- Our next scheduled news headlines on KANU will be at eight o'clock this evening. Each Monday night at this time, KANU and the Office of the Dean of Women at the University of Kansas presents "A Feminist Perspective." This program provides a forum for women to speak out on issues which concern them and listeners will have an opportunity to participate in the program by calling the KANU open line at 864-45-30. Now here's our moderator for "A Feminist Perspective," KU Dean of Women, Emily Taylor. - Good evening and welcome to "A Feminist Perspective." "Feminist Perspective" is sponsored by the Women's Resource and Career Planning Center located in the Dean of Women's Office, 222 Strong Hall. Our telephone number is 864-35-52. We hope that through this program, you can become familiar with some of the many resources available to you through our office. We are concerned with anything that concerns women and have gathered people and materials to help you with your concerns ranging from career planning and academic counseling, to legal rights and current legislation to medical services for women. We hope that you will call or come by soon so that we can find out what's on your mind and what kinds of services you need or desire. The goal with this program is to provide a forum for women to speak publicly on issues of concern to them and help inform other women and men of the movement which is remaking the shape and substance of women's and men's lives. Tonight, two of our panelists are not women, Dr. Henry Buck MD at Lawrence Physician Gynecologist, and Dean Curtly assistant Dean of Men and a law student at KAU and Terry Edwards and assistant Dean of Women. Our topic for discussion tonight is the recent Supreme Court ruling on abortion. We've all been reading a great deal about this subject, I'm sure. And I think we ought to start by finding out what are the essential parts of a Supreme Court decision? And Dean we'll ask you to tell us, what's the central parts out of it? - Well, looking over the decision, the Supreme Court has relied upon the fundamental rights included in the constitution, specifically in the Bill of Rights under the 14th amendment, they've interpreted the constitution as it has been interpreted in the past to include a right to privacy. And they have now defined that right to encompass a woman's right to make decisions regarding abortions. They weighed the woman's right to privacy and the state's interest in protecting a woman's health and in protecting potential life of the fetus. Then by extending that and relying on medical fact, Justice Blackmun, who wrote the opinion, broke the period of pregnancy into the three trimesters and pursued this dichotomy of state interest and right to privacy in those three times zones. During the first trimester, he concluded the medical, the hazards of the medical procedure were small enough that the state's interest in protecting the woman's health were smaller during that influence, was smaller than the woman's right to privacy. And that because the fetus was not viable during that first trimester, the state's interest in protecting potential life of the fetus was small. Therefore, during the first trimester, the decision regarding abortion would be left to the woman and her consulting physician. In the second trimester, the second three months, because the medical procedures become more complicated, the state's interest in protecting the women becomes stronger, but because the fetus has not attained viability at that point during the second three months, the state's interest in protecting potential life of the fetus remained small. The result of that is that during the second three months, the state may impose regulations regarding medical procedures with the safety of the woman in mind. During the third trimester, however, because of the increased complications in the medical procedures as well as with, now with the viability of the fetus in the third trimester, the state's interest becomes very strong and outweighs the woman's right to privacy almost entirely. The state at that point during the last 12 months, may prescribe or outlaw abortion altogether, except in cases where a woman's life or health may be jeopardized if she doesn't have the abortion administered. - And Dr. Buck, do you have a comment on the medical decisions that went into this Supreme Court ruling? - Well, there are always variations of course, from the norm. And it happens that the smallest surviving infant weighed 397 grams, which would be consistent with approximately 22 weeks of gestation. We speak of gestation in terms of 40 weeks. So actually by your six months, we're talking about 27 to 28 weeks. So actually infants in the middle trimester have survived. At about six months, the survival rate is about 20%, at seven months, the survival rate is 80%. So that you can see there's a very great leap in terms of survival between the sixth and the seventh month. - 20% to 80% in one month's time. - And to add to that, that these figures are probably four or five years old, although they're out of the most recent textbook on the subject and with the improvements and neonatology, and neonatal care, infants of smaller and smaller birth weight are surviving in greater percentages. - Is it entirely a question of weight? - Weight is used as it's something that can be measured. It's really a matter of maturity and a baby say, a 1500 gram baby in one situation may be quite mature in terms of particularly its respiratory system and other vital functions and another baby at 1500 grams may not be. So the insistence rather arbitrary, and it just happens to be something that can be measured. - Is there any, there's no particular time at which you could say that the fetus has, from the layman's point of view has all necessary parts functioning. - Well, what do you usually think in terms of somewhere around 34 to 35 weeks gestation, in other words, within four to five weeks of the due date, that the fetus has at that point attained probably about the same chance of survival as it would have were it to go to 40 weeks. And tests are available now, which can be done by withdrawing amnionic fluid and testing the LS ratio or lecithin-sphingomyelin ratio in the amniotic fluid. And by running this rather simple test, it's quite easy to predict whether this infant has a respiratory system which is mature or not. And respiratory distress syndrome is of course the thing that kills the premature baby. - And that's the last system to develop, the respiratory system? - No, not necessarily the last, but it's relevant, it's essential for life. And some babies at 33 weeks had been found by the work of on the West Coast, if a woman say has hypertensive disease, she may have a baby that delivers at 32, 33 weeks and they find that with the distress that the baby's been under that it's ready for life and has a normal LS ratio and no respiratory distress. It's also been found that when these babies are born, that if they were ventilated, within a matter of three or four days, they will develop an adequate amount of surfactant in the lung which is what keeps the lung function from collapsing in layman's terms. I find these babies quickly will develop a mature lung. - So lemme see if I got this straight now, the earliest recorded case was 22 weeks that the baby had to live. And born in good