Abortion Coverage in the Government Option

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President Obama and a lot of other fans of the legislation Congress has been working on for health-insurance reform have consistently insisted that there's no plan in the works to have abortions paid for by federal tax money. In his latest volley, the president called pro-lifers' claims to the contrary not true, even a fabrication intended to "discourage people from meeting ... a core ethical and moral obligation."

It's taken them too long, but Factcheck.org has finally chimed in on this issue to confirm almost everything the pro-life side has been saying. Just because it doesn't say the word 'abortion' in the bill doesn't mean it won't cover abortion as part of reproductive health. Given the history of what that term has been used to mean, it almost certainly would be used for that and certainly could be used for that. It doesn't technically mandate such coverage, at least in current forms, but it's hard for me to believe that the people who keep calling this charge a lie are telling the truth when their main argument is the absence of the word 'abortion'. It took the Hyde Amendment to prevent government funding for abortion in the current system. Why wouldn't it take something similar in a new plan that has no such ban?

Now those who think there is a moral obligation for a government health care program to cover abortions should have the freedom to pursue such a policy. But in our political system the way to do that is to propose it openly and not deceive people into thinking something they might support is something other than what it really is. I suspect those who see that as a moral obligation have realized that they can't get it passed if they're honest. So they think the obligation to do it outweighs the obligation to be honest with the voters about what they're doing.

Update: Serge observes something else that's important here. Unless we're going to be so anti-feminist as to define pregnancy as unhealth, the explicit motivation for this bill doesn't support including abortion and indeed undermines it. Starting from the premise that we have a moral obligation as a society to provide basic health care for everyone, then you might think it follows that we ought to treat all illnesses and have the top 10% of earners pay for most of it. But it doesn't follow that such a moral obligation could include something that isn't about health at all. Some do see such a moral obligation with abortion, but if so then it isn't about health care. You don't generally make a pregnant woman more healthy by aborting her pregnancy, even if you might want to argue that it has other benefits. So health insurance reform should not make it even possible that money earmarked for health care should go to something that isn't about providing for someone's health.

18 Comments

Carrying a pregnancy to term involves risks to a woman’s life and health about ten times greater than a first trimester abortion, and since over 90% of induced abortions occur in the first trimester I guess it follows that aborting a pregnancy ‘generally’ does improve a woman’s health.

If true, all that shows is that a pregnancy that doesn't go well can have unhealthy consequences. But that's true of a lot of things that it would be wrong to consider unhealthy in themselves. We don't consider properly-functioning white blood cells or a properly-functioning immune system in general to be unhealthy just because someone can develop an allergy that leads the immune system to overreact with unhealthy consequences. Why should we consider a properly-functioning reproductive system during pregnancy to be unhealthy just because it might not work properly on occasion? The vast majority of abortions are not done to achieve a more healthful purpose, but those who want abortion paid for by the government want all abortions covered. There's simply no place for that in a health care bill even if some cases of abortion might be classified as for healthful purposes (assuming you ignore the health of the fetus).

Babies are vaccinated not because they're unhealthy but so they don't get sick. As I said, over 90% of abortions are first trimester ones done on the grounds that two doctors are of the opinion that continuing with the pregnancy involves risks of injury to the woman’s health greater than if the pregnancy is terminated; and they’re covered under the NHS, in the UK at least. I don’t think American women have a different physiology unless American doctors have a different opinion.

I’ll grant it’s not straightforward to make out what should be covered under a public health system. In Europe there’ve been debates as to whether fertility treatments should be made available under national health schemes and they still go on over the specs e.g. up to what age or how many cycles. But is infertility an illness? Do people have a right to procreate? Your call for health bill provisions to be spelled out sounds prima facie sensible and innocuous enough. But as you apparently inhabit a land where contraceptives can be abortifacient and abortions can be partially births perhaps it follows that contraception is a partial birth, or perhaps it doesn’t; one’s reminded of Humpty Dumpty. So why are health services to women particularly under dispute? Is there some associated proposal that women should pay fewer taxes or lower health premiums compared to men? If women can’t afford the cost of their contraceptive supplies there’s bound to be an increase in demand for abortion and if women have to put the money together first there’s bound to be greater demand for later abortions, neither of which you’d welcome I expect. You’ve expressed concerns before over the way the ‘abortion industry’ functions in the US, so I thought you’d jump at the chance to tame that industry through a public option and even favour abortion only being available under a public scheme. Where have I got you wrong?

I did some Googling to find some statistics on reasons women give for abortion, and the three sites that actually answered that question (here, here, here) seemed far removed from the statistics you're giving. Now maybe you're right, and the numbers you give are correct in Europe. If there's anything I can think of to explain that, it might be that there's much less of a culture of having abortions for convenience in Europe. I know that in some European countries, including one that I general consider socially liberal, abortion doesn't happen much except for when a team of two doctors, one who isn't the woman's own doctor, deems it medically necessary, and the procedure known as partial-birth abortion is illegal.

I can see the prima facie argument for promoting things that lower abortion rates, but I don't think I should be expected to support just anything that might do that, and I'm not sure that government payment for abortions is going to do that even if other things falling under reproductive health will. I'm all for health insurance plans to cover contraception, but as you know I don't think it should be limited to hormonal contraception, and one reason unrelated to the effects of those contraceptives is that they don't protect against STDs. I don't have any problem with a government plan providing those, even if I think it's insane that the only way for someone on Medicaid in my city to get them is to go to Planned Parenthood, which I think it's immoral for me to give any business to, or to find an obscure facility that I've never heard of, which is the only other option. It's for that reason (among many others) that I simply don't trust my government to do a good job managing health insurance plans for an even broader group than they already do. I'd much rather find ways to provide health insurance for people already in government plans by other means. I have enough first-hand experience with Medicaid to say flat-out that it completely sucks even if it's an improvement over having to pay out of pocket.

I do appreciate that you’ve gone to some lengths to look into the claim you took me to have made, so I regret not having made it sufficiently clearly. Yes, I did have a European context in mind but the claim was about the medical assessment of comparative risks to pregnant females, which is why I expected it to hold across the Atlantic: The point is that a woman puts her life and health at significantly greater risk if she carries on with a pregnancy than if she has an abortion in the first trimester. The risks associated with having an early abortion are consequently outweighed by the risks of carrying a pregnancy to term. (So seeking IVF or failing to use contraception or having a baby rather than a first-trimester abortion may be irrational; I don’t see any problem with that.) Any reasons given by the women themselves for seeking an abortion don’t impact on the assessment that, ceteris paribus, in terms of comparative risks to life and health a first-trimester abortion is sufficiently medically warranted on health grounds alone.

I take the hint about 'the procedure known as partial-birth abortion' being outlawed in some European country or other. I didn’t mean to sound insulting; indeed I’m glad if we can sometimes still agree on what may be a reductio. I think I’m just prone to detect or project humour in situations; which is why I thought of Alice and Humpty Dumpty.

I think I can imagine the extent of your involvement with health services with four young children in the house and it’s sad you’re so dissatisfied with the service you’re getting; kids, and parents, deserve better. I’ve found e.g. suburban railway infrastructure in the US to be of museum quality. I guess this is because people don’t use it and people don’t use it because it is so; unless they have no other choice. I also suspect there’s no public service tradition in the US so a public sector career isn’t seen as worthy or attractive to high quality job seekers; there may be self-perpetuating perceptions of nepotism and corruption or that people who join the civil service are those who can’t make it in the private sector etc. I can’t understand why to fill a prescription one may have to travel to obscure places, probably not served by public transport. I’m fairly confident people can fill in prescriptions in any pharmacy pretty much everywhere in Europe. Perhaps chemists in the US aren’t ‘affiliated’ because of the fragmentation in your health care system, but that’s something that would be overturned by a critical mass of customers to serve. So there may be some vicious circles to be broken, if you care to break them; you may be worried the US will turn into some ‘European state’ or worse if you do.

