Healthcare


One point I find interesting about the controversy over the conflict between Catholic institutions and White House, over reproductive health coverage, is that the entire issue could have been avoided with a single-payer system.

Four years ago the centrist position on universal healthcare was, more or less, coalescing around a corporatist system, which is what we eventually received – matching more closely the centrist Republican model than the centrist Democratic one. Now that we have it, we are running head long into the easily foreseeable problem of what happens when an institution’s/corporation’s values conflict with the values of the general public.

The main argument being made by Rome, and allies, is that of religious freedom, freedom of conscience and so on, which is much smarter than arguing on moral grounds. In reality, if it argument were framed in terms of providing coverage for contraception and sterilization to employees, outrage would evaporate fairly quickly, given that 96% of Catholics contracept and near 90% think it is none of their Church’s business.

It is interesting how the whole “institutions as persons” argument is making its way in here – the institution’s moral conscience is violated by forcing it to provide dogmatically forbidden health coverage to its employees. So, is it the right of the capital holder to enforce its values upon its workers? I think it is possible for a freedom of religion argument to be made in opposition to the one currently being made. It is the workers’ freedom of religion to determine what form of healthcare is morally permissible, even if it is in opposition to the dogma of the religion they formally belong too. Despite the argument being made about forcing a “person” to purchase a product they morally object too, Catholic institutions, in reality, pay extra to not include reproductive care. Pregnancy and childbirth is, after all, quite a bit more expensive for the insurance company than a prescription for some fashion of birth control or sterilization. So, the argument can then become whether or not the conscience of a fictitious “person” can impose a denial of coverage on other (real) persons for near ubiquitously used medical procedures and prescriptions. What then when other institutions decide that coverage of immunizations or procedures involving blood transfusions are morally objectionable?

In the end, if our society is going to make the decision that healthcare is a human right by law, which I believe it should be, then it really needs to be distributed via the State. As it is now, I dislike either outcome – public values trumping mainstream religious values, or institution’s values trumping worker’s rights.

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21 Comments

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21 responses to “Healthcare

  1. Generally, there’s been resistance to providing federal funds directly for abortion services. Groups which provide services (most famously, Planned Parenthood) get federal funding for any number of other services (but which, of course, take economic burdens off of their abortion services), but there’s been a general truce given that slight cover. (Not that you don’t hear conservatives asking for it to stop, but it’s not anything you can motivate a large bloc over; I bet even most March for Lifers are unaware.) However, a single payer system which provides for abortion could become a highly heated issue, and could be stated as violating the freedom of conscience for taxpayers. As it is highly unlikely that every conservative Christian would be given an Amish–style opt out from the (almost certainly new) tax which would fund the single–payer system, it could probably become a flash point for opposition. Since this is perhaps the most potentially explosive issue in American politics, I imagine it is part of the dancing around actually pushing such a system.

    • I agree that this is probably the single biggest political obstacle to a single payer system in this country. And it is a shame, even from a reducing abortions point of view, as nearly all Western countries with single payer systems have significantly lower abortion rates than we do, even among those demographics given to high rates – poor, minority, immigrant, etc.

      I managed to get through the self-promotion and cringe inducing prose of Frank Schaeffer’s new book last year, and I thought that on abortion he had some insight. He thinks Roe Vs. Wade was a colossal mistake. He noted that abortion laws were in the process of liberalizing in 30 some states, that contraception laws were firmly liberalized by that point, and that there was virtually nothing of a pro-life movement in the early 70s. This was all going on with a bit of give and take compromise and finding what seemed to be reasonable prudent ground on the part of (mostly) state legislatures. The come Roe, which legalized all abortion everywhere up to the 3rd trimester, and this sparked and fueled the massive pro-life movement which was born of it. Schaeffer is of the opinion that had Roe never happened, the general paradigm for nearly all U.S. states would more or less have followed Europe – namely abortion being illegal after 12 or 14 weeks. This would end the stories about babies being born alive, there would be no “suck their brains out” abortions, and while a small pro-life minority would bitch and moan there wouldn’t have been the sentimental fuel that late term or even mid term abortions provide, and there would have been no quick change in abortion policy, and thus there would have been no large scale pro-life movement. Like Europe there would probably have been much more of a focus on contraception to prevent abortion, and because there would not have been a large pro-life movement to stop it for so long the morning after pill would have been developed sooner and better, and been more of a safety net, again preventing the need for abortions. Now we see Evangelical Prots (and other conservative religious types) being sucked into conservative Catholic arguments regarding abortificient contraceptives. I used to be in that sucked in crowd myself – I joined the disgusted once when the speaker at the local lifecare center banquet in MN was an Evangelical doctor who, while very active in pro-life stuff, had written a pamphlet for Evangelicals teaching them why the pill was morally acceptable and not ‘abortive’ in the sense that the chemical or surgical destruction of a fetus is abortive. At the time I thought it all scientific hogwash written by someone who probably couldn’t think because he’d had too many science classes. Then I took Anatomy and Physiology classes for school, and then did my OB class and clinical, and having been taught the physiology concerning the zygote I am now sorely chastened.

