movement in general:

• that women seeking abortion, uniquely, must be denied any presumption of privacy (in the sense either of autonomous choice or of confidentiality);
• that women’s sexuality is fodder for public observation, examination, and commentary;
• that women’s sexuality, women’s bodies, and women’s needs are so inherently disgusting that merely observing them will create the same visceral hostility among the general public that they already receive from the right wing (and that the general level of support for abortion that has always existed is due merely to the fact that supporters haven’t yet seen women’s bodies and healthcare up close yet);
• that women’s choices, preferences, and comfort in their own bodily autonomy and healthcare count for nothing against the demands by those who hate them that they expose themselves to hostile scrutiny for those others’ political goals;
• that policy regarding women’s autonomy and health is appropriately decided by deliberately-manipulated public emotions – in which tactic the women may be forced to participate to their own detriment – and not any considered defense of the women’s moral agency and interests, or the objective absence of moral agency in the fetus.

As with so much anti-choice agitation, women simply disappear from this invasive and offensive scheme as persons to be taken seriously in their own right. Healthcare is granted near-sacrosanct status as regards privacy, discretion, and the centrality of the needs and interests of the patient, but a woman seeking abortion must expose herself, legs splayed in stirrups, vagina dilated, instruments inserted, “in the public square” – her needs and interests, in fact her basic humanity as a person deserving of consideration and dignity, carry no weight against the creepy, invasive perversions of the sex-obsessive misogynists. The abortion debate is structured, logically, as a conflict between women’s autonomy and the religious imperatives of the anti-choice right wing, but here there is no recognition of autonomy interests at play in any way – women not only may not control their bodies or reproductive options, but may even be forced into invasive and degrading displays deliberately intended to undermine their own autonomy, as a condition of (temporarily) accessing such options. As always, women simply don’t count. Whatever protections and privileges the typical moral person might command in undertaking their own purposes in their own life simply vanish if that person is a woman seeking control over her reproduction.

But this familiar moral blindness is not accidental, and it is not merely the hyperbolic implication of a deliberately provocative suggestion. Stupid, crazy, and nasty as they may be, the right wing is not completely incapable of recognizing moral humanity, even in those they despise. The right wing gradually learned not to use racial slurs; today it would unthinkable for them to suggest that people of color should be paraded “in the public square” even as a tactic to undermine their rights, and wingers fall over themselves denying the racism in their racist policies. The gay-rights movement, embattled as it was, made remarkable progress in the space of about 35 years; today, the conservative position on gay rights extols accommodations (“Don’t Ask, Don’t Tell”; civil unions) that would have been grand liberal victories just a few years previously. Yet after thousands of years of patriarchy, women command no such deference. Even as a joke or a provocation, there are things that are not said about minorities and gays – things the public would reject in disgust. There seems to be nothing the right wing won’t say about women – there seem to be no abuses or humiliations that are beyond the pale, no degradations or invasions that are unthinkable, whether or not they seem likely as policy.

Vacating medical confidentiality to publicize abortions for the explicit purpose of humiliating women by generating disgust at their bodies, healthcare, and reproductive choices?  The only part of that scenario the right wing objects to is the abortion. All the rest is merely the rights, interests, and choices of women. Nothing at all, really.

* I am not making this up.

Apparently, tea-baggers protesting healthcare reform have adopted the slogan “Keep your laws off my body”. This is what passes for wit on the right-wing: people who are presumably largely anti-choice have appropriated a pro-choice slogan for their own purposes.

Mind-bogglingly, they claim they are not merely poking fun by making progressive symbols retrogressive, but are adopting the tools and techniques of left-wing activism for purposes that they regard as similar in motivation and intention. Adam Brandon, press secretary for the tea-bagger organization, claimed:

If we had been alive back in the 1960s, we would have been on the freedom bus rides. It was an issue of individual liberty. We’re trying to borrow some from the civil rights movement.

Right. Freedom Riders:

But that wasn’t my main point. I wanted to note just that one slogan: “Keep your laws off my body”.

It seems undeniable that the vast majority of tea-baggers would strongly oppose the liberty that slogan advocates. Surely their Congressional enablers do. But with the characteristic ignorance and lack of shame that makes it possible for right-wingers to say any of the things they say, they’ve co-opted words they don’t believe in into a context in which they don’t even make sense.

Unlike the issue of abortion rights – wherein the same noisy faction that opposes healthcare for others also aggressively campaigns to prohibit women from controlling their own bodies, and to force them to undergo pregnancy and childbirth against their will – the proposed plan for universal healthcare access doesn’t impose any unwanted procedure on anyone’s body. The access plan incorporates no specific treatments at all – it is a funding mechanism, not a treatment regimen, still less a mandatory one.