I think you’re right that publicly funding abortion services will not necessarily lower abortion rates; it will curb suspicions of market pressure. You’d claimed that Planned Parenthood paid doctors handsomely and allegedly broke the law in order to maximise the number of abortions they did. I wonder what the evidence is and if anyone bothered to blow the whistle; because filling in prescriptions for contraceptives must be the daftest way to increase demand for abortion. I think you may be unreasonably antagonistic to Planned Parenthood, which is a pity. Because I don’t see how pro-lifers may expect there to be an exception in cases of rape unless there are doctors prepared to offer abortion services in such cases. Nor do I see how they might blame those doctors if they’re also prepared to offer their services in other cases along 'Thomson's line'. Consistency isn’t a charge.

Your argument assumes that medical grounds shouldn't be concerned with the health of the fetus. That strikes me as an odd medical concern. If I could improve my own health by sucking away the life force of other beings like a vampire, that wouldn't make it medically grounded for me to do so, and this is so even if my own life force somehow were being sapped and needed the others' life force to continue on.

I also see reproductive health as including properly-functioning reproductive capabilities in carrying out their proper function. The way you're presenting it, any use of those organs for their reproductive purpose is automatically unhealthy. That's as close to a reductio as you can get. The fact that proper use of my ears (as opposed to wearing earplugs all the time) risks hearing loss if I happen to be around loud sounds doesn't make it healthier to wear earplugs every moment of the day. The fact that proper use of my lungs (as opposed to wearing a gas mask whenever I'm outside) might risk infection doesn't mean I'm being healthy by wearing a gas mask all the time. You might get a health benefit in a smaller arena by doing something that in general seems to frustrate proper function. I don't think health insurance companies should provide gas masks except in extreme cases, where someone medically needs something like that to prevent almost-certain infection because of an immune deficiency or an extremely serious allergy. It's good to wear earplugs at concerts, but it's artificial and not health-conducive to do so all the time, because it frustrates proper function. I'd say that even condom use can be health-conducive but is intrinsically frustrating to proper function, so there ought to be good moral reasons for their use (as often there are). By the sake token, abortion seems intrinsically frustrating to proper function even if you ignore the moral issues (which I don't think you can do). So it seems like there could only be extreme cases where you might argue for their place in a bill like this, cases where the health issues are important enough to outweigh the fact that there's an instrinsic element of unhealth to a process that can be described as healthy in itself, even if there might be negative consequences for health that arise from it. When you factor in the moral issues, the case for including it gets much harder, but I don't think you even need that to make the point I'm making.

Planned Parenthood hasn't had many whistleblowers but has been subject to journalistic investigations that have revealed some pretty troubling things. They've covered up statutory rape when they knew full well that a crime had occurred, a crime they have a moral obligation to report and a legal obligation not to cover up. They've covered up the ages of patients in order to get around parental consent or notification laws. They target minority communities, something deeply suspicious given their history of eugenics-motivated social engineering. Some employees have been found willing to accept donations with the stipulation that they earmark the funds for abortions sought by black women. They oppose any restriction whatsoever on abortion, no matter how popularly-supported it might be and no matter how small an inconvenience it might be for someone wanting an abortion. Is it seriously a burden to someone to wait 24 hours before having an abortion? They fight tooth and nail to prevent crisis pregnancy centers from presenting information about fetal development at different stages or requiring informed consent for anyone seeking an abortion, to the point where the kind of subterfuge involved rivals that of those who resist any teaching about contraception in sex ed classes. Unless you fear they might decide to have the baby and want to ensure as many abortions as possible, it's hard to imagine why they oppose such things.

My argument assumes that doctors in the US concur with doctors in Europe over the assessment that, on balance, God seems to provide better for women having a termination in the first trimester than for women having a baby in the third. If this sounds close to a reductio, perhaps it’s the divine sense of humour; but as you were discussing health bill provisions I thought the fact was worth pointing out.

I also thought that abortion coverage under a public option would be attractive to those concerned to prevent the kind of activity Planned Parenthood is suspected of. I admit I’ve got a bit confused over procedure; I’m not clear if crisis pregnancy centres and PP are complementary services or business competitors, so that women have to attend a pregnancy centre first to get informed consent forms signed and then go to PP the following day to have an abortion, or who precisely it falls to when to establish eligibility and comply with reporting requirements. I also fail to see what doctors may stand to gain from covering up a case of rape, unless they’re somehow bound to do it for free in such instances, which sounds like the right thing to do but may also be an incentive to under-report rape; which is sad.

I’ll grant that the consequences of having to wait for 24 hours before having an abortion may not always be as serious as the consequences of being sent home for 24 hours on election-day! But if people are presumed to have considered the options and made their choice before they present at the ballot box, it does sound sexist to have a 24-hour-sleep-over-it rule affecting just women. And I guess it would be a burden on people of limited means if they have to make multiple trips to some obscure place in your city in those suburban railway carriages I have in mind, especially if it entails repeatedly organising childcare or taking additional time off work. (Perhaps this is the reason donors wish to earmark funds for the benefit of minority women, assuming it’s legal to do so; because if it’s not legal, donors won’t be able to receive assurances that their money has been spent as intended and PP staff might as well pocket it.) An interesting question is how many women don’t keep follow-up appointments, because they’ve changed their mind overnight rather than because they had a traffic accident on the mandatory return trip or fell asleep during the foetal development class; though of course voters changing their minds overnight doesn’t affect the previous day’s election results. Irrespective of PP's alleged policies, the pro-choice position is not a pro-abortion stance; so I guess I don’t see why pro-choicers and pro-lifers can’t agree that abortion is best covered under a public option scheme like presumably they agree an election is best conducted by public servants, without fear or favour.

Crisis pregnancy centers are pro-life centers committed to helping women find alternatives to abortion. They provide the information necessary to informed consent, something Planned Parenthood generally resists doing. There's nothing compulsory about crisis pregnancy centers. If organizations like Planned Parenthood weren't bent on keeping the abortion count as high as possible through deception, there would be much less need for crisis pregnancy centers, but as it is the pro-choice activists are seeking to shut down any crisis pregnancy centers on the argument that if they show a pregnant woman an ultrasound it counts as emotional manipulation and undermines infirmed consent, when it in fact does the opposite. Now-disgraced former governor of New York Elliott Spitzer, when he was the state's attorney general, led a major campaign to have these centers shut down, at Planned Parenthood's insistence. But all they do at these centers is try to care for the needs of pregnant women, provide them information, and argue that there are plenty of options besides abortion. It's a silencing of informed consent.

I don't think it's the doctors who are not reporting the rape. It's the political activists who work at the centers and do intake or counseling. They probably think they're serving the interest of privacy. That's the argument they've given when they resisted providing this information to the authorities when it was requested. But they contribute to a structure of the oppression of women every bit as much as any kind of institutional sexism that feminists will observe and point out. Most of them just don't want to do so in this case, because it treads on their sacred cow.

The 24-hour rule affecting just women wouldn't affect just women if fathers had some role in abortion decisions. Do you want to go that route? Otherwise, it's certainly not unfair to women to give them 24 hours to think about it when they tell men flat-out that they have no say in whether their offspring can live but do have to pay child support even if their child's mother goes against their wishes when they tried as hard as they could to prevent the circumstances leading to their obligation to pay child support, but women can get out of responsibility for caring for a child by waiting 24 hours and having an abortion. In that respect, there's no argument here that the 24-hour waiting period is unfair to the women when compared to what the man faces in the same situation.

I'm not sure 24-hour waiting periods require multiple trips. It can be done to avoid that, anyway. As long as the information necessary for informed consent gets to the woman 24 hours before the abortion takes place, I think those pursuing this restriction would be happy. This can be done by having pro-life clinics all over the place to provide the first service. That would seriously anger pro-choicers, but the irony is that they would be fighting not just informed consent but easier access to abortion in resisting such a thing.

