The New Eugenics

In the UK, a couple has a new baby girl without the high risk gene mutation for breast and ovarian cancer, cancers that have afflicted females in her father’s family for three generations. Paul Serhal, the fertility expert who treated the couple, said, “The parents will have been spared the risk of inflicting this disease on their daughter.”

And it was easy. After fertilizing bunches of eggs in a dish, he let them grow to the blastocyst stage, removed one cell, tested it for the gene mutation, found the perfect one, implanted it and let it grow. Now mom and dad have a brand-spanking-new baby girl, practically perfect in every way.

And her brothers and sisters who didn’t pass embryo muster? Well, let’s just say their three days of life were rudely interrupted. But, there was no blood, no guts and no annoying trips to the abortion clinic. The doctor probably just rinsed them down the sink. Easy.

I’ve wondered what one would have to believe to be an ethical Petri-dish “rinser-outer?” What would define the ethics of a person willing select the perfect embryo and discard the others?

I surmise one would have to believe in the absurdity of life and an absent or irrelevant God. One would have to deny a final accounting before a holy judge, acknowledge we are all we have and insist existential relativism defines life. One would have to hold that life has no value except the value placed on it by whoever has the money or power to use it or control it. One would have to believe in the value of genetically improving the human race.

Now, the parents of this designer child placed a value on her, so here she is. But no value on her siblings, so here they are not. And her doctor placed a value on a genetically superior child. (The money and fame probably didn’t hurt, either.)

Make no mistake; breast cancer is an expensive, terrible disease. Chemo, radiation, lost work, lost productivity, end-of-life care, hospice, ICU time—they all cost money. Patients with breast cancer face pain, despair and possible early death. So you may think reducing the risk of breast and ovarian cancer a valid argument for this type of genetic selection (and genetic de-selection).

But where does that argument take us? Do a little projection with me, if you would.

Maybe, just maybe, the government, in order to save money on health care, could strongly recommend (or even require?) such prenatal genetic diagnosis (PGD) for other families with such a cancer history. Maybe the government could keep a record—a gene record—on everyone; so those with known genetic “defects” could receive counseling before conceiving so appropriate prenatal testing could be done. Maybe for those who conceived without PGD, the government could recommend (or require?) prenatal diagnosis and abortion if the baby was found to be carrying one of these less-than-desirable genes. We (the government) wouldn’t want to “inflict” some poor soul with a less-than-perfect genetic make-up, would we?

Oh, what a wonderful world it would be! No people with disabilities clogging up the system—no cystic fibrosis, Down syndrome, spina bifida, or early-onset breast cancer—none of the up to 6,000 known adverse gene mutations! Why, just think. When they come up with the gene for those with an IQ less than, say 90, only “smart” people could be allowed to be born! And, you know, if your political party were in power, your party could decide what “inferior” meant. Why, it could include races, or religions, or height or weight. The sky is the limit!

Those chuckles you hear in the background are the spirits of Margaret Sanger, Adolf Hitler and all the other eugenicists from ages past quietly laughing as their ideas re-surface, the ideas of the perfect race and elimination of the less-than-perfect from among us. With PGD and prenatal diagnosis clinics, the techniques are not the same (yet), but the concept is the same.

As the Jewish people know first-hand, eugenics may start small, but can end in the unimaginable deaths.

And that is why we must defend life—human life—from conception to natural death, as God intended.

Extreme Prematurity, Extreme Hard-Heartedness

Extreme Prematurity, Extreme Hard-Heartedness

The Daily Mail (www.dailymail.co.uk) from the UK reports that a woman in Great Britain held her baby for two hours until he died while doctors stood by, refusing to help. Why? Because he was born two days too soon. Guidelines in Britain hold that any baby born prior to 22 weeks not be resusitated because such resustation would be futile and the baby would die anyway. Little Jayden was born at 21 weeks and 5 days.

Even if the mother pleads for help? Which she did? Sorry—no can do—was the message to her.

Such is the effect of clinical care guidelines on medical practice, guidelines in Britain developed by a think-tank called the Nuffield Council on Bioethics, guidelines which extinguish human compassion from the care equation and provide cover for doctors to deny care and for the NHS to save money.

I find it difficult to picture an actual physician refusing a patient’s plea in such a circumstance. Theory is one thing. But standing toe-to-bed watching a mother holding her dying child and saying, “No,” chills my soul.

Extreme prematurity is not an easy issue. The earliest survivals on record occurred at 21 weeks 5 days and 21 weeks 6 days. Many times, the babies who survive such prematurity are left with lifelong physical and mental disabilities and always the cost of such care startles our fudiciary sensibilities. (Over a million dollars is not unheard of.) Thus, those who see no value in imperfect life or fail to see the worth of expensive life often carry the day in committees that set guidelines.

The article describes the British Association of Perinatal Medicine doing some fast back-tracking following this incident and her complaint, saying the guidelines were not meant to be a “set of instructions.” But guidelines soon become protocols and protocols morph into rules; rules which, if broken, require explanations and result in discipline for the rule-breaker. Rules which, if followed, save the National Health Service (NHS) millions of pounds.

Looking back on my long years of practice, I’ve been in similar situations. There have been times I’ve told mom and dad that resusitation would be futile and that they should cherish the short time they have with their child prior to his passing. I’ve never fallen back on a guideline to justify my actions, however. I’ve simply told the parents the baby would not, could not survive our best efforts. But I’ve also never turned down a request to help a baby if asked. And I’ve also made sure my statements were true.

One night in my residency, a young woman experienced preterm labor. She was deemed too early for intervention (but was close to the line) and went on to experience an unsuspected breech birth which I attended. Unfortunately, the baby’s head became stuck in the mother’s cervix making delivery impossible and death certain for the struggling premature baby. I cut the mother’s cervix to release the baby’s head, much to the parent’s relief. The baby died in spite of resusitation efforts. Although my superiors criticized this intervention, I can still see the faces of the parents as their baby struggled and wiggled, half in and half out. I’ve no doubt I did the right thing.

The medical cutoff for extreme prematurity is a target in motion, with modern technology resulting in survival of more and more premature babies. Such a moving target contradicts hard and fast rules and should require the best judgment of those physicians at the bedside. Doctors should bring together all the information possible—the stage of the baby’s development, the parent’s wishes, the availabiltiy of treatment, the doctor’s skills—then reach a compassionate and appropriate decision with mom and dad on board.

Matt Anderson

The Euthanasia Trojan Horse

The Euthanasia Trojan Horse

 

The UK Telegraph reports a euthanasia scheme which now shocks the citizens of the UK. The British, beneficiaries of a one-payor, government system, have to wonder how this came to be. How could the government be killing all these people?

 

To summarize, the UK cancer charity, Marie Currie, developed a protocol called the Liverpool Care Pathway. Designed initially for terminal cancer patients, this pathway received the endorsement of NICE, the National Institute for Health and Clinical Excellence (I’m not making this up) and soon became a standard of care nationwide.

 

This pathway uses the judgment of a medical team including the senior doctor to determine when the end of life is near. (As you might imagine, if a “team” makes a decision, no one person can be held accountable.) At such a time, the doctor withholds food and fluids (starves and dehydrates the patient to death) while administering a sedative to usher the soon-to-be dear departed from this world to the next. (In Minnesota, you can’t starve or dehydrate an pet without risking jail time.)

 

Initially only for terminal cancer, the pathwway now applies to any critical illnes.

 

Some British doctors think the problem is this: How can one accurately determine when is the end near? How does a doctor determine that a patient is about to die? Such a determination is a guess at best, and sometimes just a hunch. So if a patient gets a large amount of sedation and is denied fluids and food, how would one know if the patient might have improved? One would not know and the patient would die a premature death.

 

So a group of experts in geriatrics and palliative care including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer center in Guildford, and four others have complained.

Dr Hargreaves, Millard and Katherine Murphy, head of the Patients Association, explain in the report,

[Dr. Hargreaves]“It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”

He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.

Prof Millard said that it was “worrying” that patients were being “terminally” sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.

In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.

“If they are sedated it is much harder to see that a patient is getting better,” Prof Millard said.

Katherine Murphy, director of the Patients Association, said: “ …There is no one size fits all approach.”

A spokesman for Marie Curie [advocates of the current systerm] said: “The Liverpool Care Pathway (LCP) is an established and recommended tool that provides clinicians with an evidence-based framework to help delivery of high quality care for people at the end of their lives.

So this “tick box” [check box for us] medicine, this “evidence-based framework”, this “Liverpool Care Pathway” embraced by NICE and implemented by the British NHS has resulted in active euthanasia of very ill citizens of the UK. It’s abortion at the other extreme of life, the very old and sick.  Who knows if those people killed by this protocol would have had time to impact their world or family prior to death? Who knows if fractured relationships may have been healed without the starvation, dehydration and sedation? Who knows if someone may have heard the gospel for the first time and responded had not the “evidence-based” death taken them too soon?

I am sickened. Sickened that this occurs in the UK. Sickened that the only problem seems to be killing people too soon. (Why kill them at all? What’s wrong with food and water?) I am sickened that medicine in these United States has embraced every buzzword mentioned above such as evidence-based medicine, best practices, care pathways and protocols. And each of these schemes places a rule-setting committee between the patient and the doctor. By removing the doctor’s judgment from the care of each individual patient, pushing medicine into euthansia, rationing of care and denial of service becomes easy.

Be glad, dear friend, that we in the U.S. are in the infancy of the evidence-based, best practice jugernaut. Be glad we do not have a one payor system (yet) that can foist such atrocities on our sick and dying with the heavy hand of governmental power. But worry, please. Worry and act to stop this from becoming reality.

