(My source for the quotations and information is Justice Kennedy’s majority decision and Justice Ginsburg’s dissent in Gonzales v. Carhart. These documents can be found here.)
The Free Lance
By now, most people are aware of the summary holding in Gonzales v. Carhart: for the first time since Roe v. Wade, the Supreme Court left standing a law proscribing a particular abortion procedure without an exception to safeguard a woman’s health. Standing alone, this is a terrible result, but understanding the rationale of the decision was made is more frightening still.
In upholding the “Partial-Birth Abortion Act” (referred to here as just “the Act”), the Supreme Court’s new majority drew upon old lies about the emotional fragility of women, and the need to protect them from their own decisions. The Court used this old myth to bypass forty years of precedent safeguarding reproductive rights. The Court allowed Congress to place political values over best medical practice, and to put women’s lives at risk. The Court’s willingness to put aside legal precedent and scientific fact in this case may encourage more attacks on constitutional rights in the future.
Understanding Carhart requires some minimal understanding about abortion procedures. The Act targets the procedure used in essentially all abortions taking place after first trimester and before viability. (Viability is the point in pregnancy when, given the current state of medicine, a premature infant has a fifty percent chance of survival. At present, viability occurs around the 23rd week.) The procedure is referred to as “dilation and evacuation” or “D&E”. A D&E is performed by first dilating the patient’s cervix for a period from a few hours to a few days. The physician then removes the fetus, placenta and related material from the uterus through the cervix, and out of the body. Often, the fetus must be removed from the uterus in pieces. Sometimes, though, the fetus can be removed from the cervix intact (called an “intact D&E” by the Court). Because the fetus is not destroyed during the intact D&E process, the physician must ‘kill’ (the Court’s word), the non-viable fetus. The loaded term “partial-birth abortion” is thus an obvious mischaracterization of this procedure. The nonviable fetus cannot be “born,” either partially (whatever that might mean), or otherwise.
The Court notes that many physicians testify that trying to remove the fetus intact is sometimes medically necessary and always preferred medical practice. Removing fetal material in pieces take longer, thus extending the time the patient must stay under anesthesia. Many small pieces of material raise the risk of uterine damage, as well as the possibility of post-surgical complications resulting from failure to remove all of the material.
The line drawn separating intact D&E’s from all others appears to originate with Congress and the Court. In any case, Congress finds the “intact D&E” procedure distasteful. Well, perhaps more than just distasteful. According to the Court, Congress says the intact D&E is a “gruesome and inhumane procedure that is never medically necessary and should be prohibited”.
Congress, however, cannot constitutionally pass a law with the primary goal of prohibiting an abortion procedure. As Justice Ginsberg points out in her excellent dissent, Congress must consider all that troublesome precedent about a woman’s right to choose, and the idea that a woman’s decision to bear a child is central to her “‘dignity and autonomy,’ her ‘personhood,’ ‘destiny,’ and her ‘conception of her place in society’”. According to over forty years of developed precedent, a law cannot constitutionally place “a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability.”
But there is a loophole: Congress can pass a law that makes it more “difficult and expensive to obtain an abortion,” as long the law’s primary purpose is not specifically to interfere with the right to have an abortion. For the Act to pass constitutional muster, Congress needs a convenient fiction about the Act’s purpose. Fortunately for Congress, the new majority in the Court is happy to oblige.
According to the Court, the Act is intended to protect “mothers,” who are emotionally sensitive and liable to regret their decision to have an abortion. There are no “women” in the Carhart decision. There are only ‘mothers, a group that includes women whose pregnancies were terminated.
The Court begins by adopting nostrums from Congress: “Respect for human life finds an ultimate expression in the bond of love a mother has for her child.” Because of the importance of this “bond of love,” the Court decides that, although there is “no reliable data to measure the phenomenon, it seems unexceptional to conclude some women come to regret their choice to abort the infant life they once created and sustained. Severe depression and loss of self-esteem can follow.”
The Court then supposes, again without any factual support, that “some doctors may prefer not to disclose precise details of the means that will be used” for performing the abortion. The physician’s postulated failure to be frank about the procedure can compound already existing emotional difficulties: “It is self-evident that a mother who comes to regret her choice to abort must struggle with grief more anguished and sorrow more profound when she learns, only after the event, what she once did not know: that she allowed a doctor to pierce the skull and vacuum the fast-developing brain of her unborn child, a child assuming human form.”
This overheated language distracts from real problems with the Court’s argument. First, the story about the emotional damage that can result from having had an abortion just isn’t true. In her dissent, Justice Ginsburg provides a long list of studies from respected sources debunking the “idea that having an abortion is any more dangerous to a woman’s long-term mental health than delivering and parenting a child that she did not intend to have.”
Secondly, if a woman does come to regret her decision to terminate her pregnancy, is it likely she would prefer to learn her abortion was performed by removing the fetus from her uterus in pieces, or that it was removed intact, the safest possible method
Finally, wouldn’t it make more sense simply to require physicians to inform women of the abortion method to be used along with other information currently required by law to be provided the patient?
The Court doesn’t discuss these issues because the truth is less important than upholding the Act and setting the stage for future cases. The old argument about protecting the life of the unborn doesn’t need to be raised anymore to attack abortion. The new argument that abortion should be done away with is based upon the offensive lie: Women are emotionally fragile, and might decide on abortion, even though abortion separates them from participating in the “ultimate expression” of “respect for human life.” They may later come to regret that decision, leading to emotional illness. Learning about how the abortion was carried out will further damage these women emotionally. Therefore the practice must be eradicated.
This argument is sufficient to prohibit one method of performing abortions. Is there any reason why it won’t work to ban others?
This is the first of two posts discussing the Carhart case. In the next post, I’ll discuss the mechanics of the Act itself, how it allows Congressional opinion to overrule science, and the danger this poses to the health of women.