Naturally, of course, the wingers who oppose both abortion and healthcare in general, while demanding “keep your laws off my body”, also oppose abortion funding under any healthcare plan that is passed: that’s right, they insist that the healthcare plan they oppose because it would impose laws on their body must also be crafted so as to assist them in imposing laws on other people’s bodies. But more fundamentally, it is the characteristic right-wing solipsism and sheer imperviousness to fact that makes this absurdity possible: their aversion to healthcare means other people can’t have any, and their valorization of unplanned pregnancy means other women must have them; laws that have nothing to do with actually imposing upon people’s bodies are opposed with liberal slogans regarding bodily freedom, while the liberal demand for bodily freedom is opposed by people who spout that same slogan.

As always, the interpretive question here is whether these people are simply mind-bogglingly stupid, or deliberately dishonest. And as always, it’s hard to tell the difference in their cases.

Among the many distortions and intellectual dishonesties that plague right-wing pontificating about healthcare ethics and  policy is the constant pointing to (often hypothetical) drawbacks of policies they oppose as proof that those policies are unworkable or immoral, while exactly the same problem exists with the policies they do approve. In particular, opposition to universal healthcare often takes the form of nit-picking any possible barrier or difficulty that such programs would encounter without the slightest acknowledgment that the market-rationed for-profit system the US now has simply ignores its own gross deficiencies as if they didn’t exist – as if simply leaving people out of the system is not a problem, while having trouble treating everybody within a larger system is a fatal flaw.

The most egregious example of such falsehoods is the claim that universal healthcare will be “rationed” (meaning that no such system will pay for every imaginable treatment); for market fetishists, denying care outright to tens of millions of people is not rationing, and forcing hundreds of millions into overpriced insurance plans that ban entire categories of patients from enrollment, prohibit vast swaths of basic treatments, and then deny reimbursement for treatments they have actually contracted to cover is also not rationing, but creating a system that serves vastly larger numbers of patients more completely is rationing. But that’s just one well-worn delusion. They are nothing if not creative in coming up with new ones.

Today’s meme is that old bugaboo, the “doctor shortage“. (Some of us can remember times – more than one – when it was a “doctor glut“, and the right-wing economists who feared that, as well.) The right wing is just beside itself with worry that, under a scheme of universal healthcare, there simply won’t be enough doctors to go around. (Leading, of course, to . . . healthcare rationing!) Instapundit is convinced the problem is we don’t pay them enough. David Bernstein at Volokh thinks we should educate them less, so they’d have less school debt. Dr. Helen is convinced that the administrative hassles of healthcare are “going to get a whole lot worse with more government intervention” – apparently she believes that reducing the 30% overhead of for-profit insurance company administration would be offset by providing more and better healthcare to hundreds of millions of people, and figures that’s a bad thing. (It goes without saying that none of them thinks we should just subsidize doctors’ education and let them pay it back with service, so as to attract more people who actually care about practicing medicine and aren’t in it for the highest dollar. As Instapundit would say, “Naah, that wouldn’t make sense!”)

But, aside from the complete inability of of market worshippers to care or consider whether not rationing healthcare by profit margin would in any way improve the ability of people to actually get healthcare, there is in this case the gross hypocrisy of simply ignoring the entire question how this issue plays out in the market-rationed system these people all favor. (Remember that the problems the market doesn’t care about are not problems for the market; they’re only problems for systems that actually care about people’s needs, and thus are uniquely guilty for failing to solve problems that marketeers just don’t bother with in the first place.)

How is it the near-term supply of doctors is insufficient for a national healthcare system, but not insufficient for the market-rationed system we currently have? We’re talking about essentially the same number of doctors and the same number of potential patients – so if there aren’t enough doctors to go around under a system in which everybody has equal access to care, why is that not a problem now? Why haven’t the right-wingers who are so very, very (sincerely, no doubt) concerned that not everybody will be able to see a doctor immediately, when they actually have a right to do so, not concerned that not everybody can see a doctor at all, now, when they simply can’t afford to?

The answer, of course, is that they don’t care in the slightest whether or not people get the healthcare they need (especially those who have proven themselves unworthy by being unable to afford it). And they don’t really care whether there are enough doctors to staff a universal-access system, except to the extent that a potential shortage can be used as an argument against initiating such a system. If the actual impact of a supply/demand imbalance – the fact that some people can’t get access to a healthcare provider – mattered to them as a problem in itself, it would matter much more now, where some people have no access at all and most people are trapped in the hugely oppressive and constraining for-profit health insurance morass, than it would within some hypothetical future system which provides access to everybody, possibly with longer waiting times. But, again, the complete refusal of the market-rationed system to even attempt to do anything about the most helpless and desperate people trapped under it is of no consequence whatsoever, because if you’re ideologically wedded to profit-maximization for healthcare providers, you’re ideologically indifferent to actual healthcare for patients as a goal in its own right. But the idea of the great unwashed flooding your for-profit system and taking up the time and attention of the doctors you paid for, dammit, is both a real inconvenience (to you) and a moral offense (to the principle of purchased entitlement in a market environment).

