US Supreme Court overturns Roe v Wade: the moral dilemma

 In a leaked opinion written by Judge Samuel Alito, the US Supreme Court overturned Roe v Wade, the landmark decision that granted universal access to abortion in America. Alito found reasoning behind Roe v Wade was weak and reportedly referred abortion back to the legislature.

Critics on the left are outraged, calling it an attack on reproductive rights and individuals’ rights to make decisions about their bodies.

 However, in countries where abortion is allowed, it is legislated so the US Court’s decision is not unusual. In the US, conservative Republican-run states like Mississippi that brought the present challenge have been curtailing abortion through restrictive laws. But that leaves Democratic states that permit abortion.

 While the Court’s decision is a setback for abortion, it is not banned so comments like late show host Trevor Noah who called it “a hostile takeover of America’s reproductive rights” are hysterical.

 The left, who generally claim they are rational about morals and other matters, are not different to the right in taking the high ideological ground.

 In 2018 the Australian-founded global online journal The Conversation ran an article by a female University of Sydney gynaecologist who was stridently pro-abortion. Not supported by medical evidence, her personal opinion was there were no psychological impacts on women who’d had abortions.

 Comments to the article, including from a woman who said she’d had one, that said abortions could cause lasting trauma were removed from the discussion forum. Only views supporting the writer’s opinions remained. (This is typical of The Conversation’s approach: remove or reprimand comments critical of the left narrative which make up its contributions. As a so-called academic journal it’s not objective and credible, touting mostly hard left propaganda. I stopped reading it.)

 Two decades ago a Catholic priest we knew said the US Supreme Court would in time overturn Roe v Wade because Roe was wrong. He was not dogmatic about the Church’s abortion stance, though, as with other teachings like divorce. He said each case must be treated compassionately. This is the view too of many priests and Pope Francis who said similar about gays.

 Abortion advocates who go on about reproductive and individual rights pretend the decision is no more difficult than deciding what shoe to wear. But it’s vexatious for a reason. If abortion is not morally, ethically and legally problematic, why do societies around the world have difficulty with it decades after it was first allowed?

 First, it concerns life and when conscious life starts – conception or later – is still debated by theologians and philosophers. Even medical science is not definitive.

 Second, it’s dishonest to say there is no problem for women, and their families, considering aborting. Aside from the significant psychological and moral dilemma, every medical procedure, particularly invasive ones, carries risk and requires care and consideration by the patient and practitioner. Why should abortion, which has the added factor of terminating life as variously defined, be different?

 The left and right take opposing sides on death penalty, abortion and euthanasia; they are equally unsure what to do about euthanasia, though, so leave the status quo.

 Conservatives say the death penalty is “justice”, not vengeance that it is. To the left it is institutional murder.

 The left say abortion is about reproductive and individual rights, their idea of justice, and not the termination of life, or murder as opponents call it. Ironically, left-liberals are dismissive of absolute individual rights, the libertarian ideal, over social, community rights.

 Both claim social and individual rights simultaneously come first, although following the greater good principle (the tramway philosophical conundrum of saving many over the few) it’s often impossible.

 For the right, society must be protected from the murderer by executing him. For the left, the individual’s right of choice must be protected by abortion despite harm to society’s conscience by allowing it.

 With and within these opposing arguments, individual and social rights clash; they are mutually contradictory. Both death penalty and abortion are killing, however one defines it, legal or not, that infringes upon individual and social rights. The person on death row is an individual and part of society as much as the mother of the foetus, a potential unborn life. And the people performing the execution and abortion are individuals and members of society who are affected by it even if they claim otherwise.

 Both left’s and right’s arguments are reductive and simplistic. They cannot be correct at the same time. If one values life, then it must be all life including the unborn and the murderer’s. There are alternatives to the death penalty and abortion. 

Legally banning abortions after the second trimester is more for the medical safety of the mother than it is about determining when consciousness begins, the purported medical criteria. The fact is when that happens is unclear because foetuses react to stimuli early on, so following that criteria, abortions should not happen at all (except at embryonic stage). 

With euthanasia the person decides for himself to end his life. It’s suicide with medical assistance. Of the three, it should be the simplest but also is socially problematic. Most countries do not permit it. It’s unclear why when many, especially America, have death penalty and abortions.

 All religions teach human life is precious. Buddhist and traditional beliefs include natural life – animal and plant. While abortions were probably performed for thousands of years, it is only in the 20^th century with enlightened social mores and social and sexual freedoms it was allowed in most countries of the west.

 But these freedoms did not result in greater sexual education and responsibility. Sexual freedom – being able to choose one’s sexual practices although today homosexuality is s till frowned upon and in places criminalised – coincided with promiscuity as Victorian attitudes gave way to the swinging 60s and 70s. Despite abortion and contraception on demand, unwanted pregnancies and STDs are still prevalent. Abortion is just another form of contraception (this excludes instances of forcible sex, rape and incest).