      • I think the only consistent anti–abortion position is actually an anti–BC position. I have a hard time reasoning against this without creating some insane scenarios. It is often said that modern embryology created the shift from ensoulment to full humanity is present from the moment of fertilization. Given the number of fertilized ova that never implant, I have a hard time believing in this sort of gross evil. Perhaps this is simply a weakness on my part, but it disturbs me enough to be uncomfortable with the life begins at conception dogma.

        Not being particularly resistant to controversy, I’ve aired this in places I probably should not.

        I do not think that, given everything else, the “we won’t pay for single–payer health care if it covers abortion” position is tenable. Your scenario is likely correct, but it became impossible when the post–’68 (or ’72, depending on who you ask) formation of the national Democratic Party became insistent on destroying the traditional alliance with working class whites, especially Catholics. Such a compromise on such care could have been possible even after Roe if the single–payer system was enacted as a constitutional amendment (which it may have to have been), but the move from democratic socialism to cultural leftism has left that dream unfulfilled. So now, for “cultural conservatives”, even conservative Catholics, resistance to single–payer health care at all costs is simply resistance to a national Democratic Party which has alienated many of them.

        I actually don’t understand the resistance to single–payer among practically minded libertarians, especially ones influenced by Austrianism. One, consistent source of market distortion is certainly better than the ridiculous numbers of plans, special laws and what else governing insurance in this country. Insurance against health other than catastrophic care makes little sense, and single–payer functions less like insurance. I am not even sure if the inflation of health care costs (which is real— I watched prices for a number of name brand drugs crawl up beyond the norm after Part D, which is something you notice when managing inventory for a pharmacy) would be worse under a single–payer system than the current. The real challenge would be creating better bureaucracy, which should be possible, but isn’t. The American habit of sending many of the worst of its lower classes to be the rank & file and the worst of its upper classes to manage its bureaucracies is one of the biggest reasons there has been a loss of faith in the competence of government since WW2. (Medicaid phone workers, for example, were even worse than the outsourced workers some insurance companies employ. The best were Americans employed by “private” insurers. My wife has noticed this through the competence of EPA scientists versus those employed by private firms such as her own. And it isn’t about pay— because the EPA pays more, especially after Federal benefits are taken into account. This makes one suspect that our bureaucracies see competence and intelligence as a detriment, rather like how police officers cannot be too intelligent.)

        The problem, of course, is general cultural decay across American governance and industry. I am not sure we can fix these problems, which makes me rather open and OK with experimentation. Given my family’s average life span, I’ve got at least sixty years left of seeing what’s going to happen.

      • Oh, and I have to say the thing that most bothers me about the pro–life movement in this country is the lack of propriety. I went to March for Life last year mostly out of curiosity (and because seminary was out that day, so why not), and while there was a lot of camaraderie and it was fantastic people–watching (like the strange monarchists with the expensive banners that made me curious as to who funded them), I couldn’t get into both the use of imagery (though most by “side” protestors) and the mobilization of school children, which I find inappropriate, even with high schoolers. I’m not regretful that I went, but I doubt I’d ever go again.

      • I pretty much agree with you on the bureaucratic problems. It’s hard to parse exactly the root of these particular sorts of problems because there are so many within gov’t who want these programs to fail, and that surely has an effect upon the bureaucratic culture – one would think this would effect the performance and expected competence of workers within such cultures.

        Part of me thinks that they should simply require that all bureaucratic functionaries for the national single-payer system should be Minnesotans. One of the things my wife and I bitch about all the time is the difference in services (private or govt) seen here in the South compared to what we knew in the upper Midwest. To this day my wife, who fights health insurance companies 5 days a week, feels relief when she talks to someone at an office in the Twin Cities or Madison or Appleton, WI, or Duluth, etc, because she knows that means there will at least be a coherent conversation, and that when the person on the other line says they will do something, there is at least a chance they will do it.

