July 04, 2008

Obama - "Mental Distress" Doesn't Justify Late-Term Abortions

On the one hand I find this remark quite troubling, partially because it suggest limitations over women's health care rights, and partially because it seems to take mental health less seriously than physical health. On the other hand I really don't think there's much of a story here. The president of the United States isn't going to be writing the details of legal opinions, and his opposition to Gonzalez v. Carhart probably has far greater implications for where he would come down on laws tied to regulating abortions.

Posted by armand at July 4, 2008 11:08 AM | TrackBack | Posted to Politics | Reproductive Autonomy


Comments

It's appalling. You want my Barack Obama yard sign?

Posted by: binky at July 4, 2008 02:58 PM | PERMALINK

Sure, I'll take it should you at some point want to get rid of it.

Like I said, happily I don't think this'll have much practical effect in terms of reproductive health issues. But it's highly troubling. And while I hold out hope that eventually these comments will be "clarified", I'm not going to hold my breath for that.

Posted by: Armand at July 4, 2008 03:28 PM | PERMALINK

So NARAL deems Obama's comments Roe v. Wade compatible, while a right to lifer contends that you can't exclude mental health in the health of the mother and support Roe v. Wade. Since when are we taking that side's views of Roe credible? Sounds to me like: "Oh yeah, libs be afraid, be very afraid, and can I introduce you to my friend John McCain?"

Interestingly, I've never known much about the mental health component of the health of the mother exception, but without that clarity I've always thought that health of the mother meant birthing the infant will directly imperil the mother's safety, not, it would be really traumatic and suck, the baby would have birth defects and be very upsetting (and, specifically, birth defects that evidently couldn't have been, or more bothersomely just weren't, detected in the first two trimesters give or take) . . . that's just not what I thought the health exception was about.

This has nothing to do with my own convictions -- and when it comes to late term, non-lethal-risk-to-the-mother situations, I'll confess that I have none -- but rather reflects only my understanding of the issues. And in that light, I have trouble finding Obama's comments overly disturbing. It's still hard for me to figure out -- legality aside -- why anyone can't make that decision in the first six months (again, give or take) absent some specific, direct, mortal threat that may emerge in the last phase of a pregnancy.

All in all, I'll take your yard sign if Armand won't.

Posted by: moon at July 4, 2008 10:57 PM | PERMALINK

There are two main problems with his statement. The first of which is the standard objection to portrayals of women casually choosing late term abortion, such that others have a better capability to judge the necessity. Nonsense. Second, and even more problematic and wide-ranging beyond the issue of abortion at all, is that mental health is not health, or that it is less deserving of consideration or treatment. Also nonsense. Regarding the inclusion of mental health with respect to abortion, here (PDF) is some reading for you on mental health parity.

Posted by: binky at July 4, 2008 11:34 PM | PERMALINK

Okay, first, if Bolton says, in context and fully understood, what the article says it does, then clearly my understanding of what the health of the mother involves in the constitutional context has been incomplete.

As for your second sentence, I find it unintelligible. Yes, casually chosen late term abortions are problematic in my view on a constitutional basis: because they run into the still-in-effect viability line. (This is not a defense of this fact; merely a legal theoretical observation. If you want to beat it up, feel free, but do so legally, because morally and as a matter of conviction I'm being very clear that it doesn't speak for my own moral sensibility.) I'm not sure what "others" you're referring to, but I'm certain that "nonsense" is no invitation to discussion. I've complained of this before, Binky -- it's arrogant and off-putting when this is how you respond to a lengthier point. If you think I'm wrong, please engage what I said, rather than just lumping me in with some category of person of which you disapprove and spitting in my eye.

Now, the article you refer is fine as far as it goes, and you'll find absolutely no objection from me with regard to health insurance parity of mental and physical care.

The problem with the mental health aspect of abortion, however, is a problem of policy: if one could as concretely isolate and assess the risk arising from mental complications as one could those same factors at a physical level, the point might be easier to hash out. But instead, there is the risk of an exception eating the rule. Now you may not like the rule, clearly you do not, but there's a distinction between liking the rule and making points from within its context, and I'm only talking about where we are, where viability is a key constitutional threshold.

The article itself illustrates part of the problem: if the law says one cannot abort a fetus for birth defects post-viability, but it says one can abort a fetus with birth defects post-viability if birthing same will present a risk to the mental health of the mother, something that frankly tends to be true of most mothers facing the raising of a severely disabled and permanently dependent child, then it's unclear what's left.

Of course, birth defects are something identifiable in a scientific way, and there will clearly be fetuses who do not have birth defects, taking their mothers out of this classification. As to those mothers, however, given the circumstances that sometimes drive women to abortion, there are probably very few women who given opportunity and resource cannot find a physician willing to indicate a heightened risk of depression, say, in the event of carrying a healthy fetus to term. Indeed, we are a heavily medicated society, and most of us know what to tell a psychiatrist to ensure we'll be prescribed something. This is how an exception comes to devour a rule.

Now, as I said, Bolton may commend nothing less, but in light of more recent rulings it may not be so cut and dried. And as a matter of policy, while I might be more permissive were I in charge, the fact remains that the Court has held that significant restrictions are permissible on post-viability abortions. In light of that fact, and the recent judicial trends, the Court may be moving back toward permitting late term abortions only for imminent physical threats to the mother.

While, when it comes to mental disorders suicide is often a risk, it's statistically insignificant alongside the threat posed by certain physical complications for certain mothers preparing to give birth. In the context of a viability-driven jurisprudence, I have trouble providing a nuanced account, which honors the state of the law as it is, that doesn't allow (as distinct from compelling) such a distinction. And I don't think the insurance issue is all that apposite to the question at hand.

I'm sure this is all amenable of the "nonsense" response but, you know, I'm still trying to examine the question posed, and curious to hear what you might say if you spoke at more length.

And to tie this back to Obama, you're free to stay home come November, and make it one vote more likely that the man elected won't believe in abortion at all.

Posted by: moon at July 5, 2008 04:13 PM | PERMALINK
Post a comment









Remember personal info?