Matt Anderson

The Joy of Doctoring

I wrote the following article last year and submitted it to The Minnesota Medical Journal for consideration for publication as part of a writing contest. I’m learning how to accept rejection graciously as it was not published. Anyway, this article is directed toward doctors, which is why I never posted it on my blog. But now, I’m working with the American Ass’n of Prolife OB/GYN’s (AAPLOG) helping recruit prolife medical students, residents and doctors in order to encourage, network and stay informed. Since I now have more MD readers, or soon-to-be MD readers, I’ll post it.

Those of you in medical school may recognize the cynicism, those in residency I know will recognize the cynicism and those in practice may be inspired to re-evaluate their perspective on medicine (I hope and pray).

Enjoy the read.

The Joy of Doctoring

I told my wife first. The letter from the medical school admissions committee landed in my college pigeon-hole mailbox on a January day in 1974. I opened it with my heart about to beat out of my chest. “We are pleased…” is all I read. I ran all the way to our apartment. I was in! Medical school! I couldn’t believe it. I would join the long line of doctors stretching from antiquity to the present, men and women who provided the most intimate and difficult and special care to human race. Men and women highly esteemed by society. What an opportunity! What an honor!

But a funny thing happened to me on the way to actual medical practice. “Funny” meaning tragic. I became a cynic.

I adopted a jaundiced, unsatisfied view of medicine. Since I was the first in my family to embark on a medical career, medicine and medical practice was a big unknown. So I reflected the attitudes and thinking of the attendings, residents, other students I encountered. And everywhere I went I ran into cynical and dissatisfied students, residents and attendings. To my discredit, I found myself becoming cynical and dissatisfied as well. Only my faith, which constantly reminded me of the worth of each individual life, kept me from embracing cynicism as a way of life.

Cynicism—it was contagious. Stereotyping the overweight, the poor, the unwashed, the uneducated, the non-compliant and the belligerent became easy and fun. Cutesy, degrading monikers for different classes of patients, none of which I will repeat, elicited sniggers and outright laughter from other doctors and doctors-in-training.

But the cynicism I encountered went beyond patients and their unpleasant characteristics and into the everyday activities of medical school, residency and then practice.

In medical school, we complained that teachers graded unfairly, organized classroom material poorly and required us to learn material which was irrelevant in nature or overwhelming in amount. In residency, we complained that scut and clerical work occupied too much valuable time and lazy attending staff unnecessarily burdened us with work so they could leave early. Brutal hours, low pay and constant criticism added to our angst. We longed for the nirvana of private practice which would yield fair compensation for our work, no more tests to take and schedules under our own control. Our patients would love us and would all have insurance and be thin and clean and intelligent.

Well, guess what.

Private practice just re-routed the cynicism.

As private practitioners, we discovered unfair insurance companies, high overhead expenses and surprisingly low paychecks. Call duty now seemed even more burdensome and our hours were still too long. Patients who experienced complications returned to us, not our attendings or our institution. And they asked, “Why did I have this complication, doctor?” We faced the real burden of patient care with the responsibility of our patients’ outcomes all our own. Many doctors in private practice worked with greedy or unreasonable partners, a problem I was spared. I now work for a large health care company and the complaints continue, principally that the corporation keeps us from receiving our just compensation. In our hospital, a nurse with a cookbook can now trump our reasoned clinical judgment. The unwashed patients are ever with us.

Furthermore, home life stress did not lessen as we expected. Nirvana never appeared. Husbands or wives who delayed gratification and sacrificed for our medical career now suddenly realized that the new doctor was still too busy, still detached, still not happy, still not a good communicator and still spending too much time at the office or the hospital. Private practice did little to improved one’s spousal relationship, and, in fact, often made it worse as raised expectations went unmet. Those who helped many survive the “hard times” realized that there was no end to the “hard times” and wanted out.

Oh dear.

JAMA in January, 2003, reported 18% of physicians nationwide were somewhat or very dissatisfied with their careers with higher dissatisfaction in physicians practicing in areas with higher proportions of managed care. Women fared lower on the satisfaction scale.1

Archives of Internal Medicine in July 22, 2002 reported 70% of physicians satisfied or very satisfied with their careers and about 20% dissatisfied. Specialties of pediatrics, perinatal medicine, neonatal care, geriatric internal medicine and dermatology showed the highest level of satisfaction and specialties of OB/GYN, ophthalmology, orthopedic surgery, internal medicine and otolaryngology showed higher levels of dissatisfaction. New England and the West North Central areas of the country were more satisfied. Older age, longer hours, specialist in solo practice and foreign medical graduates showed lower satisfaction scores.2

My own observations of physician satisfaction are somewhat at odds to those statistics.

When do I see happy doctors? That’s easy. In a social setting where mere mortal human beings are holding the doctor in high esteem, hanging on his or her every word. At medical meetings when hobnobbing with other immortals, meetings generally held in beautiful areas of the country with warm weather, usually near some attraction or in an interesting city and always in a very expensive hotel. When they get a big paycheck or buy a new car or move into an expensive house. When a health care team member of the opposite sex fawns over them. When they have time off to pursue expensive fun. Doctors like those parts of doctoring. I see them smile and watch their animated conversation when discussing such times.

When do I see them unhappy? That’s also easy. When they look at a very busy schedule. When they look at a not busy schedule. (It means the paycheck will be less.) When a nurse tells the doctor about a patient with an obvious problem and wants the patient worked in that day. When an emergency presents and threatens to make the doctor stay late. When the hospital calls about a patient with a problem, especially if the call is after-hours, even if the doctor is on call. When a doctor receives any call after 9:00PM. When a doctor receives any call that requires the doctor to go to the hospital. When a doctor sees a patient who talks too much, requires too much time in the office, is too complicated, is dirty or smelly or mean or non-compliant or belligerent. When a medical helper doesn’t have all the right equipment RIGHT NOW. When slow lab or X-ray turn-around occurs. When a doctor has to deal with employee issues. When a doctor feels ignored by administration. Even when facing the open-ended encounter, just walking into a room and saying, “What brings you to the office today?” causes unhappiness for many physicians.

You notice that the happy things have little to do with the practice of medicine. The unhappy things sound like a normal day.

So, who is satisfied with their career? I would contend that many, if not a majority of physicians are profoundly unhappy about medicine. But to admit unhappiness would mean that all that work and all that sacrifice maybe wasn’t worth it. It would mean that they really are in it for the money and status and not for caring and helping, which is what they told everyone starting with the admissions committee for medical school.

I believe telling if someone is happy about a career choice is just not that hard. People who like what they are doing, really like what they are doing and it shows, even through the hassles and difficulties of any job.

A satisfied physician might look like this: Busy day? A challenge I can handle. Pt takes too long? That is just how medicine is. Explain to the waiting patients that I’m late, but I will also give them the time they need. Or the waiting patients can reschedule. Need to add someone in? The clinical indication, not the schedule, dictates the yes or no. Stay late? If needed, OK. Caring for the unpleasant, the unwashed, the belligerent, the non-compliant? That’s why I’m here. Illness is not a respecter of persons and all God’s children need health care. On call? It’s my calling. Unnecessary nurse calls at night? A response with a pleasant demeanor and education, not an angry bark. Partner needs help? No questions asked—help is on the way. Hassles of managed care and electronic medical record, lack of autonomy and insurance companies? An inconvenience to the greater goal of patient care.

I read in journals how to improve physician satisfaction. They all talk about money, physician autonomy, hours worked—things like that—which do have validity.

But real joy from medical practice originates in the heart, from within. This joy transcends the hassles of patient care and finds fulfillment in relieving suffering in all its forms and improving the health and well-being of patients. What a glorious goal! This joy from doctoring comes from understanding and even meditating on the calling. It takes realizing that medicine, daily patient care and all it involves, satisfies more than the material rewards and accouterments of medicine. It takes realizing the honor of the job. It takes realizing that patients and their care are the point, not the problem. It takes realizing that a busy schedule does not translate into a burden, but into the satisfaction of being needed. (Unless the schedule is motivated by greed.) It takes realizing that normal medical practice means dealing with add-ons and emergencies at inconvenient times. It takes realizing that call means someone out there is desperate enough to seek your service at inconvenient hours, inconvenient for you and for them. It takes realizing that what medicine has to offer outweighs trying to wrestle the medicine monster to the mat forcing it fit your own ideal. The real satisfaction with doctoring comes from…actual doctoring. The hands-on, active-listening, emergency-seeing, patient-adding, medicine-embracing, call-taking, detail-attending and always-caring doctoring. Find someone practicing like that and you will find someone living the joy.

Trust me, I understand that medical practice is a difficult life. A busy OB/GYN practice, which I have, stresses the most satisfied of us. Hours, call, clinic, surgery, deliveries, partners, administration, liability, unhappy patients—all can be and often are sources of major stress and unhappiness. But I’ve found the joy of medical practice—all of medical practice—is a rock, a home, a calling, a mission and a blessing from God which provides stability and contentment through those times and keeps me excited and satisfied, supremely satisfied with where I am and what I am doing.

I would encourage you, if you are a physician, to embrace all of medicine—the good, the bad and ugly. The joy in your calling is there.

Matt Anderson, MD

Endnotes:

1. JAMA. 2003;289:442-449.
2. Arch Intern Med. 2002;162:1577-1584.

The Cookbooking of Medicine

  I’ve been in practice (out of residency) for more than 27 years, a doctor for 31 years and doing clinical medicine (since a 3rd year medical student) for 33 years. (Goodness, I’m old!) I’ve dealt with cranky ward clerks, primadonna nurses, obtuse administrators, incompetent MD peers, powerful insurance companies, government bureaucracy, employee conflicts, good financial times and bad financial times. I’ve even survived two lawsuits. But the cookbooking of medicine is the most fraudulent, intrusive, problematic and dangerous paradigm to come down the pike yet. I’ve written about it and submitted it hoping to get it published. It wasn’t. So I’ll contribute it here, my blog. If you are a young doctor, you may think I’m nuts, because it may be all you have known. If you are an older MD, you’ll probably understand. If you are not in medicine, you may be appalled. Most people to whom I tell this story–can’t believe it. But true it is. Hope you enjoy the read.