Some people may want to earmark money for minority women seeking abortions for the reason you give, but the callers in question were fake in this case, and they explicitly stated eugenics reasons with the desire to prevent as many minority women, and the Planned Parenthood donor line operators often responded with lines like, "That's very understandable."

Planned Parenthood donor line operators probably understand things I don’t about the American mind. I still can’t tell if you agree that it would be sensible to have abortion covered under a public option, perhaps exclusively, or not; I can't believe you'd resist a departure from the status quo just so you be able to whine.

I understand that the doctor who will perform a medical procedure like abortion is required to obtain informed consent before going ahead; I expect you don’t dispute that in the overwhelming majority of abortion cases, i.e. early on, any doctor acting in good faith will have to tell a pregnant woman that she’s bound to be better off if she has an abortion than if she doesn’t. How can a woman who wants to have an abortion be put off by being told this 24 hours in advance? Are ultrasounds always necessary at that stage? They cost money. Of course a woman faced with an unintended pregnancy is not obliged to have an abortion. She may want to explore alternatives instead. But why would she need to see a doctor or sign a consent form to do that?

You haven’t said anything about the effectiveness of the 24-hour rule; how many women don’t keep follow-up appointments because they’ve changed their minds. And I’m not sure it makes sense to ask how many women change their minds after visiting crisis pregnancy centres either. Because if these centres are committed to helping women find alternatives to abortion, they serve a self-selected population, i.e. pregnant women who don’t want to have an abortion; those looking for an abortion will presumably go to PP instead. To be honest what you describe looks like a circus to me. If you focus on user requirements, you need a one-stop service point and non-directive counselling. I agree having clinics all over the place sounds great, and I ask what would be wrong in your view if they were staffed by government employees rather than political activists.

Incidentally, I’m not afraid to go down any route! I just fail to see how ‘the 24-hour rule affecting just women wouldn't affect just women if fathers had some role in abortion decisions’. Don’t the choices of female voters affect the male population also? Or do you mean if we were seahorses instead of humans, or some other counterfactual? I do tend to get lost without my truth tables. I thought you considered men likely to push women into having an abortion; that you wanted feminists to realise that they should better carry all unintentional pregnancies to term and sit back and rejoice watching the men pay! So why would you risk bringing men in? In each case would you know which man to bring in? Or would you encourage pregnant women to tell through the employment of strictly legal interrogation techniques? More seriously, I think you’ve put your finger on a real issue here, though it complicates this discussion unnecessarily. What you could have said is that women seeking ante-natal care should also receive counselling over the alternatives to having a baby and briefed about the comparative risks of aborting vs carrying to term and sent home for 24-hours to think about it. That might do.

What’s the ‘sacred cow’ of those who ‘contribute to a structure of the oppression of women every bit as much as any kind of institutional sexism’ I can’t tell. Yours must be ‘proper function’ though! I note the emotive language and I gather it’s something I said. There is a ‘cultural distance’ of course. This whole debate about universal health care sounds unreal; that people should lose their health insurance with their job sounds absurd. Some issues just aren’t ‘live’ any more in Europe; this doesn’t mean they’re perfectly settled but they are settled in principle.

I agree people may be oblivious to the motives of prospective donors to pet projects. I’m just not sure why they shouldn’t be or when. As long as there’s no dedicated budget line I can’t see why you shouldn’t accept general donations from people who intend them for eugenic reasons or for the benefit of pregnant extraterrestrials. What if a donor incidentally admits to an intention to avoid tax? Is it any different if the intent is to evade tax? What would Paul do if Lydia said that?! Just to finish on a lighter note.

I would be in favor of revoking the license of any doctor who did anything as irresponsible as telling a newly-pregnant woman that she'd be better off having an abortion.

The cost is not the argument pro-choice advocates use against ultrasounds. Their resistance is entirely due to the fact that it might make women uncomfortable at having to see the fetus they're about to kill. In other words, they oppose informed consent because there won't be as many abortions if women have a better understanding of what they're actually doing when they kill their child.

My understanding from talking to people who have volunteered at crisis pregnancy centers is that a lot of women who go to them enter with the expectation that they will have an abortion, and they don't always know that it's a pro-life center. Many of them are undecided and just want to talk to someone uninvolved with their situation. Those who have opposed such centers, such as Planned Parenthood and former New York Governor Eliot Spitzer (who tried to shut down all the centers in the state when he was Attorney General) have claimed (falsely from all I've been able to discern) that these centers mislead people and coerce them into not having an abortion, an argument they wouldn't bother to make if they didn't think these centers were effective.

I'm not sure why it would be in principle bad for government employees to be the ones who share information about pregnancy, the capabilities of an early fetus, and the negative consequences of having an abortion, at least if we could trust them to provide the information accurately. That would be much better than what some government employees spend their time doing. I'm not opposing government distribution of information. I'm opposing government funding for abortions.

The issue with men and abortion decisions is that women have an absolute right in the U.S. under Supreme Court fiat to reproductive choice that allows them to get out of all responsibility for raising a child by killing the child at the fetal stage, as long as they do so early enough. Men have no such right to get out of child-rearing responsibilities. I think it's evil to want to get out of being responsible for your children, even if killing isn't involved. But there's clearly a gender disparity here and not one of the usual male-favoring ones. Men are expected to pay child support and can't do anything about it, while women can. I'm not proposing remedying it by giving men the right to dictate that a woman have an abortion (which was the issue where I was pointing out coercion can occur). If men had a right to the birth of their child if medically possible and safe, that would remove one aspect of the disparity (although I think you have a disparity on this issue no matter what you do). But it would never happen. What I was saying, though, wasn't to advocate that men's role in abortion decisions should be expanded but to point out that men already have no option either way with abortion. The decision is legally only the woman's. You were complaining that the 24-hour rule affects only women. I was pointing out that women have a lot more control over this than men do, so the 24-hour wait shouldn't be seen as a ridiculous burden.

As far as I know, people don't lose health insurance when they lose their job. There are options to continue it or to move to public insurance for those who quality. Continuing it is expensive (although much less expensive than just buying it upfront), and they work it out so that you can get it retroactively (and thus not pay for it unless you need it, and then you need to pay for it for the time you lapsed). It involves more paperwork, but I had to rely on that as a safety net for a few months one time. But your status certainly changes with job loss.

The Planned Parenthood callers weren't just saying they intended it to go for abortions of black moms. They were asking for Planned Parenthood's assurance that it would be dedicated toward that, and I thought some of the workers were actually giving such assurance. But I think there are a lot of people who would insist that they not accept such donations and would be very upset if they knew they were responding the way they did.

‘That would be much better than what some government employees spend their time doing.’

That’s a great line; thanks for making me smile. I appreciate you seem open minded, and I admit I keep forgetting about the Supreme Court decision. To my mind it’s a women’s health issue and excluding abortion costs is sex discrimination. I do miss hard figures about the effectiveness of 24-hour rules or CPCs. I’m not quite sure how to take the claim that people wouldn’t want to close CPCs unless they were effective. Is the 24-hour rule still in effect because it’s ineffective?

But I’d like to go back to the voting metaphor, if you don’t mind. If you’re suggesting that all prospective Republican voters should self-identify and report to local Democratic HQs to attend a mandatory lecture on the virtues of Democratic ideology before they can get to cast a valid Republican vote, and they’d better hurry or the polling booths will close, the reason I know you must be joking is because where there’s no privacy there are no booths! Correct? (Well, perhaps I substituted ‘Democratic’ for ‘Republican’ but it will do.) When people come forward to exercise their rights in some way you may disapprove of it’s the wrong time to have those deemed unworthy of the privilege educated by those who know better. Actually, it’s illegal in Europe to campaign on election-day. Where were you during the election campaign?