        On biology, if you mean by ” the only consistent anti–abortion position” one in which all known acts which could potentially divert a pregnancy then I agree, which is why I have changed my own positions on abortion. There is a guy at my old (Orthodox) church, my brother knows him better than I so I heard this via him, who is militantly pro-life to the point that he won’t let his wife have caffeine even when they are trying to get pregnant, because after intercourse during her ballpark fertile period she could lose a zygote from a cup of coffee. Nor is she allowed to drink during these times (which extend from trying to get pregnant through the pregnancy). Nor is she allowed to eat exceptionally spicy foods or watch scary movies. Once pregnancy is confirmed they stop having sex in order to protect the baby. That, it seems to me, is the logical approach one should take if one is going to be ” consistently anti–abortion” – even to the point that getting legalistic about such activities as this guy wouldn’t allow his wife to do makes as much sense to me as opposing the pill on moral grounds. There are many factors which must be in place in order for a zygote to get to embryonic stage and there are many things women do which can effect those physiological factors – the pill (usually) effects some but not all of those factors. Plenty of other things effect other factors. Why single out the pill? Because of intent? Intent requires knowledge. Thus if a women knows that caffeine or high stress or vigorous sex or x, y, and z, can make things physiologically hostile to the zygote, and she chooses to do those things anyway, does she sufficiently rise above the moral issues regarding a woman on the pill? From the RC perspective the problem with the pill is not the desire to have sex without getting pregnant. The RCC allows this desire to be acted upon when expressed through NFP. So the intent to prevent pregnancy is not the moral issue with the pill. It’s rather the usurping of nature via artificial means. But that being the case I could probably list 50 chemicals and behaviors common to modern American women that create altered reproductive physological conditions to varying degrees and which could be argued are “unnatural,” and to the degree a woman knows that the use of these alters or can alter physiological conditions pertinent to reproduction, how is the continued use/ingestion/action vis-a-vis said chemicals and behaviors substantially different than use of the pill? Thus I come back to the position that the only consistent non-contraception position is one in which the women tries to do nothing to regulate pregnancies. Let come whatever comes whenever. Which is not a position most modern women want, and is not a state of affairs very many people can afford. The idea that God demands any of this moral scruplization is something I find utterly laughable. Sure, like the God who wanted you to stone a woman found not to have her hymen intact on her wedding night.

        On the question of ensoulment I share your concerns. How can we refer to a zygote at the moment of fertilization as a soul when it remains to be seen if it will be one person or two (monozygotic twins) or an ectopic pregnancy or a hydatidiform mole or a flush out of reproductive cellular matter the “mother” never knows a thing about? That’s a can of worms, but one thing is for certain – the talk of there being “an eternal soul” at the moment of zygote creation is very simplistic.

        In terms of public policy, I think it should be a no-brainer that abortion should be outlawed at viability – so nowadays 23 or 24 weeks. The “my body my choice” bit doesn’t work by that point, when the unborn could live on his/her own. Not to mention doing an abortion at that point is far more harmful to the mother than inducing labor or even doing a section. But I think pro-lifers would have been smart to take this compromise position – that abortion should be made illegal anytime after the fetus becomes a sentient being. I know that is a matter of debate, but I think it could be fairly easily argued that abortion after the general consensus parameters of sentience is something the vast majority of people could agree with if presented the facts. The outside parameter there was 12-14 weeks, which seems to have informed much of non UK Western European abortion policy. Now I think general consensus parameters on that question would put things between 8-12 weeks. 8 weeks is not much time to learn you’re pregnant and then end that pregnancy, but we are getting to the point where finger prick blood tests will confirm pregnancy very early on, so….

        Another interesting social aspect here – the changed definition of abortion. My A&P prof, a devout Calvinist who considered himself very pro-life, taught us that the medical definition of abortion used to be exactly what the first line of the Wiki article on abortion states – “Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability.” He was so emphatic about this that I half wonder if he didn’t put that portion of that Wiki page in there. In his mind he was pro-life because he was against abortion as defined there, though he had no moral problem with the pill, or the morning after pill, because they acted prior to there being an embryo. But if he raged against the changing definition of abortion in regular dictionaries, one which he insisted was politically motivated – the definition which goes “Abortion is defined as the deliberate termination of a human pregnancy.” That was far too vague for him. Thus, he argued with a girl in our class about the “abortificient” properties of the pill. It was interesting on a number of levels, one of which is how many women I’ve encountered doing my pre-reqs and then in nursing school who are from Prot backgrounds and have heard the “the pill is abortificient” bit. Now, most of them still use the pill, but perhaps that argument has gotten much further traction in conservative Prot religious circles than I once thought it had.