 

 

 

The Cookbooking of Medicine

 

Standards. Protocols. Evidence-based medicine (EBM). Pay for performance. Best practices. Buzzwords all—these terms describe the new direction of medicine in the 21^st century.

 

As you read this, groups of doctors along with administrators, bureaucrats, nurses and lawyers gather at corporate headquarters, medical schools, insurance companies and government buildings to set standards of care every doctor should follow. Such groups base these standards on “best practices” or “evidence-based medicine”, a consensus of opinion on what the best care should be for any and all illnesses. Such a system sounds so good, so wonderful—what could possibly be wrong with encouraging all doctors to practice the best medicine possible?

 

Well, plenty, it seems to me, as one who deals with it everyday.

 

For example, 26 year old Mrs. Johnson (name changed), a missionary home on furlough, presents for her annual exam. She and her husband were virginal until married and have remained faithful to each other. As the doctor does her pap smear, a test for cervix cancer, she also swabs her cervix for Chlamydia and gonorrhea, two STD’s.

 

The doctor knows her chances of having Chlamydia and gonorrhea are exactly zero, but has to meet a quota of screening 80% of all women up to age 27 for Chlamydia and gonorrhea or she will not get her bonus, or “pay for performance”. So, knowing the test will be negative, she does it anyway. Why does this rule exist? Because most research done on STD’s occurs in inner city hospitals where the rates are very high, not on missionaries home on furlough. The doctor, wanting her “pay for performance” performs an unnecessary test.

 

For diabetics, doctors may order unnecessary tests or prescribe unnecessary medicines to capture pay-for-performance. Worse, early diabetes does not qualify for treatment, even if the doctor, looking at the big picture, deems treatment appropriate. So, the doctor may deny care he or she may judge necessary, since the protocol won’t allow it.

 

Welcome to the world of cookbook medicine, where one-size-fits-all. A world in which your doctor receives money, “pay for performance,” for following “guidelines” or “best practices.” Such a system removes the doctor’s judgment about what is best for you and substitutes corporate or government guidelines regarding what is best for a group.

 

Doctors, me included, always want the best for our patients. But how does one determine what is best? Even the best studies can be in error. Two of the largest and best studies of regarding postmenopausal hormone therapy came to opposite conclusions regarding the risk of heart disease. Does a study on an inner-city population translate to a well-to-do suburban population? Do studies on one race translate to all races? Does a study based on thousands of people necessarily translate to the individual patient in the exam room? Individuals vary by sex, physical characteristics, mental capacity, emotional make-up, cultural differences, values, ethnicity and side effects to medicines just to name a few variations a doctor sees. Is what may be good for a majority the best for you in your situation? Are you really unique? Could politics influence these protocols, say, to save money? Or further a politically correct “treatment”, such as euthanasia?

 

For me every encounter, every crisis, every illness, every life-threatening emergency is unique to my one patient at that particular time in her life. I collate all the information I have about…everything—her needs, her social situation, her illness, how it affects her life as she lives it, her fears, her exam and her history; then decide what the best treatment would be for her. Such a process is antithetical to the cookbook.

 

When I speak with those in charge of the protocols, they always say the doctor must still use his or her best judgment even if such judgment conflicts with the guidelines, but that really isn’t true, in my experience. The leap from a guideline to a protocol to a rule is short. When I’ve gone against protocols, administration demands explanations, threatens discipline and docks my pay if I don’t measure up. Soon the heavy hand of the protocol dictates what you can and can’t do regardless of your judgment.

 

As we go down the path of more central control of medicine where doctors are told what constitutes disease, illness, and appropriate treatment, your doctor will become more and more a technician, doling out care, tests and medicines based on the whim of government bureaucrats or corporate panels. I fear the protocol, the best practice prescripts, the machinations and rules which stand between you and your doctor will plow the furrow for the seeds of health care rationing and denial of care.

 

 

 

 

Unexpected (and Unintended) Support

The American Journal of OB/GYN, July 2009 has a clinical opinion by Drs. Minkoff and Ecker entitled, “The California octuplets and the duties of reproductive endocrinologists,” in which they discuss the ethics and obligations of embryo transfer and those who do them.

They assert that reproductive endocrinologists need not consider the economic interests of society (patient on welfare), cannot refuse embryo transfer based on perceive parenting ability or lack thereof and can limit the number of embryos transferred both ethically and medically.

Leaving aside the moral issue of in-vitro fertilization and creating embryos for transfer, I noticed the logic used to justify limiting the number of embryos transferred parallels our arguments regarding rights of conscience.

They write, “Yet while respect for autonomy [patient autonomy--the ethic that trumps all in this day and age] is the central tenet of a principle-based approach to providing ethically appropriate medical care, there are important differences between “negative” and “positive” autonomy. Pregnant or not, a patient may decline any procedure or treatment offered her; she may not, however, demand and receive treatment that her provider feels is inappropriate or that is an undue risk to her health.”

Now why would such a statement apply to “any procedure or treatment”, as they state above, except abortion? The American College of OB/GYN in its ethics statement #385 contends any doctor refusing perform abortion or refer for abortion at the patient’s request is unethical. But here, Minkoff and Ecker make a blanket statement which would obviously contradict ACOG ethics.

Why should a pro-life OB/GYN doctor be obliged to perform a procedure (abortion) that her or she feels “is inappropriate or that is an undue risk to her health,” as our authors state above? According to the argument made by Drs. Minkoff and Ecker, such a pro-life doctor should not be obligated at all.

Now I don’t know Dr. Minkoff or Ecker, but I would guess they are not members of AAPLOG. Promotions into the higher reaches of academic medicine usually involve genuflection at the alter of “choice.” Maybe they should write a hasty addendum stating there argument does not apply to abortion lest someone use their names to argue for life in the halls of congress. How embarrassing would that be?

Once again, the lack of consistency in their arguments illustrates the true ethic ACOG uses against us pro-life doctors, the ethics of might-makes-right. (We are bigger than you, more powerful than you and so we will make you agree with us or shut you down.)

How sad! Do they not understand the battle is not ours? And the battle belongs to the LORD?

Missing the Joy

Following is a piece I wrote hoping to have it published. It doesn’t look like it will be, so I am posting it here. It regards family size. I hope you enjoy the read as much as I enjoyed writing it.

 

Missing the Joy

 

Everyone knows we live on an over-populated planet. Too many people (carbon footprints) harm our environment causing global climate change, a threat to us all. In addition, increasing population means more poverty and starvation. Socially responsible adults must respond by limiting their family size.

 

What I just wrote is nonsense, of course, but is religion to environmentalists and accepted by many if not most Americans. In spite of such bleak pronouncements, abundant space remains in and on this world for more people. The sun controls our weather more than we thought. Carbon dioxide helps plants grow. Denmark and Japan, two densely populated countries, experience remarkable prosperity in spite of (because of?) their many citizens. Dishonesty, graft, greed and corruption seem to contribute more to poverty and starvation in third world countries than anything else. It’s hard to do business with a dishonest person or run a business in a country with a corrupt government.

 

But what does a socially responsible young adult do about family? Should a couple have children? If so, how many? Is a large family a curse on the planet or a blessing? As Psalm 127 says,

 

3 Behold, children are a heritage from the Lord,
the fruit of the womb a reward.
4 Like arrows in the hand of a warrior
are the children of one’s youth.
5 Blessed is the man
who fills his quiver with them! (ESV)

                                                          

I deal with this issue everyday in my OB/GYN practice. It’s my job to inquire about childbearing desires, an inquiry which always leads to a discussion of family size. When I ask women if they will have children, or have more children, I usually get a ‘you-just-want-more-OB-business’ comment with a sly smile. But when I press, the comments I hear are almost always the same: We have the perfect family, a boy and a girl; my husband won’t let me; day care is too expensive; we just moved into a new house and can’t afford another child; one child is too much hassle, more would be worse; we want to travel and have fun; we should limit our family to not hurt the planet. Money. Time. Fun. Job. Daycare. Travel. Hassle. Husband. Environmental responsibility. Such are the reasons I hear for limiting family size.

 

I’ll ask to share my perspective on family size. If permitted, I do my best to counter such arguments and am occasionally persuasive.

 

For those with money trouble, I counter by saying there has never been a better time to afford children. Discount stores and thrift shops dot the cities and towns. Frugality is not poverty. The most important things a parent can give a child—time, support, love, care, discipline and training—cannot be bought with money. A strong social safety net protects in the event of hard times. No one starves.

 

To the hard-core environmentalists, if pressed, I mention Denmark and Japan as examples of countries maintaining a healthy environment with dense populations and present the view that people are the solution, not the problem.

 

It’s harder to counter the “perfect family” argument and the “we want to have fun” argument. To that I ask if her children bring her joy. And, of course, they do.

 

Then I ask if I can share my Thanksgiving story. I’ve never been turned down.

