2012.02.19
Abortion in Virginia: Point / Counterpoint
This week’s topic: The Department of Health is writing permanent regulations for first-term abortion centers. What should it consider?
Victoria Cobb, president of The Family Foundation, makes the case that regulations will ensure women’s safety. Katherine Greenier, director of the Patricia M. Arnold Women’s Rights Project with the ACLU of Virginia, argues the rules should be guided by medical professionals, not politicians.
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Abortion centers will now operate within medical mainstream
By Victoria Cobb
Cobb is president of The Family Foundation of Virginia.
Late last year, medical experts at the Virginia Department of Health recommended and medical leaders on the Virginia Board of Medicine voted to pass health and safety regulations to ensure the health of women who make the unfortunate choice to end the life of their unborn child in a Virginia abortion center. This action by Virginia’s medical community caused the abortion industry in Virginia to go into hysterics. Ironically, the day before the regulations went into effect, a Virginia abortion center owner was arrested for multiple counts of murder in Maryland — a state with lenient abortion laws.
Earlier in the year, The Family Foundation discovered that Dr.Steven Brigham, who had been under investigation by authorities in New Jersey for starting late-term abortions in that state and transporting the patients to his Maryland centers to complete the procedures, owned and operated two abortion centers in Virginia, one in Fairfax and one in Virginia Beach. His websites advertised abortions “between 14-24 weeks” where the procedure is started in Virginia facilities and then patients are asked to “travel to … one of our other locations … for the completion of their procedure.” Our research generated a news story in The (Norfolk) Virginian-Pilot, and the fact that abortion centers in Virginia were operated by someone like Brigham was one of the reasons the General Assembly passed the requirement for emergency abortion center regulations.
Don’t let women’s health get caught in a ‘TRAP’
By Katherine Greenier
Greenier is director, Patricia M. Arnold Women’s Rights Project, American Civil Liberties Union of Virginia.
In March2011, Gov.Bob McDonnell signed Senate Bill 924 into law. This law directed the Virginia Board of Health to adopt regulations requiring women’s health centers that provide five or more first-trimester abortions per month be classified as a category of hospital.
That means women’s health centers in Virginia will now be subject to burdensome and unnecessary new regulations that could limit access to vital reproductive health care and will only hurt women.
Katherine Greenier’s rebuttal
The regulations for women’s health centers that provide abortion care are not about women’s health, and they are certainly not about patient safety. They are about ideology and, specifically, about anti-choice efforts to make it impossible for women to get first-trimester abortion care in Virginia. The temporary regulations that the Board of Health was pressured into promulgating are a far cry from the version that was actually recommended by the medical experts who were involved in the drafting process.
A medical panel comprised of OB/GYN department chairs from hospitals around the state, representing both sides of the abortion debate, worked with the Department of Health to draft the temporary regulations. But the Attorney General’s office intervened before the regulations could even be proposed to the public. From documents obtained through a Freedom of Information Act request, we know that the Board of Health was instructed to scrap the medical experts’ recommendations and to replace them with regulations that would impose extraordinary burdens that are medically unnecessary.
First-trimester abortion care is extremely safe, and health care professionals safely provide it to women in office-based practices throughout the country. Other procedures that are provided in the same kind of setting, such as colonoscopies or dental surgery, have higher complication rates than abortion care, but have not been singled out by the Virginia legislature for burdensome and unnecessary regulations. There is no evidence indicating that this kind of over-regulation of health care facilities improves patient health.
However, onerous and extensive physical plant requirements that require massive renovations for no good reason is a great way to push women’s health centers to close their doors. And that’s what these regulations are really about: closing down health care facilities that have been providing safe and affordable first-trimester abortion care for almost forty years. Women and their families deserve better treatment from their elected officials.