 Even after it became known HIV/AIDS is transmissible by sex, protection was not universally used. In the global South particularly, although it happens in enlightened countries too like America, there are large numbers of unwanted pregnancies. Reproductive rights without responsibility is meaningless so legislation restricting abortion and the Supreme Court’s decision are abortionists’ straw man.

 Sexually transmitted disease and abortions are not an individual’s problem alone. They place a burden on society in terms of human, financial and social resources, and of course on the individual and their families. Therefore, abortion, which requires medical intervention, mostly at public facilities, is beyond the individual’s right to decide.

 A person has agency over her body but that is limited to actions she can do on her own to herself. A person can commit suicide but getting another person’s help is murder. People will not stand by and do nothing as a person is harmed including by herself. Women are encouraged to obtain counselling before seeking an abortion and consider options (informed consent, see second part of this article) like adoption. This is society getting involved in a personal decision whether the person wants it or not. So why do advocates demand non-intervention.

 Likely the conservatism of the Supreme Court bench was a factor in its decision.  But the fact the court revisited Roe fifty years after the decision indicates abortion is deeply problematic. Now all it must do is revisit the death penalty.

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Health Professions Council’s position on abortion ... and corruption

 In 2019 the Health Professions Council of South Africa (HPCSA) prosecuted a doctor of No.2 Military Hospital at a disciplinary inquiry for providing a woman seeking an abortion with informed consent.

 Informed consent is the universal medico-ethical principle of providing patients with the risks, benefits, cost and alternatives to treatment, tests and operations. Depending on the matter, it may involve counselling before and after, e.g. HIV/AIDS. For routine matters, health providers generally skip over full informed consent.

 HPCSA’s charges, as obtained from the complaining patient, were that the doctor violated the patient’s dignity and freedom of choice. His defence was he did his medical, and legal, duty.

 However, at the inquiry HPCSA’s case fell apart. The doctor’s lawyer said they had not followed procedure and months later had still not provided documents including the full charges.

 This case had an element of racism too: the doctor was white and patient reportedly black.

 Like other South African institutions, e.g. SAHRC, NPA, SAPS, HPCSA follows a political agenda. A few years ago it prosecuted Nelson Mandela’s former physician who wrote a book about their time together. Mandela’s daughter gave him permission. But Mandela’s widow, Graca Machel, laid a complaint against him for allegedly revealing confidential patient details.

 Like the abortion case, the prosecution was a political witch-hunt, though. It should never have been brought.

 But in a politically sensitive case (then premier Helen Zille and senior Western Cape Health Department doctors and officials were implicated), without examining all the evidence, HPCSA dismissed complaints against Groote Schuur Hospital doctors involved in my mother’s death in 2017 – unlawfully withholding and withdrawing treatment without the family’s knowledge or permission (see in this blog).

 Ironically, here there was no doubt doctors violated informed consent and other medical laws and regulations. 

Other inquiry irregularities were the HPCSA did not draw up charges required by regulations; did not review all complaint evidence; granted doctors far longer to respond – up to a year – than allowed, and accepted unverified hearsay statements from the accused.

 If that was not bad enough, a board member had an ongoing personal/business relationship with an accused. It’s likely they were in communication during the course of the proceedings. There is circumstantial evidence the accused, a professor and head of Groote Schuur's trauma surgery, was coached – he was granted an opportunity of a second statement in order to massage a story so HPCSA could rule in his favour.

 Like the abortion case, HPCSA refused to release all information, to the complainant this time. They decide base decisions on the political nature of the case and not its merits.

 HPCSA CEO/registrar Raymond Billa was told about all this but did nothing, i.e. he condoned potential corruption, an offense under the Prevention and Combating of Corrupt Activities Act.

 This was not the first and only time HPCSA was corrupt and dysfunctional regarding inquiries. In 2019 the Supreme Court of Appeal ruled for “apartheid doctor” Wouter Basson, after the North Gauteng High Court dismissed HPCSA’s case, for violating objectivity (conflict of interest) and inquiry procedure: the people who brought complaints against him were also members of his disciplinary panel who found him guilty of professional misconduct relating to his apartheid-era activities over 20 years ago.

 Disciplinary inquiry procedures are regulated in the Health Professions Act. The board members are public officers named in the Government Gazette.

 HPCSA is a corrupt and dysfunctional organisation (former health minister Aaron Motsoaledi described it as such. The SIU investigated it for taking bribes for medical registrations). Its executive including registrar/CEO has turned a blind eye and at worst condoned corruption.