I bet you think there’s some asymmetry here but until you can put your finger on it, it seems to me that you overestimate the merits of your position. We could show a woman an ultrasound pic and comment how cute it looks and that it’s waving to mummy but she wouldn’t be able to tell a human from a pig embryo unless she’s a developmental biologist. OK, it may be a fact that human embryos have tails. But it’s also a fact that a woman is ten times more likely to die if she carries on with a pregnancy than if she has an early abortion and I can’t see why she shouldn’t be told that also, while her options are still open, or why the doctor should be struck off the register, unless we’re being deliberately selective with ‘facts’ and playing for time, aiming to shove the woman into a cul-de-sac till the option self-extinguishes.

I don’t see why PP would accuse CPC of manipulating women, or why Mr Spitzer would have taken up PP’s cause unless some women actually complained that they felt manipulated by CPC. Was it just some pregnant PP activist who attended a CPC posing as a client, like CPC activists presumably make prank calls to PP donor lines posing as benefactors? I think it would be more apt if CPCs were called ‘ATA’, ‘Alternatives to Abortion’ or something, since ‘Crisis Pregnancy Centre’ seems to create false expectations; unless CPCs deliberately intend to create confusion and deceive as to their mandate, in which case it's deplorable to accuse PP of deception instead. I also fail to see how PP could be threatened by the ‘effectiveness’ of CPCs if, as you said, PP also give out prescriptions for contraceptives. Do CPCs also hand out those condoms that you’d like to see being handed out for free? Because if they don’t, CPCs arguably do more to boost PP’s business than PP does.

So I hope the point of making a woman faced with an unwanted pregnancy watch an ultrasound isn’t to convince the woman that her pregnancy is not ‘really’ unwanted. Because if your idea of informed consent is that people ‘choose’ to do what you want them to and that you’ll keep ‘informing’ them till they ‘freely’ do it, then if you’re no advocate of fascism you’d have made Stalin proud! Especially in a context where basic quality of life issues like health care are still under dispute; where a major concern is to ensure that ‘illegal aliens’ can only be exploited for cheap labour till they need to see a doctor, when they’ll be refused medical attention and left out to rot. Is that why you think the American ways are ‘superior’ to Europe’s? No, the US is not the place where that platonic nursery will be set up to receive and provide for one million unwanted babies each year; because people just aren’t prepared to put their hands in their pockets to finance the budget. And those who have own agendas and better things to do with their precious resources had better not preach to others, I think.

Those who are ‘pro-life-with-a-little-rape-exception’ need to put their house in order and keep a lower profile in the meantime. I think it unreasonable to expect PP doctors to do our bidding in all and only those instances when we happen to support an exception even though there’s no moral justification for it. We should know that once we’ve crossed that line we can no longer occupy the high ground and call PP doctors ‘moral monsters’ who commit ‘despicable acts’. That’s launching a boomerang. Because PP doctors are doing our work even if they also do other work we may disapprove of. What’s there to stop them from the other stuff but our arbitrary disapproval? How can our own pet exception lacking in moral justification be any more morally justified than the rest unless it’s because it’s our own?

It sounds unreasonable to seek to fault Thomson or Obama for failing to pinpoint precisely when life begins or its exact value where one’s already been granted more than one ever asked for. If I owe you nothing because I’m content to have overpaid my debt, insisting we sit down to do a minute calculation sounds pedantic; go home, do the math and you can keep the change! Just please don’t blame those who can’t get interested in the exercise.

I expect PP have a legal obligation to publish audited accounts. It should be easy enough to establish if there’s a budget line dedicated to ‘black women’; if there isn’t, any assurance about spending donations for their benefit is ultra vires and void. Volunteers need training too.

I’m puzzled over the male involvement scenario continuation: What does it mean ‘If men had a right to the birth of their child if medically possible and safe, that would remove one aspect of the disparity’? Is this a science fiction where men can be turned into male seahorses? I’ll admit when you asked if I’d like to go the route of giving men a say in abortion decisions, rhetorically and pre-empting my response ‘otherwise’, I didn’t know what to think. Were you threatening with thicker layers of paternalism unless I recant? Because I’d dared suggest the 24-hour rule is sexist? You sounded like something right out of ‘The Crucible’! Perhaps you didn’t appreciate the analogy with voting; I thought that was a fair point to make, as well as funny, which is why I made it: To put a smile on your face at the same time, not to get on your nerves. I think it was all in my mind; I was projecting my worst prejudices onto you, and I’m glad this was so. I just wonder if it crossed your mind that you may be projecting own prejudices too sometimes. Because I think your attitude towards PP and Obama is unreasonably hostile.

I think it would actually be misinformation to tell a woman that she's ten times more likely to die if she continues her pregnancy than if she has an abortion. Even if that statistic is true, it's entirely misleading, because the chance of dying is so low that ten times more likely isn't a lot more likely. You can spread misinformation without saying anything false.

The numbers I'm finding are a 1 in 2100 chance of dying in pregnancy in a developed country (and we're talking about the laws of a developed country here, since we're talking about U.S. law). 1 in 2100 is so low that if all you said is the "ten times more likely" figure (and you knew the full information) I'd be willing to call it deception. Unless a woman has a particular medical situation that makes it more likely, it ought to be clear how low that chance is. It's basically negligible for most women. People do a lot more dangerous things every day than continuing with a pregnancy, e.g. getting in a motor vehicle.

I'm not sure what you're trying to do with the voting analogy. I'm all for voters being better educated, but I don't see how mandating that is in the same category as mandating informed consent about what medical personnel do to your body.

I'm also not sure what your "overpaid my debt" comment refers to. Are you saying Thomson and Obama have erred on the side of caution by granting more than their arguments require? I can see how you'd say that of Thomson by her granting personhood and then still arguing for abortion (although I disagree with her argument from that assumption anyway). What I've said about Obama, though, is that he doesn't do that. He talks about how reasonable people can disagree on the issue, but then he goes ahead and acts as if reasonable people whose consciences can't tolerate paying for something they consider murder and oppose their government allowing that sort of thing should just suck it up. Erring on the side of caution means not allowing it unless you can be sure it's morally allowable. If Obama is really being honest when he says he doesn't think we can answer the metaphysical question, and he's really being honest when he says reasonable people can disagree on the ethical question, then he should recognize that everything he's said implies that it's epistemically possible (for all he knows) that he's tolerating murder. I think that's what his statements do imply. I can see how someone who thinks moral rights appear gradually won't want to parse exactly where they begin, but his official view is that he doesn't have any idea how to answer such a question. It was above his pay grade as a senator who had to vote on such things, and I imagine he thinks it's still above his much higher paygrade (because I don't think he was talking about actual salary). He dodged the question, not because he hasn't thought about it, but because he didn't think he could politically be honest. But I'll take his words seriously and point out how they conflict with his actions, and you're faulting me for holding him accountable for what he said.

My comment about men and abortion decisions was simply to point out that there are unavoidable gender disparities no matter how you set the policy. If men have sole authority in deciding if their offspring can be aborted, women have no say. That's unfair. If men and women have to agree to abort, women who bear the greater burden are having only an equal say. If men and women both have to agree to continue the pregnancy, women won't continue without consent, but they also won't be able to have a child the father doesn't want, and since women bear the greater burden there's something unfair still about giving them equal say. But if women have the sole burden, there's an inequity with men if the man can't get out of responsibility for paying child support when he does all he can to prevent the pregnancy and to prevent the birth once pregnancy has occurred, but it's not as if you can selectively figure out who made such attempts when you determine child support. So on the strict question of whether there's a gender inequity all I'm saying is that you're stuck with some gender inequity no matter what you do. You could remove the gender inequity with 24-hour waiting periods by having men more involved with the process of making the decision, and then the men would have to wait 24 hours too, but it adds a further gender inequity by taking more power from the woman. Adding a requirement for a 24-hour waiting period does add a requirement for a woman that a man doesn't face, but the reason he doesn't face it is because he isn't legally responsible for the decision, and I doubt you'd want to change that, so it seems the woman's ability to face a 24-hour waiting period simply means she already has more decision-making ability than the father does. So I'm not seeing a problem here.

