Medical Ethics: Its Accommodation of Abortion and the Effects

MEDICAL ETHICS: ITS ACCOMMODATION OF ABORTION AND THE EFFECTS

TABLE OF CONTENTS

I. Introduction II. History of medical ethics A. Hammurabi B. Hippocrates C. Percival D. Twentieth century 1. Declaration of Geneva 2. International Code of Medical Ethics 3. Declaration of Oslo 4. AMA Principles E. Comparison of ethical codes F. Erosion of medical ethics 1. Roe v. Wade law 2. California Medicine editorial 3. AMA policy statements G. The new ethic 1. In practice 2. In textbooks

III. Effects of the new ethic A. On moral climate B. On physicians 1. Practicing abortion 2. Reconsidering 3. Retreating a. Separate life in womb acknowledged b. NARAL exposed c. Doctor's duty recalled C. Medical technology presents dilemma 1. Treatment in utero 2. Ultrasound imaging D. AMA's principles vs. practice 1. Principle V 2. Principle I 3. Principle II 4. Principle III E. Fraud F. Fetal politics 1. Experimentation 2. Killed for organs 3. Used for soap G. Infanticide H. Euthanasia 1. Nazi Holocaust 2. Roe v. Wade IV. Conclusion

ABSTRACT

It is the mission of the doctor to save life. Since induced abortion to save the life of the mother is rarely necessary, the mission of abortionist doctors is the destruction of life in the womb. There is a unique set of ethics for abortions vs. all other surgery. Acceptance of this ethic has caused an erosion of the former high standards of medical ethics and allows for some human lives, at all stages of development, to be judged less worthy of existence than others.

If the physician presumes to take into consideration in his work whether a life has value or not, the consequences are boundless and the physician becomes the most dangerous man in the state. Dr. Chistoph Hufeland (1762-1836).

"Ethics concerns the thoughts, judgments, and actions on issues that have the greater implications of moral 'right' and 'wrong.' A 'morally right' attitude is usually understood to be directed toward an ideal form of human character or action, which should culminate in the highest good for humanity [22:32]." "Law codifies minimum standards of societal behavior; ethics builds values and ideals upon thatbasis which exceed the minimum [19:14]." Historically, medical ethics and the law have been closely entwined. It might then be presumed that ethics would also have evolved to contribute to the passage of moral laws. Instead, has ethics condescended to accomodate immoral laws, specifically with reference to induced abortion? Consider a brief historical review of medical ethics and abortion.

The main principle of the Code of Hammurabi (Babylonian ruler, circa. 1800 B.C.) was that "the strong shall not injure the weak [15:36]."

Traditional ethics was encoded in the "Oath of Hippocrates" (Greek physician), to which almost all doctors swore from 400 B.C. until recently. The oath states, in part:

I will give no deadly medicine to anyone if asked, nor suggest any such counsel; furthermore, I will not give to a woman an instrument to produce abortion. . . .With purity and holiness I will pass my life and practice my art [22:32].

In 1803 a British physician, Thomas Percival, developed the "Scheme of Professional Conduct" upon which the American Medical Association's (AMA's) first adopted Code of Ethics was substantially based in 1847. Essentially, it exhorted the physician to dedication, honesty, competence, high personal moral standards, and good citizenship (19:14).

In September 1948, the World Medical Association adopted the Declaration of Geneva, which said, "I will maintain the utmost respect for human life, from the time of conception; even under threat, I will not use my medical knowledge contrary to the laws of humanity [17:317] ."

In October 1949, the International Code of Medical Ethics stated, "A doctor must always bear in mind the importance of preserving human life from the time of conception until death." Chairman of the committee, Dr. Paul Cibrie, stated that abortionists were condemned in the Declaration of Geneva [17:317] .

In 1970, the World Medical Association reaffirmed its position with the Declaration of Oslo: "The first moral imposed upon the doctor is respect for human life as expressed in . . . the Declaration of Geneva [17:318]."

The AMA's Principles of Medical Ethics have been revised in 1903, 1912, 1947, 1957, and 1980. The 1980 revision was done "to clarify and update the language, to eliminate reference to gender, and to seek a proper and reasonable balance between professional standards and contemporary legal standards in our changing society [22:33]."