The North Dakota House of Representatives has deliberately passed an unconstitutional law intended to foster a legal challenge to Roe v. Wade. It will probably fail in the state Senate, and almost certainly go nowhere even if it does pass, but it’s a classic example of the kind of gleeful, obstructionist bomb-throwing that characterizes the anti-woman brigade. It’s also – and equally characteristically – immensely stupid, and grossly ignorant.

North Dakota’s House of Representatives has passed a bill effectively outlawing abortion.

The House voted 51-41 this afternoon to declare that a fertilized egg has all the rights of any person.

That means a fetus could not be legally aborted without the procedure being considered murder.

Minot Republican Dan Ruby has sponsored other bills banning abortion in previous legislative sessions – all of which failed.

He also sponsored today’s bill and says it is compatable with Roe versus Wade – the Supreme Court decision which legalized abortion.

(Rep. Dan Ruby, -R- Minot) “This is the exact language that’s required by Roe vs. Wade. It stipulated that before a challenge can be made, we have to identify when life begins, and that’s what this does.”

It took some digging (for some reason, it appears, no newspaper reporting this could be bothered to include the name or number of the bill, and North Dakota’s legislative Web site seems almost designed for impenetrability), but this turns out to be North Dakota HB 1572 (2009), and it is a doozy. Apparently written by Rep. Ruby himself (clearly not by anybody faimiliar with the law), it is filled with folksy expressions of opinion, ungrammatical and ungrounded assertions, weird non-sequiturs, and vaguely written legal directives referencing “pre-born citizens”.

It is also a perfect illustration of the utterly bizarre, distorted, and obsessive fantasies that inform the anti-sex misogyny crowd’s perfervid agitation over controlling women’s reproduction, and of the deep and thoroughgoing ignorance that in many ways makes that movement possible.

First, Ruby is completely wrong on the Roe decision – which explicitly states that its holding is not dependent upon a determination of when personhood obtains, because that question has been so contentious throughout history. That particular point (along with the central holding defending abortion rights in general) was reiterated in Casey. These decisions do not require, and certainly do not request or encourage, the states to pass definition-of-personhood bills, or imply that doing so will invalidate the central holding regarding abortion. But that’s just ordinary ignorance – he simply doens’t know what he’s talking about and doesn’t let that stop him. But Ruby’s brand of ignorance is of an extraordinary kind. He reaches great heights of stupidity when he tries to describe, and legislate for, women’s actual bodies.

The sections of the bill on abortion are filled with references to, and descriptions of, procedures that either don’t exist or are so badly garbled that it’s obvious the author simply has no idea whatsoever what he’s talking about. In an apparent attempt to ban abortion by intact dilation and extraction, the bill stipulates that:

Personhood may not be denied:
a. If all the body parts are pulled out of the uterus except the legs or arms or portions of legs or arms are still inside the uterus;. . .
f. Once a uterus is placed back inside the mother.

and states that:

When the uterus with a child inside is placed back inside the mother, personhood extends to all other preborn children due to equal protection of the laws.

This is just insane. He obviously just doesn’t know how childbirth and abortion actually work. (If it weren’t so scary, it would be humorously reminiscent of the bizarre fantasies about sex entertained by the title character of The 40 Year Old Virgin: “You know how when you grab a woman’s breast… it feels like… a bag of sand?” Yeah – and abortion involves taking a woman’s uterus out of her body and putting it back in with a fetus inside it. Good God – why doesn’t Dan Ruby just write a bill entitled “Whereas: I’ve Never Seen a Woman’s Body, Be It Resolved That I Desperately Need to Get Laid”?)

It goes on from there. After all the abortion stuff (or what appears to be abortion stuff, given the unimaginable ignorance and complete fantasy that makes up the content of the bill), there are a bunch of catch-all concluding sections, amending various parts of the state criminal code to stick the words “born alive child” (i.e., partially-delivered fetus) into them. And what crimes, exactly, is Dan Ruby desperate to prevent?

12.1-20-11. Incest. A person who intermarries, cohabits, or engages in a sexual act
with another person related to him . . . is guilty of a class C felony. If the victim is a born alive child, as defined
in section 1 of this Act, the person is guilty of a class B felony.

Subsection 2 of section 12.1-20-17 . . . A person who, [has HIV and] willfully transfers any of that person’s body fluid to another person is guilty of a class A felony. The person is guilty of a class AA felony if the victim is under the age of fifteen or the victim is a born alive child as defined in section 1 of this Act. Section

12.1-27.2-04.1. Possession of certain materials prohibited. A person is guilty of a
class C felony if, knowing of its character and content, that person knowingly possesses any
motion picture, photograph, or other visual representation that includes sexual conduct by a
minor. A person is guilty of a class B felony if the minor is a born alive child as defined in
section 1 of this Act.

Yep. Dan Ruby amended three sections of the North Dakota criminal code to prevent incest or child pornography with a fetus during the course of a birth or abortion, and to criminalize the deliberate infection of a fetus with HIV+ bodily fluids during those same procedures. Because apparently, to Dan Ruby, these are crimes that need to be deal with . . . right now. (Odd that he assigns them lower penalties in the case of fetuses – blatant discrimination, I would say.)