You may be glad to hear that I think you’re overestimating the chances of maternal death in a developed country by a factor of 5; I say ‘may' be glad, because this means you’re overestimating the chances of a woman dying as a result of abortion by the same factor. So whilst I admire your valiant effort to defend the indefensible, I can’t accept that when the chance of dying as a result of abortion is so low then ‘ten times more likely isn't a lot more likely’; because whether ten times more amounts to ‘a lot’ or not, in absolute terms, it’s still ‘ten times more’. I have no objection to quoting absolute figures and drawing comparisons to put risks in context; but it’s the standard rationale for any medical intervention that the risks of doing nothing outweigh the risks of intervening.

We’re only considering the chance of death of course. How about the hugely greater risk of undergoing major surgery, at 1:3 in the US, or of becoming depressed or psychotic? In many European countries there’s specific legal provision for treating leniently women who commit murder within a year of giving birth. Of course you’re right that it’s sometimes possible to pick those women mostly at risk: Being poor or being black are risk factors, and the variables aren’t independent. I fully agree with you that one can spread misinformation without saying anything false: If a doctor only tells a pregnant woman considering to have an abortion that if she has the abortion the chance of her dying is 1:100,000 and omits mentioning that otherwise the chance of her dying is 10 times greater, then that doctor is misinforming the woman; and doctors know better than to do that, however ‘pro-life’ they may be.

But I get the impression that by ‘informed consent to abortion’ you mean something other than what doctors mean by it. What you seem to want to do, since you oppose abortion, is to intercept the pregnant woman on her way to the doctor to make sure she’s considered those ‘plenty of alternatives’. Fine; but then how can you fail to see the analogy with voting if all and only Republican voters should report for that mandatory lecture before they can cast a vote that will be considered valid by the opposition? Of course for the plan to work one needs to be able to tell which pregnant woman has decided to have an abortion or which elector has decided to vote Republican. This is why I said there should be no need for booths at the polling stations since there’s no privacy or confidentiality in such a parody of an election. The point is that there are no corresponding obligations for those who opt not to vote for the Republicans, e.g. that they should be made aware of the alternatives also. In this 'free' election there's a ‘default option’, which is voting against the Republicans, and only those who choose to vote for them have to satisfy additional requirements before they can cast a valid vote. Says who?

I did try to help you out when I said you could have suggested all pregnant women should receive counselling over their options and be sent home for 24-hours to think about it; but I doubt you realised quite what I was trying to do since your reaction was you wanted to strike doctors off the register. I also think when I say the 24-hour rule is sexist you read me as claiming that you are sexist. This is wrong. I have no reason to doubt what you say and have no access to your intentions other than what you tell me. I’d claim that positions you support effectively discriminate against women, whether it’s the 24-hour rule or the apparently arbitrary refusal to have abortion covered under a public health scheme. You may not be intent on direct or indirect sex discrimination but that’s what the legislation you favour amounts to. That you see no other means to achieve your laudable ends or that you're stuck with some gender inequity no matter what you do is right until humans can get to reproduce exosomatically like fish or something. How the 24-hour rule can be some ‘concession in exchange’ for keeping men out of abortion decisions is beyond me. But I'm not asking for any favours: Bring the men in and see what happens, if you can get them to come in and if you can find/identify them in the first place!

It’s a pity you couldn’t come up with any performance measure for the 24-hour rule. I admit it bothers me when people seem oblivious to the efficiency of rules and regulations, as if piously keeping them in a book is a badge of honour and a value in itself. And irrespective of the cost which, inevitably as well as habitually, just ‘happen’ to be born exclusively by women. So, to concentrate the minds of those favouring sleeping-over-it, one could seek reimbursement for ‘compliance costs’ against the state or federal budget: Women should be entitled to get compensated for loss of earnings, childcare costs and either additional travel or overnight accommodation costs, against receipt. This would be an incentive for bureaucrats to assess the rule and scrap it if it ‘fails to do work’, like one drops a question from a multiple-choice questionnaire if everyone gets the answer right or everyone gets it wrong. Women should also have an entitlement to actuarially reduced insurance premiums, to compensate for reproductive health exemptions to be paid out of pocket. How does that sound?

You got me right about Thomson; I regret I can’t see Obama’s fault. Should he take the view that if the death penalty is still in the books in the US it’s because Americans wouldn’t allow anything unless they’re sure it's morally allowable and it’s epistemically impossible for the US to be wrong? I guess it’s my turn to exclaim ‘come on’; you could be committing worse than murder when you take the kids to MacDonald’s ‘for all you know’.

Risks of doing nothing can be compared with risks of interfering only if there are no other issues on the table. I'm not sure how you could consider those the only morally relevant issues with abortion. I don't think those are the only issues that matter for what counts as natural or for what we ought to do.

Maybe this explains why you have so much trouble accepting the consistency of not having a default option for elections but having a default option when it comes to pregnancy. I don't think it should even be merely a default. I think there should be an incredibly strong burden of proof to meet in order to justify an abortion. But given the legality of abortion, I'm all in favor of attempts to make continuation of pregnancy the default option. If we legalized the killing of terminally ill people on the ground that they're going to die anyway, is there any reason to consider it unduly biased that we might also at the same time set up constraints to make it very difficult for someone to meet the requirements necessary to achieve such a killing legally? I don't think that's unduly biased, even if it is biased in the bare sense of favoring one option over the other. There are moral reasons to favor one over the other, and those are moral reasons that outweigh the consequentialist arguments you're giving against them.

My refusal to have abortion covered by public fundings isn't arbitrary. It comes from my resistance to being made to be an instrument of something I consider immoral.

My point with the inability to remove ourselves from gender inequity was merely that its inevitability should caution us from abandoning a policy merely because it has that effect. In some issues, virtually anything we do will have a gender inequity effect. The question is which policies are worth implementing all things said. That one policy happens to have a gender inequity effect isn't a strong argument in light of that, depending perhaps on how severe the inequity is and what other factors are present.

Sorry, but it's hard for me to feel sorry for someone who loses work time for having to wait a day to kill her child. You get much longer waiting periods for most surgery, especially under government-run health care like in Europe. If we can have waiting periods for buying a gun without having to compensate someone purchasing an implement of deadly force, we can certainly afford to have waiting periods for someone to procure the actual use of deadly force on a human organism without feeling sorry for not compensating her for any cost that might incur as a result.

My argument isn't that there's no position according to which someone can say that reasonable people can disagree but nevertheless take a stand on one side of that disagreement. I think reasonable people can disagree about the death penalty, but I have a view on it that I think is correct. Obama may do the same. What I take issue with is his pretense at not having a view. He does have a view, and it's obvious from his actions what it is. He then acts as if he doesn't have a view in order to earn more pro-life votes when he says that it's above his pay grade and that he has no stance on the metaphysical question. It think it's pretty obvious that he does, but during the election he was loath to admit it because he knew it would cost him some votes in the current climate, since pro-life identification seems to be on the increase.

Terminally ill people and convicted people are ‘people’ in a sense fertilised human eggs are not taken to be by most people; so it would take a bit of work to establish parity in the first place though Thomson will grant it for free. But am I alone in having trouble accepting there’s a default option when it comes to pregnancy? I’ve said before there’ve been debates in Europe as to whether fertility treatments should be covered under a public health system, not least because they can be so costly. Is infertility an illness? Do we have a right to procreate? Do we have an obligation to procreate? How many kids should a woman have? Is it immoral of a lesbian or a nun not to seek IVF treatment? I admit I’m at a loss how to answer such questions. Do you have definite views as to ‘what counts as natural or for what we ought to do’ yourself? I also have trouble accepting that rules creating difficulties just for women in the exercise of their legal rights aren’t sexist.