 

Thanksgiving—it’s a busy day at the Anderson house. Family and friends arrive from all over. People trickle in, some bringing food, some Thanksgiving cards, some half a gaggle of kids and everyone their appetites. Decorations of turkeys and pilgrims delight the little ones. The smell of food fills the house. In the kitchen, a passel of woman (and men) prepare food in abundance as talking fills the air. Discussions of kids, jobs, cars, church, joys and sorrows go on between where’s-this-bowl and what-shall-I-add-to-this. In the living room, three sit discussing politics. Four play a board game at the kitchen table. Toddlers run, scream, fall, laugh and cry. Babies are admired, diapers are changed, naps go on in the quiet rooms and comments are made about how every child is taller this year. Eventually, everyone gathers at the table where I read a thanksgiving Psalm and pray, thanking God for His providence, praying for those in need, remembering with sorrow the close family and friends who have passed on and blessing those who could not attend for one reason or another. Everyone eats as conversations continue. A few do the dishes, sometimes even joyfully, as most bundle up for the football game outside where someone is always learning the game and someone always gets hurt.

 

Then I tell them that when they get to my age, material things—cars, houses, bank accounts—dim in importance. But family, this gift of God, provides abundant, often indescribable, joy. Even with the sorrow of loss, family events like that are as close to heaven as I’ll ever get this side of glory. I tell her my desire for her to have children has nothing to do with my OB business, but everything to do with her joy. Don’t give up the joy! Don’t settle for “stuff”—money, cars, homes, travel, big retirement nest eggs—just stuff—when you can have family!

 

Of course, everyone knows families can be dysfunctional, traumatic, abusive and broken. Just read a newspaper. But the Psalmist had it right. Children are a reward and a joy, not a carbon footprint destroying the planet.

Psalm 61

This morning, I read Psalm 61. That God would speak through His word continually amazes me. My meditation on Psalm 61.

Lead Me to the Rock

To the choirmaster: with stringed instruments. Of David.

Lead Me to the Rock

To the choirmaster: with stringed instruments. Of David.

61:1 Hear my cry, O God,
listen to my prayer;
2 from the end of the earth I call to you
when my heart is faint.
Lead me to the rock
that is higher than I,
3 for you have been my refuge,
a strong tower against the enemy.

4 Let me dwell in your tent forever!
Let me take refuge under the shelter of your wings! Selah
5 For you, O God, have heard my vows;
you have given me the heritage of those who fear your name.

6 Prolong the life of the king;
may his years endure to all generations!
7 May he be enthroned forever before God;
appoint steadfast love and faithfulness to watch over him!

8 So will I ever sing praises to your name,
as I perform my vows day after day. (ESV)

1) To know you hear me is blessing on blessing!

2) When my heart is faint, it feels like I am at the end of the earth. I know you are there, I know I can trust you, but my feeling is gone. Hold me, Oh God!You are my rock, so above me, so strong, so worthy my devotion and worship. Lead to that place of refuge, higher than I can go myself.

3) You have been my refuge against my enemy, but my enemy is myself, my sin, my rebellion. So you are my refuge against…myself. Thank you, Oh God.

4) To dwell in your tent forever is to forever behold your glory, the glory of the one without beginning and without end, here before the universe and here after the universe has melted away. Beholding the glory of the one who spread the stars across the heavens with His finger! Who has named every star.

5) Take me and make me worthy to be your follower.

In Jesus Christ, I find my refuge and strength. Thank you, God. Amen.

Wrongful Life–A frightening concept

It seems Great Britain is determined to catch up in two areas–medical malpractice and the concept of wrongful life.

The US leads the world in medical malpractice lawsuits because of our contingency fee system. The contingency fee system means the lawyer gets a percentage, usually a high percentage, of the winnings. Thus, it pays to sue if you win and especially pays to sue if you win big. I think, don’t know for sure, but think we are the only country which has such a system. In other countries, lawyers are paid for the work they do, not on the outcome of the trial. Thus, lawsuits are much less frequent.

But it seems a woman in Great Britain is bucking the trend and is suing for “wrongful birth” (wrongful life is another term that means the same thing). Her baby was born 5 years ago with a disability. Had she known, she contends, she would have aborted.  You can read about it here.

How would you feel to know that your mother wanted you dead? Or, at least wanted you dead as an unborn baby? I think I’d be glad I slipped past the abortionist’s suction curette and made it into the world alive. Then, I’d want to leave home as soon as I was able. How do you live with someone you know would have killed you if they knew you were…just you! Warts and all. Disabilities and all. Would you have to apologize to your own mother for your existence?

I object fundamentally to the whole concept of  “wrongful life”. (Lawyers sue all the time for “wrongful death.”) I believe life is a gift from God, a gift to be cherished, loved and nutured. We are made in God’s image! Think of that! No other being carries the image of God. What a privilege it is. The Bible says nothing about the disabled being less of God’s image. So to see your own child, made in God’s image, as a wrongful life just sends chills up my spine.

I pray she will drop her suit and love her child unconditionally.

Matt Anderson

Sarah Palin Sees Through the Smoke-Screen

All due respect to the mainstream media (MSM), but they must have just fallen off the turnip truck. They’re contending the death panels mandated in the house version of the health care reform bill are not really death panels, just patient education sessions.

My goodness! The proposed house version of government health bill includes a provision of mandatory “education” regarding “end of life decisions” every 5 years for people medicare age, the education repeated each time they are admitted to a hospital.

How do you spell, “Hurry up and die already,” with a “here’s how you do it,” added in? Can anyone with half a brain miss the meaning of that?

Sarah Palin, bless her heart, has called these mandatory counseling sessions, death panels, which they are. The MSM in the article here becomes apoplectic, stating her claim has been debunked. They then go on to describe just what she was talking about! Governor Palin states such panels invite rationing of health care. It does more than that. It mandates it! (Just try to opt out of one of these sessions. You can’t.)

Fortunately for the pro-life movement, what Sarah Palin says makes waves in the MSM. They cannot ignore her, as hard as they may try. Because of  her recent run for the white house and her probable candidacy in 2012, she a big fish in the political pond. God bless her for saying what needs to be said. Let’s pray she stays strong in her pro-life views and physically safe as the months and years pass. I pray God will grant her high political office for the cause of life.

Prolife Discrimmination

Dear Reader,

Following is a piece I recently wrote to a reporter from WORLD magazine explaining some pro-life discrimination I experienced long ago, brought up to date with some recent events. With ACOG now declaring pro-life behavior unethical, the experience remains a valid look at the thinking of the abortion supporters.

I’m somewhat hesitant to bring up my experiences because of what Christian through the centuries have endured for the cause of Christ. My minor skirmishes seem trivial. Anyway, I received a note from a medical student wondering about referring for abortion and prenatal genetic testing and how one responds being pro-life.

Congress codified our rights of conscience, but the proabortion folks want that changed. So, standing for life will likely still involve some persecution. And I expect the persecution to intensify.

Here’s my story.

Pro-Life Discrimination

The year was 1977. I was just starting my last year of medical school at University of South Dakota. My class rank was high, #1 or #2. I had done well on the National Boards. Residency programs viewed me as a desirable candidate. My wife and I, always committed Christians, had three children. I feared my pro-life views could be a problem when applying for an OB/GYN residency position. Many publicly-supported OB/GYN residency programs ran large abortion services staffed by resident physicians. I knew I would face the issue, but hoped to get into a good residency, nonetheless.

I interviewed at St.Paul-Ramsey County Hospital in St. Paul, MN, and, as I came to expect, I met with the chairman of the department last. His name was Eric Hakenson, MD. During our talk, he got around to asking if I would do abortions. I told him I would not. He got nervous, started to pace and explained that the abortion service was very busy and having a resident not perform abortion upset the order of things and put more burden on other residents and staff. Then, with a firm voice, his hands on his desk leaning forward, he looked me straight in the eye and said, “If two candidates are otherwise equal, I will always choose the one who does abortions.” Translation: You won’t match for this program.

I interviewed at the University of Wisconsin in Madison and met with Ben Peckham, MD, chairman of the department last. It was a “hurry-up” meeting as I was not scheduled to interview with him. I think someone with whom I interviewed must have told him I was a good candidate. Just speculation, of course. Dr. Peckam invited me sit and then spent some time perusing my file. After about 5 minutes, he asked, “Will you do abortions?” (He got right to the point.) I said no. He then leaned back in his chair and went on to explain with great flourish how busy their abortion service was, how important it was to have everyone on board and what a problem it was to have a resident try to opt out. Then, he leaned forward and said, “I can tell you, Dr. Anderson, if you won’t do abortions, you are at the very bottom of our list.” His fat jowls shook back and forth as he emphasized the word, “bottom”. He impressed me for three reasons. One, he called me “doctor” and I wasn’t a doctor yet. Two, his declaration of my lowly position because of my pro-life views surprised me. Maybe stunned is a better word. Third, only two of us were in the room. He could deny ever having said that if I made a fuss. No one witnessed his statement but me.

I then understood that being pro-life meant more than a philosophy, a religious conviction or a world view. My pro-life views contained a real, tangible cost–job denial. But I didn’t care for the Wisconsin program anyway.

When I interviewed at Iowa, I spoke with the only pro-life staff member and one of the only pro-life residents. They both assured me the abortion service was optional and that I could opt out without penalty. At that time, a new chairman had just been appointed. William Keetel, MD, the outgoing chairman, had worsening health and was stepping down. James Scott, MD, and Roy Pitkin, MD, vied for the chairmanship. Both were outstanding candidates for this prestigious position to which Dr. Pitkin ascended. (He later went from Iowa to chair the OB/GYN department at UCLA and edit Obstetrics and Gynecology, probably the premier OB/GYN journal in the world. Dr. Scott went on to chair the department at Utah and I think edited the same journal later.) Of my two interviewers, neither had worked significantly under Dr. Pitkin and so based their statements about the optional abortion service from their experience with Dr. Keetel as chairman. I discovered later just how wrong they were.

