Alabama SB 12: Legally Mandated Rape and Torture


Is it just me, or is this one of the most bizarre legislative sessions in Alabama’s recent history?  It seems as if once they managed to pass HB 56, they decided to go for broke and introduce every outrageous bill they could imagine!  I was busy this past week gathering information about the planned closure of Alabama’s major psychiatric hospitals in September (stay tuned).  Then Friday afternoon, I started getting phone calls from local TV stations, asking for an interview about SB12.  Please stop a minute and read the actual bill if you haven’t already.  Don’t go just on what you see in the press summaries.

 

I was a little taken off guard by the requests.  I’m a pediatrician, not an Ob-Gyn.  I have no training in abortions and never witnessed one—I did deliver some babies in medical school, but that’s it.  All I can think is that I’ve gotten a reputation for sticking my neck out.

 

I said yes.  I didn’t get to see the one on channel 19, so I don’t know which parts they picked to air.  I said a lot on the one by 54 that didn’t get through because of time limits.  So here is my effort at reviewing the bill.  This is a very long post, the longest I’ve ever done.  I want to get every nuance of it in one place.  Please chime in if I’ve missed a part.  And feel free to copy and quote any part you like, with or without attribution.

 

SB12 would require physicians or their ultrasound technicians to perform an ultrasound on women seeking abortion, while narrating the details of the image, before the women give consent to the abortions. 

 

Let’s take it apart.  First, there is a requirement that a physician or ultrasound technician must perform a trans-vaginal ultrasound instead of an abdominal one (the bill says abdominal but it would really be pelvic) if the image would be clearer.  This is most likely in the very earliest pregnancies. 

 

From the woman’s perspective, she is being required to undergo a medically unnecessary procedure before having the right to consent to a fully legal medical treatment.  I believe it meets the legal definition of rape.  See this well-done discussion of how rape is defined in court.  Rape is clearly understood in courts as not requiring physical force—coercion and manipulation alone is sufficient.  An example is given, in date rape, of the assailant saying things like “if you really loved me, you’d have sex with me.”  The woman is not considered to have given actual consent in that case.  So a doctor saying to a patient “you have to let me stick this probe into your vagina before I can give you medical treatment” would certainly be coercion and would count as rape.

From the physicians’ perspective, which I’m not seeing considered much online, the bill forces them to become rapists before being able to perform work they are legally licensed to do.  Otherwise, they will be guilty of a Class C felony, with jail time.  The doctors I know who perform abortions have entered into this dangerous job, at risk of being shot and killed, because they feel a strong duty to women—they don’t want to see them dying from botched coat hanger jobs.  So if they stop doing the procedures to avoid being rapists, they will feel that they are abandoning their patients to death.

 

This certainly doesn’t square with another current conservative bill in Alabama, SB105, the Health Care Provider Conscience Act! 

 

One alternative the physicians and women would have?  Wait longer in the pregnancy, until the fetus is more clearly visible by pelvic ultrasound.  This could present more medical risk to the woman.  I have to wonder if the bill writers were aware of this possibility and did it intentionally.

 

When I used the word “rape” on my Facebook posts, someone commented that it wasn’t rape because the woman didn’t have to go to the abortion clinic.  We have to expect that argument, despite the wrongness of it.   I countered by saying that people don’t have to have any number of elective procedures, such as tooth extractions, vasectomies or cosmetic surgeries.  So would it be ok to require vaginal or rectal penetration before these procedures, just because they are elective?  The commenter said that these ultrasounds were “related” to the abortion whereas the others weren’t.  But that isn’t true—he was confused because it involves the same body part.  The ultrasound is in no way related to the following abortion, medically speaking.

 

In the same vein, I don’t technically have to go out to a movie at the theater—does this mean I can be subjected to a crime, because my behavior is optional?

 

If we are going to make it legal to deter procedures we don’t like by requiring other procedures first, wow does that open up a can of worms!  Some people don’t like Viagra—so they could require doctors to give men painfully prolonged erections before giving a prescription,  in order for them to “know and see” the possible side effect. 