It’s just breathtaking how pervasively and openly ignorant the anti-choice movement is. They hide behind pseudo-feminst camouflage, pretending concern over the danger to women’s health of wholly imaginary abortion traumas, and giving pro-woman names to their anti-choice organizations and fake health clinics. They claim they are merely concerned for the “human rights” of microscopic non-persons. But at bottom they simply loathe women, and sexually independent women most of all. And like most forms of prejudice, misogyny harbors a vast pool of ignorance at its core. They don’t understand sex, women, or women’s bodies; they’ve been taught to hate and fear them, and have – either deliberately or accidentally – avoided acquiring the familiarity or comfort that would lay those fears to rest. Misogyny requires ignorance (part of the reason for the knowingly false propaganda anti-choicers spew, and their desperate hostility to factual sex education). Nowhere is that ignorance more obviously – and hilariously – displayed than in this insanely stupid bill.

That ignorance is accepted as unremarkable within the anti-choice movement. This level of complete factual incompetence would be unacceptable in any other area – let alone one that touched on the freedom and autonomy of more than half the human race, or on technical issues of medical procedure – but is no barrier to anti-choice policymaking, because factual accuracy is not a pre-requisite to policymaking about women’s lives. If this clown had submitted a bill demonstrating an equal level of scientific illiteracy in any other area of healthcare, any other technical subject at all, or any issue involving the fundamental rights of any group of people whose rights are taken seriously, he would be a laughingstock. Apparently, however, no other member of the North Dakota legislature spoke against this bill even on grounds of factual meaninglessness, to say nothing of pro-choice principle. Complete incompetence and paralytic ignorance (it is not clear how this bill even could be implemented) are no barrier to being a leader of the pro-choice movement, or to legislating away women’s control over their own bodies and lives.

I don’t know whether we should laugh to keep from crying, or cry through our laughter. But it remains clear how utterly negligible women’s interests are. You don’t even have to know, or be able to identify, what rights, exactly, you are stripping away from them, and what parts of their bodies you are criminalizing, to vitiate women’s own interests in their own lives.

It could be almost any news story from the developing world, and any of many from the rest of the world, but this one will do:

Afghanistan’s President, Hamid Karzai, has signed a law which “legalises” rape, women’s groups and the United Nations warn. Critics claim the president helped rush the bill through parliament in a bid to appease Islamic fundamentalists ahead of elections in August.

In a massive blow for women’s rights, the new Shia Family Law negates the need for sexual consent between married couples, tacitly approves child marriage and restricts a woman’s right to leave the home, according to UN papers seen by The Independent. . . .
The most controversial parts of the law deal explicitly with sexual relations. Article 132 requires women to obey their husband’s sexual demands and stipulates that a man can expect to have sex with his wife at least “once every four nights” when travelling, unless they are ill. The law also gives men preferential inheritance rights, easier access to divorce, and priority in court. . . .

Even the law’s sponsors admit Mr Karzai rushed it through to win their votes. Ustad Mohammad Akbari, a prominent Shia political leader, said: “It’s electioneering. Most of the Hazara people are unhappy with Mr Karzai.”

The fault in this case lies squarely with the Afghani men, of course. (British officials, rushing to the defense of women, have “raised concerns at a senior level”. Thank God!) But it’s worth noting that this government is America’s “ally” – in the sense that if we don’t acquiesce in their doing these things, and pay them a lot of money besides, they’ll . . . be even less cooperative against Al Qaeda. One might also note that this sort of thing is once more on the rise in Iraq, where women had once had full legal equality under Sadam, now that de facto separatist governments under religious extremists have been established, with American approval, in parts of the country.

It has to be acknowledged how disastrous the situation has always been for women in most of the world, and how little leverage the nascent democracy movements in the most backward countries are. Except in places like Iraq and Iran, where modernist governments have been fully or partially replaced by theocracies, it’s not clear that, however horrendous conditions are, things are getting much worse for women, even in the worst countries. In a practical sense, the new Afghan law may not change anything, since the practices in question are widespread there anyway. The fact that there is even a tiny amount of freedom for women in the capital city is a – very depressing – step forward.

But those facts, inescapbable as they are, do not tell the real story. What’s most galling is not that conditions for women are so bad, but that that is regarded as a negligible problem. Women’s rights, and women’s freedom, are simply not issues worth caring about, to virtually any government or any influential group of (male) people.