I still can’t tell precisely what the objective of the 24-hour rule is or if it’s achieved because you haven’t told me. Does anyone know if the 24-hour thing has the intended effect? Because if it doesn’t then it’s a waste of both the women’s and other taxpayers’ money that could be put to better use elsewhere, e.g. in providing housing subsidies for single parents, don’t you think? You’re right there can be queues for surgery in Europe but there’re none for female patients exclusively or for certain operations only. So I’m sorry too if you’re content to have taxpayer’s money wasted just so as to give a hard time to women you disagree with. And by the way, here’s this article on the BBC site this week, http://news.bbc.co.uk/2/hi/americas/8325685.stm, and here’s the summary: ‘The US spends more money on mothers' health than any other nation in the world, yet women in America are more likely to die during childbirth than they are in most other developed countries, according to the OECD and WHO.’

I think ‘gender equity’ is a red herring: If it’s wrong for a woman to have an abortion, it can’t be any better if there’s some male party who also wants the woman to have it. You seem to forget other parties or their interests anyway as soon as a woman is prepared to carry to term or agree to adoption. You’re too quick to dismiss scenarios on my account and I don’t see why: I’m sympathetic to the plight of a man who may find himself becoming liable for child support payment while he took reasonable precautions to avoid a pregnancy or took the woman’s word that she did. He’ll certainly not become liable if the woman has an abortion; so the 24-hour rule can’t be meant to protect this guy’s interests. He’ll only exercise a veto against the woman continuing with the pregnancy: I think that’s why you don’t want him to have a veto, not because I wouldn’t want you to give it to him! If the pregnant woman could overturn his veto by releasing him from any financial or other obligation, why would you object in principle? You don’t object in principle to the woman being released from any financial or other obligation by giving up for adoption.

You also think there’s another kind of male who’s so strongly pro-kids that if a woman unilaterally decides on abortion that man’s legitimate expectations are frustrated. But I can’t think of a man more likely to be in this plight than the man who raped a woman, especially if he’s going to spend the next 18 years behind bars, with no liability for child support and little chance of impregnating anybody else! If such men are about as numerous as the men who can’t wait to open the door to their homes and their hearts to receive the child of their wife whom that rapist raped, perhaps there’s a good match already, so I don’t see why we need to give men a veto against a woman having an abortion mostly for the benefit of convicted rapists.

The asymmetry is that a woman may continue with a pregnancy beyond the first trimester by being deemed to have overturned a notional veto through releasing any presumed other party from all obligation, while no one may exercise a veto against her having an abortion at that stage since no one could be conclusively shown to be ‘the’ party presumed to be entitled to a veto. So if we can’t establish if another party agrees with the woman’s decision because there’s no way to tell who the other party is, let alone his opinion, we’re not doing women any favour by keeping unidentifiable parties out of the equation since it’s an empty claim that we could do otherwise.

I see something ironic too in people demanding having a choice about their taxes so they don’t get to become instruments of immorality just as women resist being turned into unwilling instruments of others’ morality. You want to make women pay for their abortion, as if to punish them, and forget that in denying public funding for abortion you’re also letting off all those ghost-parties you were keen to bring in when ironically that’s perhaps the only effective way to ‘bring them in’. As long as he’s sexually active, what heterosexual pro-lifer can be certain he’s never been involved in a pregnancy that was aborted? And I don’t know if you’d still expect the woman to foot the bill for her abortion in rape cases, or if you’re willing to be less picky with your taxes then; but I doubt you’d want to tell me.

What I object to in principle about the 24-rule is that it puts in doubt whether a woman means what she says just because it’s not what some people want to hear. I see no connection between this rule and effective inability to identify ghost parties; it’s a non-sequitur. You’ve generously explained to me all about the Roe decision and I think I understand. What I don’t understand is the insistence on sexist policies and irrespective of whether they have the intended effect or not so states may get to air their frustration with the constitution or at the Court by subjecting women to them. I don’t like petty opportunism. Should Americans who think capital punishment is immoral demand executions not be covered by public funds? Is this what you’d advise them to do, rather than lobby for abolition? Incidentally, in the view of most people on this planet your taxes have been instrumental in procuring immoral activity and ‘the actual use of deadly force’ all over the place and on actual ‘people’, in the straightforward sense.

When I mentioned Thomson and Obama in one breath, it was because I thought Thomson’s line was open to Obama in principle and in your eyes. I didn’t claim he’d explicitly quoted Thomson and indeed I’m amazed that US politicians pronounce over questions metaphysical; do they take themselves to be philosopher-kings or is it that philosophy graduates field into journalism? I don’t think Thomson is any more optimistic than Obama about the prospects of settling metaphysical disputes. Her granting personhood for the sake of the argument was precisely so she could bracket the whole issue off and get on with doing some business; so I don’t take Thomson to be committed over the metaphysics any more than Obama is. I’m not sure what you mean that Obama has a view and you can tell from his actions what it is: He’s a man; I thought you’d agree he ought to defer to Michelle.

Infertility, if caused by something not functioning properly, is a medical disorder. That doesn't mean we have a right to procreate. I certainly don't think we have a right to procreate if that means being able to expect someone else to provide the means if we can't provide it ourselves. But I also don't think we have the right to cut off procreation once fertilization has occurred. Then again, I just don't like thinking in terms of rights to begin with.

I'm not sure why it would be immoral for a nun or lesbian not to seek IVF. Are we working here with a view that we ought to maximize our reproduction? I don't know very many people who think that. Most pro-lifers are certainly not going to go there given the pro-life objections to IVF. Or are you suggesting treating parents of embryos who refuse to implant them losing custody and opening them up to be implanted into other women? That's an interesting idea that hadn't occurred to me. There does seem to be too much of a notion that embryos are our property, but I think a lot of parents see their children as their property too. If we can revoke parental rights in cases where parents are immorally failing at their parental obligations, then I think freezing your child and refusing to allow biological development should count.

It's pretty obvious to me that it's not necessarily sexist to create a rule that makes things more difficult for women and not men to do something that women and not men can do. If men can't do it at all, and we limit women doing it in some way, how is that sexist? Doesn't it bring things closer to even? Medical coverage that won't pay for pap smears for men isn't sexist. It isn't sexist to have laws making penile rape more serious than rape with an external object or a finger or something. It isn't sexist allowing men to go topless and not women (New York judicial fiat notwithstanding). It isn't sexist to allow women to have a child suck on her external sex organ but to criminalize men having children suck on theirs. When there are morally relevant differences between men and women, differential treatment is not sexist. Either that or sexism isn't something we should worry about, and we should find some other category to cover the morally problematic cases. I'd prefer to reserve the term 'sexism' to cover immoral cases rather than just applying it to any differential treatment whatsoever.

Here's one study that seems to imply some effect. I also found one article claiming a reduction, but it doesn't fully support it by showing the rate of increase or decrease before the law was changed, and it doesn't consider whether some of those abortions occurred in other states. But as I've already said several times, I think you're oversimplifying what would be required to justify something like this. There's the informed consent issue, completely separate from the issue of decreasing abortions. Then there's the fact that we have much greater delays for pretty much every other kind of surgery. Why is abortion so expedited? Is it because pregnancy is seen as the worst emergency situation that could ever happen to someone's body? The refusal to allow the routine delays in pretty much every kind of surgery makes absolutely no sense unless pregnancy is seen as worse than actual medical problems and thus needs to be taken care of immediately. Such a notion is crazy enough to be not worth taking seriously.

