Philadelphia abortion doctor accused of murdering patient, newborns

[SWTXBelle]

Originally Posted by Drolefille

This doctor wasn't running a legit clinic in the first place though, correct? Illegal clinics are illegal now and would be just as illegal under further restrictions, but still, obviously, exist either way. How would adding additional regulation to legal clinics prevent the illegality of what this guy was doing already?

In short, he was already breaking the law, I'm not sure making a new law would actually do anything but make abortion harder to access, which then makes people more likely to seek out this sort of doctor in the first place.

Looks like it started out as "legit" - it was licensed in 1979. From the CNN report:

"
Originally, he said, the clinic used another doctor as a consultant so it could receive a license to perform abortions in 1979.
Two primary state agencies, the Department of Health and the Department of State, have oversight, Williams said Wednesday at a news conference.
But a grand jury investigation found that health and licensing officials had received repeated reports about Gosnell's dangerous practices for two decades with no action taken, even after the agencies learned that women had died during routine abortions under Gosnell's care, the district attorney's statement said."

[Drolefille]

Originally Posted by SWTXBelle

Looks like it started out as "legit" - it was licensed in 1979. From the CNN report:

"
Originally, he said, the clinic used another doctor as a consultant so it could receive a license to perform abortions in 1979.
Two primary state agencies, the Department of Health and the Department of State, have oversight, Williams said Wednesday at a news conference.
But a grand jury investigation found that health and licensing officials had received repeated reports about Gosnell's dangerous practices for two decades with no action taken, even after the agencies learned that women had died during routine abortions under Gosnell's care, the district attorney's statement said."

Ah, sounds like a definite failure by the DH/DS in PA then. But I think the same query applies, does adding more regulation actually fix the problem in this case? I'm not sure it actually would have. Following the current regulations SHOULD have shut him down. (Was the third decade run underground or was his first decade in practice actually 'clean' ?). Restricting abortion to hospitals or similar facilities would be devastating to access for women, so does the law actually cause the problem it would intend to stop? It seems to me that it would.

[SWTXBelle]

Originally Posted by Drolefille

Ah, sounds like a definite failure by the DH/DS in PA then. But I think the same query applies, does adding more regulation actually fix the problem in this case? I'm not sure it actually would have. Following the current regulations SHOULD have shut him down. (Was the third decade run underground or was his first decade in practice actually 'clean' ?). Restricting abortion to hospitals or similar facilities would be devastating to access for women, so does the law actually cause the problem it would intend to stop? It seems to me that it would.

At what point does the "right" to a medical procedure trump the right for it to be regulated? I have a "right" to have my eyebrows waxed, but the state of TX regulates it - only licensed cosmetologists can do it, and their places of business are inspected and must meet certain standards.
It sounds like you are arguing for a moral reason for not changing the regulations while I am arguing, admittedly using a very unusual case, that there may be medical reasons for requiring facitilites to be held to a higher standard. I'd like the statistics for the incidence of clients at out-patient clinics having complications. I know of an abortion doctor's office here in Houston (now closed) that was well-known for having ambulances come to pick up patients on a rather frighteningly constant basis, but know of no place to get city/state/national statistics for that. Those would be useful.
(eta - it's easy to find statistics about complications in general - it's just not easy to find them broken down by hospital vs. out-patient or doctors' offices.)

[AOII Angel]

Abortion Clinics ARE regulated. Licenses are required. They have regulations they must follow. The problem here is that the Department of Health didn't follow up with complaints. I think Drole's point is that if you aren't going to follow the regulations you have already set up, what's the point in legislating new rules, which may further restrict access, if your original rules aren't being followed in the first place? Safe practices can be followed just like in regular doctors' offices that perform procedures. I perform biopsies everyday in my office. The Health Department was just here today checking us out. Further intrusion on the Doctor/Patient relationship is not needed. However, I expect that reports of major complications, much less deaths due to in office procedures should prompt a swift investigation.

