Forum, 3-4: The Legislature's arrogance

By Marvin Buehner, M.D., a Rapid City physician, specializing in family practice and obstetrics/gynecology. | Saturday, April 01, 2006

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My professional life has been dedicated exclusively to women's health care for the past 18 years. I have spent a great deal of time contemplating and discussing the issue of abortion with colleagues and patients of all religious and political persuasions, and I share the same ambivalence about abortion as the majority of folks I know.

I am not an ideologue. But like most South Dakotans, I know the arrogance of unmerited certainty when I see it. When our Legislature passed House Bill 1215, the abortion ban law, that arrogance was unprecedented.

The Task Force to Study Abortion, upon whose report the law was based, chose to ignore the testimony of the medical professionals who specialize in women's health care. It was comprised mostly of ideologically driven members, two-thirds of whom were committed anti-abortion activists.

Its report asserted that there is "scientific proof" that life begins at conception, though other medical experts and I testified that this is a religious or philosophical conclusion that can never be proven or disproved in a scientific framework.

Instead of forever debating an unsolvable problem, the question we as a state and a nation truly need to answer is: Under what circumstances do the rights of embryo or fetus supersede the rights of pregnant women to make their own health care decisions? And this question cannot be answered by science, despite the claims of this bill's proponents.

It is difficult to avoid the conclusion that the task force report and the abortion ban were the result of a blatant misuse of political power to promote an agenda with essentially religious underpinnings.

The abortion ban is not based on "technological advances and medical experience," as stated in the law, but is driven by the national anti-abortion forces that have chosen South Dakota to be the battleground to promote an agenda not consistent with the values of mainstream America. According to a latest Gallup poll, 53 percent of the American public considers itself pro-choice, and 66 percent of Americans continue to oppose the overturn of Roe vs. Wade.

Nobody that I know, pro-choice or pro-life, promotes abortion. But most South Dakotans, like the majority of other Americans, favor keeping abortion safe and legal, at least under certain circumstances.

The God-fearing South Dakotans that I know who disagree with the anti-abortion movement are simply afraid to express their dissent in the environment of intimidation that is the legacy of this movement's extremist faction.

The debate we should be having is not whether or not to ban abortion, but what reasonable restrictions are most consistent with the values of the majority of Americans.

Most troubling of all, the abortion ban fails to consider the health of mothers who have serious medical problems. I have cared for pregnant patients who were victims of cancer, strokes, potentially lethal heart conditions, kidney failure and diabetes with end-stage complications. Each of these conditions poses significant risk of death or major organ failure and disability and would not be covered under the extremely narrow exception in this law.

Unhealthy women whose only crime might be contraceptive failure would be forced against their will to risk their lives to carry a pregnancy to term, or to leave the state of South Dakota. Even if they were raped or victims of incest!

I feel safe in saying that this is not what most South Dakotans would consider sound policy or good medical care.

This law draws from the task force's conclusion that women are usually coerced into abortion by others and are essentially incapable of making responsible decisions regarding their pregnancies. There are no penalties under this law for women seeking abortions, only for their physicians, apparently because its proponents believe that to consider an abortion one must by definition be mentally incompetent. This is not supported by any medical literature and completely inconsistent with my experience.

Patients who find they must contemplate terminating their pregnancies nearly always do so with a great deal of thoughtful, often prayerful contemplation. I try to offer the most unbiased, complete and contemporary information on perinatal care options available to them.

The diversity of religious and ethical positions of South Dakotans still astounds me in a state that considers itself to be rather monolithic in its thinking. But the notion that women are forced into abortions or are duped into terminating their pregnancies by their doctors is a profoundly inaccurate and offensive myth. On the other hand, forcing every pregnancy to term is by definition a coercive act.

The abortion ban dismisses out of hand the possibility that pregnant women may be able to make responsible decisions. It criminalizes comprehensive health care for women. It coerces women into medical situations that are simply not compatible with any standard of decent medical care. Remember that history has shown that abortion prohibition does not stop abortions, only safe and legal ones. The thought of practicing women's health care in this environment is simply untenable.

Gov. Mike Rounds and our Legislature were elected to represent all South Dakotans, not just those who share the particular religious viewpoint of this law's sponsors. Our elected officials were sent to Pierre to use our tax money responsibly for purposes of solving real problems in our state, not with a mandate to overturn Roe vs. Wade.

Let's think about what our priorities really are when we choose in the next election.