But it's actually pretty obvious that you shouldn't need hard statistics to have an informed-enough understanding of the issues to expect some effect. Forcing a delay to allow someone to think about it more will almost certainly lead to some people actually reconsidering. Crisis pregnancy centers do see people changing their minds after being asked to think about it for 24 hours, so there's at least anecdotal evidence that it does happen. It isn't going to increase the abortion rate, and even the small decreases that would be impossible to deny given the anecdotal evidence should count as a genuine decrease. So those who argue for such policies as a result of carrying out President Clinton's goal of making abortion safe, legal, and rare (something President Obama has said as well at times), then it's hard to say that it wouldn't help achieve that. I think the burden of proof lies with those who would resist such a commonsense argument, since it does make sense that it would have some effect.

If I wanted to use taxpayer money to give a hard time to women I disagree with, I'd probably urge funding for more philosophy awards from the federal government. This isn't about making life more difficult for women I disagree with. It's about taking people at their word when they say they want abortion to be rare and making attempts to pursue such a goal.

I see that later in your comment you do seem more open to seeing restrictions on abortion as affecting men who want the women in their lives to have abortions, even though earlier you were assuming it was just a restriction on women to make the argument that it's sexist. But later you acknowledge that it's not so simply, which seems to make my point for me (but strangely you think this somehow undermines my claim).

I'm not arguing for a particular view about how to do things without gender inequality if we allow abortion-on-demand. I was simply pointing out that the current way of doing things doesn't really avoid gender inequity. You seem to be taking that as an argument for how to revise things while still allowing abortion-on-demand. But my policy preferences wouldn't allow continued abortion-on-demand. So my argument doesn't require changing the child support laws one bit. It just finds an inconsistency between some of the arguments used to support the current abortion laws and how people who endorse such arguments think about some of the same issues of parental responsibility when they apply it to child support. People seem to have this notion that women have an absolute right to preventing any parental obligation. I don't believe in such a right, and I don't think the very same people accept it for men, so I think that's a pretty good argument (given that such people are usually gender egalitarians) for not worrying about an absolute right when it comes to abortion. You don't seem to take that argument for what it is but rather want me to be arguing for a change in child support law, which isn't at all what I'm doing.

No, I wouldn't want a woman who wants to kill her child to pay for it if I think it should be illegal for her to do it, so I wouldn't think she should pay for it either. I oppose federal funding for it, and I oppose private funding for it. If I can help achieve only one of those, and she ends up having to pay for it but can still legally do it, then I've achieved one of the two goals but not the other. Don't take that as an argument that I would like her to pay for it, though. I wouldn't want her to do it to begin with. I don't think rape is a good justification or even excuse for abortion. The only cases where I think you might have a good reason involve saving another life, and even then it depends on the circumstances.

I'm a heterosexual pro-lifer, and I'm sure I've never been involved in a pregnancy that's been aborted. My wife is disgusted at the notion of abortion, and there's never been anyone else who could have had access to the relevant biological materials. This is probably true of most pro-life men, actually, since most of them are also committed to monogamy and sex within marriage.

As for being motivated by punishing women, I think I've said enough to preclude that. I've explained the motivation, and it didn't involve that. But I can provide lots of examples where I don't approve of the government paying for something that doesn't involve punishment. I don't think the government should pay for beer for people receiving government help for food. I don't think it's always wrong to drink beer, even though much drinking of beer does involve wrong. So I don't justify my resistance based on punishment. I justify it based on its being something that other taxpayers shouldn't be subsidizing. My willingness to allow the government to cover any health care funding at all is primarily because I believe in collective responsibility, contrary to most libertarians, and I think society as a whole can sometimes have a responsibility to care for those who need help with basic needs. Medical care can fall under that. But abortion isn't a basic need. Even in the very few cases where I think abortion might be morally allowable, it's not a basic need. As Thomson argues, we don't have a right to someone doing what's required to ensure our survival just because we have a right to them not doing what will guarantee our death. A right to life doesn't imply a right to others supplying the means of our survival.

Your argument against the 24-hour rule makes most routine delays in surgery equally immoral if they involve operations only women have. Only women have hysterectomies. Does that make it immoral to require delays in hysterectomies? Hardly. We require it for surgery that men receive too. The fact is that abortion is the only major surgery that people can get on demand without a delay. It's not sexist against women to restore things to the usual way we do things for other surgeries.

Yes, I do think those who are opposed to capital punishment should argue both that executions not occur and that they not be paid for by tax money. Someone who opposes something should oppose both its occurrence and its being paid for by government. If they can achieve only one of the two goals, then they will have achieved something. It's highly unlikely that they could achieve just the removal of funding, though. So it's probably not worth their time to pursue it as a compromise to get one goal achieved. The same is not true of abortion. So the two cases end up not being parallel.

I'm not arguing for politicians to make metaphysical pronouncements. I simply want them to acknowledge that their policy votes and implementations assume metaphysical claims and that if they assume controversial ones that they acknowledge it and be able to explain why they can assume such controversial claims as a basis for their positions. If they want to take an agnostic stance and then argue for a certain policy based on such agnosticism (e.g. err on the side of caution and give Cylons rights because they seem to be intelligent, to use a science fiction example not immediately present in our time), I'm fine with that. What I disapprove of is not taking a stand but them implementing a policy that seems to take a stand. It's dishonest. Obama's official policies involve refusing to allow any restriction whatsoever on abortion for any reason. He wouldn't even vote for a bill that got 100% support in the U.S. Senate to require life-saving actions for a premature infant that survives abortion. The pro-choice contingent at the national level happily supported such a law, but Obama and a number of his colleagues in the Illinois Senate refused even to allow their Senate to vote on it, never mind to support the law.

Why would I think a man should always defer to a woman on what his view of abortion should be? I've always found the view that men should have no views on abortion pretty lame, and I think it's even worse that men should simply accept whatever view the women in their lives happen to hold, regardless of whether there are good reasons for such a view.

‘If I wanted to use taxpayer money to give a hard time to women I disagree with, I'd probably urge funding for more philosophy awards from the federal government.’

Good to see your sense of humour developing; just think of the time when your baby daughter will be crossing swords with dad over chocolate, on this blog or in class.

So you think we have no obligation to procreate, and we have no right to procreate either unless we can provide the means ourselves; which is puzzling since parthenogenesis isn't the norm for the human species. You also think we have no right to cut off procreation once fertilization has occurred, which is even more puzzling: Because if procreation lies beyond ethics, the intuition about ‘cutting it off’ free-floats in moral thin air. But I’ve already admitted I can do no better: I am sympathetic to ‘not cutting off’ but then can’t see why not when the one pregnant does. So I'd feel unable to legislate over abortion on the basis of conflicting ad hoc intuitions.

I do appreciate the effort you've made to unearth information about the effectiveness of the 24-hour rule, though I'm surprised there seem to be no government stats. I appreciate too how you qualify claims for what you did find: You make valid points and I think you'd have done a good job designing a study; the argument in the paper you link to is rather dubious, schematic and not entirely clear to me. Assuming she has made up her mind to have an abortion, I agree with you that a woman may change her mind within 24 hours though I can’t accept that genuine abortion decrease is therefore ‘impossible to deny’, since I don’t see why one so volatile may not change her mind again. I can’t see why she’d go to a CPC in the first place, but she’s unlikely to go to the CPC then; so they may never know. I must say I object in principle to medical imaging techniques being used without a medical indication, by CPCs or anywhere else. It’s certainly a waste of resources if not worse; and self-indulgent, I think, of an affluent society to throw money away so as to finance hobby-horse politics to no demonstrable effect. So I insist that keeping the 24 hour rule in the book is bad practice and not worth the overall hassle and expense; not when you’ve also got those millions of uninsured and higher maternal death rates than in Europe just as you spend more on health. This is a pragmatic argument which I think is significant in a policy debate.

You say the rule is about ‘taking people at their word when they say they want abortion to be rare and making attempts to pursue such a goal’: But I suggest you start by taking pregnant women at their word when they say they want to have an abortion. And I suggest you scrap the 24 hour rule so as to contribute funds to subsidising contraception; and get CPCs to distribute condoms: There is non-anecdotal evidence that contraceptive investment does bring down abortion rates.