We’ll go to war over oil, land, religion, vaguely-articulated political and economic beliefs, other countries’ refusals to do our bidding, or a soccer match. We’ll claim as justification for our wars other people’s freedom to vote for the candidates we approve, be Christian whether they want to or not, and buy American consumer goods. The one thing we’ll never fight for, or even claim as justification for fighting, is women’s freedom to live their own lives. It’s simply not an issue. The idea that we should invade Iraq to establish a quasi-democracy in some parts of the country while igniting an indigenous religious war and all but completely destroying the country’s economy and material infrastructure is somehow not seen as ludicrous. The idea that we would invade Afghanistan – or refrain from invading Afghanistan – because it’s women are subject to widespread, organized rape and open murder – legally – now that is seen as ludicrous. The idea that we would threaten preemptive nuclear war with Iran because they might someday have one warhead to our current 10,000 is not absurd; the idea that we would threaten any serious engagement of Iran because the women of that country have virtually no legal rights and are subject to arbitrary imprisonment, rape, abuse, and murder by the religious police, is beyond absurd – it is unthinkable.

The idea that women’s rights and women’s freedom is an issue that commands our involvement – that it is one of the things we must pursue and protect, among the many things we accept as justification for our adventures and misadventures around the globe – that it would constitute any kind of reason at all for any kind of action at all, let alone aggressive engagement or sacrifice on our part – is quit obviously a joke. Of all the places we’ve invaded, bombed, or threatened over the past few decades – Nicaragua, Grenada, North Korea, Panama, Iran, Iraq, Lebanon, Russia, and on and on and on . . . – and usually on the most ridiculous pretenses (Reagan invaded Grenada because they were building a runway, which he then continued building after occupying the island), in which of these is it even imaginable that the same things could have been done because the women of that country did not have full equality, or even basic rights?

Women’s interests are negligible. Whatever misery, oppression, or lack of freedom motivates political concern, in the US or anywhere else, it is not women’s misery or oppression that provides that motivation. The US courted Afghanistan for decades without any overt action on the basis of the grinding, indescribable misery and abuse of the women of that country, and we continue to tolerate those same conditions while occupying that country and propping up its government. But that occupation was prompted – on little notice and with little debate – by the fleeting presence there of a small group of terrorists we still haven’t managed to locate. That minor military problem was sufficient justification for occupying and remaking the country; the horrific abuse of its female population for all time up to that moment was not such a motivation, and its continuation during our presence there is not motivation for any proportional expenditure of energy on their behalf. Women are not a reason for doing anything, in Afghanistan, though smaller groups of people who catch our male leaders’ attentions are more than enough reason. The US invaded Iraq, twice, on the pretext of its supposed military ambitions; in the process we eliminated the freedom for women that existed there at the time, and returned them to the insecurities of religious politics, and for many of them outright partriarcal theocracy. The oppression of a small percentage of its population who were political opponents of its leader was justification for destroying that country and its government; that that government was the only source of liberty for more than half its population – the female half – was not justification for not doing so. Women simply didn’t count, in that equation. And they never do.

Until women count – until women in and of themselves are a reason for doing anything – until the oppression and misery of women is seen as human oppression and human misery, the sort of thing we say we care about and act on – there will be no progress. And until we powerful nations, nations who shake the world and make and unmake governments and laws and wars, do what we do because women matter at least as much as oil, or land, or religion, or markets, or men, women will not count where it counts.

Just once, I wish we could have a debate over an important political issue that wasn’t entirely shaped and determined by sheer stupidity and ignorance from the right wing. Today will not be that day.

The winger blogs are all a-twitter over a story noting that the Omnibus Budget bill that was (finally) just passed contains a provision – known as the Dickey-Wicker Amendment, which the religious wingers have stuck in every budget since 1996 – prohibiting federal funding for research “in which human embryos are created, destroyed, discarded, or knowingly be subjected to risk of injury or death”. Setting some kind of a record for intellectual incompetence, the right-wing CNSNews mis-reported this as “Obama Signs Law Banning Federal Embryo Research Two Days After Signing Executive Order to OK It” – which, in one single sentence, misrepresents the event (he did not sign a law on embryo research, he signed the budget bill, which contained one small amemendment addressing embryonic research among its reported 3,500 pages of text and appendices), false as to fact (his executive order did not address embryo research), and completely wrong in its implication (the budget amendment does not undo the research policy Obama announced, as this headline implies). Despite this falsity and confusion, the event is viewed as some sort of humiliation for, or hypocrisy by, President Obama, since he had made a point of repealing the Bush ban on stem-cell research funding just two days before signing the budget with its unrelated embryo-research amendment. Much chortling and back-slapping is now underway, among people who know nothing about the issue and are apparently too dumb to read.

(more…)

Yuval Levin was a staff manager of the Bush-era “President’s Council on Bioethics”, a body widely derided for its almost comically right-wing leanings and gross intellectual malfeasance. Today he steps in it trying to say something all clever and sophisticated about the new authorization for stem-cell research. I got as far as the second paragraph before the crankery blew me away:

(more…)

Man, they are insane over at National Review! I mean it literally – their minds don’t work normally. I usually think that’s just the inherent limitation of being a right-wing second-stringer (you’re already lower than a very low bar), but here I’m not even talking about their developmental team at The Corner – today NRO runs a feature piece by some professional abortion-myth peddler that simply takes a wig-out and keeps on flippin’. The reason Sarah Palin is a laughingstock, you see, is that . . . her critics all feel guilty about abortion.

