Common Ground on Late-Term Abortion: AnguishThe Killing of Dr. George Tiller Has Rekindled an Old Debate, but Partisans on Both Sides Acknowledge Each Other's Pain
It's a pretty well-balanced article and a sound thoughtful read all-round. By STEPHANIE SIMON
In a faceless building by the freeway, George Tiller performed thousands of abortions a year. Some of his patients were well advanced in pregnancy -- seven, eight, even nine months along. And so his clinic became a battleground.
Fewer than 1% of all abortions in the U.S. -- perhaps 1,000 a year -- are performed late in the second or third trimester. But they are a potent symbol of a deep cultural divide. In the abortion debate, little elicits more emotion than the idea of killing a viable fetus, weeks or even days from birth.
Dr. Tiller was killed in church Sunday, and an antiabortion protestor has been charged in the case. In the days since, even as they condemn the violence, some abortion opponents have held up Dr. Tiller as a symbol of the worst excesses of a culture they believe devalues human life -- a culture of "abortion on demand." Many of Dr. Tiller's patients have praised him, through tears, as a hero who put his life at risk to help them through their darkest hour.
The bumper-sticker slogans in the abortion debate pit the right to choose against the right to life. Many Americans, though, seek a middle ground. But where to draw the line? At what point does the fetus's interest outweigh the mother's? Looking closely at the extremes of the debate -- at the decisions made in the Wichita clinic -- can help define the stakes.
Both sides agree on one thing: Late-term abortions are anguishing. Nearly all the late-term abortions at Dr. Tiller's clinic involved fetuses that were deformed or disabled in some way, said Peggy Bowman, who worked at the clinic as a top aide to Dr. Tiller for a decade. Some mothers had painted nurseries, set up cribs, purchased tiny booties -- only to get the devastating news, late in pregnancy, that their babies had genetic deformities.
So they found their way to the Wichita clinic, where they paid Dr. Tiller thousands of dollars to inject a needle into their wombs to stop their babies' hearts.
"We loved our baby boy too much to suffer the misery of waking up every morning awaiting his impending death," said Miriam Kleiman, who found out in her third trimester that her son had fatal brain abnormalities. Dr. Tiller performed the abortion in 2000.
Dr. Tiller also took some late-term patients with healthy fetuses. Though the clinic's medical records typically remain confidential, he said they were only the most desperate cases: very young girls, victims of rape, drug addicts, women in abusive relationships. "The idea that someone would get a late abortion so she fits in her prom dress is outrageous," he once said in an interview.
The procedures are expensive, at least $6,000 cash, upfront. There are risks to the mother -- 8.9 maternal deaths per 100,000 late-term abortions, compared with 7.1 deaths per 100,000 births, according to the Guttmacher Institute, which supports legal abortion but is regarded by both sides in the debate as a reliable source of statistics.
Late-term abortions also are grueling. In 2007, the Supreme Court upheld a federal ban on one late-term procedure, sometimes called "partial-birth abortion," in which the physician begins to deliver the fetus, feet-first, then punctures its skull. Doctors are still allowed to dismember the fetus in utero. Dr. Tiller's preferred method is also legal. He stopped the fetal heart with an injection of digoxin, a drug used to treat adult heart patients. Then he would induce labor. Patients said they would wait in hotel rooms through two to three days of contractions until they were ready to deliver their stillborns at his clinic.
Such procedures discomfit some abortion doctors. William F. Harrison, who performs abortions in Fayetteville, Ark., said he considered Dr. Tiller a friend and called him "a very brave and great doctor." Yet he has long expressed concern about Dr. Tiller's willingness to abort into the ninth month. "Some of his practices are hard to defend," Dr. Harrison said.
Numerous public-opinion polls over the years show Americans are uneasy with letting women choose abortion at any time, for any reason. The polls, from a variety of organizations including FOX News, CNN, Gallup and Harris, generally show that less than 30% of Americans -- in some polls, just 15% -- believe abortion should be legal in every case, though a solid majority supports keeping abortion legal in most cases.