 

Ok, on to the next outrageous element.  In section 2, where the terms are defined, the bill specifically includes not only elective pregnancy termination but removal of an ectopic pregnancy or removal of a “dead unborn child who died as a result of natural causes, accidental trauma, or a criminal assault on the pregnant woman or her unborn child.”  It is true that in medical terminology, what laypersons call a miscarriage is technically a “spontaneous abortion.”  But, really??  Why on earth did Scofield include this part?

 

For those of you who don’t know, an “ectopic” pregnancy is one where the fetus has implanted somewhere it will not be able to live to term.  This includes the fallopian tubes, the ovary itself, the area of the uterus leading into the fallopian tubes (too small to hold a baby), the abdominal cavity, or the cervix.  These are very scary—not only is it impossible for the fetus to survive, but the woman will bleed to death in a hurry if the fetus is not removed before whatever part it is in ruptures.  If she is already bleeding, the exception for medical emergencies would apply—but the medical emergency category is very narrowly written.

 

This horrific element of the bill would require that a woman who may have become pregnant intentionally and with great longing for a child would have to be told in detail about the dead body of her baby, or the live body of her ectopic fetus, before it could be removed.  It seems to me that most of these women would have to have ultrasounds for medical reasons, prior to surgery.   But the doctor must point out the parts—“here is the heart, no longer beating, of your dead baby.  Here are the fingers, let’s count them.  Here is his mouth and nose.”

 

What sort of permanent psychological damage might that cause to a woman under the circumstances?  How about the doctor, who is now being required not just to rape but to inflict torture? 

What sort of legislator would even THINK to insert such a requirement?  I’m going to hope Scofield didn’t write it himself but was provided the text by one of the conservative lobbyist groups. And I’m hoping he also didn’t really read or think about what it said.  Whoever actually thought about it and wrote it is a sadist.  This part of the bill does nothing to address elective abortions—it can only be to torture women whose babies have already died.  Those who vote yes may not have read the actual bill, but if they did and if they understood it, they are also sadists.  Is there some ground for impeachment?

 

I am so appalled by this incomprehensible bit of cruelty that I had to take a break before returning to the computer.  Now let’s look at the exceptions for emergency exemption from the ultrasound requirement.  If an immediate abortion is required to prevent death or “irreversible physical impairment of a major bodily function”, without time for rape or torture first, there doesn’t have to be an ultrasound.   In this bill, “major bodily function” specifically excludes psychological or emotional conditions. 

 

There you have it—Senator Scofield and his buddies do not consider the brain to be an important body part.  They may not be aware of the significant advances in science demonstrating actual structural changes in the brain as a result of major depression or some anxiety disorders.  They are falling right in line with corporate health insurance, which almost always tries to treat the brain as a minor, dispensable organ.  And, based on what I’m seeing in this legislative session, it is true that you don’t need a fully functioning brain to be elected to office.

 

 It is not an emergency, according to Scofield,” if based on a claim or diagnosis that the woman will engage in conduct which she intends to result in her death.”  Even though a person diagnosed as suicidal is considered by every insurer and hospital as requiring emergency treatment, Scofield says that doesn’t count.  This means that if a doctor is fully aware that a woman is suicidal and that if the mandated ultrasound is performed, she is likely to kill herself, that doctor must go ahead and coerce her anyway.  It is a crime to encourage another person to kill themselves—in some states it is called manslaughter.  Under this bill, doctors must rape, torture, and commit manslaughter in order to practice their professions, or be put in jail.  I’m beginning to think Scofield hates not just women but doctors as well.

 

I understand Scofield may be retracting the part about vaginal probes.  Let’s say he also removes the parts I’ve just discussed, leaving only the requirement to do a abdominal (pelvic) ultrasound and narrate it before elective abortion of a living fetus in the safe area of the uterus, with exceptions to include psychological trauma and suicide risk.

 

I suspect the final version of the bill will be much watered down.  Is it still a problem?  Yes.

 

In general, it is better to avoid legislating medical practice, with a few exceptions for matters of public health.  Medicine, if properly practiced, is based on evidence.  Much of what I was taught in medical school, 19 years ago, has changed because of new evidence.  These days, by the time a medical textbook is printed, it is out of date.  The law can be slower and harder to change than a textbook.  We can legislate morality, it turns out—we do it all the time.  But we can’t legislate science.