[Digglah: Forget the baseball tie-ins. The Gibbering Abortion-Rights Exquisite Corpse Dadaesque Word Association Prize has now been retired.]

Here’s Kevin Burke explaining what everyone else pretty much figured needed no explanation:

Some of the very personal and often uncharitable criticism of vice-presidential nominee Sarah Palin and her family may have a relationship to [the country's] collective grief, shame, and guilt from personal involvement in the abortion of an unborn child.

Right. The massive outpouring of largely political, fact-driven, and entirely reasonable criticism of a complete airhead who consistently offers an unrecognizably garbled version of basic constitutional principles affecting the job she is currently seeking, began her campaign for that job by stating she did not know what it entailed, invariably responds to the simplest substantive questions with idiotic evasions and irrelevancies, cites the most bizarrely tangential facts – often incorrectly – as evidence of her own preparedness for office, conducted personal vendettas in office and attempted to ban library books as mayor, has been cited by her own state’s attorney for abuse of authority as governor and is still under investigation for related transgressions, cannot name any Supreme Court decision other than Roe v. Wade, cannot name any magazine or newspaper she herself reads (while claiming to read “all of them”), constantly infantalizes her office and her own supporters by filling public appearances with childish slogans, jargon, meaningless folksy expressions, and winking in lieu of answers to topical questions, campaigns almost exclusively by vague generalizations and character assassination, denies scientific consensus on environmental protection, global warming, and creationism, and adheres to extremist religious superstitions about witchcraft, “the apocalypse”, and God’s supposed direct intervention in her career and electoral campaign . . . is an expression of everyone’s personal feelings about . . . abortion.

What kind of a nut thinks so? The kind of nut who spends his life promoting the entirely made-up, and repeatedly scientifically disproven, myth of “post-abortion syndrome” – a supposed psychological malady that afflicts women who have had abortions (and now apparently the entire nation). It’s particularly an issue in Palin’s case, you see, because she has a child with Down Syndrome, but the majority of such pregnancies are aborted, so all those women are – he knows this – racked with guilt over the fact that Palin is a better woman and mother than they are. They attack her to assuage their own feelings of guilt and inadequacy. I’m not making this up (though, obviously, Burke is):

Seeing the Palin family, in a very visible public forum, with an uncompromising and public pro life philosophy arouses deeply repressed feelings in post abortive parents, as well as media members, counselors, health care professionals, politicians and others who promote abortion rights, especially the abortion of children with challenges such as Down Syndrome. These powerful repressed feelings of grief, guilt and shame can be deflected from the source of the wound (i.e., abortion) and projected onto an often uncharitable focus upon the trigger of these painful emotions…the Palin family.

Burke, by the way, is a founder of a Catholic anti-choice organization specifically dedicated to promoting the “post-abortion” myth. It’s his job to say nonsense like this. But it’s important to re-emphasize that there is absolutely no evidence whatsoever that any of this is true – this Burke clown, and people like him, made this up and just keep saying it. The “post-abortion syndrome” lie has been disproven again and again, by multiple studies in different settings over a period of almost 30 years – there is simply no general phenomenon of depression or regret following abortion (though individual women have differing reactions, of course), and on average women who have had abortions are happier after having done so than they were before. As to whether people’s reactions to Palin have to do with guilt over abortion, he obviously can’t know that and it’s obviously insane. It makes as much sense as saying they love Obama because of feelings of guilt about suntan lotion. He made it up, and asserts it as fact because it serves his purpose. He’s been doing that for decades, shamelessly, in direct contravention of established evidence proving his statements to be lies, and with no evident regard for that fact.

What strikes me, more and more over the years, is the bizarre lengths the anti-woman crowd goes to to promote their false and absurd view of women, sex, and the world in general. They really do see everything as related to those topics. Archbishop Egan, in the risible and obnoxious essay cited in my last post on this topic, claims to hope for “one day, please God, when the stranglehold on public opinion in the United States has been released by the extremists for whom abortion is the center of their political and moral life”. Can he really be that un-self-aware? Is there anyone who better fits that description than people like him and Burke – for whom the merest mention (or photograph) of a fetus is grist for an unhinged and reality-free rant about abortion, in whose minds the entirely predictable failings of an absurdly unqualified political candidate are actually caused by a fictional product of abortion that they themselves made up out of whole cloth? (I guess Colin Powell, Christopher Buckley, Charles Fried, and Ken Adelman are all suffering from “post-abortion syndrome”.)