Comparing the wording cited in the 1980 revision to that of all the aforementioned codes (except Percival's, upon which the AMA's is based), there was a shift from the concrete to the abstract. Any reference to abortion was conspicuously absent. This was because the hierarchy of the AMA embraced a judicial law handed down by the United States Supreme Court on January 22, 1973, which allows for killing a human being in his or her mother' s womb throughout nine months of pregnancy for any reason. Roe v. Wade best speaks for itself as summarily found in the opinion of the two dissenting justices:

At the heart of the controversy in these cases are those recurring pregnancies that pose no danger whatsoever to the life or health of the mother but are nevertheless unwanted for any one or more of a variety of reasons-convenience, family planning, economics, dislike of children, the embarrassment of illegitimacy, etc. The common claim before us is that for any one of such reasons, or for no reason at all, and without asserting or claiming any threat to life or health, any woman is entitled to an abortion at her request if she is able to find a med ical advisor willing to undertake the procedure [9:1138].

Instead of Roe v. Wade being challenged by the medical profession both scientifically and for compliance with traditional ethics, medical ethics shifted to accommodate the new "law." Perhaps it would be more honest to say that erosion of medical ethics actually paved the way for the new law. This was never so boldly admitted as when an editorial appeared in California Medicine, official journal of the California Medical Association, September 1970:

The Traditional Western Ethic has always placed great emphasis on the intrinsic worth and equal value of every human life regardless of its state or condition. . . . The process of eroding the old ethic and substituting the new has already begun. It may be seen most clearly in changing attitudes toward human abortion.... Since the old ethic has not yet been fully displaced it has been necessary to separate the idea of abortion from the idea of killing, which continues to be socially abhorrent. One result has been a curious avoidance of the scientific fact, which everyone really knows, that human life begins at conception and is continuous whether infra or extra-uterine until death. The very considerable semantic gymnastics which are required to rationalize abortion as anything but taking a human life would be ludicrous if they were not often put forth under socially impeccable auspices.... It seems safe to predict that . . . the new ethic of relative rather than of absolute and equal values will ultimately prevail [33:67, 68].

How did the AMA separate the idea of abortion from the idea of killing? A comparative look at their policy statements spanning a century shows how it was done:

What should the ethics of abortion be?

1871-"Thou shalt not kill. This Commandment is given to all without exception. ... it matters not at what stage of development his victim may have arrived" [5:191].

1967-"This is a personal and moral consideration which in all cases must be faced according to the dictates of the conscience of the patient and her physician" [S:191].

1871-"The work of destruction; the wholesale destruction of unborn infants" [5: 191].

1967-"The interruption of pregnancy; the induced termination of pregnancy" [S:191].

What should be done to physician-abortionists?

1871-"They should be made the outcasts of society. We will . . . guard and protect the public against the machinations of these characters by pointing out the physical and moral ruin which follows in their wake" [5:191].

1970-"They should be permitted to perform abortions as long as they take place 'in an accredited hospital"' [S:l91].

Just three years later, in 1973, the Supreme Court ruled that the decision to abort rests solely with the woman and her doctor, not even specifying what kind of a doctor. A podiatrist became legally permitted to perform an abortion. A general practitioner would be disciplined by his colleagues for doing a heart operation, but the podiatrist-abortionist goes undisciplined, unpunished, because acceptance of abortion as a private right has allowed the "new ethic" to prevail.

Since Roe v. Wade, there has been increasing evidence of a schizophrenic mentality in medical practice and in medical textbooks. In practice, physician-abortionists have been killing babies at nine months gestation in one room of a hospital while doctors labor to save the life of a prematurely born baby at five months gestation in the next room.

Williams Obstetrics, a highly respected medical textbook, published the following:

Since therapeutic abortion to save the life of the woman is rarely necessary or definable, it follows that the great majority of such operations previously performed in this country went beyond the letter of the law [46:501].

In the same text, same column, the following appeared, which is the first indication for abortion in the policy of the American College of Obstetricians and Gynecologists:

When continuation of the pregnancy may threaten the life of the woman or seriously impair her health. In determining whether or not there is such a risk to health, account may be taken of the woman's total environment, actual reasonably foreseeable [46:501] .