In any event, the interview thrilled me. The Iowa OB/GYN residency program ranked near the top of OB/GYN programs in the country. My wife’s parents lived only 3 hours away from Iowa City. I applied and matched for Iowa.

I started in July, 1978. In September, I rotated through the outpatient clinic. During that rotation, those residents who did abortions would spend 2 ½ days a week in the abortion clinic. I told my chief resident I wouldn’t be going to which he replied, “Who you going to get to cover?”

“What?” I stuttered. “What do you mean? Get to cover.” He explained that the rotation was my responsibility and it had to be filled by me or someone who would fill in for me. “Well, who would that be?” I asked. “One of your resident-mates, of course,” he replied.

There were 6 of us first year residents. I would have to ask one of my residents-mates to give up the rotation they were on, either surgery, OB, NICU or whichever to help me. Fat chance of that, I thought. I had to fill the spot or get coverage—and there was no coverage.

Then, the chief resident explained I could just go over to do the history and physical exams (H&P’s) in the abortion clinic, and not actually do the abortions. That would fulfill my requirement. He didn’t see a problem with that even being pro-life since I wouldn’t actually be required to do the abortions. The OB/GYN staff would the actual abortions. Following that conversation, two or three staff doctors pulled me aside to “enlighten” me about abortion. I was naïve, I was told. I didn’t understand the problems these women faced they said. I was just obviously stupid I was told. If I went to work in the abortion clinic and saw the plight of these women, saw what a great and needed service abortion was, then, by the end of the rotation, I too would be pro-choice. (Looking back, I believe I was “tag-teamed” by the residents and staff at the direction of Dr. Pitkin, the new chairman.)

So, I caved. I went over and worked the clinic; doing the H&P’s and having the patients sign a consent form. Then I stood back while staff did the abortion. Following the abortion, I dug through the “POC’s” (products of conception) to see if all the parts were there—arms, legs, head, hands, feet, placenta. Part of helping without actually doing the abortions, you understand.

I did that for two months my first year and two months my second year. (A supposedly pro-life resident who started the next year also didn’t do abortions, but decided do them for a week, just to get good at the procedure. Oh dear.)

To understand my behavior, realize that I was 27 years old and had been a student my whole life. My teachers were my bosses and authority figures. I wrote down and memorized everything they said. So I felt incredible pressure to work the abortion clinic when they told me I was stupid and could not possibly understand about abortion since I hadn’t been there. I have no excuses though. I took the easy way. I should have stood my ground and raised a ruckus. I should have known you don’t have to crawl into the pigpen to know it smells bad. But I didn’t stand my ground, much to my shame.

When I started my third year, I slowly realized I had been duped. I remained pro-life and had not changed my mind at all. Abortion-minded women faced problem pregnancies, but none of these problems justified ending a baby’s life in my mind. I heard again and again: I’m not ready, my boyfriend wants me to, I’d have to leave school, my parents will never understand, I’m too young, I’m too old, and on and on. Abortion counselors always reached the same conclusion: the reason these women gave justified abortion.

Then, I started to think about all those conversations, about how I was naïve, stupid and uninformed. About how I would change my mind if only I could understand these women and these problem pregnancies by working in the clinic and seeing and speaking with those women desiring abortion. But I didn’t change my mind. My pro-life views solidified. The more I thought about it, the angrier I became. I asked to see Dr. Pitkin to share my concerns. I wanted him to understand the pressure I felt and how wrong that was. In my mind, I thought he would listen and issue some directive that such coercion stop. At that time, I hadn’t considered that he directed my experience intentionally.

As I explained to him my experience, he argued back, telling me the process had worked just as planned, that I needed that exposure and that he wouldn’t change a thing. What an eye-opening experience as the realization settled in. He was glad I had been coerced!

Shock and anger filled me. I had to do something. I couldn’t let this go unchallenged. I looked up right to life organizations (pre-internet) and was somehow placed in contact with Bob Dopf, a pro-life lawyer in Des Moines who did pro-bono work for pro-life organizations. I explained my story to him. He told me not to go to the newspapers or press (which I suggested), but to just calm down. He would write a letter to Dr. Pitkin asking for clarification. In the letter, he stated that if indeed pro-life residents were coerced into working the abortion clinic, any available remedy might be pursued.

Later that week, the letter hit like a bomb. I got this frantic call from Dr. Pitkin’s secretary telling me to drop everything and meet with Dr. Pitkin ASAP. When I came in, he was holding the letter from my attorney while pacing back and forth. (He had a plaque in his office that said, “Lead, follow or get out of the way.”) After about five minutes of pacing, he said, or rather yelled, “Does this mean you are suing the department?”

“No,” I replied, “not if you change your policy.” I don’t remember much after that except about 15 minutes of ranting and anger directed at me. I felt I was in a position of equality with him. He could harass me all he wanted in his office, but the letter made it clear I already felt harassed which meant he would certainly face repercussions if he fired me now. Even feeling that way, I left his office shaken. I wanted to explain myself to someone higher up than Dr. Pitkin. If I could get Dr. Pitkin’s boss to see my dilemma and support me, I could better survive. I went right to the president of the hospital’s office and asked to see him. He was just hanging up the phone—from Dr. Pitkin!

I knew word of this would be everywhere within a day, given that academic institutions thrive on gossip, so I decided to write a letter to the resident physicians explaining myself. I knew whatever they heard from administration would be negative.

So I did.

It didn’t help.

I lost all my friends. People avoided me. Conversations were strained. When I would approach a group, all talking would cease. People started wearing buttons in support of abortion and pro-choice politics, making sure I saw them everywhere.

More letters between Mr. Dopf and Dr. Pitkin followed with a promise from Dr. Pitkin that the department would respect the conscience of pro-life residents. Mr. Dopf and I discussed Dr. Pitkin’s response. Mr. Dopf wanted to be sure Dr. Pitkin’s response was adequate and that I felt satisfied. We both wanted to help future pro-life resident physicians. Dr. Pitkin’s letter satisfied me that future pro-life resident doctors would be free from harassment which resolved the issue. I heard later from other resident-mates that Dr. Pitkin stood his ground and that nothing had changed and I was defeated. Oh dear.

One good thing came as a result of my actions. As a result of our conversations, Mr. Dopf’s political connections came to realize Medicaid (Title XIX) paid for abortions in Iowa at that time. In January, two months later, Iowa passed a bill into law stopping Medicaid funding of abortions.

In time, the issue cooled and, by my last year of residency, I was again one of the group—sort of.

About four years into private practice in Burlington, IA, a pro-life patient of mine asked about my views on abortion, so I shared some of my story. That led to many speaking engagements and eventually a position on the board of directors of Birthright, a mostly Catholic crisis pregnancy organization. Eventually, I was asked to sit on their international board.

In private practice, I’ve worked almost exclusively with pro-choice doctors but I’ve always told them up front that I was pro-life and would leave the practice if any of them did abortions. So, life issues were not much problem. Unfortunately, the office staff would preferentially route abortion-minded patients to my pro-choice partners, so I saw few women considering abortion.

In 2004, my wife and I moved to Minnesota to be closer to children and grandchildren. (Four children, twelve grandchildren with #13 on the way!) I found work with a large health care organization. No abortions are done in the hospital at which I work.

After WORLD published my piece on the Hippocratic Registry of Physicians (Life and Death, June 20, 2009), my employer blocked my blog site, www.mdviews.wordpress.com, from their network. WORLD listed my blog site address at the end of the piece. I showed the article to some doctors and nurse friends around the hospital. Apparently, word got out that I had a blog and someone complained that my site contained inappropriate content since I advocated for the traditional family. My employer (specifically, the vice-president of nursing) viewed such advocacy as anti-gay and anti-unmarried-having-children-and-shacking-up. (“Very sad” read her e-mail describing my blog.)

So, in addition to facing possible government censure or loss of livelihood should Mr. Obama get his way, I can’t even view my own blog at work! I rank right up there with the pornography sites.

So at what price do I stand for life? Not much price, really. We 21st century Christians are a coddled bunch, I think. Consider Christians in the first and second centuries who were thrown to the lions for sport just for counting themselves as followers of Christ. Consider the reformers, Martin Luther in particular, hiding out at Augsburg for over a year to avoid capture. Consider William Tyndale, captured and killed for translating the Bible into English from Greek and Hebrew. Consider John Bunyon, imprisoned for not bowing to the Church of England. Consider David Brainard, missionary to the Indians in colonial America, developing tuberculosis and dying at the house of Jonathon Edwards. Consider Adoniram Judson, missionary to Burma, losing 3 wives to tropical diseases, then becoming ill himself and dying on board ship with no family or friends while trying to make it back to America.

So I can write my own story of discrimination and despair, but I feel silly doing it when I place it in the perspective of the centuries. But, having said that, one can possibly see economic sanctions and loss of livelihood on the horizon, and who can tell what next? Perhaps our sovereign God will deign for us persecution—real persecution—as our Christian forefathers faced. In all, my faith and hope rests in Him, “For from him and through him and to him are all things. To him be glory forever. Amen.” Rom 11:36 (ESV)

Perinatal Hospice

Perinatal hospice, the brain-child of Byron Calhoun, MD in 1995, provides compassionate care to those couples found to have a baby with a lethal disability prior to birth.

Such conditions do exist, unforturnately, and are often found on routine ultrasound or genetic testing.

When such a condition is found, the pro-abortion maternal-fetal-medicine specialists (MFM’s) and genetic counselors often recommend abortion. (No hope, you understand. So, why not?) Of course, abortion, even of a disabled child, carries with it the guilt of killing your own child–your own helplessly sick child. How cruel is that?