I’m puzzled by ‘the informed consent issue, completely separate from the issue of decreasing abortions.’ Doesn’t the 24-hour rule hold in all and only abortion cases? Why is early abortion ‘major surgery’ if it's always safer than giving birth, or if it’s a prescription for a couple of pills? Where I live it’s either that or an outpatient service. Do you also show a woman about to have a hysterectomy an ultrasound of her uterus and invite her to bid good-by to it for ever over the next 24 hours? It all sounds surreal to me, and condescending towards women: What do you tell one about foetal development if she’s got three kids waiting for her at home, or if she’s that developmental biologist?

I think delaying tactics and funding exemptions are about barking up the wrong tree because that’s the tree you can bark at. As I said, your problem is the US constitution and the Supreme Court decision. But you won’t face straight up to the problem because it’s too tough to do something about. So you get at the woman instead, because she can be got at and just because you can; which is why some men won’t take no for an answer, from a woman. I find this ironic, cowardly and humiliating for women. It is absurd to expect women to finance the 24-hour rule as taxpayers and the abortion plus rule-compliance-costs out of pocket because you refuse to finance health services you disapprove of women having. Because even a right to life is not a ‘basic need’ if one’s a woman! So where a woman’s life is under immediate threat she has to wait for 24 hours to have an abortion, if she can afford it privately and though you’d rather she didn’t have it at all. But you’re not being sexist or misogynist because there’s no moral difference between being a woman or a foetus; and you have noble motives while women who have an abortion just like to slaughter kids.

Sorry to disappoint you but you’re likely to have fathered more children than you currently have; and they’ve likely been flushed down the toilet without anyone knowing they were there. The evidence is that whether they’re pro-choice or pro-life women abort most fertilised eggs naturally. So the legislation you favour won’t stop the majority of abortions from happening. That it won’t even stop the minority of abortions it’s supposedly designed to stop either you seem to consider an argument in favour of adopting it. So whether it's re-criminalisation or the 24-hour rule you consistently support legislation that makes no difference ‘on the ground’; you must have a legal fetish.

I tried to explore your ‘gender equity’ argument because for some reason obscure to me you thought from the start that I wouldn’t want to, and you kept coming back to it: If you can live with a woman being released from any financial or other obligation through adoption, then you can live with a man being so released. The fact remains you can’t establish who the male party is or if he gives a toss: As long as it’s between a woman and a ghost, there’s no ‘equity’ for any rule to restore; I think that’s the gist of it. And I don’t understand why you get the option whether to be committed or not to a premise you grant for argument’s sake while Thomson doesn’t; unless there’s a morally significant difference between philosophers who have balls and those who don’t.

It is generous to give me credit for suggesting to you the ‘adopt-a-frozen-child’ campaign but I think it’s more likely those science fiction novels you read and which I don’t, since I have no idea who or what Cylons are; you may also award fairies in the bottom of the garden any status you like as long as they don’t need to be worshipped in my back yard: It would still be my priority to see every thawed child placed in a welcoming household first. But I fully agree with you that men shouldn’t simply accept whatever view the women in their lives happen to hold, regardless of whether there are good reasons for such a view: So is it or is it not sexist that women should simply accept whatever view their husbands happen to hold, regardless of whether there are good reasons for such a view?

Maybe I should be more precise:

1. We have no absolute obligation to procreate. I do think there's a general human obligation to procreate, and most people ought to do something to make attempts toward contributing to that, but I don't think it's an absolute obligation in any individual's case, and I do think there are some people who have an obligation to make attempts not to procreate.

2. I don't think anyone has an absolute right to procreate, meaning there are always considerations that can interfere with any prima facie right I might have to make attempts to procreate. For example, if my biology makes it unlikely that I can conceive naturally, I don't have a right to anyone else providing any expensive means to try to remedy that (especially if it's got extremely low chances of working.)

3. If we don't have an absolute obligation to procreate, and we don't have an absolute right to procreate, why is it puzzling to the point where you'd suggest we'd need parthenogenesis? If we did have an obligation to procreate but not the ability, that might be a problem if it meant we had unfulfillable obligations. But I haven't said anything that implies any such thing.

4. Why does any of this imply that procreation lies beyond ethics? There are plenty of moral claims that I have endorsed about procreation.

If you think medical imaging is problematic without a medical condition, but you think pregnancy is a medical condition that's unnatural and harmful, then what's the problem? Wouldn't that be a justification for giving ultrasounds to every pregnant woman to make sure everything is all right? That's not the reason I'd give for it, but it's hard to see how your own principles can allow the argument you give against it.

I'm not not taking women at their word when they say they want an abortion. I just think it's worth injecting better information into their pool of sources. You've been insistent all along that pro-life counselors not deceive women into having a child by giving misinformation about abortion's effects. But the same can happen with Planned Parenthood counselors who tell women that a fetus isn't really alive or that it's just a tissue. Ultrasounds counteract misinformation and ensure a more informed decision.

Where did you get this new claim that abortion is always safer than giving birth? I thought you were arguing that it's on average safer, not that it always is. As I've already pointed out, it's certainly not safer for the fetus. Even if the fetus has no moral rights, I don't see how something's being safer than birth makes it somehow not major surgery. It's major surgery to remove the contents of someone's stomach. Why not if it's the contents of a uterus?

Why do you think I'm not facing up to the constitutional and Supreme Court problem? When a Supreme Court nomination process occurs, I follow it very closely and support or oppose nominees according to whether I think they will be a good justice. I have given lengthy arguments about what I think the Constitution requires and why I agree or disagree with various Supreme Court decisions related to abortion. I'm not dodging that question. I just think there's only so much you can do on that question, and in the meantime there's other things to do that will limit the effects of a bad judicial decision that prevents good public policy.

I don't think the 24-hour bans being proposed would apply in cases where the abortion would be taking place to save the woman's life. Supreme Court precedent would never allow such a law to be enforced. It would be immediately appealed and overturned at the appeals court with virtually no controversy, since appeals court judges have to apply Supreme Court dictate even if they believe it to have been wrongly-decided. Your claim that I don't think women can have noble motives in getting an abortion is also thoroughly unfounded. I haven't said that, and I haven't said anything that implies it. I do think most abortions are morally wrong, but I haven't said that the reason they're wrong is because the motives are always wrong, never mind that women who have abortions do so just because they like to slaughter kids.

There's no point in trying to save lives you can't know about or to try to save lives whose biological structure is such that saving it is really impossible (both of which are true in cases of spontaneous abortions). What I would like is for people to engage in democratic means to make some changes that will probably decrease the number of deliberate abortions, abortions that in almost all cases are preventing the development of a child who has all the potential to have a decent life but whose parent or parents choose not to allow that for reasons that seem to me to be grossly inadequate, even if they are not what accused me of saying they were (that they simply like to slaughter children).

So why do you think I'm saying Thomson can't give an argument based on a principle she doesn't endorse? I've said that her argument doesn't establish its conclusion. If you start from the pro-life premise, what she says doesn't follow unless you grant some other controversial claims that a lot of pro-life people, including me, would not grant. I haven't said that it's illegitimate to start an argument from your opponent's premises and see where it leads. All I've said is that her argument that does that fails for other reasons.

So is it or is it not sexist that women should simply accept whatever view their husbands happen to hold, regardless of whether there are good reasons for such a view?

It might well be. It's been a very long time since I've heard of someone adopting such a view, though, so it's not as if we're talking about anything very mainstream in Christianity here, at least nowadays. I think my parents might have known a couple who behaved this way when I was a kid, and they belonged to a pretty extreme church on a number of other issues. (For example, they disapproved of my family's acceptance of rock music, because the African beat in rock music is Satanic.)

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