 

Decades ago, we thought x-rays were perfectly safe.  We even used them to size our shoes.  Now we know better.  Acetaminophen, used in over the counter pain medicines, was once thought relatively safe—now we have evidence it can cause liver problems even at the correct dose, may contribute to high blood pressure, and may even be a factor in asthma.  Ultrasounds, so far as we can tell, are very safe—but what if we’re wrong?  Suppose we find out they cause some unexpected side effect, maybe decades later?  It’s generally better not to do any medical test or treatment, whether that’s aspirin or a CT scan, unless there is a definite medical benefit.  At the least, it is a waste of money and resources we need for other purposes. 

 

Channel 19, WHNT, says that Senator Greg Reed, who is on the health committee, is VP of a company that sells ultrasound equipment.  Could there be a profit motive involved as well?

 

The better way to regulate medical care is through oversight by licensing boards.  Lawsuits provide a painful but probably necessary additional means of reining in bad doctors.  There are also more general laws requiring informed consent before surgical procedures, including abortions.  Which brings me to my next point.

 

This bill, titled “The Right to Know and See”, presumes that women do not know what they are doing when they come to the doctor for abortion.  This is absurd and insulting to our intelligence.  Of course they know—of course they have agonized and sweated and cried about it.  I know several women who have had abortions for various medical or personal reasons, and there is not one who made the decision lightly.  It’s an awful, wrenching position to be in, and no one but that particular woman can possibly know what it is like.

 

I’m not sure if Roe v. Wade could have been settled with different reasoning.  Using viability and personhood as a criterion may have been a huge error.  An analogy called the “dying violinist” has been proposed instead, although it certainly has flaws.  The best I can do is say it is a terribly complicated matter duplicated nowhere else in ethics or law. To me, the question is:  can we really force one human being to give her very body over to another, for any period of time?  I do not think we have that right.

 

To cap the whole thing off, Scofield and his supporters are spouting off some questionable statistics. They are saying that if shown the ultrasound, 95% of women will change their minds and not abort.  I wondered about that number so I went hunting on Medline.  Lo and behold, there are no such data, at least not published in a peer-reviewed journal.  Instead, I found only one study, done recently in Canada.  350 women seeking abortion were asked if they wanted to see the images (remember, the law already says we can request our medical records).  Interestingly, the majority said yes, and they also said women should be offered the option.  How many, after seeing the images, changed their minds? 

 

Exactly zero.  So where is this 95% coming from?  My guess is from pseudo- abortion clinics that lure women in on false pretenses and assault them with pro-fascist techniques.  I say pro-fascist, not pro-life, because I don’t think life has much to do with most of them—it is about power, not the baby.  The unfortunate women who get caught in this trap would probably say anything to get these folks to shut up.  How many leave and find a real abortion clinic?  I doubt if they keep track.  The truth is more likely the result found in the Canadian study—women who have already thought through the decision know what they have decided to do.  If this bill passes, it will be unlikely to reduce our abortion rate.

 

Personal disclosure:  I have two children, both planned and wanted.  I have never had an abortion or been in a position where I was faced with that choice.  I am not pro-abortion—I think it is a dreadfully sad event.  I am pro-contraception and safe sex.  I am 48 and peri-menopausal, hot flashes and all—my husband and I take precautions, and we have no plans for more children.  What would I do if our precautions failed?  I don’t know.   I have inflammatory arthritis in my sacro-iliac joints and spine that would make pregnancy very painful.  Pregnancy for me was miserable, even knowing how much I wanted the end result—I threw up almost the entire time.  I work about 70 hrs a week on average, help care for a disabled family member, and have multiple other obligations to my community I couldn’t maintain in that state.   If I became pregnant next week, there is a strong possibility I would decide to abort.  It would be a traumatic decision and experience, and I would have no need for my doctor to further damage me.

 

This is a disastrous bill, on all counts.  It is an affront to women and their physicians.  Please contact your legislators today and tell them that if they vote yes, you will do everything in your power to put them out of office.