There is a kind of funhouse-mirror aspect to the ways these people’s minds work. Back in 1994, when the Edvard Munch painting The Scream was stolen from the Norwegian National Gallery, an anti-abortion group announced that they could get it returned if anti-abortion propaganda were shown on national television (in fact they had no connection to the incident and were just grandstanding). After 9-11, Jerry Falwell famously declared that “the abortionists have got to bear some burden for this  because God will not be mocked.” (It also turned out that gays, lesbians, feminists, and the ACLU were involved.) In 2006, a panel of Republicans in the Missouri State Legislature investigated the problem of illegal immigration (into Missouri?), and discovered it was the result of “the effects of 30 years of abortion.” It is a commonplace within the crypto-racist right that Western (i.e., white) societies are facing a “demographic bomb”, resulting from the different birthrates of white and non-white population groups, caused by abortion and birth control. Certain Catholic scholars, including John Noonan and Philip Rieff, have declared that abortion is itself the product of the “therapeutic culture” which seeks “wellness” (scare quotes always, please) rather than rule-following – sexual autonomy is for them a mental illness. The latest fad phrase among conservative thinkers is “the culture of death” – our entire society, or at least its progressive faction, is devoted to killing human beings, not because preserving biological life is not always the only goal in the healthcare setting, but as some sort of ideological principle in itself. Another fad phrase is “the contracepting culture” – society that accepts the horrors of sex with contraception (do you really think I’m making this up?). And of course, Sarah Palin declares that William Ayers, who helped bomb a number of government installations during an illegal war while causing no deaths, is a terrorist, but when questioned whether the bombers and shooters who murdered numerous people in legal abortion clinics were terrorists refused repeatedly to address the question.

It appears there simply isn’t any issue or circumstance, however far-fetched, that isn’t relevant to abortion; there isn’t any problem or trend, however dubious, that isn’t caused by abortion; there isn’t any need or difficulty, however unlikely, that can’t be solved by criminalizing sexual freedom. The bizarre obsession that leads to such thinking, and the contortions and delusions it requires to make such leaps while ignoring the glaring contradictions they entail, is difficult to grasp. It is simply very hard for a normal person – one who isn’t terrified by sex and obsessed with controlling and limiting other people’s sexual freedom – to imagine how this kind of thinking originates.

Make no mistake: this has nothing to do with taking a reasoned position on the appropriate balance of moral rights and interests between a pregnant woman and her fetus. This is simple full-gone loony craziness. These people make up absurd factual claims and baldly lie when they are refuted, hypothesize bizarre psychological projections upon those they disagree with, and obsessively posit – with dizzying certainty – the most tenuous and far-fetched links between virtually any event or phenomenon in the world and their consuming misogynist bete noir. They’re nuts. And these are the leaders – the thinkers – in the anti-choice movement. This is what the anti-choice movement is like when it’s not ranting at patients in front of health clinics or shooting doctors. This is what being anti-choice is like at its most subtle, sophisticated, and learned: bat-shit loony.

[NB: Crossposted to the blog Lean Left, where I also contribute. I don't usually cross-post, but Lean Left is picked up by the aggregator Memeorandum, and this blog is not, so on topics where I think it's important to reach a wider audience, or to respond directly to posts from Memeorandum, I sometimes do.]

Cardinal Egan, supremely obnoxious Catholic Archbishop of New York, has an essay up on some Web site, complete with the standard handwringing condescension and heart-tugging photos, declaiming how desperately we need to take control of women’s bodies and impose forced pregnancy as a matter of law and culture. Its contents are typical of this well-worn genre: a lame argument about whether a human fetus is a “human being”, willful elision of the difference between biological identity and moral status, sweeping moral declarations grounded on nothing but his unreflective certainty, and of course obligatory references to Hitler, Stalin, and Dred Scott.

The heart of this superficial and nonsensical (or perhaps it could be said: “a-sensical”) piece is a photograph of a 20-week fetus – a photograph which, Egan declares, proves by itself that abortion is wrong and it is utterly worthless to even consider the actual moral issues raised by the question.

Why, you might inquire, have I not delved into the opinion of philosophers and theologians about the matter? And even worse: Why have I not raised the usual questions about what a “human being” is, what a “person” is, what it means to be “living,” and such? People who write books and articles about abortion always concern themselves with these kinds of things. Even the justices of the Supreme Court who gave us “Roe v. Wade” address them. Why do I neglect philosophers and theologians? Why do I not get into defining “human being,” defining “person,” defining “living,” and the rest? Because, I respond, I am sound of mind and endowed with a fine set of eyes, into which I do not believe it is well to cast sand. I looked at the photograph, and I have no doubt about what I saw and what are the duties of a civilized society if what I saw is in danger of being killed by someone who wishes to kill it or, if you prefer, someone who “chooses” to kill it. In brief: I looked, and I know what I saw.

Why it is that the moral attack dogs of the right wing are always so eager to proclaim their own lack of comprehension I don’t know, but it is no longer surprising as a practical fact, and still less in light of the product of their “reasoning”. But ask yourself: who would take such idiocy seriously in any other context? On what moral issue would anyone seriously say “I saw a picture of an organism affected by this subject that moves me in some way, so I refuse to think about it carefully or read what the best thinkers on the subject have said, and that justifies both my unsupported, idiosyncratic religious beliefs about it and my intention to impose them on everyone else in the country!”? Who would seriously claim that not thinking about, reading about, or analyzing a serious problem could possibly produce a correct answer, or was a proper ground for imposing a solution to it as a matter of law and policy? Well, who but a religious right-winger?

