“Her body! Her choice!” chanted New York Governor Cuomo’s angry voice in this year’s state of the State. But is medical ‘choice’ best interpreted by politicians or by physicians?
When a woman faces unplanned pregnancy she is vulnerable and often feels so overwhelmed that she does not even know what questions to ask. All she knows is that her life has been involuntarily arrested and she believes the doctor can help her. So she says to the doctor, “Give me my freedom back. Give me an abortion.” The sentimental politician or judge who knows very little about the practice of medicine is tempted to think that it is the doctor’s compassionate job to give her the abortion in order to restore her autonomy, that the abortion is in fact her ‘right.’ But a good doctor knows that these ethical dilemmas are solved not by bad legislation but by good medicine.
Medicine is a helping profession. Like all helping professions there is a disparity of power between the helpers and those being helped. A person with a life-altering medical condition places her life in the hands of a physician because she has lost some aspect of her physical autonomy and believes medicine can help her regain it. If the patient knew how to gain back their physical freedom they would not need to go to the doctor. In the past the medical profession recognized this power disparity and ascribed to an agreed upon code of professional ethics such as the Hippocratic Oath to insulate the individual patient and the profession from an abuse of that power. Is it the doctor’s job to safe-guard a woman’s right to choose?
The Commission for Reproductive Health Service Standards (CRHSS) states; “Autonomy (freedom to choose) is the physician’s ethical obligation to facilitate the patient’s right to un-coerced choice or refusal of treatment.” Let’s examine the phrase “un-coerced choice.” In the context of unplanned pregnancy a woman often experiences socio-economic pressures to have an abortion from her parents, her boyfriend, her peers, her finances, etc. She feels trapped like she has NO CHOICE at all, unable to refuse abortion. In fact, circumstances of most unplanned pregnancies represent the very definition of coercion itself—the opposite of true ‘choice.’ Can legislation solve her problem?
The violence done to medicine by legislation like Cuomo’s Reproductive Health Act (RHA) should have a bone chilling effect on us all. This legislation would make abortion a fundamental right and force medical professionals to coldly treat women as a population block rather than compassionately insulating them from the coercive pressures driving them to get an abortion. Under the guise of human rights the ability of a physician to help a woman exercise true self-determination is gutted. Through the RHA women are depersonalized under the banner of ‘Women’s Reproductive Health.’ Babies are no longer deemed people at all. Depersonalizing women and dehumanizing the child casts a dark shadow over the most basic of all helping professions—medicine. So instead of protecting and healing the weakest among us medicine is forced to exploit and destroy us even against the trained and thoughtful conscience of doctors everywhere.
It is the medical provider’s job to ensure that every woman’s decision is not undermined by coercive pressure. An ethical medical clinician understands that only when she is able to refuse an abortion, only when she is empowered to make that most difficult of all choices to have the baby, is her decision truly free. Far from empowering and protecting women, Cuomo’s abortion expansion act serves to further harm the public’s trust in the medical profession, the conscience of the medical provider, and the dignity of all patients including both the pregnant woman and the pre-born boy or girl.
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