As an OB/GYN doctor who has been around the prenatal diagnosis block a few times, I seen “non-directive counseling”, as the geneticists and MFM’s call it, relentlessly push patients who carry such a child into abortion on many occasions. Dr. Calhoun saw the same thing and came up with the concept of perinata hospice, a blessed process which honors life and which provides wonderful support  for such couples.

I’ve written a piece about this topic and WORLD magazine has graciously agreed to print it in their upcoming issues. You can access WORLD magazine on the web at www.worldmag.com. It requires an online subscription or a print subscription to see entire articles. (A bargain, I can assure you!)

I’ve also copied it and pasted it below. (This article is copyright by WORLD magazine and may be used with their permission.) Enjoy the read. Should our sovereign God deign such a circumstance for you or one you love, please, keep perinatal hospice in mind.

August 1 5 , 2009

A grief conserved

Perinatal hospice offers an alternative to the trauma of aborting a disabled child

Something’s wrong with this baby,” my ultrasound technician told me. She had just scanned Mrs. Jones (a fictitious name) at 20 weeks and went on to describe her findings, findings that surely meant little chance of survival for that baby. As I later spoke with Mrs. Jones to relay the findings, she wept. I arranged an appointment with a maternal-fetal medicine (MFM) specialist. The next day I received an urgent call from my patient. Through more tears, she described her visit in which the MFM doctor confirmed the grim prognosis. The baby would die, probably within a week or two. The MFM insisted on scheduling her for an abortion in three days. “Do I have to have an abortion?” she asked. I promised to call the MFM and assured her she did not have to abort.

When I called the MFM specialist, she immediately rattled off the severe abnormalities found, the fetus’ incompatibility with life, and the scheduling of an abortion. I interrupted: “If the baby is going to die anyway, why do you want to kill it before it dies a natural death?” There was silence on the other end. I went on to explain that the parents would not have to deal with the guilt of killing their child if it died naturally. There was a pause, then, “I hadn’t thought of that,” she said.

So much for nondirective counseling, as it is called. Sadly, I’ve had several similar experiences in my 27 years of practice.

My patient’s baby did die in utero about two weeks later. She labored and delivered a stillborn baby with all the grief and pain associated with it. She was thankful, however, for the love and support of family and friends during the process and the knowledge that she had not contributed to her baby’s death.

When a pregnant woman clearly understands the primary purpose of genetic testing—abortion of a handicapped baby—a majority decline testing in my experience and almost all pro-life women decline testing. Nearly every problem now identified by prenatal diagnosis has no treatment. David Grimes, a well-known OB/GYN, professor at the University of North Carolina School of Medicine, and a strong abortion advocate, spoke truth in a rare moment of public clarity when he said prenatal diagnosis would disappear if abortion were not available.

But what happens when a routine 20-week ultrasound shows a baby with a profound abnormality, possibly an abnormality that will certainly result in the death of the baby prior to or shortly after birth? Or when a genetic test is done and shows similar results and the patient then decides against abortion? What then?

Enter perinatal hospice, the brain child of Byron Calhoun, a pro-life maternal-fetal medicine specialist.

Perinatal hospice honors life. The woman carrying the disabled child receives extensive counseling and birth preparation involving the combined efforts of MFM specialists, OB/GYN doctors, neonatologists, anesthesia services, chaplains, pastors, social workers, labor and delivery nurses, and neonatal nurses. She carries the pregnancy to its natural conclusion. She and her husband are allowed to grieve and prepare for the short time God may grant them with their child while their baby lives inside or outside the womb. Such a process obviates the grief caused by elective abortion, killing the child before it could be born.

Doctors and nurses often withdraw from hopeless patients, and surely a baby with a lethal anomaly is a hopeless patient. Add to that, as my example above illustrates, the concept of natural death for babies with lethal anomalies perplexes those who advocate abortion and prenatal eugenics. For them, not terminating a hopeless pregnancy is stupid.

Perinatal hospice, on the other hand, allows natural grief and separation with the support of the medical community. Calhoun says parental responses have been overwhelmingly positive. “These parents are allowed the bittersweetness of their child’s birth and too-soon departure. Grief lessens as time passes and the parents rest secure in the knowledge that they shared in their baby’s life and treated the child with the same dignity as a terminally- ill adult.”

Even those mystified by a patient choosing life have recognized the value of Calhoun’s idea, as perinatal hospice programs now dot the nation. But this mystery is no mystery to us. As Job 1:21 states, “Naked I came from my mother’s womb, and naked shall I return. The Lord gave, and the Lord has taken away; blessed be the name of the Lord.”

Call for One-Child Policy in Australia

Once again, the people-are-the-problem groups are campaigning to make already sparsely populated Australia even more sparsely populated.

LifeSiteNews documents their folly here and here.

Environmentalism, the religion of the left, demands it.  Mother Earth represents God, and Earth Day symbolizes Christmas and Easter rolled into one. Prophet Al Gore writes canonical books for them. Universities and public schools serve as houses of worship where the young receive their indoctrination, huh…education. Vestments consists of colored ribbons worn on the lapel announcing solidarity with the newest fad. Symbols of evil include the American flag, the US soldier, any SUV and any home in the suburbs. They evangelize, but prefer control through government-mandated teaching and the EPA regulations to control our children, our property, our cars, our roads, our toilets and even our livelihoods. They haven’t yet devised a way to control our family size in the US.

So, as Europe and Russia see their cultures disappearing into Eurabia from the birth-dearth and immigration, Australia pushes to join them.

How different the Biblical view of children and family! God bless those whose quiver is full!

Separating Life and Death

Here is an article I submitted to WORLD magazine regarding OB/GYN physicians, rights of conscience and the Hippocratic Registry of Physicians on which I’ve posted before. They graciously decided to publish it.

So, here I am on a Friday night, pizza night at our house, surrounded by life; children and their spouses, numerous grandchildren, nieces, sister-in-law; enjoying the glory and warmth of love and life and family. All the while the culture of death marches on. 4,000 unborn lost their lives today in the US. 4,000 women now carry the wounds of the tearing of that life from her womb. Many aged passed across the river to eternity today, some, unfortunately helped by misguided physicians who judged their sick life to be no longer worth living. Somewhere tonight, a woman in an ER hemorrhages from an abortion done earlier while her “hero of woman’s rights” who performed her abortion deposits the money she paid into his bank account and goes out on the town, unavailable to help her now.

Life is always bitter-sweet, eternally significant, joyfully sorrowful; and today is no exception.

In the joy of the weekend, the relaxation of time off, the refreshment of vacation, the rejuvenation of renewed relationships; remember, always remember, the weak, the helpless, the lost and the battle we face, with God as our help, to save them.

Thanks for reading.

Matt Anderson

“For man does not know his time” Ecc. 9:12 The Murder of Mr. Tiller

It seems everyone has commented on the murder of Mr. Tiller. I will call him “Mr.” as opposed to “Dr.” as his role was the ending of life, not the preserving of life. He was a killer, not a healer. The term “Doctor” has a wonderful history and a deep meaning to society. Doctoring is a profession, a calling. What Mr. Tiller did in no way resembled the practice of medicine.

I agree with my daughter who eloquently stated a Christian way to view this horrible act of murder. The man who murdered Mr. Tiller should be punished to the full extent of the law, which, I would guess, he is ready and willing to receive.

Why were Mr. Tiller’s actions as an abortionist so heinious, so revolting, so unjustifiable, so abhorrent? Several reasons, actually, some common with all abortionists and some unique to him.

First, killing is easy. (Don’t let anyone tell you otherwise.) And he was particularly good at killing.

As an OB/GYN physician, I had to spend time in the busiest abortion clinic in Iowa when I was in residency; so I saw abortion, up close and personal, and  spoke to the women seeking abortion. In the following paragraphs, I describe, in some detail, abortion mill procedures and especially the late-term abortions for which Mr. Tiller gained his fame. If you would prefer not to be exposed to such details, you may want to skip to the last couple paragraphs.

The usual first trimester abortion (up to 14 weeks) done in a typical abortion mill takes 10 minutes, max, for an experienced abortionist in a well-organized abortuary. An abortion-minded woman or girl calls an abortion clinic because she thinks she may be pregnant and is considering abortion. Most don’t call already determined to have an abortion. She is, however, drawn in by careful words. “Oh, your pregnant,” the receptionist says, confirming the pregnancy without a test. Then, the receptionist confirms her worst fears.  ”You’re right,” she says, “a pregnancy now in your situation (boyfriend not supportive, may have to quit school, mom and dad won’t approve, too young, too old, too poor and on) would ruin your life. We can help.” The receptionist makes clear the cost and the cash needed and offers suggestions about how to get the money from family, friends, loans, savings or other relatives, because the need is so great and the abortion-minded girl doesn’t want her life ruined. Once she arrives for the abortion appointment, the receptionist collects the cash before anything is done. Once the cash is in the drawer, the young girl sees a faux-counselor who confirms with her the great need to end the pregnancy. The nurses or medical assistants turn over rooms like lightening to keep the abortionist working.They clean only visible blood off the table or floor. Any hesitation to back out on the girls part during this process is met with reminders of her ruined life if she delays. The abortionist enters the room with the patient on the table, in the stirrups and ready. Gentle is not a word used to describe the procedure. The typical woman seeking an abortion is young and has never had a baby, so the exam itself is not comfortable, not to mention injecting the novacaine, dilating the cervix and suctioning out the baby. Once done, the canister containing the baby and placenta may be emptied into a container to count arms and legs and identify head, thorax and placenta as confirmation all the parts are out. Many places don’t even do that. The woman may be watched for a short time–very short time–and hustled out the door with a prescription for pain meds and instructions to go to the ER if problems develop.

And those are the easy ones.