      • The problem with state–to–state bureaucratic differences (or even regions within states) are largely due to culture. I’ve noticed it in PA, where I chose to deal with PennDOT up near seminary when I was going rather than in the Philly area, where incompetence reigns. In Louisville where bored neglect was a sort of norm, especially across color lines— in both directions. (After going there for a year and a summer, I think the University of Louisville would be as good or better than the University of Kentucky if anyone at the registrar’s office ever did their job.) This was all sort of shocking to me, who had grown up in a smaller town, and then went to high school in a small suburban town; bureaucracy in both places was fairly competent, largely because people knew each other.

        Minnesota works because the people are Minnesotans, much like Germany works because it is full of Germans. (East Germany was the economic powerhouse of the Soviet bloc, too.) The purely ethnic argument here is hard to justify, when you have places like Eugene, Oregon where getting change or even a simple response is this insane game where I eventually would have to shed my manners and start getting in faces. (Maybe the problem there is veganism.)

        But I’m serious about the Germans thing. When I was in Munich—which amounted only to a long day—I felt far more comfortable and at home there than I’ve felt in a number of places in America. It was full of people with the same standards of function that I have. (My dad says this about doing business in Germany and Denmark.)

        & yes, I did mean by the (normal) “any act” position, though not with the insane degree of scrupulosity displayed by your former acquaintance. (Such scrupulosity, which I’ve encountered in more benign forms, I think is born of a sort of misogyny, or in some cases, that with a repressed homosexuality. Like the men who grandstand about how much they don’t have sex.) Of course, I do include NFP here, which I think is just a semantic work–around.

        I tried to use the twin and ectopic pregnancy argument with a bishop once; I felt for a bit he was considering excommunicating me. I pretty much buried my knowledge about such things (I loved reading my mom’s nursing textbooks as a child— I know, I know…) when I first became Christian, but wasn’t really confronted with the sort of feverish life begins at conception rhetoric until seminary.

        To me, the resistance to realizing this sort of stuff is just like the same resistance to refusing to accept the overwhelming evidence for common descent, or the fact that you’d have to throw out all of modern physics, geology and chemistry to believe the world is only a few thousand years old. It’s born of incredibly shallow and tenuous faith that needs to bunker down against perceived aporie. I’m not saying I’m a person of any sort of great or strong faith, but I am repelled by the fear of the reasoning faculty. Then again, I basically had a collapse this summer due to the stress of trying to maintain sanity over this in a culture devoted to insanity, so maybe I should tone it down a bit. (This hasn’t stopped me from beginning an essay—which may as well be a book at this point—on this topic.)

        I guess it also may not be faith, per se, but the lack of strong self–concept (like how narcissists are such because they have a weak self–concept and need it bolstered by doubling–down on their importance). People are so brittle.

      • I think it is unfortunate that there has been so little real discussion on the subject of when life begins, with the majority of opinion shapers within Churches acting as though “life begins at conception” is ancient tradition. I think that modern science does make the logic of the personhood of a zygote doubtful. At the same time I am uncomfortable with saying whether viability or even sentience would be proper.

        I think this is one of those complex situations that requires some real theological discussion, utilizing the latest scientific understanding. I am left wondering how smoothly the transition took place when it was discovered that life did not begin as semen, and that pulling out or masturbating was not committing murder.

        With “abortifacient” contraception, there comes additionally the situation where women know they will likely pass many zygotes and experience many miscarriages without contraception. What about intent in that case? I know a woman who followed the anti-contraception line despite warnings that it could kill her. One year she had at least three miscarriages. Towards the end of menopause she suspected she was miscarrying every other month or so. You can’t tell me that going on the pill, and likely not passing any zygotes in that same two years is immoral because she might have killed a zygote, which would have died anyway (or killed the mother if it didn’t)..

        *Most doctors I’ve heard on the subject say the pill, IUD and Plan B are not abortifacient because they don’t abort pregnancies, which they say begins at the attachment to the uterine wall.

    • Anita

      Owen,

      ” To this day my wife, who fights health insurance companies 5 days a week, feels relief when she talks to someone at an office in the Twin Cities or Madison or Appleton, WI, or Duluth, etc, because she knows that means there will at least be a coherent conversation, and that when the person on the other line says they will do something, there is at least a chance they will do it.”