All patients, whether they seek reproductive or other forms of health care, have a right to expect and demand high quality care. Women’s health centers in the Commonwealth have been safely providing first-trimester abortion care in an office-based setting for decades. The health care professionals who provide first-trimester abortion care, like all other medical professionals, are subject to a complex matrix of state and federal laws. Licensing boards for doctors and nurses regulate and monitor health care delivery. Women’s health centers in Virginia already follow state and federal safety regulations. Patients can use malpractice laws to seek redress when they feel they have been wronged.
If women’s health were actually at issue, politicians would improve access to quality, affordable health care rather than limiting it. Instead, by possibly forcing clinics to close, these regulations make it much harder for women to access cancer screenings, gynecological exams, prenatal care, sexually transmitted infection testing and treatment, and birth control.
Abortion providers have been singled out for regulation that ignores the medical reality regarding the safety of first-trimester abortion services. These regulations are not about women’s health and safety; they are a transparent attempt to do in practice what the U.S. Supreme Court has prohibited by law: deprive women of first-trimester abortion care.
Victoria Cobb’s rebuttal
In the final days of last year’s General Assembly session, legislation was passed requiring Virginia to finally regulate Virginia’s abortion industry. Unfortunately, some reports of the process by which the regulations were implemented have been wholly inaccurate.
Once that legislation became law, medical experts at the Virginia Department of Health spent months researching the issue and receiving input from multiple medical experts. After that thorough review, they recommended regulations to the Virginia Board of Health, a body of medical leaders representing multiple specialties. After lengthy public comment, those medical experts on the Board of Health voted 12-1 to implement the emergency regulations to ensure the health of women who make the unfortunate choice to end the life of their unborn child in a Virginia abortion center. It is important to note that the majority of members of the Board of Health were, at the time of the vote, appointees of former Governor and Democrat Tim Kaine.
Those emergency regulations went into effect the first of this year, and the Board of Health is now in the process of considering permanent standards of operation for Virginia’s abortion industry.
Abortion industry apologists argue the procedure is safe and thus there is no need for regulations. However, prior to the regulations, the only “standard” of care for abortions done in Virginia during the first trimester was that they had to be performed by a licensed physician. The facilities where abortions take place were not required to meet any health or safety standards. They were not inspected by anyone. Nor were they even licensed.
In fact, prior to the regulations, because there have been no requirements for reporting complications from abortion to the Commonwealth, Virginians had no way of knowing if the procedure is safe. What really happens inside these centers has been anyone’s guess. Virginians have had to take the word of the abortion industry that the procedure is safe. The industry has for years fought even the simplest complication reporting requirements, begging the question, if the procedure is safe, what have they to hide? The women of Virginia deserve better.
The abortion industry has predictably argued that the regulations “go too far.” But a serious look at the regulations themselves show that they require very reasonable and common sense safety standards like licensing, regular inspections by health department officials, sanitary conditions, adequate training for staff, and emergency equipment such as defibrillators. It must also be noted that some of the regulations regarding the physical structure of abortion centers can be waived by the Department of Health if the abortion centers can make the case they are unnecessary.
Contrary to the hyperbole of the abortion industry and many in the media, the General Assembly did not require abortion centers to be subject to the same requirements or the construction standards of general hospitals. In Virginia, there are numerous categories of “hospitals,” including general (or inpatient), psychiatric, rehabilitation, outpatient surgical and others. Outpatient surgical centers, for example, are a category of “hospital” but they are not subject to the same regulations as general hospitals. Similarly, abortion centers are now subject to regulations that are appropriate for that procedure. The new regulations will be specifically tailored to facilities where abortions are performed and will likely mirror regulations already found constitutional by federal courts.
Some have also claimed that the regulations are unconstitutional, but the U.S. Court of Appeals in the Fourth Circuit, in which Virginia resides, has upheld abortion center regulations similar to those implemented in Virginia. In fact, Virginia’s recently enacted regulations were modeled after South Carolina standards that were upheld by that court to ensure their constitutionality.