27 Comments

Filed under Alabama legislative session 2012

27 responses to “Alabama SB 12: Legally Mandated Rape and Torture

  1. Melissa Garver

    I saw your interview on Fox-channel 54. I was SO proud of you for sticking your neck out against this bill. I am just horrified at the language of this bill. It is bad enough that it calls for a medically-unnecessary procedure that is invasive and meets the legal criteria for rape. However, as a woman whose first pregnancy ended due to it being ectopic and rupturing one of my fallopian tubes, I am especially appalled to think that my doctor whould have had to try to point out the features of my dying fetus. My husband and I were already crying due to the impending loss and fear that I was going to die. Having that cruel tour of my vagina would have sent me over the edge. People REALLY need to read the full bill as you have done.

  2. A few clarifying questions: (Due to my lack of medical knowledge)
    1) I thought aspiration and D&E abortion precedes were both preformed vaginally? If so, then your argument for rape is based on the fact that a vaginal procedure outside of the requested vaginal procedure is cohesion or manipulation?
    2) Similar to the Canadian study, do you think there should be an offer rather than a forced requirement before woman chooses to have an abortion?

    As a counselor, I understand the possible psychological damage. I would be APPALLED if some of my female adolescent clients, who have endured incest or rape, were required to have an ultra sound of any type. I know the perpetual guilt that plagues them and leads to depression. I also think the force of such a procedure is a slippery slope. Still, I wonder if an offering of an ultrasound would be better, and possibly empowering to come clients.

    I know that empowering may seem like a strange term to use here. Recently I’ve worked with a few adolescent girls in the foster care system who felt forced into abortion and they have guilt over not using their voice to self-advocate. In these situations I’m not a proponent of pressure from either side. I think empowering young women through educated decisions is the best way to build self-esteem and help them make choices they can live with.

    • Hi Angel– to your first question, think about it this way. A woman may have vaginal sex with one person with full consent. She may end the relationship later, and be raped by that person. Should the second vaginal penetration not count, since she already let him do it once?

      Consent to one vaginal penetration does not imply that the doors are now just open to all comers. A penetration done without full consent is rape, period. You may not realize it, but that is the type of argument people used to give when accusing the victim– she “asked for it”, was a “loose woman”, etc.

      To your second question, it is tricky. This is where I would question legislating medicine. As a doctor, I do not want to be forced by the law to perform medical procedures, even if requested by a patient, since the science is always susceptible to changing. To use an analogy, about 20% or so of young children have strep in their throats when well– it is not supposed to be treated. Sometimes parents really want to insist that I do a test, even when the child has zero symptoms that go with strep.

      In that case, I will not do it, because a positive test would be meaningless and a waste of resources. So I would be uneasy if patients started getting the power to force me to use my license to do things I know are medically wrong, according to the standards of care.

      The better path is to repeat the Canadian study, to validate it– and if the findings hold up as true, incorporate the offer of an ultrasound into professional practice guidelines. You would want to make sure that there is some kind of definite benefit to the women that makes the cost of the procedure acceptable to society. That way, if the original studies are later found to be fraudulent and other studies find something unexpected– say ultrasounds cause depression and suicide later, or cancer, or some such– the docs won’t be forced to continue an outdated, dangerous procedure under threat of imprisonment until legislators decide to change the law.

  3. Offering an ultrasound is in no way the same as legislating a forced ultrasound. “The Right To Know And See” is so misleading. It isn’t a right if it is forced on you, against your will or wishes.

    Thank you for writing this blog entry. I will be sharing it on facebook and anywhere else I think it may do some good.

    • Good article in “Time Magizine” by Rich Lowry entitled “Just Not the Marrying Kind.” He says that 73% of births among blacks are born out of wedlock, 53% of Latinos, and 29% of whites: and ,most of these women will probably never marry and will probably have more out of wedlock. My thought about this is that they will all probably need government help such as Medicaid for mother and child. They also will probably qualify for food stamps, etc., etc.
      What can we do to change this dymamic? it is only going to get worse. Sharia Law would take these women out and stone them to death. I do not propose going that far, but, I do think that we need something to change this drift. Maybe, have government plans for this the first time, but also make it so the mother and father must pay something to support this child. If you had a second child, they would not be allowed to get gov. support unless they agreed to be sterilized. Society could say, if you have another child if you can support it 100% and remain fertile. If you cannot afford it, the only way that you would be eligible for assistance would be to have the woman have tubal ligation and father had a vasectomy. We couldn’t force them to have this procedure: we give them a choice get fixed or get nothing.