An abortion done after 14 weeks entails more risk and more time, but the encouragement to proceed, the tight organization to make maximum money with minimal effort, the quick discharge and use of ER for complications is the same.

Abortionists prefer D&E (dilatation and evacuation) from 14 to 18 weeks. The procedure is like a suction, except 1) the baby is more developed and doesn’t collapse into the suction tube easily 2) the cervix has to be open to a bigger diameter to get it out 3) the blood loss is greater 4) the risk of perforating the uterus with an instrument is greater and 5) the pain is more severe. After opening the cervix overnight with laminaria or cervical ripening medicines, the abortionist dilates the cervix even more, then inserts a large grasping forceps with tissue-crushing teeth into the uterus, crushes the baby and removes it in pieces. Then the abortionist suctions out the remaining pieces and the placenta.

Past 18 weeks, the abortionist may inject a strong salt solution into the uterus through the abdomen which kills the baby. The patient then labors over the next 1-2 days and delivers a dead baby. (Not always, of course, but that’s the plan.)

Also, past 18 weeks, the abortionist may choose D&X (partial birth abortion). I would imagine this technique would have been the one done most by Mr. Tiller, as he specialized in late term abortions. With a D&X, he would open the cervix as in a D&E abortion. Then an assistant would scan the baby with the ultasound while Mr. Tiller would insert grasping tools through the cervix into the uterus to grab the baby’s feet or legs and deliver the baby up to the head. The head stops in the cervix because it is too firm and too big to get through. Mr. Tiller would then take a long, sharply-pointed scissors and poke it into the skull, spread it apart to make a hole and insert the suction tube into the skull. Then he would apply suction to empty out the brains which collapses the skull. The now-dead baby then comes all the way out.

Picture this if you can without vomiting. The baby is 3/4 of the way out, wiggling and squirming in the abortionists hand when he sticks the scissors into the skull. The baby stiffens to the trauma. When the abortionist applies the suction, the baby goes completely limp, dead, is removed and then discarded into the trash.

Mr. Tiller had no limit on gestational age. He bragged once that he aborted a baby a day before its due date.

And that, dear reader, is why Mr. Tiller was such a lightening rod for controversy. He was a baby-killing machine, killing mostly those babies who could have survived outside the womb had they been born alive.

Was he a selfless hero as describe by the pro-abortion groups? No. Like all abortionists, I imagine him a self-serving, lazy, money-grubbing man who, in years past, would have been jailed or perhaps executed. Self-serving as he seemed to craved the praise and attention of the abortion activists and advocates by performing abortions so much like murder that no one else would do them. Altruism? Hardly. Lazy in that he likely worked the day shift with no night call or weekend work. Pretty cushy. Money grubbing in that the money is always the draw for abortionists. A good abortionist can make 7 figures, with no collection problems, no insurance hassles, no clinic inspections, no recording keeping rules, no dealing with postop complications and no messy relationships with patients (by the time they meet him, they are on their backs, on the table, draped and ready), generally speaking.

Do I mourn Mr. Tiller’s death? Yes. The killer removed Mr. Tiller’s chance for repentance and salvation. I also mourn that a lawless man murdered him. I would have rather seen laws changed and his activities stopped by an outraged society. I mourn that the pro-abortion groups will use this act to paint all pro-life people with a terrorist brush. See how terrible we all are, they will say. That man didn’t kill Mr. Tiller. Mr. Tiller died as a result of the retorhic and encouragement from prolifers, they will say. The murderer was just the point of the spear thrown by pro-lifers.

But I don’t mourn Mr. Tiller’s death too much. I am not disappointed that some babies may now live who would not have otherwise lived.  I am not disappointed that some women will have a take-home baby to love instead of the grief and guilt of killing her own child.

Will someone take his place? Probably. But one has to love money–really, really love money–to wear a bullet-proof vest to work and deal regularly with the controversies involved in late-term abortions.

Lastly, am I any better than Mr. Tiller? No. My only hope is salvation through the redeeming work of Christ, His sacrifice and my hope of eternal life in Him. Prior to His effectual call, I sinned. I only sinned. I continually sinned. And sin is sin. Any sin separates me from a Holy God. Once redeemed, I am justified in Him and declared righteous by God. Still, I am continually reminded of my fallen state and my need for His grace. Mr. Tiller was mudered at church, but I doubt he heard a sermon on Revelation 21:8 which reads, “But as for the cowardly, the faithless, the detestable, as for murderers, the sexually immoral, sorcerers, idolaters, and all liars, their portion will be in the lake that burns with fire and sulfur, which is the second death.”

A Victory at the UN Commission on Population and Development

WORLD magazine has this article regarding the UN Commission on Population and Development’s recent session. This commission attempted to direct countries to provide “reproductive services” (read: abortion and birth control) as a fundamental right. In addition, they tried to sneak in language calling for worldwide legalization of same-sex marriage, abortion, prostitution, and for explicit sex education for young children. WORLD Magazine states,

The session’s final document contains language that calls on governments to provide young people with “comprehensive education on human sexuality,” adding, “reproductive health and reproductive rights embrace certain human rights.” It urges countries-where abortion is not against the law-to “train and equip health-service providers and . . . take other measures to ensure that such abortion is safe and accessible.”

The organization called Family Watch International led the charge against the United States and other abortion-minded countries. Of interest, some European countries complained about their declining populations and Japan “joined them in recognizing the disadvantages of a rapidly declining population.” Hmm…Let’s see. You kill your young and wonder why there are not enough young. I am missing something here?

When I think of world meetings of this sort, I imagine international dignitaries in native dress with aids in tow, reams of statements and statistics, rooms with cogent, elegant arguments and everyone thoroughly informed of the documents on which action is taken, but the agenda set and minds generally made up before the meeting.

I read the account on the Family Watch International web site. I…was…inspired! Sharon Slator is president of this organization and logged this account.

As I summarized in a previous report, members of our Family Watch team uncovered a ploy to trick UN delegates into endorsing a document entitled the “International Guidelines on HIV/AIDS and Human Rights.” Among other things, this awful document calls for worldwide legalization of same-sex marriage, abortion, prostitution, and for explicit sex education for young children…. It is one of the most anti-family documents ever circulated at a UN meeting.

Even though UN delegates had agreed not to open the document up for any changes, with the help of my foster son, Luis, who is from Mozambique, and the rest of our Family Watch UN team, we were able to get the attention of the African delegates charged with negotiating the text. They were outraged when we showed them direct quotes from the very document they were about to “take note” of. As a result, they demanded the reference be removed.
Thank you to all of you who called the White House and the U.S. mission to express your outrage that the U.S. was endorsing this document. I am disappointed to report that the U.S. did not reverse its position, so we owe our success not to the U.S. but to the African delegates who helped us remove it.

So, this woman who is president of Family Watch International took her adopted son (probably black, from Mozambique) with her to the UN. He helped her get the attention of the African delegation. They were able to point out the proposed changes which were anti-family. The African delegation then got the language removed. What a story!

I have two comments to make.

First, it takes work, forethought and planning to educate, argue and persuade. Such efforts are not always rewarded, but in this case, they were. Certainly, without work, forethought and planning, the result would have likely been different. I think that applies where ever you are-not just at the UN! Knowing good, concise, effective and persuasive arguments for why you believe in life, why you stand for the family, why homosexuality is wrong and destructive and anti-family and any other issue important to life and family is our duty! We can’t slack on this. Thank God for His providence in this situation and thank God for these people at Family Watch International committed to this cause.

Second, I have to say I almost wrote that it takes some luck on occasion to get your point across. Well, I don’t believe in luck. All things in life are ultimately God’s providence. He decides. He controls. He provides. He gives life and takes it away. He is the I AM. To Him be glory in this victory.

So what about you, dear reader? Are you uncomfortable when you here several people at work making some statement against life, but just don’t know how to respond? I would recommend Randy Alcorn’s book, Prolife Answers to Proabortion Arguments. It is a quick and effective read and will prepare you to stand for life in the public square, with friends and with family.

The Oath of Hippocrates and the newly-formed Hippocratic Registry of Physicians

I thought I would update you on an exciting concept being championed by John Patrick, MD. In response to laws and rules designed to remove the rights of conscience from physicians, John Patrick has started a Hippocratic Registry of Physicians. It is only in Canada for now, but AAPLOG board discussed this concept at its meeting in January. It’s a concept that has feet and hands.

Basically, the death lobby (abortion and euthanasia folks) is not content with permission to practice the killing trade. They want acceptance and approval. They do not want people (me and others) accusing them of an immoral act. They want everyone to know and accept that they are right and moral and ethical and justified in all their killing.

So, that is the motivation behind the American College of OBGYN (ACOG) issuing an ethics opinion stating an OBGYN doctor is ethically obligated to perform or refer for abortion. And it’s the motivation behind the American Board of OBGYN (ABOG) to require adherence to the ACOG ethics code as a requirement for board certification.

The death lobby has prolife pharmacists in the crosshairs as well. They want them to be required to dispense abortifacients. There are rumblings from Oregon, Washington (recently passed laws legalizing euthanasia) and countries across the pond of moves to require doctors to “provide euthanasia service” if requested.

All this has motivated physicians who hold to the Oath of Hippocrates to establish a Hippocratic Registry of physicians who would pledge to support life, as the Hippocratic Oath does. One can see an entire parellel health system developing which would include life-affirming hospitals, doctors, pharmacists and nurses. It would be a system which would have competing accreditation agencies.

Whether the death lobby would even allow such a system to exist is questionable in my mind. But it is the right thing to do. If the killers intend to force us to participate in abortion and euthanasia, we must quit, withdraw or start our own health system which honors life.

So there you have it. Stay tuned for more updates.