[Drolefille]

Originally Posted by AOII Angel

Abortion Clinics ARE regulated. Licenses are required. They have regulations they must follow. The problem here is that the Department of Health didn't follow up with complaints. I think Drole's point is that if you aren't going to follow the regulations you have already set up, what's the point in legislating new rules, which may further restrict access, if your original rules aren't being followed in the first place? Safe practices can be followed just like in regular doctors' offices that perform procedures. I perform biopsies everyday in my office. The Health Department was just here today checking us out. Further intrusion on the Doctor/Patient relationship is not needed. However, I expect that reports of major complications, much less deaths due to in office procedures should prompt a swift investigation.

You beat me, but this. Unless the current standards when upheld are truly unsafe, I wouldn't advocate making them more restrictive.

[SWTXBelle]

DF - the eyebrow waxing is actually a better example than it might first appear. The rationale behind the regulations of cosmetology is often medical - you can hurt someone, so it is in the interest of the state to regulate it. Currently in Texas there is a debate about threading - cosmetologists argue that it must be done only in licensed facilities, while many argue that because the potential for injury is so slight it is fine to have it done in, for example, malls.
I'd say comparing abortion regulations to those applied to flu shots is more of a stretch. Flu shots have no demonstrated risk that would necessitate they only be given in hospitals. Again, we need firm data.
I don't buy the "ultrasounds are only a delaying tactic" argument. The stage of development does impact what can and can't medically be done. Informed decision is a component of every surgical procedure - if women are to make a choice, shouldn't they have as much information as possible? (rhetorical question) And just because a woman might have an emotional response doesn't mean she shouldn't still understand exactly what will happen in an operation. I dealt with a breast cancer scare - my reaction was VERY emotional, but I still had to deal with the realities of the situation and the possible procedures. I needed all the information in order to make an informed choice. That's true for all medical decisions.
Even Roe v. Wade distinguishes between the three trimesters in terms of balancing the rights of a pregnant woman and the rights of the fetus. I think we see this recognition in the fact that studies have shown a higher percentage of support for abortion on demand in the first trimester than the second or third.
It seems to me that viability is a common accepted line of demarcation - not for the black/white, abortion-on-demand-until-the-baby-crowns camp and the no-abortion-ever-no-matter-what crowds, admittedly. The problem of course is that viability is much earlier today than back in 1979.A former student had a daughter who weighed 1 1/2 lbs., 4 months early. She and the baby are now home and the baby is doing very well.

I think one thing we can agree on is that without objective data it is hard to argue convincingly for EITHER side of increased/decreased regulation. (Look at me underailing the thread). Perhaps this horrific incident can result in a close look at the data so the public CAN decide whether or not increased regulation, or a revamping of enforcement , is necessary.

[Drolefille]

Originally Posted by SWTXBelle

DF - the eyebrow waxing is actually a better example than it might first appear. The rationale behind the regulations of cosmetology is often medical - you can hurt someone, so it is in the interest of the state to regulate it. Currently in Texas there is a debate about threading - cosmetologists argue that it must be done only in licensed facilities, while many argue that because the potential for injury is so slight it is fine to have it done in, for example, malls.
I'd say comparing abortion regulations to those applied to flu shots is more of a stretch. Flu shots have no demonstrated risk that would necessitate they only be given in hospitals. Again, we need firm data.

I'm not denying that eyebrow waxing doesn't require some safety, but you missed that I wasn't comparing flu shots to abortions, I was pointing out that flu shots and surgeries are regulated entirely differently based on medical safety and needs. Abortion, both medical and surgical, should be regulated to that same standard, it should not have increased regulation because of an extraordinary case or because of political reasons.

I don't buy the "ultrasounds are only a delaying tactic" argument. The stage of development does impact what can and can't medically be done. Informed decision is a component of every surgical procedure - if women are to make a choice, shouldn't they have as much information as possible? (rhetorical question)

The laws require that the doctor show a woman the ultrasound, not that they do an ultrasound for the purposes of the procedure. You're reading what I'm saying wrong. And rhetorical or no, when you pass a law requiring a woman to see her ultrasounds prior to abortion, you don't care about her informed consent. That's not informed consent, that's intentional, paternalistic, misogynistic, manipulation of someone trying to get a medical procedure that you disagree with. No one passes a law requiring the patient to watch their own colonoscopy prior to a biopsy or surgery on their colon, right?

