Sunday, May 01, 2005

BBC NEWS | Americas | Florida girl has abortion blocked

13 year old girl, 3 months pregnant has her abortion blocked on the grounds that she is too young and immature to make an informed medical decision. This is despite a state legislation which removes the need for parental consent for an abortion.

Um...yes...right. The kid doesn't understand that she's pregnant or what abortion entails?! So presumably, unless it is a situation that is life-or-death, a person under some arbitrary age cannot consent to that operation. I can understand the ruling especially when it is in light of some superficial cosmetic surgery e.g. breast enhancements. It's relatively obvious that in that situation the state is probably right (though still a dubious decision depending on the rationale of denying that form of 'treatment'. Harm? Body development? Intellectual capacity?). Perhaps a better example would be some forms of dental surgery, say braces before the age of 10. But that in and of itself has a demonstratable harm.

But let's move along the scale upwards towards operations that are very important but not life-or-death per se. What about removal of infected tonsils? It's not likely to kill a person and theoretically we could use a regime of anti-biotics to treat the person until it can be demonstrated that they do not work before we have the operation. Or how about facial reconstruction? I mean the person is just disfigured right? If it doesn't affect his ability to see or to eat, why should we allow him to choose such reconstructive surgery? Or better still, circumcision? Definitely unnecessary and causes pain and trauma to the child. Mostly done on religious grounds now although, it's become a cosmetic thing in America apparently.

I think it would be safe to say that most reasonable persons would argue that such operations ought to be allowed.

1. It's a personal decision that does not affect the life of a fetus/ball-of cells/parasite/unborn human being (that should cover the spectrum of views). While this is a strong and valid point, that is not what the basis of the suit and court ruling was about. But more fundamentally, it is simply begging the question on when life begins or more accurate, when should the fetus be considered a human being and hence have adult human rights.

If one argues the possibility (or probability of development in Life) than oddly enough, the only consistent stance that has been taken is that of the Catholic Church which denounces even contraception, because ceteris peribus (all things being equal), the union of the sperm and egg will result in fertilization and so on and so forth. But most people of religious affiliation don't take that stance anyway.

So maybe the appropriate decision should be that taken in Roe v. Wade which balances the state's right to the health of the mother and its unborn citizen will that of the mother's right to choose. At this stage (12 weeks), the fetus is non-viable and incapable of surviving outside of the mother's body anyway.

2. So taking into account the examples of reconstructive surgery and 'unnecessary' operations, the issue becomes one of harm in the broader sense of the word than the narrow definition of say physical harm per se. In those instances, we accept that the state of mind and general suffering of the patient is sufficient cause for the operation to continue, regardless of the age of the patient.

As long as the patient is aware of the risks involved in the operation, why not? That's why informed consent is about, the capacity to understand the risks of going ahead and not going ahead with the operation. Which is why in Re F, the court said that a mentally insane person could refuse the amputation of his grangenous leg on the basis that it was an informed decision. Good news in that case, the anti-biotics worked.

So anyway, forcing the kid to continue with 6 more months of an unwanted pregnancy, disrupting her life and her schooling seems terribly at odds with looking out for her best interests. Now, let's add in the psychological trauma of the ostracism and stigmatisation, taking care of the infant (assuming that the state doesn't force her to give it up to foster care) and that she doesn't get kicked out of the house to live on the streets. Or what about the health risks of a 13 year old giving birth?

Cultural wars have massive impacts on the people living those lives. Which is why I'm still generally leery of letting religious voices have a say in public policy.



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