This policy is in total agreement with Roe's abortion-on demand, and member doctors functioning under it would insist that they are operating ethically. However, there is an implicit admission of the "new ethic" prevailing. As noted, pregnancy rarely threatens a woman's life and doctors abused the "life of the mother" excuse prior to Roe. "Risk to health" was broadened to mean any excuse to get rid of the unborn baby, whose total worth is no longer intrinsic, but based on wantedness.

Another textbook example of the schizophrenic mentality is demonstrated by the following three paragraphs, which appear in sequence, uninterrupted, in the college text The Medical Assistant:

The physician is not prohibited by ethical considerations from performing a lawful abortion in accordance with good medical practice.

The discovery that a patient is abusing a child or a parent creates a difficult situation for the doctor's office. The law requires that such abuse be reported.

The physician, being a member of a profession dedicated to preserving life, should not participate in a legally authorized execution [22:34].

The reader is referred to Figures 1 to 7. The above textbook quote (all three paragraphs) raises several questions: How can killing another human being (abortion) ever be considered "good medical practice"? Is not induced abortion also child abuse? Are only abortionist-doctors allowed to abuse patients? Is not induced abortion "legally authorized execution"? In 1871 the AMA thought so, calling physician-abortionists "educated assassins; modern Herods; the executioners [5:191]."

What are some of the effects of Roe v. Wade? The public did not overwhelmingly accept abortion-on-demand as "morally right." In an apparent effort to gain moral respectability for killing by abortion, a referral service called Clergy Consultation Service was put together in 1967 [29:42]. They referred many women to a Dr. David Sopher, known for his late abortions at 14 to 26 weeks gestation. As he described his technique at a Planned Parenthood meeting in Des Moines in 1973, he showed. . . the fetus reconstructed at the end of the abortion like a grisly jigsaw puzzle. One could see where the arms and legs had been ripped from the body and removed separately, how the spine had been snapped in two, . . . how the skull had been crushed and the brain drained out before the bony parts were removed [29:26, 27].

Other physician-abortionists have related the emotional turmoil this procedure inevitably wreaks on themselves and staff. Drs. Roaks and Cates admitted:

Ossified parts such as the skull must often be crushed and the bone fragments extracted carefully to avoid tearing the cervix. Reconstruction of the fetal sections after removal is necessary to ensure completeness of the abortion procedure. Clearly, D & E transfers much of the possible psychological trauma of the abortion from the patient to the professional [36:276, 277].

It is ironic that, just months after the 1973 Roe v. Wade decision, Dr. Bernard Nathanson, who had done so much to bring the decision about, began to rethink his position:

I am deeply troubled by my own increasing certainty that I had in fact presided over 60,000 deaths. There is no longer serious doubt in my mind that human life exists within the womb from the very onset of pregnancy [31:1189].

Dr. Nathanson was a founder of the National Association for the Repeal of Abortion Laws. It was later renamed National Abortion Rights Action League. Dr. Nathanson commented on NARAL's opening of a new headquarters in Montclair, New

Jersey on June 24, 1990:

In over twenty years, NARAL has learned nothing and forgotten nothing. They're still perpetuating the same lies Larry Lader and I invented two decades ago before abortion was legal. To sway public opinion we created abortion statistics which claimed 10,000 women a year died from illegal abortions when the real figure was probably closer to 200. I helped unleash the abortion monster which since 1970 has claimed the lives of 25 million children. All that has changed with NARAL in these years is that their lying has become more audacious, their budget has become more bloated and their murderous intent more nakedly obvious [32] .

Dr. Nathanson's complete turnaround is a witness that concurs with Dr. Walter F. Judge's opinion: "Medical ethics deals with the physician's obligation to the patient. These obligations are furnished by a moral code as commanded by a higher law-the law of nature itself [21] ." Dr. Nathanson could no longer ignore the "higher law," could no longer accommodate the "new ethic," but now works tirelessly for a return to traditional ethics. He reminds fellow doctors that "the science of fetology-the study of the fetus in his own environment- shows incontrovertibly that the unbom child is a human being. It is a doctor's sworn duty to protect that second patient, not kill it [32]."