(more…)

tgirsch of Lean Left (and my own blogfather!) writes:

I’m interested in the issues surrounding animal testing. I’m certainly not a member of the PETA crowd or anything, but at the same time, I’d certainly think we should keep such testing to a minimum, using it only where it’s necessary, useful, and relevant. But I honestly don’t know what all the issues are.

(more…)

I really loathe PETA, for lots of good reasons.

But that can take many forms, one of which is mocking, in appropriately childish fashion, PETA’s own tactic for pressuring corporate chicken-torturers [sic]. They have a Web sign-generator site in which they encourage people to post comments about Kentucky Fried Chicken’s practice of, as they put it “tortur[ing] chickens for profit”. Whatever the hell that’s about, it interests me far less than the fact that PETA, as a group, is offensive and abusive to real people, whom I care about far more than the animal fetish-objects that are their sole obsession. So if we’re going to make little signs about cruelty and inappropriate moral priorities, well, let’s get our inappropriate priorities straight, first:

Make your own!

There has been a kind of mini-carnival developing across the blogs lately, on the subject of sexual violence in prisons. It began with a recent LA Times Op-Ed on the subject by high-profile blogger Ezra Klein. It’s good to see attention being paid to this issue; the number of bloggers getting involved is encouraging.

But, as important as the issue is, and as vital as it is to re-assess and reform our justice and prison systems overall, I think viewing this as merely an aspect of the mis-management of prisons is a mistake. Systemic sexual abuse occurs not merely in prisons but in the military, among the “contractors” of KBR in Iraq, between priests and congregants, in the workplace, and throughout society. As feminist critics of violence against women have long been saying, the problem is not one of sex in itself, but of the use and abuse of power in general. It is just one manifestation of an issue that pervades the authoritative control of human beings by other human beings.

(more…)

Michael Gerson, Bush administration tool and terminal sufferer from Conservative Comprehension Disorder, continues his pattern of getting everything exactly backwards in his Washington Post-sponsored campaign of attacks on Barack Obama. The day after April Fool’s Day (he must have missed a deadline), Gerson published another misinformed screed, this one claiming that Obama is an “extremist” on abortion for opposing laws that would have sentenced women to death. As usual with Gerson and the forced-pregnancy crowd generally, almost everything he says is factually false, and a repetition of standard right-wing myths. The column consists of nothing more than Gerson and the Post carrying water for the organized anti-woman crowd by repeating their well-worn talking points verbatim, with no pretense of originality or reportorial integrity. (more…)

“Reproductive Health Reality Check” is running an April Fool’s Day blog carnival against “Crisis Pregnancy Centers” that mislead patients seeking abortion with deliberately deceptive tactics and false information. “CPCs” are medical fraud – there is no other description for it. And they are an increasing problem as abortion services are continually targetted and women have fewer real options; currently they outnumber real, full-service reproductive health clinics 2:1.

College women are specifically targeted by these charlatans – sometimes with official support from the colleges themselves. Shockingly, not only does Georgetown University – a Catholic school – refuse to provide any form of contraception or abortion referral through its campus healthcare center or hospital, they apparently have also been blanketing the campus with anti-abortion stickers whose only pregnancy-care referral number is to a CPC, not a real health clinic. (Full disclosure: I have an MA from GU, from the early 90s, and their behavior in this regard was even more reprehensible then.) UNC Chapel Hill students have had to create their own sex-ed programs for fellow students, who mostly come from local high schools with “abstinence only” programs and literally don’t know anything about reproductive health, and then are targeted for lurid propaganda by a CPC located just off campus. Students at other schools have had to do the same.

CPCs are a threat to the larger patient population as well. Vicki Saporta of the National Abortion Federation documents many of the problems they represent, including their deceptive tactics, medical fraud, and the support they receive from the anti-choice right (including over $30 million in taxpayers’ money from the Bush administration, and more from state legislatures). Allyson Kirk reports her experience with a CPC that had deliberately located itself along the entranceway to a real health clinic; after receiving an appointment at the real clinic, she mistakenly entered the wrong door, deliberately made up to look like a pro-choice facility, and was treated as if she was the expected patient, then subjected to invasive questioning and fraudulent misinformation.

This kind of behavior would be criminal in a real health clinic. CPCs present themselves in a deliberately fraudulent manner, impersonating real clinics with trained personnel (almost invariably, nobody at a CPC is a licensed healthcare practitioner) offering appropriate healthcare services, for the deliberate purpose of manipulating patients’ decisions and foreclosing their options; they then defend themselves legally by denying that they are subject to the professional obligations of real healthcare providers. The more this is known, and the more their tactics are exposed, the safer women will be.

I don’t usually write link-only posts, but this is worthwhile and the stories some contributors have to share are appalling. Go take a look.