Octuplets in California–Liberal Angst Over Opening Pandora’s Box

A woman in California has delivered 8 babies at one time–octuplets, no less, at 31 weeks, the smallest at 1lb 8oz and the largest 3lb 4oz and of them 6 boys and 2 girls and apparently all doing well. Details come drizzling out and have caused more than the usual amount of “water-cooler” discussion in the hospital and clinic where I work.

This woman is alleged to be single, to have conceived by in vitro fertilization and to have had her first six children the same way. Reports say the same father is listed for the first six children. The neighbors have reported this sperm donor from a while back  is apparently not in the picture. Other reports says she had left over frozen embryos which were implanted at her request. She declined “selective reduction”, abortion of the several while in the womb, leaving a lower number of babies inside to try to improve outcome. She released a statement stating she was thrilled. She has been identified and has an advanced degree. She went through bankruptcy 3/08 with a debt of almost $100,000.  She lives with her parents who have also been impoverished and do not sound to be supportive of their daughter’s blessed event.

So, what are the complaints?

First, I’ll tell you mine.

She’s not married. The babies are from a “donor”. That, to me, is immoral. The number? 8 is a lot. But once conceived, I agree in doing everything to bring them to safe delivery. I do not regard infertility treatments to be immoral except for traditional reasons. The Catholic church has a different view that the only moral way to have a baby is from sexual intercourse between a married couple.

Complaints I’ve heard and some I’ve read.

1) The doctor who implanted the embryos should a) lose his or her license b) be disciplined c) be arrested. This is based on the generally accepted medical rule of only implanting a few embryos at a time.

2) A woman having 8 children at once with 6 children at home is a) stealing money from the state b)totally irresponsible c) crazy d) should have her children removed from the home by social service because the children will obviously not receive good care.

Mostly, what I hear is the tut-tut-ing of self-righteous indignation.

Sorry, but it does little good to get worked into a lather now. Pandora’s box was opened long ago.

How often have I heard it is morally OK for a lesbian woman to conceive via in vitro with unknown donor sperm? Or a single woman the same way? Lots of times. And what I hear is that I have no right to make a moral judgment on such behavior. Even now, there is an OB/GYN in California who is in trouble with the state because he would not perform in vitro on a single, lesbian woman. And he even arranged a referral complete with an appointment to a different clinic that would do the procedure!

How often have I heard that marriage should in no way be tied to welfare benefits? Women need a man like a fish needs a bicycle, to quote a famous feminist.

So let’s review. This bag full of babies causes bloviating and bluster from so-called “tolerant” politicos and other amateur moralists for what reason? She’s single , used in vitro to have a gaggle of kids and might go on welfare? Puh-leese.

Poor Ms. Nadya Suleman, the octuplet progenitor, educated and working on a counseling degree has committed the cardinal sin of illustrating the logical extension of the moral bankruptcy of in vitro for anyone at anytime combined with an exuberant love of children. Both unacceptable violations of the liberal ethic.

The doctor, if from the US, may yet be have to explain his or her actions. It’s too late for liberals to question her behavior, in my mind.

Pastor John Piper, where were you in October?

John Piper is my pastor. He preached a sermon on 1/25/09 that I wish everyone could hear or read. He takes Mr. Obama to task for his pro-abortion acts since he has become president. I love him for it. I respect him more than any pastor I have sat under. He is a man who loves God and shows us God.

But I have a beef with him about this issue. He seemed surprised by Mr. Obama. It seemed like he thought Mr. Obama’s “official” stance, which was neither pro-life or pro-abortion, was the truth. He sounded betrayed by Mr. Obama. Following is the written portion of the sermon regarding Mr. Obama taken from here.

As everyone knows, our new President, over whom we have rejoiced, does not share this reverence for the beginning of human life. He is trapped and blinded by a culture of deceit. On the 36th anniversary of Roe v. Wade, he said, “We are reminded that this decision not only protects women’s health and reproductive freedom, but stands for a broader principle: that government should not intrude on our most private family matters.”

To which I say . . .

• No, Mr. President, you are not protecting women’s health; you are authorizing the destruction of half a million tiny women every year.
• No, Mr. President, you are not protecting reproductive freedom; you are authorizing the destruction of freedom for a million helpless people every year.
• No, Mr. President, killing our children does not cease to be killing our children no matter how many times you call it a private family matter. Call it what you will, they are dead, and we have killed them. And you, Mr. President, would keep the killing legal.

Some of us wept with joy over the inauguration of the first African-American President. We will pray for you. And may God grant that there arises in your heart an amazed and happy reverence for the beginning of every human life. [His actual sermon deviated from the written text and was so powerful.]

Pastor Piper is a guest columnist for WORLD magazine and wrote a piece on November 4, 2000 which defended those who are called “single-issue voters”. He argues that there are many singe issues which would disqualify one for high office. Would a sexual molester of children qualify? He notes that people face bigger penalties for cruelty to animals than taking human life from the womb. In 1989, he was arrested for picketing an abortion clinic. Pastor Piper is no marginal, fair weather pro-lifer. He is passionately pro-life.

As I listened to his sermon on Sunday, I had tears as well. Not tears of joy for Mr. Obama’s inauguration. Tears that Pastor Piper did not preach that sermon against Mr. Obama’s pro-abortion stand in October when hearts could have been changed and votes would have mattered. It dawned on me as I listened that Pastor Piper did seem betrayed and surprised, so I wonder if he was hoodwinked into believing the lies or ignoring Mr. Obama’s past because he was black. Pastor Piper is also passionate about racial reconciliation. I’ve written to Pastor Piper about this matter and would not have brought it up here except that his sermon and its content is featured on www.prolifeblogs.com where public comments have been made. Since it is all public, it is fair game for public debate and comment. His sermon can be watched, listened to or read from the www.desiringgod.org web site.

“Red and yellow, black and white. All are precious in His sight. Jesus loves the little children of the world,” so the old Sunday School song goes. So I don’t care if Mr. Obama is red, yellow, black or white. If he won’t stand for the unborn, he will not be my choice for office.

I had tears on his inauguration day as well. Tears of regret for all the unborn who will die because of Barrack Obama.

OB/GYN Organization Wants More Abortion Training and More Abortionist!

In the spirit of updating those of you who are not OB/GYN doctors, I’m reporting on the latest American College of Obstetrics and Gynecology (ACOG) Committee Opinion, #424 issued this month, January 2009.

The title is Abortion Access and Training. The abstract from the document follows.

ABSTRACT: Despite a decrease in abortion rates over the past decade, numerous political, social, and provider barriers limit access to abortion services. Barriers include state restrictions and mandates limiting access, lack of public funding for abortion services, and the decrease in abortion providers. Abortion education and training are limited in medical schools and in residency programs. The American College of Obstetricians and Gynecologists supports education in family planning and abortion for both medical students and residents and abortion training among residents. In addition, the American College of Obstetricians and Gynecologists supports availability of reproductive health services for all women, including strategies to reduce unintended pregnancy and to improve access to safe abortion services.

Some comments about the article. They cite the decrease in abortions (2005 was the lowest per capita rate since 1974) to better family planning, more contraception and better contraceptives which led to fewer unintended pregnancies. Funny, what else happened in 2000 that might have led to a decrease in unintended pregnancy, something that gets no mention? How about abstinence education. The decrease in abortion corresponded to more widespread acceptance of abstinence education which embodies a respect for life.

The article bemoans no federal funding for abortion and  lack of universal insurance coverage for abortion, two development for which I praise God.

State mandated restrictions on abortion, such as waiting periods, mandatory consent forms, parental notification are all given the thumbs down by the authors. Which must means those laws are helping. How wonderful!

Abortionist’s numbers have declined from 2,042 in 1996 to 1,787 in 2005.  How heartwarming! What follows is the paragraph at the end of that section which should give hope to all those pro-life people who walk outside abortuaries, picket abortionists homes and expose abortionists publicly.

Abortion may take place in an atmosphere of controversy, harassment, and sometimes violence (13). [I disagree. Prolife folks are some of the most kind and gentle people in the world. The pro-aborts just wish we were violent. We are not.]The highly charged emotional and political debate stigmatizes the women who undergo abortion and the providers who offer abortion. In addition to creating a barrier for seeking care, this negative atmosphere may be a deterrent to training providers and offering reproductive health services.

In other words, our efforts are worthwhile and working!! Big time! It’s one thing for an abortionist to knock down big bucks for easy work (killing is never hard) in the privacy of some clinic in the inner city where none of his friends can see. It’s ugly and shaming, however, to have several people on his sidewalk where all his neighbors can see carrying signs identifying him as an abortionist! His kids don’t like it. His spouse doesn’t like it. The neighbors don’t like the attention. The news people may show up. Dear, oh dear. The light of day has such a sanitizing effect.

Next, the article discusses the unfortunate occurrence of “opt-in” for abortion and family planning training for medical students. In other words, medical students have to make an effort to take a course that exposes them to abortion. Not many do. In OB/GYN residencies, abortion training is also more of an “opt-in” event than a required event as well. Doctors who object to abortion on moral or religious grounds can opt out. (It was not always so.) In 2004, 51% of programs offered routine abortion training, 39% offered elective training and 10% offered no training at all.

My own experience in residency training was, well, terrible. I was pro-life but had to help in the abortion clinic. It’s a long story which I have told to many pro-life groups through the years. Stories like mine are what led to the abortion service being made elective in residencies. Maybe I’ll post my story one day.

They end the article with a call for all medical student and OB/GYN residents to be educated about family planning and abortion as a routine part of medical school and residency training.

Overall, the Committee Opinion lifted my spirits. They would not write something like that unless they were frustrated with the state of things and worried about the graying of the abortionists in America. Praise God!