The story of Dr. Steven Brigham, owner and operator of two abortion centers in Virginia, who is now charged with multiple counts of murder in Maryland and has had his license to practice medicine suspended in several states for putting the lives of women in danger, has been dismissed by abortion industry apologists as an isolated case or not reflective of the industry. But another doctor listed in a Virginian-Pilot (Norfolk) article as working for Brigham’s Virginia clinics has a long history of restrictions on and suspensions of his license to practice medicine in Virginia, yet presently holds a current and active Virginia license.
Again, we are simply supposed to take the abortion industry at its word it is safe, despite evidence to the contrary. Fortunately for the women of Virginia, the General Assembly, the Department of Health, and the Board of Health have put health and safety ahead of politics and are no longer allowing Virginia’s abortion industry to hide behind a veil of politically motivated secrecy.
As the Virginia Board of Health was voting to implement these important health standards, polling showed than overwhelming majority of Virginians supported the regulations. That’s not surprising. Virginians are reasonable when it comes to abortion, and they understand that simply providing for common sense standards of care in Virginia’s abortion centers is the right thing to do for women.
I believe it was that Dem icon, former President Bill Clinton, who said that abortion should be “safe, legal, and rare.”
Thanks to Obama’s recent declaration of war on the the Catholic Church and other believers, social issues are now back on the table this election year.
Consevative social issues are a reaction to the liberal left’s agenda against the concept that there are absolute values and individual freedoms which our Founding Father’s called God given and unalienable and not peculiar to any one religion or group, but for all mankind.
The liberals believe that rights are bestowed by the state on groups, not individuals, e.g. affirmative action, gay rights, health insurance, etc.
Social conservatism plays well with the voters everywhere except on the two coasts. The Virginia GOP is merely enacting Clinton’s plea to make abortion “safe, leagal, and rare.”
Electings do have consequences!
Comment by John R — February 19, 2012 @ 12:15 pm
A “hilarious” take on the issue of women’s control of their own bodies. You have to wonder how prophetic the cartoon is.
http://anticap.files.wordpress.com/2012/02/848.png
Have you registered your uterus with the government yet? Are you carrying a concealed uterus? Do you have an unlicensed uterus?
Why is we as a state seem to be doing everything we can to make carrying a gun easier but having a uterus more difficult?
Comment by Scott M. — February 19, 2012 @ 12:54 pm
Yes, “Electings do have consequences!” and the social conservatives who think the nation will just accept their religious ideology ridden agenda are in for a big ole surprise. NOTHING the TP/GOP has done will indeed make abortions “safe, leagal, and rare.” In fact, quite the opposite has been true and people have finally realized that the right wing hypocrites who whine about the safety nets, early childhood intervention and education, teen programs and job corps policies and sex education and contraceptive use along with reproductive education and care are once again on the wrong side of history and progress. Typical conservative bluster when they know they have overplayed their hand.
Comment by Sandi Saunders — February 19, 2012 @ 2:27 pm
Sandi, Don’t you think the TP/GOP (your term, not mine) or more correctly the teaparty freshmen House Republicans are doing exactly what they were elected to do?
What procedures do you believe a Catholic hospital should be required to provide?
Do you think a Catholic general hospital that accepts patients of all faiths and turns no one away should have to privide abortion whatever the circumstance?
I visited a patient (a non Catholic) in St. Mary’s Hospital in Richmond recently, there was a crucifix on the wall in each hospital room and a statue of Mary Mother of Jesus in the lobby. Should these have to be removed if they offend some patients?
Often patients are admitted to a hospital via the ER and not of their free choice, does this make a difference in what services must be provided? What should HHS require?
Where does big government intrusion into individual freedom end?
Comment by John R — February 19, 2012 @ 5:47 pm
John R, No, I don’t think the TP/GOP, which is what they are (there is no TEA Party!) are doing remotely what they were elected to do and I think many will not be re-elected. You may believe people voted for this obstruction and dysfunction, ideology over compromise to keep the nation going and ridiculous gamesmanship but I do not. If you think that is what they promised, campaigned on and owe this nation, I find that sad.