The very fact that the prebom human can be treated in utero establishes him or her as "patient" [16:1582-1584]. When any pregnant female presents herself for medical attention, there are at least two patients present. However, the prebom human is not acknowledged as patient if he or she is unwanted. Some of the wording on the patient information sheets from Pennsylvania Hospital's Antenital Testing Unit for "Real time Ultrasound Examination" and "Real time Ultrasound Examination Prior to Termination" may be compared to illustrate this. When the baby is wanted, it reads:

You have been scheduled for real time ultrasound for your baby. This procedure uses reflected sound waves . . . to form a picture of your pelvic organs and your baby. This picture . . . can help the doctor estimate your due date, show the position of the baby . . . show if your baby is growing well, and show movements of the baby....there is no known risk of harm to you or your baby . . . [47:241].

When the baby is not wanted, he or she is literally removed from the picture by this wording:

You have been scheduled for real time ultrasound to determine how far your pregnancy has progressed. This procedure uses reflected sound waves to form a picture of your pelvic organs and your pregnancy. This picture . . . can help your doctor determine which procedure will be appropriate for termination. ...there is no risk of harm to you [47:242].

It seems that advances in technology, such as ultrasound imaging and medical care for the preborn baby, are inversely proportional when abortion is the choice. Meanwhile, Principle V of the AMA's Code of Medical Ethics states, "A physician shall continue to study, apply and advance scientific knowledge, make relevant information available to patients. . . [22:32]."

AMA's Principle I states, "A physician shall be dedicated to providing competent medical service with compassion . . .[22:32]." There is no compassion for the baby involved in an abortion. Dr. Liley, known as the Father of Fetology, observed that "the unborn knows perfectly well when he has been hurt, and he will protest it just as violently as would a baby lying in a crib [24:50] ." Dr. Jay Kelinson learned this the hard way when he consented to be filmed in "The Silent Scream" while performing an abortion. That was the last time he walked into an abortion facility. He testified to the authenticity of the film in another film called "The Answer": "There was no manipulation of that tape; there was no misrepresentation. I was horrified at what I had seen."

AMA's Principle II states, "A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception [22:32] ." One example of dishonest dealings in the abortion industry is a procedure termed "menstrual aspiration." It also goes by the names of "menstrual extraction," | "menstrual induction," "instant period," and" a traumatic abortion" [46 :501]. When a female's menstrual period is one to three weeks late and pregnancy is usually uncertain, she is given a suction curettage operation and told that it's "just regulating your period." Besides being immoral, illogical and unsafe, this is an ethical violation of her informed-consent.

Principle III states, "A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient [22:32]." It cannot be presumed that the unborn patient would consent to his or her own death.

Also, physician-abortionists are operating under a law based on fraud. Roe v. Wade and its companion case Doe v. Bolton are based on fraud. Both plaintiffs, Norma McCorvey ("Jane Roe" of Texas) and Sandra Bensing ("Mary Doe" of Georgia), have come forth and disclosed how they lied. "Roe" was not raped and "Doe" never sought an abortion but was "manipulated" by pro-abortion lawyers seeking a test case to challenge the laws prohibiting abortion [38:4]. Many in the medical profession are aware of this but do not bother to challenge the fraudulent law. Where are the ethics? Are not ethics and the law presumed to be based on truth?". . . from the fact of [the Court decision, Roe v. Wade], no conclusion follows for morality or for the ethical practice of medicine [34:41]." Fetal experimentation did follow, plus infanticide and euthanasia. Writing on "Fetal Politics," Dr. Willard Gaylin and Dr. Marc Lappe' continue:

Affording the fetus the same protection as the child [both innocent and non-consenting subjects] seems ludicrous in the light of prevailing public acceptance and government approval of abortion. In abortion we more or less readily condone procedures which subject the fetus to dismemberment, salt-induced osmotic shock, or surgical extirpation; . . . Mere consistency would seem to demand that society cannot condone abortion procedures which must subject the live fetus to unimaginable acts of violence, and then balk at giving a mother an aspirin prior to those procedures in order to determine if the drug crosses placenta-with hopes, thereby, that the knowledge will prevent damage to future wanted babies [34:41, 42].