      I have a new day job in which I am now one of those insurance customer service reps you describe up here in WI. I feel like a pinball – half the time I’m trying to make patients’ bills go away because, say, a doctor inadvertently billed a claim as non-routine instead of routine, and the other half I’m trying to help a provider’s claim process correctly so they can be reimbursed, so I talk to people like your wife many times per day. When I have to tell a caller that they have to call Medicare to get an answer to their question they nearly cry because, from what callers have told me over and over again, the Medicare call center in TX has horribly long wait times and the reps can’t answer basic questions.

  2. To me what is lacking in this debate is more reflection on practical concerns. Modern medicine is such that you need large systems to provide it. Well, it works best with a mix of large and small systems, but you need some large systems to provide the pharma and specialty care that are now an intrinsic part of modern medicine. Obamacare, for all its faults, is trying to streamline and make more efficient and accessible care via the corporatist models. It is quite flawed in many respects, but the idea that systems need to be streamlined and made more uniform in terms of care provision is not one of the problems. This question of extending exemptions to potentially millions of people (note that employees of parishes and dioceses remain exempt – it is only employees of organizations not directly involved in Church services that are being refused exemption thus far – so non-profit charities not run through a parish but through a legally established organization, hospitals, schools and universities (and not all schools – a school whose teachers were paid by the parish itself would be exempt) begs further questions about how far this can go. If Westboro Baptist Church started a non-profit large enough to be required to provide insurance for its workers, and they declared that they will not pay for insurance coverage for medications and clinical services related to HIV and AIDS treatment, because it is there religious belief that all HIV and AIDs sufferers are being condemned by God, what then? What of Jehovah’s Witness non-profits from refusing to pay for insurance coverage of people in need of blood transfusions? What of Seventh Day Adventists or Orthodox Jews refusing to pay for the insurance covering the meals during hospital stays if those meals are not kosher? And what of Evangelicals of all sorts who are increasingly splintering into niche moralisms that could potentially result in non-profits refusing to cover this or that? Do they deny covering Viagra? What about for a vet coming back who suffered a spinal injury in Afghanistan and comes home and works for one of their non-profits?

    That question brings up the question of the clinical implications.

    There are non-contraceptive reasons for the prescription of chemical forms of birth control, and for “sterilization” (particularly hysterectomies). Many women with irregular menstruation patterns, and with certain uterine problems, and with certain dermatological diagnoses, and even with certain mental health diagnoses (to mention a few areas, there are others) get prescribed “the pill” in order to treat those conditions and/or their symptoms. There are plenty of medical reasons to get a hysterectomy that have nothing to do with contraception – there are even a few odd conditions in which a tubal ligation may be used for reasons not primarily related to the prevention of conception. If the Catholic Church is not required to provide coverage for artificial birth control or sterilization, what do women who need these procedures for non-contraceptive reasons do? I suppose it could be (and perhaps is) argued that in such cases the procedures/prescriptions would be allowed, but this would then require some agency or administrative body which has oversight regarding which women are allowed the drug/procedure and which are not – such an organization being set up on the part of the employer would seem to almost inevitably involve issues with regard to HIPPA (patient privacy law) and create an undo and intrusive burden on the patient and her doctor (with respect to the doctor having to figure out exactly which clinical decisions the employer is going to have a moral problem with, especially).

    Perhaps some think it is as simple as the doctor using a diagnostic code unrelated to birth control when ordering the drug or procedure, but anyone who has worked in health care knows that it is rarely that simple, and if it were that simple then clinicians would simply find some relatively benign diagnostic code to “get” their patients birth control for birth control reasons, thus circumventing the “rules” the docs will inevitably not like having imposed on them by some employer providing cut&paste health coverage, and making the regulation somewhat pointless.

    It also potentially creates an administrative issue for the health insurance company, and will thus potentially increase costs. One can envision health insurance companies and clinicians having to deal with all sorts of different policies with different moral clauses, as mentioned above. Clinicians already have to deal with the complexities of patients with different belief systems influencing their decisions about health care, but think about adding to that different employer moral parameters and it could make things exponentially more complicated – “OK – we’ve got a JW who has insurance provided via a Catholic employer, what exactly are we allowed to do?” It’s complicated enough for a clinician when they have to negotiate the patient’s moral parameters, but adding to that the moral scruples of the employer providing insurance makes for an administrative headache. Of course, this has gone on, but as the RCC makes a big fuss about this, and after they win in the courts (a strong possibility) look for other religious employers to follow suit. This sort of entrenched moralism is pathetic.