I believe that a Catholic (or any other denomination) hospital should be required to provide every service any other hospital provides, both to their patients and to their employees. The “religious exception” is for churches and actual clergy not businesses that religious entities run. Unless of course it is an actual “charity hospital” that does not charge for their services. In that case they can be as Celestial as they see fit.
I think that “a Catholic general hospital that accepts patients of all faiths and turns no one away should have to privide abortion” if that is the decision reached by a patient and her doctor.
I have no problem with the religious affiliations of any hospital, geriatric home, clinic or doctor’s office. Unless there is no other choice in getting care for a patient, the care itself trumps any religious difference for any sane individual. Religious icons do not need to be removed whether they “offend some patients” or not, but they should not be allowed to decide patient care or employee rights based on religious belief or bigotry (and do not try to pretend that does not exist).
The object for HHS is to get equity in care and coverage and I applaud that effort as a real solution for the number of abortions we face.
Seriously? The party of mandated unnecessary ultrasounds, refusal of abortions even with great cause, and the invasive “personhood” legislation has the gall to ask “Where does big government intrusion into individual freedom end”? Are you kidding me?
Comment by Sandi Saunders — February 19, 2012 @ 7:55 pm
Sandi, It seems that that you do not support the First Amendment.
Comment by John R — February 19, 2012 @ 11:05 pm
I do not believe the first amendment gives a religious business the right to not abide by employer mandates.
Comment by Sandi Saunders — February 20, 2012 @ 8:02 am
Just as importantly concerning the catholic hospitals and their icons on the walls; Would you want to be treated at a hospital where they believe in magic?
I mean come on….why have these things on the wall and other places if you didn’t think they served some purpose? If they serve a purpose it can only be by magic.
Comment by Scott M. — February 20, 2012 @ 9:51 am
7 – that’s a confusing statement Sandi. Employer mandates are those imposed by the employer on the employee, not ON the employer by an external force (e.g., the government).
Don’t you mean to say that you “do not believe the first amendment gives a religious business the right to not abide by government mandates…”
Comment by 89Hoo — February 20, 2012 @ 10:23 am
8 – Scott, if I’m sick, I’m going to the doctor/hospital that can best cure me, whether it’s a Jewish hospital or not. Period.
If I don’t like something about them, I have the freedom to go somewhere else.
Comment by 89Hoo — February 20, 2012 @ 10:25 am
“Electings”, indeed. “Believers” are constantly stating they’re being persecuted for their beliefs, when in actuality the reverse is true. Their concept of morality is very loosely based on the old testament of the Bible, and they fail to acknowledge their willful picking and choosing of which moral codes to follow. How many of these same zealots profess not to believe in birth control (instead pushing unrealistically and dangerously for teen abstenince), and then blindly adhere to their premise that abortion is but a form of it? By the way, John R, “groups” are comprised of individuals. “Christians” (and I apply that label loosely and with derision, because so many ARE NOT as shown by their thoughts and actions) are also a “group” who would have individual rights given only to themselves if they had their way.
Comment by Jeff F — February 20, 2012 @ 10:50 am
If you need to quibble, I do not believe the first amendment gives a religious business the right to not abide by government mandated employer responsibilities. I do not think anyone did not know what I meant.
Comment by Sandi Saunders — February 20, 2012 @ 11:06 am
And I did not invent the phrase either:
http://businessinsure.about.com/od/healthinsurance/f/empman.htm
Comment by Sandi Saunders — February 20, 2012 @ 11:08 am
Thank you, Sandi.
I would argue that there is no constitutional justification for employer mandates (as defined by you and the link you provided). Nowhere in the Constitution does it give Uncle the right to tell private employers how to run their businesses. EXCEPT the overly misapplied, misused, and abused elastic clause of the Constitution which, per the concerns of the prophetic Patrick Henry, that the clause would lead to limitless federal power that would inevitably menace individual liberty. It – the elastic clause – is even an abuse according to the standards of Alexander Hamilton, who assured the elastic clause applies only to those power constitutionally granted the government. It never was intended to create powers where none existed.