And just because a woman might have an emotional response doesn't mean she shouldn't still understand exactly what will happen in an operation. I dealt with a breast cancer scare - my reaction was VERY emotional, but I still had to deal with the realities of the situation and the possible procedures. I needed all the information in order to make an informed choice. That's true for all medical decisions.

Were you required to view pictures of your breasts? Or (with some creative license to mirror the emotional effect of ultrasounds) were you required to view a sketch of what your chest might look like with a double mastectomy? If you think there isn't the intent to influence a woman's choices not an intent to inform behind those laws then you're missing something.

Even Roe v. Wade distinguishes between the three trimesters in terms of balancing the rights of a pregnant woman and the rights of the fetus. I think we see this recognition in the fact that studies have shown a higher percentage of support for abortion on demand in the first trimester than the second or third.
It seems to me that viability is a common accepted line of demarcation - not for the black/white, abortion-on-demand-until-the-baby-crowns camp and the no-abortion-ever-no-matter-what crowds, admittedly. The problem of course is that viability is much earlier today than back in 1979.A former student had a daughter who weighed 1 1/2 lbs., 4 months early. She and the baby are now home and the baby is doing very well.

Thing is, that such young infants are still the exception rather than the rule. That's why though people may say "oh yes third trimester is wrong" there's no hard and fast line. Again this ignores when the abortion is sought due to genetic/medical problems that would result in a stillbirth or an infant dying shortly after birth.

I think one thing we can agree on is that without objective data it is hard to argue convincingly for EITHER side of increased/decreased regulation. (Look at me underailing the thread). Perhaps this horrific incident can result in a close look at the data so the public CAN decide whether or not increased regulation, or a revamping of enforcement , is necessary.

Honestly I'd rather it not be the public, but the medical profession, that's just me though.

[Drolefille]

Originally Posted by violetpretty

Um how? The bolded is where we disagree. I think women of every social class and age and in every state should be able to have an abortion for any reason at any time until viability free of harassment from protestors, biased counseling, parental notification, and mandatory waiting periods. Fewer restricitions and lower costs of EARLY abortions will eliminate/greatly reduce the need for LATE abortions, and if late abortions are needed for medical reasons, they can be performed at a safe reputable licensed regulated place.

This would be a weird place to say "please let me have your babies" right? Even if it were just a euphemism for how much I love what you said? Yeah, it'd probably be weird.

Originally Posted by SWTXBelle

At what point does the "right" to a medical procedure trump the right for it to be regulated? I have a "right" to have my eyebrows waxed, but the state of TX regulates it - only licensed cosmetologists can do it, and their places of business are inspected and must meet certain standards.

First, I think conflating eyebrow waxing with medical care is just wrong. Secondly, I believe that medical care should be regulated based on medical necessity. For example, requiring women to see ultrasounds prior to an abortion is intentionally emotionally manipulative and a delaying tactic. It does nothing for the actual needs or safety of the mother and is purely a political regulation. Similarly if the level of regulation is more than is needed then you are limiting access to care. If all flu shots had to be provided in a doctor's office, and could never be provided in a pharmacy or a school or nursing home then far fewer people would gets shots, right? But obviously open heart surgery requires an OR, multiple medical professionals, and sterile equipment so doing that at Walgreens would be a bad idea.

It sounds like you are arguing for a moral reason for not changing the regulations while I am arguing, admittedly using a very unusual case, that there may be medical reasons for requiring facitilites to be held to a higher standard. I'd like the statistics for the incidence of clients at out-patient clinics having complications. I know of an abortion doctor's office here in Houston (now closed) that was well-known for having ambulances come to pick up patients on a rather frighteningly constant basis, but know of no place to get city/state/national statistics for that. Those would be useful.
(eta - it's easy to find statistics about complications in general - it's just not easy to find them broken down by hospital vs. out-patient or doctors' offices.)

I'm actually making the argument that the standards are actually in place and the goverment regulatory departments failed to uphold them in this unusual case. Which is why unusual cases are generally poor grounds for changing laws yet still frequently the only thing that spurs changes in laws.

Now if well-regulated clinics are having persistent medical complications that go beyond those expected then there is probably a case to be made, but as you said, I don't know where there statistics are either and in lieu of them I'm not willing to make the argument to increase regulations.