    On the matter of a single payer system and conscientious objection – I know a lot of people who opposed our country’s murderous wars yet continued to pay taxes, so I don’t really have much sympathy for those who have made a religion out of abortion and whose cults of the saints makes supreme martyrs out of the unborn dead. Living in a large modern Western society with 300 million people is always going to involve discomfort with some large scale social decisions – at least for most people. But in assbackwards America where public health policy has to worry about a large number of people whose insights into public health are gained at slap your knee and punch an atheist gawd and Americuh praising revivals, we’re only going to see more politicians like these:

    http://pamshouseblend.firedoglake.com/2012/01/31/anti-gay-tn-lawmaker-stacey-campfield-whines-about-booting-from-restaurant-defends-obsession-wbuttsex/

    • Even with the current exemptions, we are going to get cases where the Adventist janitor doesn’t get his vasectomy covered, and despite Catholic Social Teaching, you can be damn sure the parish isn’t going to pay enough to cover a kid every year and a half. Even if Rome loses this fight, we will have the case where it is a citizen’s right to receive medical care, unless they are employed by the wrong institution.

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  4. M.Z.

    I think you have largely hit the nail on the head as regards the conflict in the “liberal” community. The communitarians, who are a very small minority, are having great difficulty over the attempt to re-privatize what is now a public benefit. They see the assertion of institutional prerogative as little more than a might makes right argument. To put it another way, if the folks in power had been exercising proper oversight, we wouldn’t be in the position of the federal government needing to make health care a right for each and every American. On the other hand, the inclusion of birth control was little more than an olive branch to middle class women. Medicaid and Title X had been covering birth control for poor and lower middle class women – I know, I missed hearing the outrage too — for decades. So as a communitarian, I think the policy is poor, but I don’t in the end support a broad exemption because I think the decision was legitimate.

    On the other end of the “liberal” spectrum are folks who seem more obsessed with voluntary association. They are more likely to support contraceptive benefits in principle while allowing anyone that wants to call themselves religiously based exclude the benefit from their employees. These are the same folks who can maintain at the same time that it is bigoted for the State to deny homosexuals marriage and it is bigoted for a person to demand the church allow them. They have a grounded belief that if they are nice enough and tolerant enough of every other voluntary association, other people will be nice and tolerant of their voluntary association. That is the only way I can really understand Catholic liberals who think Obama betrayed them by this.

    As for the conservatives, I think one is right in questioning their motives.

  5. Leah

    I don’t know if this is exactly relevant to this post in particular, but since there are posters here who are more familiar with the science than I, there is something that I’d like to bring up. Despite the “Life Begins at Conception” rhetoric, it seems to me like even the most hard core pro-lifer doesn’t regard a fetus/embryo/zygote as being the moral equivalent of a newborn baby. Most, if not all pro-life organization and/or ministries, say that abortion is murder. However, if a murder has taken place, there must be a murderer who committed the act. The pro-lifer would say that the murderer is the abortionist, but what about the woman who commissioned the abortion in the first place? Wouldn’t that mean that she was hiring a hitman to kill her fetus? If you’re going to say that abortion is murder, then the only logical thing to do is to paint post-abortive women as being the moral equivalent of Susan Smith and not victims in need of prayer and conversion (not saying that Susan Smith or any other criminal shouldn’t be doing prayer/conversion, but no one would ever suggest that Smith just needs a sympathetic ear and a Blessed Virgin prayer card, rather than life in prison). Given the morally and legally ambiguous status of the unborn, a more prudent path to take might be to take a page from the Old Testament and say that abortion is “bad,” but not nessesarily murder. At this point, the “abortion is murder” meme has been around for so long, I don’t know if a retraction would be any good.

    If nothing else, the flap with Komen and healthcare illustrates why the anti-abortion movement never goes anywhere. The entire issue is viewed in culture war terms, and many people think that if you are against abortion, then you have to be in favor of a bunch of other conservative talking points. Even conservatives in other religious groups don’t agree with the “Life Begins at Conception” notion that is seen among evangelicals and Catholics. In Judaism, for example, the fetus is viewed as being a part of the mother, so abortion is okay if the mother’s life is danger. Is abortion even an issue in other European and advanced Asian countries? The American pro-life movement seems to be very isolated. Unlike other social movements (e.g., Civil Rights, women’s movement, environmentalism) you don’t see American pro-life activists learning and collaborating with their peers in other countries, possibly because these like-minded individuals don’t exist.

    • Is abortion even an issue in other European and advanced Asian countries?

      LMGTFY.