The First Amendment DOES, however, limit the role government can play in religion and religious institutions. Specifically, it says the government cannot interfere. Period.
I know we’ve been down this trail before, but would you insist that a business enforce an employer mandate or policy that outlawed the employment of homosexuals?
Comment by 89Hoo — February 20, 2012 @ 11:27 am
No 89Hoo, I would fight any law that upheld discrimination. Just like I do already.
Comment by Sandi Saunders — February 20, 2012 @ 11:45 am
15 – fight the law, yes, but until it was overturned, you would insist that it be enforced, right? You’ve stated as much in prior threads – that there is no exception for federal laws. Where do you draw the line? Would you encourage civil disobedience of laws that discriminate? And does it matter who the target of the discrimination is?
More to the point, who has the right/responsibility to refuse to obey bad laws?
Comment by 89Hoo — February 20, 2012 @ 12:29 pm
No, 89Hoo, I would not “insist that it be enforced”. I believe in Civil Disobedience to egregious laws and that one would have me marching in the streets. I am sorry, but I have never said there was no exception to any bad law, not local, state or federal. Women’s suffrage and the Civil Rights Movement comes to mind. No, we do not have to accept bad laws. We just do not all agree on what laws are bad.
I already do not offer a photo ID to vote and I will not until I am forced to do so and then I will do so under protest. It is not necessary.
Comment by Sandi Saunders — February 20, 2012 @ 12:49 pm
17 – no Sandi, you have not stated that there are no exceptions to bad (unconstitutional) laws (and that’s to your credit), but neither have you acknowledged a right to nullification on the part of states in response to laws they deem unnecessary. You have, in fact, tacitly acknowledged the canard that those who propose and promote a right to nullification are simply racists who are sorry the South lost.
Are you saying that states cannot protest unconstitutional law, but individuals can? That’s an interesting line to draw.
Comment by 89Hoo — February 20, 2012 @ 1:23 pm
18 – ‘unnecessary’ should read ‘unconstitutional’ – apologies.
Comment by 89Hoo — February 20, 2012 @ 1:36 pm
Did I even mention states? When states challenge a bad law, it is generally overturned, if it was indeed a bad law, but I was not talking about states doing anything so why are you changing the parameters now?
There is a process to challenge federal law and nullification is an issue that the SCOTUS will eventually decide. Abortion has been the law of the land since what 1973 and they still protest outside the clinics. Gays have been protesting and demonstrating and lobbying for equal rights for over a decade as well. If you want to make this about nullification maybe you should not have picked such an egregiously offensive law as your test case. Generally speaking, federal law is sterner and more legal stuff than blatant discrimination.
Comment by Sandi Saunders — February 20, 2012 @ 2:24 pm
20 – but that’s the whole point, Sandi. If the federal government cannot – as you rightly note – enforce bad/unconstitutional law on individuals (or, put differently, if individuals should civilly disobey bad/unconstitutional law) why should a state be any different? Nothing in the Constitution gives Washington more power over Richmond than it does over Virginians. In fact, it’s pretty explicit that Richmond has MORE authority over Virginians than does Washington, per the 10th Amendment. If you leave it to SCOTUS to determine that states do not have a right to nullify (civilly disobey) bad/unconstitutional federal law, then they will also determine that you – an individual – do not have the right to civilly disobey bad/unconstitutional law. There are no exceptions.
To bring this back around, this is precisely why most – the vast majority – of things should be settled at the state level, and not in Washington.
Comment by 89Hoo — February 20, 2012 @ 2:48 pm
I consider the secession and Civil War this nation fought to be the seminal reason for Federal actions since that time and frankly I supported the vast majority of those actions as states, Virginia included can be as backwards, bigoted, discriminatory and wrong as individuals can be. I do not view the Constitution without the light of history and I consider it a fool’s errand to do so. Nothing that effects people in a mobile nation should be settled (or better put), be left to the states, and for good reason.