Some would argue that if the fetus (Latin for "young one") is going to die anyway, why not put it to "good use" such as research (often live) or for "spare parts"? One U.S. woman demanded to be artificially inseminated with her father's sperm so she could abort the baby and have the kidneys transplanted to replace the father's diseased kidneys [30:19].

Even more bizarre was a practice admitted to by a British gynecologist. He sold babies to soap manufacturers. This was done without the approval of the Ministry of Health, but done, nevertheless, because his colleagues turned their backs. He spoke to two undercover reporters:

Now, many of the babies I get are fully-formed. . . . One morning, I had four of them lined up crying their heads off. I hadn't the time to kill them there and then because we were so busy. I was loathe to drop them in the incinerator because there was so much animal fat that could have been used commercially. . . . They could live at that stage if they were put in an incubator . . . [but] it would be a breach of contract if I allowed that child to live [25:146-148].

Late-term hysterotomy abortions are commonly done in the United States when the babies are fully formed and developed. With proper care, most of these babies could live, but they do not qualify for care because they are not wanted by the natural mother. Hysterotomies do qualify, though, being done often enough to qualify for code 59105 in the AMA's 1989 CP] manual. (The Current Procedural Terminology manual is a physician's guide for setting fees. One requirement for inclusion of a medical service in CPT is that it must be commonly performed.) Code 59850 even acknowledges "delivery of fetus" in its listing for the abortion procedure [10:238, 240]. Could this be infanticide? Dr. Koop, former Surgeon General, said of hysterotomy abortions, "These babies are truly alive and they are allowed to die through neglect or are deliberately killed by a variety of methods [23:31]."

Abortion is the beginning of the slippery slope in America. The Nazi Holo caust also sprang from "small beginnings." In the novel Judgment at Nur emberg, American Judge Haywood visited his German colleague Judge Janning in his cell. The one-time Nazi judge said of the deaths of millions of men, women, I and children in gas ovens, "I did not know it would come to that." Haywood replied, "Herr Janning, it came to that the first time you sentenced to death a man you knew to be innocent [17 :263] ."

America's death toll from abortion alone has far surpassed that of the Nazi Holocaust. Now the Planned Parent hood inspired slogan "Every child a wanted child" has progressed to "Every grandparent a wanted grandparent." Many abortion advocates are also active in the euthanasia movement. Before his death, Dr. Alan Guttmacher, head of Planned Parenthood World Popula tion, was also a prominent member of the Board of the Euthanasia Society of America [47:218]. Chapters of the Euthanasia Society, sometimes called Society for Concern for Dying, often have the same address as abortion pro viders. The intent of Roe v. Wade can be extended to include euthanasia be cause of Roe's discussion of "quality of life [20:A8]."

Ethically, society has moved from the eighteenth century B.C., Hammurabi's time, when a physician would lose one of his hands if he violated codes of law and ethics, to the twentieth century A.D., when physicians dismember the hands of preborn babies and it is both legal and acceptable medical practice.

Reality sets in. It is 1990, the year for college applications for the class of 1994, applicants conceived in 1973, the year of Roe v. Wade. The Boston Globe headline on June 16, 1990, reads, "The College Pool Dwindles: New England Schools Resorting to Unfamiliar Measures to Attract Incoming Freshmen." (One measure proposed is to lower academic standards [44:1].) Where have all the students gone? Perhaps the answer lies in the fact that 30 percent of America's babies (1.5 million per year) are induced abortion statistics [11:121].

Is it possible to return to the old ethic? Is it too late to try?

The most merciful thing that a large family does to one of its infant members is to kill it. -Margaret Sanger, Founder of Planned Parenthood (Woman and the New Race)

From eight in the morning until midnight, seven days a week, doctors working in ten operating rooms performed vacuum aspirations on an endless parade of pregnant wombs. -Dr. Bernard Nathanson

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P.O. Box 1350 Stafford, VA 22554 (703) 659-4171

Cost: $2.00

X) Mary Clare Zedler December 10, 1990