      There are small, (nearly all Christian) groups in India, but I don’t know if you can even really compare “advanced Asian countries” to Western ones on this issue for obvious, cultural reasons. (Though, if you have a strong stomach for horror stories, the story of liberalization on abortion in post–war Japan is somewhat interesting, especially from a nation where oral contraceptives were only approved in 1999 and are still extremely rare.) But yes, foreign pro–life groups exist and there is some solidarity. (I was surprised to see Italian, German and British activists at the March for Life in DC last year.)

      That said, the reason you may not think of it as being as much of an issue abroad was already stated by Owen, above: American abortion policy is incredibly liberal by the standards of advanced Western nations— liberal to the degree of allowing practices which are morally horrifying to a much broader swathe of the public.

      • I think half of the people ever arrested protesting abortion in the UK have the last name Geach, as in Peter Geach, as in the Geach offspring of Peter Geach and G.E.M. Anscombe. I met all but one of the Geach children at a dinner party once. Whatever about their politics (which was pretty much social dem other than their very “traditional” response to identity politics and being fervently opposed to war) – they are the most amusing eccentric genius family imaginable, and drink in such a manner that clearly demonstrates that their pro-life sensibilities do not apply to human livers. Before the party my boss said to me that we would need “more wine than even you might think appropriate.” Not a drop was left, and it got rowdy in the English frumpy intellectual manner of rowdiness. Surprisingly they got more witty as the night went on – through with a crudeness that I think would horrify some of the Evangelical American converts to Catholicism who discover Anscombe in the pages of First Things.

      • Anyway, thinking about the Geaches, for all of their bombastic language about abortion (very appealing to me at the time), and the dire need they expressed that society ACT NOW to prevent the (still somehow) inevitable horror flick worthy dystopia that is coming, it seemed to me then that they relished in their quixotic roles in the UK. They were ideological freaks – I suppose they saw their militant pro-lifery as carrying on the family tradition – like when Anscombe had opposed fighting the Germans in WWII. I know that you can tell yourself and others that you adamantly want x change, and you can think you believe that, but when listening to them talk about their antics in the UK, where there was nothing like the scale of Operation Rescue or Lambs of Christ, let alone mainstream Right to Life organizations, I did kind of wonder if the point was to actually change society or the point was some sort of propheticish spectacle that provided great stories and a vehicle to launch into more tirades.

        It seems to me that if you assert that there is some mass sin out there so horrid and so heinous that you kind of build a religious identity out of opposing it (and man have I experienced this among both radical and mainstream pro-lifers here in the States – it is the norm) then you have one of two options, existentially/theologically:

        Either you really do believe what you are saying, in which case you effectively take a quasi-Calvinist position and fix yourself and your small group of dedicated cohorts as the elect and the rest of society as a sea of the damned for not responding to the utterly obvious heinous sin in question. Or, you don’t really in your heart of hearts think it is as bad as you are saying it is, but you relish in the identity boost you get by being contrarian and setting yourself apart from mass culture. I think the latter was my motivation for ranting again ‘pansexualism’ in a former blog life and for my own experience being drawn in to the more radical end of the pro-life movement for a spell years ago. Did I really think it the sort of end-all, screw-society-when-this-is-happening sin I made it out to be – well, it never really effected relationships outside of religious/”movement” circles. Having been arrested at clinics was an experience, and one that served as a bump toward ever greater moralism. The stark religious dichotomy at these events (talk about “us vs. them” with both sides knowing it) gave the ultimate divine stamp. But it’s not like that stopped me from sleeping around in high school and bible college – and whenever you do that sort of thing you are allowing for the possibility of abortion, at least in this culture. But one needn’t do “that” to show an indication that you aren’t as fervent as the rhetoric/activism implies – I saw many pro-life activists during that time that struck me living two lives. You’d see them at a pro-life event (rally, rescue, etc.) and they would act and speak as if the occurrence of abortion were so dreaded that it rendered all other aspects of social coherence moot. But then you meet them when their shift ended at work and see them with their coworkers and go out to eat with them and their coworkers and their interactions and camaraderie with people who don’t give a damn about abortion were utterly mundane. America (and probably the UK as well) is a great place to be a part-time prophet, for shits and giggles and divine stamps of approval that you don’t have to show all the time.

        I would later work with two of the Geach grandaughters from Wales, and met another couple of Geach grandchildren that were based in MN – I think all of them in their later teens when I met them. If they are representative of the next generation of Geaches, they didn’t catch the same fire for quixotic social action that the previous 2 generations had had. This stuff does tend to play itself out eventually.