      • Bill, I have a lot of problems with that. First, even though statistics do say that children with single parents struggle more financially, I would not point fingers at unmarried mothers who choose to have children. The choice to marry or not should not be tied to a person’s right to have children, and who are we to judge those choices?

        Second, financial “fitness” to bear children does not correlate with good character or parental fitness to raise children with love. I know that from personal experience in my office. If we limit reproduction to the well-off, aren’t we going to get more of these selfish corporate genes, people who care more about money than humans? The successful sociopaths?

        Do we really want the ability to have private insurance be a litmus test for whether someone can have children? Then they are rationing not just healthcare but our babies! Perish the thought! That’s yet another reason to have a national health insurance.

        Think how many of our cultural heroes were born into poverty and contributed mightily to our wellbeing. We would be preventing their births and shooting ourselves in the foot.

        The raising of children (and the funding required) is really at least partly a societal responsibility. If we want our future generations to be healthy, productive and educated, we need to shell out whatever it takes to do that. We will all benefit (or suffer) from whichever choice we make.

  4. Barbara Power

    Pippa,

    Your piece is exceptionally well written and enlightening. You have the ability to strip away the [intentionally] obtuse language of the proposed legislation to describe the reality behind the “curtain.” The legislation is an outrage, and outlandishly sadistic in intent. Thank you, also, for the links you took the time to provide, which add very helpful information to your post.

    I an not an Alabama citizen but wish to know if there is anything I can do, here in the northeast, to take action against this legislation — it certainly won’t stop in Alabama — as there may already be similar sadistic attempts to hurt physicians and vulnerable patients throughout the USA.

    I am 57 years old. I have seen a lot. I knew young teens who had botched abortions in the early 1970’s. I knew a few who had no options and carried their pregnancy to term — after being forever expelled from “public” school for failing to prevent a pregnancy. Back then, some women ended up with permanent fistulas (2nd to infection). To believe that abstinence is possible flies in the face of all knowledge of human behavior. To believe that education about birth control is available is yet another cruel joke. To think that birth control is affordable for all adds another layer of ignorance-by-choice to this sad state of affairs…It is unbearable to see that the rights we finally obtained over our bodies are being taken away and to see the clock being turned back to a darker age.

    Sincerely,

  5. Elizabeth Potter Graham

    Thanks for your perspective.

    Thirty years ago in law school, I learned that it takes probable cause to administer a breathalyzer test. To take a blood sample, the state must have consent or a court order. It is unconstitutional for the state to intrude on a body in this way.

    My experience is similar to the good doctor’s, in lift, motherhood and law practice with adolescents and mothers. We women and doctors have handled these issued just fine. The GOP needs to Get Out of our Panties.

    Elizabeth Potter Graham, BA MAS JD

  6. The one thing I am hoping here is that the bill has a grammatical error and that they meant to include the ectopic pregnancy and dead foetus as part of the exceptions. That reduces it to mere state-enforced rape, without the additional extra gratuitous sadism.

  7. Gregg

    I’m going to stop reading when you misconstrue your “definition” of rape…maybe you should actually look at the law before you start spewing your opinion. Here, I’ll make it easy for you….
    Section 13A-6-61 – Rape in the first degree.

    (a) A person commits the crime of rape in the first degree if:

    (1) He or she engages in sexual intercourse with a member of the opposite sex by forcible compulsion; or

    (2) He or she engages in sexual intercourse with a member of the opposite sex who is incapable of consent by reason of being physically helpless or mentally incapacitated; or

    (3) He or she, being 16 years or older, engages in sexual intercourse with a member of the opposite sex who is less than 12 years old.

    (b) Rape in the first degree is a Class A felony.

    and I can already see you twisting the wording so for clarification, #2 is referring to unconscious or incapable of giving consent because of intoxication or temporary inability to reason.