Comment by Sandi Saunders — February 20, 2012 @ 2:55 pm
And since we are on the subject, a state is MUCH more likely to pass your fantastical bigoted law than the federal government ever is.
Comment by Sandi Saunders — February 20, 2012 @ 2:56 pm
22 – you are correct that the Civil War and Lincoln are singularly responsible for subsequent intervention on a massive scale in the affairs of states. An unnecessary precedent, as the slaves could have easily been freed, as they were throughout the rest of the western world, without the loss of 700,000 Americans and untold billions in reconstruction.
23 – No, Sandi, the fantastical bigoted law was in place until just a few years ago. Federal law forbade homosexuals from serving in the military. President Clinton issued an unofficial policy that gay service members could serve as long as no one talked about it (it had to be unofficial because it was in violation of federal law), a policy that came to be known as “Don’t Ask, Don’t Tell”). This law, as you know was ultimately repealed, and the policy became moot, but it was a federal law, and the President of the US openly defied it.
It was bad law, and it is a good thing it was repealed, but the fact remains that the policy was technically in violation of that law; it was a case where the Executive Branch nullified its own law.
Is it your position that states cannot do that?
Comment by 89Hoo — February 20, 2012 @ 3:41 pm
But there was rather massive resistance to that law 89Hoo, Homosexuals risked all of the wrath behind it to serve anyway. In every conflict and peace time too, there have been homosexuals defying that law. Which was my point all along. And yes, it was finally overturned (no thanks to states IMO either) because it was wrong. Personally I think any such conflict should be put on a fast track to the SCOTUS and not dragged out and tinkered with a la “DADT” but I don’t get to control, I only get to rail.
Again, I do not think states can or should just nullify federal laws. For what I think are good reasons. I do not trust states. I see no reason to trust states and I have every reason and then some not to. Virginia has lost its mind IMO and I WISH someone could overrule these whackos.
Comment by Sandi Saunders — February 20, 2012 @ 4:29 pm
25 – there is massive resistance to lots of laws, Sandi, good, bad and indifferent. Some I agree with, some I don’t, some I just don’t care.
There was a lot of resistance to anti-slavery laws, in the north and south, prior to the Civil War. It’s interesting that the Emancipation Proclamation only freed slaves in the parts of the south that were not currently occupied by northern armies; it did nothing for the slaves in the conquered territories or the north; that would likely have been an unpopular move on Lincoln’s part. And the 13th Amendment was not adopted until after Lee has surrendered.
And then there were some states (Wisconsin, for example, and Vermont) that wanted to nullify the Fugitive Slave Act, a federal law that treated slaves like chattel, and forced their return to their “owners”. Wisconsin objected, wanted to allow its citizens to help fugitive slaves; current nullification dogma would insist that because Wisconsin wanted to nullify a federal law, they were racist and wished the south had won! The ignorance is astounding.
But I digress.
The point is, we all, as citizens, have a duty to civilly disobey laws we find unconstitutional. Clinton was right to enact the DADT workaround until the SCOTUS could resolve it once and for all (and yes, that should have happened a lot sooner). And states have a right, an obligation to disregard laws THEY find unconstitutional…it’s the centerpiece of our federal system.
You can’t justify obedience (or disobedience, as the case may be) for laws you disagree with, while compelling others to obey/disobey laws they agree with that you do not.
(Understand, I mean “you” in the general sense, and am not picking on “you” Sandi Saunders).
And I can’t tell you, on the one hand, “Sandi, that law is unconstitutional and we should ignore (civilly disobey) it, even as we work to change it” while on the other hand, telling Richmond, “Sorry, federal law, gotta enforce it.”
Comment by 89Hoo — February 20, 2012 @ 5:03 pm