      • Leah

        “Or, you don’t really in your heart of hearts think it is as bad as you are saying it is, but you relish in the identity boost you get by being contrarian and setting yourself apart from mass culture.”

        I think this is at the heart of the issue. One reason why the American pro-life movement, which is primarily populated by a small subset of white Catholics and evangelicals, never makes much progress is because most conservatives are “law and order” types at heart and look down on protesters and full-time activists. I can’t see Judi Brown, Fr. Pavone, or any other pro-life leader being willing to put up with the kind of harassment and criticism that black Civil Rights leaders did in the 1960s. It’s just not that kind of social movement. If abortion is really genocide, then we should all be taking up arms and storming hospitals, clinics, and doctors’ offices. Since no one outside of the fringe advocates such a tactic, it is a tacit admission that the unborn do not have the same moral status as newborn infants in the eyes of the pro-life movement.

        Because the pro-life movement has basically stalled, I think that the pro-life position has become somewhat of a “life stance” among some religious conservatives; the situation itself isn’t going to change anytime soon, but being against abortion shows that you’re against “mainstream America,” whatever that means. The recent flap with the Komen Foundation illustrates the weakness of the pro-life movement. The big winner was Planned Parenthood, which is now being flooded with donations, many from people who probably wouldn’t have given anything under normal circumstances. Planned Parenthood may be right’s “Great Satan” but nobody outside of the pro-life bubble believes it.

      • I’m not so sure that intensity of emotion or action necessarily reveals a person’s true beliefs.

      • Salvation is certainly a more serious issue than abortion, yet saints have held friendships with those who firmly rejected the Christian faith. While I’m not denying there is the sort of identity thing that happens with the mass “life” movement (like it does with any sort of impotent protest movement in this age) which dominates for many members, one can have true convictions about this (or other issues) and not be inclined to devastating action or everyday social disruption over it.

        I suppose though—to make a bit of a Leninist joke here—the pro–life movement may be stuck in a “trade union consciousness” awaiting its vanguard party.

      • Ari,

        Yeah, but how many of those saint-heretic or saint-pagan relationships a matter of aristocratic courtesy? I suspect the class obligations of the saints (who mostly came from the upper classes in premodernity) were, aside from the old “she won’t have sex with the rich guy who wants her routine” generally felt and fulfilled – at least on the level of rhetoric and “friendship” styles.

        Not to mention the Greek ability to use bombastic language that was never meant to be taken at face value. I’m not sure we can compare a modern American social movement and its rhetoric and tactics with pre-modern conventions. It seems to me that whether a pro-lifer or Westboro Baptist or an environmental activist group speaks of coming doom, they, as Americans, generally mean so literally and their words are interpreted by others as literal beliefs. Thus when you find out that the environmentalist is the son of some corporate CEO and when not out activisting he is off jet setting with this extended family, you naturally question what exactly the belief is about. Perhaps this is related to America being the locus of hermeneutic literalisms – both political and theological. We are the most textual literal people in human history. I think rhetorical forms in modernity, particularly modern America, grant the ability to think one believes something literally when they really don’t believe it literally (the backdrop of get saved religion and revivalism had to have some influence here) in a manner rather unique in the history of human belief – in part because of the American impulse to believe literally, an impulse that is just not all that effectively livable.

        On the vanguard – yes. I think most of American politics is caught up in vanguard fetish. Hell, even most libertarians here seem to want a vanguard right now, which is pretty damn funny I guess.

  6. Owen,

    I don’t think such “aristocratic courtesy” is against the point here. One of the features of American society from pretty early on has been the extension of a sort of democratic version of such courtesy, the impulse to not become socially aggressive on ideological grounds. Even today, we find it shocking and it’s used as ammunition against groups that do engage in it, from fundamentalists in the South to upper–middle class liberals who go into hysterics when encountering thought–crime. While you’ll encounter a lot of ignorant rudeness in American society over various issues, it’s rarely followed up by a blanket refusal to engage in friendship and normal social relationships. It’s no more a part of our “polite” culture than it was for aristocratic culture in late antiquity.

    The libertarian vanguard impulse is about as old as organized libertarianism in the US. It was the MO of the first incarnation of the LvMI and Murray Rothbard, who was willing to find whoever and wherever to mobilize an uncertain political movement into the anarcho–cap aims. Actually, I guess that vanguard versus purist split is the fundamental schism from the beginnings of the modern libertarian movement in the 70s.

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