    There….you can now edit your blog and correct the mistake in the very beginning. As for the rest, I care about the women in my life but I cant agree with you on abortion so we’ll just stop there. I only believe in termination for the mothers health and in cases of legitimate rape and pregnancy.

    Where did you go to medical school?

    • Did you read the hyperlink to the legal discussion? There is a lot of case law defining the parameters of rape. If that is the Alabama Code you are citing, attorneys I talk to tell me we have evolved beyond that through case law.

      I attended South Alabama. Residency at Children’s in Greenville, SC.

  8. Pingback: Morning Awful: Alabama Ultrasound Sexual Torture | Osborne Ink

  9. Lisbeth

    Before I ask this, please know I’m a pro-choice female and I am personally against this type of legislation. I continue to try to educate the people in my life about women’s reproductive rights issues. In going over both sides of the debate, I just wanted to clear a few things up.

    I have a medical question on this, having never had to go through the process of getting an abortion. When you go to a OB doc and you are pregnant, I thought they did an ultrasound anyways to confirm you were actually pregnant. Is this the ultrasound the legislation is referring to? Or does this mandate a second ultrasound? Perhaps ultrasounds are always completely elective. I just wanted to clear that part up, because I’m certain it would come up at some point.

    • Thanks for asking– most of the time ultrasound is not necessary prior to abortion. Docs used to think it was but studies proved otherwise. The positive pregnancy test and physical exam is sufficient. But if they are not sure it is intrauterine or have reason to suspect another problem, the doc would want an ultrasound.

    • RobynHeud

      I know personally too that even if you decide to go through with a pregnancy, an ultrasound is not necessary even then. Legally, you can ask for a procedure and your doctor can refuse if they do not think it is right for you. But likewise, no matter what your doctor suggests for procedures or medications, you have the right to refuse some, none, or all of it.

  10. Lisbeth

    Also, in reading this bill, the language suggests the intend to include Plan B, as “The intentional use or prescription of any instrument, medicine, drug, or any other substance or devise or method to terminate the life of an unborn child” (SB12 Pg3 Lines 8-12). Would that mean any woman who goes to get Plan B because she suspects she is pregnant would be required to undergo an ultrasound before proceeding?

    • I don’t think so, because it prevents implantation primarily. Pregnancy is not established before implantation.

      • Lisbeth

        I hope you’re correct. The language on this bill is so obtuse… it defines a child as a human at ANY stage of development and defines an abortion as ANY drug or device used intentionally to terminate the life of an unborn child. Well, an egg is a stage of human development…

        That’s tricky language, and just another example of how poorly written this bill is. As the bill stands, I believe an angry father could sue a woman if he found out she went to get Plan B because she feared she would become pregnant.

        Just seems like a slipper slope. Thanks for your knowledge on this!

  11. Reblogged this on Matt Thomas and commented:
    The anti-abortion social agenda being pushed in the Alabama state legislature is obscene in its disrespect for women. I can’t believe we’re having this debate in 2012.

  12. Chris Perry

    Thanks for your hard work in this fight. I am a physician myself (emergency medicine and critical care) and I am concerned about this bill for multiple reasons, most of which you highlighted above. I actually never looked into the data regarding women changing their minds after seeing the sono, although I shouldnt be surprised that there really was no such data. With regards to ectopics, I am even more concerned of the growing (especially in Alabama) “personhood” movement. There actually is a push within your state by non-medical religious leaders to suggest that ectopics are neither dangerous for the mother or the fetus. It’s insanity to say the least. But ignorance spreads easier than knowledge, and if this goes unchecked who knows what your legislature will pass. Anyways, keep up the good work! I am cheering for you from New Jersey!

  13. Reblogged this on Acoustic Poetree and commented:
    A pediatrician’s perspective on the anti-choice bill in Alabama

  14. I have removed the paragraph saying the bill allows the woman to be sued– the wording in this section was confusing, and after studying it some more, I do not think that’s what it says. The physician can be sued. Sorry for the error! I also had been told by others it allowed the woman to sue, but I just don’t see it in there.

  15. Pingback: Facebook Twitter You Tube RSS Email Updates As Women Rally, Doctor Speaks Out Against Forced Ultrasound Bill in Alabama « War on Women

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