Wednesday, June 29, 2016

The SCOTUS On Abortion And Scientific Evidence

A long-standing strategy of the forced-birthers has been to impose more and more regulations on abortion clinics.  These regulations pretend to be about preserving the health of the women who have abortions by stipulating that abortion clinics should be equipped like ambulatory surgical centers, that the doctors working there should have admitting rights to the local hospitals and so on.  The real intent, naturally, is to force abortion clinics to close.  That makes getting an abortion more difficult, at least for the poorer women who can't afford the costs of long travel.

One of the more unsavory aspects of this forced-birth strategy have been the bogus health risk arguments its proponents keep advancing, such as the idea that abortion causes breast cancer (not true) and also the general fear-mongering which tries to destroy the mental health of women who have had abortions, while pretending to care about that very health. 

To put that fear-mongering into a wider context, note that giving birth is much more dangerous, on average, than having a legal abortion in the United States:

A key study published in the journal Obstetrics & Gynecology estimated that the risk of a woman dying after childbirth was 10 times greater than after an abortion. The study estimated that between 1998 and 2005, one woman died in childbirth for every 11,000 babies born. That compares with one in 167,000 women who died of abortion complications. Doctors who perform abortions say the most common complications are not bladder issues or problems with reproductive organs -- as some abortion opponents like to emphasize -- but mild infection that can be easily treated.

Now the Supreme Court of the United States (SCOTUS) has addressed the question whether strict health regulations of the above type, as used by the state of Texas, constitute an "undue burden" for Texas women seeking abortion.  The 5-3 decision answers that question affirmatively:

The Supreme Court on Monday ruled resoundingly for abortion rights advocates in the court’s most important decision on the controversial issue in 25 years, striking down abortion-clinic restrictions in Texas that are similar to those enacted across the country.


The Texas provisions required doctors who perform abortions at clinics to have admitting privileges at a nearby hospital and ordered clinics to meet hospital-like standards of surgical centers.
“The surgical center requirement, like the admitting-privileges requirement, provides few, if any, health benefits for women, poses a substantial obstacle to women seeking abortions, and constitutes an ‘undue burden’ on their constitutional right to do so,” Justice Stephen G. Breyer wrote for the majority.
The missing scientific evidence about the actual (rather than imaginary) risks of legal abortions mattered in the decision:

Among the evidence undermining the surgical-center requirement, Breyer said, is a finding that early-term abortions have a lower mortality rate — five deaths in a decade in Texas — than childbirth, which the state allows to take place at home, or procedures such as a colonoscopy or liposuction, which do not carry the surgical-center requirement.
Texas could also not show why doctors needed an admitting privilege to a local hospital, Breyer said.
“When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case,” Breyer wrote.
In short, why fix something when it's not broken, as the old saying goes.

That's not to argue that abortions has no health risks.  But other similar or larger health risks of various procedures do not provoke the same concern from the Republican politicians of Texas.

One ethicist who is fervently opposed to legal abortions has argued that this SCOTUS decision is just a temporary setback, that all the forced-birth side needs to regain the right to turn abortion clinics into centers of nuclear medicine is to collect stories of harm to women who have had an abortion.

But that wouldn't work, in my opinion,  because nobody argues that abortion has no health risks.  Rather, the question is whether these risks are so large that they require especially stringent regulations, compared to, say, colonoscopy, liposuction or home births.  Those procedures do not  provoke the same urgency  for more stringent regulations, despite having higher mortality risks.