Pro-Abortion MDs Refused to Help Craft Informed Health Exceptions to Later-Term Ban

By Wesley J. Smith

And now they are bragging about it in the New England Journal of Medicine. From, “The Ethics of Abortion Care Advocacy–Making Exceptions to the Rule”:

Lawmakers proposing abortion bans sometimes seek guidance from Ob/Gyns on potential lists of exceptions to incorporate into such bans. Creating lists defining when abortion is medically necessary places clinicians in the ethically fraught position of providing input on laws that will harm patients.

Well, limitations sure don’t hurt the babies that are born–which from what I understand, are counted in the many thousands since Dobbs, precious people who will now have the opportunity live full lives.


Despite our commitment to advocacy, when legislators asked us to provide lists of maternal or fetal health exceptions to incorporate into the law, we refused. We felt strongly that legitimizing exclusions was unethical, and we implored legislators to have compassion for people needing abortions after 12 weeks. Although 90% of abortions in the United States occur in the first trimester, bans based on gestational age disproportionately affect young people and low-income people, and the gestational-age limits used in such policies are often too early for many fetal genetic and anatomical diagnoses to be established.

Although not providing a list of possible exceptions risked a less medically informed bill, we found it ethically problematic to attempt to protect certain patients’ access to abortion care while compromising care for others. If clinicians engage in negotiations that lead to restrictions on abortion, we fail to uphold our duty of nonmaleficence, since patients who have conditions that aren’t deemed “exception-worthy” are harmed.

Of course, that ignores another patient, the gestating baby.

Why allow a “less medically informed” law to be enacted? Ideology:

Limiting access to abortion care by means of exclusionary lists exacerbates health injustices and disproportionately harms disenfranchised and marginalized patients, since more privileged patients are more likely to have timely access to care and to be able to travel for abortion care. Enacting exclusions also further stigmatizes abortion care and creates a false dichotomy between acceptable and unacceptable care. We care for patients with myriad personal and compelling reasons for seeking abortion care. These reasons often aren’t reflected in exceptions included in abortion bans. In addition, when legislators receive lists of exceptions from physicians, they tend to promote their legislation as being approved by doctors, even if the physicians involved were primarily trying to reduce harm.

And then they yell that the laws passed in states restricting an atmosphere of open season against fetuses are ham-fisted.

And they seem to prefer abortion to birth:

When carrying a pregnancy to term is 14 times as likely as undergoing legal abortion to lead to death, some would argue that the risk associated with pregnancy alone is sufficient to merit care.

By “to merit care,” they mean killing the gestating baby.

There is a strongly implied threat to cease practicing obstetrics if abortion isn’t open-ended:

How long can thoughtful, compassionate clinicians continue to practice obstetrics when laws prohibit them from providing necessary care to their patients? These laws exact a high cost not only on patients, but also on clinicians.

And pro-lifers have to admit they are wrong!

Until we find a way to start discussions from common ground — acknowledging that abortion is health care — the most effective way of advocating for our patients may be to bear witness to how care, or the absence of it, shapes their lives.

For many Americans, abortion is fraught with conflicting ethical and moral considerations, and polls show, that majorities are not absolutists either way. But it seems to me that the pro-life side focuses on both protecting the unborn baby and helping mothers in need. In contrast, for these abortion absolutist professors, the baby’s life isn’t even worth a passing mention, and, it would seem, of no more importance than a burst appendix.


Editor’s note. Wesley’s superb columns appear at National Review Online and are reposted with his permission.