I’ve always said to people who ask why I’m pro-choice that I believe it’s a decision to be made by the woman in question, in consultation with her doctor and anyone else she seeks to involve (the father, family members, clergy, etc). Which is why this opinion piece by Frances Kissling, the former president of Catholics for a Free Choice, really hit home for me. In it, Kissling posits an uncomfortable question for pro-choice advocates such as myself to consider: say a woman comes to an abortion doctor late in her second trimester of pregnancy. She does not want to continue the pregnancy. However, the fetus is viable and there are no health problems facing either the mother or the fetus, nor are there other tragic circumstances. Performing the abortion may be legal, but does the doctor have a right to say “I’m sorry, but I think you’re doing this for the wrong reasons and I cannot perform this abortion for you”?
It’s a difficult question to consider. After all, one reason why pro-choice advocates support the right to choose is that we believe every woman is best equipped to make the decision for herself. Who is the doctor – or anyone – to deny her the right to do so? But I also believe wholeheartedly in maintaining the integrity of the doctor-patient relationship, and that includes the right of the doctor to tell a patient, “I think you’re doing this for the wrong reasons. Let’s figure something else out or I’ll refer you to someone else.”
Honestly, I’m not quite sure where I stand here. Generally speaking, I do think the doctors have a right to refuse to perform a medical procedure if they do not believe it is in the best interest of the patient. If the patient disagrees with the doctor’s assessment, then the doctor is obligated to refer that person to another doctor who would be more willing to perform whatever the procedure will be. And at the end of the day, abortion is a medical procedure, and the government has absolutely no business interfering with the doctor-patient relationship: the right to consult with a medical professional without fear that the government will try to regulate the conversation or the decision ultimately made. That’s why I was aghast at the Supreme Court ruling that banned a certain late-term abortion procedure. In the vast majority of late-term abortion cases, the woman is facing pretty shitty circumstances. Do we really want a group of old lawyers without medical licenses superseding the doctor’s expert opinion, not to mention the patient’s wishes?
Basically, I’m sympathetic to the idea that a doctor can tell a woman, “Look, this procedure is not medically necessary and you don’t have any other extenuating circumstances that would warrant it. I cannot perform this procedure for you. If you think about it and decide this is still what you would like to do, here is the phone number of Dr. So-and-So who will be more likely to perform it for you.” The same discussion could take place if the patient wanted to have drastic plastic surgery or a radical heart procedure. We consult with doctors because they are experts, after all. We may ultimately disagree with their approach and go to somebody else, but I don’t think a doctor should have to perform a procedure s/he believes is wrong or unnecessary.
I do NOT think that the law should get involved at all – no ethics panels for women considering abortion, no blanket ban on procedures after a certain date, no notification laws – except to require a doctor who does not wish to perform the abortion (or, for that matter, any procedure) to give the would-be patient a referral to another doctor who will.
Of course, even as I type this, I’m having second thoughts. What if the doctor in question is a total jerk and judges the woman’s circumstances unfairly? What if the woman is unable to travel to the office of the doctor to whom she is referred? So no, I’m not totally convinced that Kissling is right. But it’s something worth considering.