Over the years, Dr. Tiller's clinic -- just one of three in the country to do late-term abortions -- has been bombed, blockaded and vandalized. In 1993, he was shot through both arms by a protester. Opponents have also regularly picketed his home and the homes of his staff. The "Truth Truck," a white van covered with photos of aborted fetuses, is a familiar sight around Wichita.
Troy Newman, president of Operation Rescue, said calling attention to late-term abortions emphasized the fundamental truth that abortion ends a budding life.
"We've showed that Mr. Tiller was not aborting a blob of tissue; those are real children," Mr. Newman said.
Protesters, including Mr. Newman, express great sympathy for women carrying disabled children. But they point out that some of the conditions women cite when seeking abortions from Dr. Tiller aren't fatal, such as Down syndrome. Others, including some heart ailments, could possibly be corrected through surgery.
Even in the worst cases, abortion opponents urge women to carry to term and cuddle their babies for as long as they survive. God doesn't "cut us off after we fail," and neither should women abort disabled babies, said Marilyn Manweiler, who works next door to Dr. Tiller's at Choices Medical Clinic.
The Choices clinic offers a free prenatal hospice to support women carrying fetuses with fatal deformities. Clients get medical consultations, as many ultrasounds as they would like to help them bond with their babies, and support from volunteers who help them plan for the birth and the funeral that will follow.
Holland Kisch came to Choices this spring when an ultrasound midway through her pregnancy showed that her daughter, Aida, had a fatal condition that covered her face in tumors. Ms. Kisch and her husband decided that an abortion felt wrong. Instead, she chose to carry Aida as long as she could. "She brought us great joy for the little time we had with her," Ms. Kisch said. Aida was stillborn, prematurely, in March. Around her neck, Ms. Kisch wears a tiny ring the Choices volunteers gave the baby.
Ms. Kisch said she could understand how other women facing a tragic diagnosis might choose differently. "For me, it was the best choice," she said. "I don't know how I can say what's right for someone else."
Thirty-seven states, including Kansas, prohibit late-term abortions. But under Supreme Court precedents set in 1973 in Roe v. Wade and its companion case, Doe v. Bolton, state restrictions on abortion must generally include exceptions for the woman's life and health, which includes mental and emotional health.
Medical records subpoenaed by prosecutors in Kansas indicate Dr. Tiller approved some late-term abortions on the grounds that the women suffered from anxiety or depression. To opponents, those are shockingly flimsy excuses. But several attempts to prosecute Dr. Tiller for violating the law failed.
Christine Becker, who lives in Tennessee, was 28 weeks pregnant with her first child, a boy that she and her husband named Daniel, when tests showed he had a fatal form of dwarfism. Ms. Becker is Catholic, and had always considered abortion a sin. Yet as she and her husband prayed over several days, she said, they decided they could not bear to think of Daniel suffering.
"We wanted him to be released as an angel," Ms. Becker said. Dr. Tiller aborted Daniel in 2000.
Dr. Tiller's killing has pushed some young doctors to commit to a career in abortion. Lisa Hofler, a medical student at Emory University, had been mulling over the idea for some time despite her husband's concern for her safety. Now, she said, she's determined to offer abortions as part of her practice.
Still, she expects to limit her practice to first-trimester abortions. She doesn't feel comfortable, she said, pushing the boundaries.
I am and always will be pro-choice, as far as the foreseeable future goes, despite my Catholic background, etc.
Do admit that it’s difficult for me to defend being pro-choice to the death and if ever faced with the decision, I’m not sure if I could actually undergo abortion despite being pro-choice.
The idea of third-trimester abortions is not too comfortable to me.
Nevertheless, I have no delusions coming from a moral high ground that making the decision to have a third-trimester abortion or performing it would be anymore comfortable for the mother or to the doctor.
It would be an insult to them to consider the choice an easy way out for the mothers or a money-making venture for doctor without principles.
I wouldn’t consider $6000 grand up front as fantastic payback for daily threats against your life, snubbing from your medical profession and public condemnation.
Dr. Tiller to me, was simply a brave man who made tough decisions everyday to provide an option for women in a society who did not want to give them those options.
He may not have our agreement but his courage deserves our respect.Requiescat in pace