Informed Consent Laws

Sooner or later, one is going to hit a wall in any political discussion involving opposing views. However, on most political issues, there is much room for compromise. On the remainder, there is at least room for conversation. It seems there is only one issue on which the opposing sides are unwilling to give any ground – each seems to think the other side is out to destroy the world and comes into any argument looking to draw blood.

I am referring, of course, to abortion. Although I have no idea as to whether my fellow pro-lifers at Brown would support me, I must say that this attitude is not effective. Without any disrespect towards her, I like to think of this attitude as the “Ann Coulter” way of thinking. If you have ever watched her debate, you know that she is aggressive, gives no ground, and wants her opposition to be whimpering on the floor in the fetal position by the end. She really seems to believe the “other side” hates America and wants to see the country come crashing to the ground. Yes, she is entertaining to read. Yes, I agree with many of her views, particularly those on abortion. Yes, I admire her courage. No, I do not want to be she, for several reasons, the most important of which is that I believe her way cannot lead to victory.

One wants to find common ground on which to stand, not just to make it easier to pass legislation through Congress, but also so that one’s side becomes more mainstream, and more people accept it as the truth. If the other side is willing to agree on a given point, maybe there are now other points that can at least be discussed.

How likely is it that every pro-choice person in the United States is suddenly going to stop and say, “Hm, you’re right, pro-life people! Abortion IS murder. How silly I’ve been! Let’s criminalize it!”, if one simply shouts louder? At a recent speaking event at Brown University, sponsored by the Brown College Republicans, National Review Senior Editor, Ramesh Ponnuru, alluded to this reality – he advised that pro-lifers take it in steps, and the tide will eventually turn. According to one poll conducted by Overbrook Research in Missouri, it has already begun: while in 1992, 39% of women and men under 30 considered themselves strongly pro-choice, and only 23% strongly pro-life, the ratios have almost reversed themselves; 36% now consider themselves strongly pro-life, with only 18% strongly pro-choice. I would like to polarize those numbers even farther, but clearly this change was not accomplished overnight.

In order to take the first step to make pro-life views more mainstream, I have been looking for the next point to champion, and I have found it: informed consent laws. In reference to abortion, these laws require a doctor to discuss all the aspects, risks, and results of the procedure when talking with the pregnant woman.

Those who consider abortion nothing more than a medical procedure and who initially react poorly to the concept of informed consent laws might be interested to learn that the most helpful information I have received on this topic is from the American Medical Association (AMA), regarding its standard for communication when discussing an upcoming treatment with a patient. If abortion is nothing more than a treatment for a medical condition, then informed consent laws should not be a controversial issue. Informed consent is a recommended standard for all medical professionals to follow (not to mention a legal requirement in some form in all 50 states).

The AMA’s first point on its list of procedure for informed consent is the necessity of disclosing a diagnosis. The diagnosis in the issue at hand would be a pregnancy; the only argument would be over the required wording, though I do not think anyone would object to “You’re pregnant.” The argument would erupt over what other information must be provided in addition to that simple declaration. Many pro-life advocates want it to be required that the woman see a picture of the unborn child. Since a patient is allowed to see an x-ray of a broken bone, or an approximate diagram of a tumor, I fail to see why this should be an issue.

The next step is telling the patient the “nature and purpose of a proposed treatment or procedure.” Basically, this means that the doctor must explain what is going to happen. Again, the wording that would describe this procedure has differed greatly between the opposing sides, from the removal of a bunch of undeveloped cells to the murder of an unborn child, but a compromise could be reached, if both sides truly wanted this information to be provided. Clearly, neither of the previous terms could be used, but with some discussion from both sides a relatively neutral term could be chosen.

The AMA also states that the risks and benefits of each procedure must be discussed with each patient. The doctor would mention the positive effects of avoiding the dangers of childbirth, and of not being responsible for a child one does not want, but he should also mention the possible dangers of receiving an abortion. Most operations, even if their success rates are close to 100 percent, still involve some risk, and these risks must be discussed with the patient. Like most invasive operations, abortion carries serious risks to the patient. Most importantly, doctors must discuss the possible psychological effects of abortion on the patient.

The mental health issues from which a significant number of post-abortive women suffer are particularly pertinent. And though many pro-choice activists blame this feeling of guilt on pro-lifers and their agenda, where this guilt originates is irrelevant as a health issue. If guilt exists, it must be discussed as a risk to mental health. The possibility of fetal pain – i.e., the idea that the fetus can feel pain as early as the first trimester – must also be discussed, since there is still disagreement as to whether or not a fetus can feel pain as early as the first trimester. Until the exact time is resolved, or it is concluded that a fetus cannot feel pain, the possibility that a fetus can feel pain must be mentioned.

The AMA also says alternatives must be discussed, no matter their cost, including the option of not continuing with the procedure at all. Bringing a pregnancy to term is the alternative to abortion. It must be discussed as an option, and it should not be difficult to give an objective analysis of the risks and responsibilities inherent to carrying a pregnancy to term and giving birth.

There are benefits to both sides of the abortion argument for passing informed consent laws. For pro-lifers, these laws would cause a decline in the number of abortions performed, which is clearly a step towards our ultimate goals. For pro-choicers, the existence of these laws would prevent lawsuits stating that abortion doctors did not provide enough information, and would most likely prove that women still have abortions even with explicit information on what the procedure entails. Clearly, there are individual wordings to be worked out, but this is a great step to take, and one that could be accomplished with relative ease. Will either side be content with it, permanently? No, of course not. But right now, it is better to compromise than to continue to shout at each other and get nothing done.