condition and do you know anything about what happened to this baby? - No, I don't there is no- - Hey listen, I'm just curious if the hospital or do you know anything about whether or not it was in sophisticated, a hospital with sophisticated equipment and so forth, I'm assuming it probably was in a hospital in a more, that had equipment that could naturally help in- - I suspect that is true, I suspect that is true. - I would like to mention one thing about going back to what Dean had to say about exactly, sort of the synopsis of what the Supreme Court decision was. I do feel that we ought to touch on the point that this decision was 13 months in coming and the way I understand it, it was the result of two one from the Georgia and one from Texas which each had two states that had a restriction set on when a mother or a pregnant woman could get an abortion, is that right? - That's correct, did those two states have at any time that abortion was legal? - One of the states had a residency requirement and this was what was being appealed. I believe it was Georgia that had the residency. - No, it was Texas, but the medical standards and the consultations and so forth necessary were very, very similar. And I believe that the statutes as they were written would allow abortions only in cases of, well the mother's health was jeopardized or in cases of rape or felony and of course there's instances like that, but with very little discretion. - Excuse me, but we have a call, hello, hello? Can you hear? Our number is 864-45-30 and we would welcome your comments or questions at any time. Dr. Buck, could you tell us little about mortality rates for abortion and live births and also the kinds of complications that a woman could run into with either one of these procedures? - Yes, the figures for maternal mortality in this country are about 20 per 100,000 births. Now these figures were 1967 figures that takes a while for these to be ground through the statistical now. The figure of 20 per 100,000 applies to the white population. The nonwhite population, the maternal mortality was 65 per 100,000. Now, until only recently have we had any statistics on abortion mortality in this country. The original statistics on abortion mortality came from Europe and Japan in two instances where abortions are permitted only until the 12th week and their mortality rate was four for 100,000. In Denmark, which allows abortions to any length of pregnancy, the complication rate was 70 for 100,000. So you have to be careful with your statistics to realize what you're talking about and what particular local situations are. In New York, initially, the statistics were that the mortality rate was something like 23 for 100,000, that has now dropped probably down to about seven or eight per 100,000. The big problem with New York statistics is, and this was readily admitted by the physicians in New York who are involved, is many of their patients are out of state patients coming from all over the United States and their degree of follow-up is admittedly not optimal. California reported experience from 1967 and their mortality rate is five to six per 100,000 and three of these were early, occurring within the first 12 weeks of pregnancy, two of these occurred after. In one series with saline abortions, in other words, ones done after the 12th week or mid trimester abortions, the mortality rate may be as high as 200 for 100,000. So there was a tremendous difference in the mortality rates based upon how far along the pregnancy has been. - We have call now and I'd like to go back to that for a moment after we finished to ask you how you would account for those tremendous differences in the mortality rate, for instance, between Japan and Sweden. - Or Denmark. - Or Denmark. - Mainly the ones in Denmark were included, a number of them that were done later on in pregnancy, where you get your higher risk. - Hello? Hello? If you are having difficulty in getting through, please call back again to 864-45-30. We are going to have difficulty tonight with your appointments, because we certainly wish to take the comments and questions from the audience on this highly controversial subject. - I wanted just to ask Dr. Buck one question, is that on, of course on reported abortion, so as far as you know any that are not done in any type of legal standing or so forth, is that what your statistics are or do they include all reported after the fact on abortion? - Well, the statistics are ones that are done under legal circumstances. It's been assumed, but no one has ever really had any good figures, but it's assumed that the mortality of illegal abortion is extremely high. - I would think there'd be some figures on that though, if people who end up in the hospital from complications of an illegal abortion. - But that's just never been tied up in a nice, neat mundo. And and talking with the people of the Kansas State Department of Health are very knowledgeable about this. So it's just, there are no studies that would reflect this. - We've certainly heard a lot of figures floated about. And so it's interesting to know that there really are no inferring figures on that, on this subject. - Along the same line in turn, you cannot only consider mortality, but you must consider morbidity or complication rate with abortion. And I think there's been some tendency in the lay press particularly to make abortion sound as a completely safe procedure, which like any medical procedure, it isn't, there are complications that can occur. From the New York experience, they were running 7.7 complications per 1000 abortions. These were the ones done during the first three months of pregnancy and ones done after the first three months, the complication rate rose sharply to 30.4 per thousand. And when we're talking about complications, we're talking about hemorrhage, infection, perforated uterus, anesthetic complications, shock, retained tissue, laceration of the cervix, et cetera. These are all things that potentially can be quite serious. - But from which people do recover or else they become part of the mortality rate, is that it? - They could become part of the mortality rate, the vast majority of them of course are managed and their lives are saved, they may end up with a hysterectomy if they've had a perforation or they may end up being sterile because of infection. So there may be long-term consequences. - Well increased training, for example, either increased training in medical schools as to the performing of abortions, taking practicing physicians back for seminars and additional training, with this, do you feel lower those rates of the complications? - Yes, this is born out by New York where they were running mortality of 23 per 100,000 in 1971 and their mortality now is down to eight and I think this reflects experience. - Let's try again on this telephone call. Hello? Are you there? Hello? Are you on the line? I'm sorry, we can't hear nothing in a way of a question. Well, we try again, 864-45-30. Now this ruling of the opinion of the Supreme Court affects as I understand that the laws in 31 states, is that your understanding Dean? - I think so from some of the articles in magazines and newspapers that have a reason for this decision, I believe there are about 30 states that are affected significantly. There are only about four states in the district of Columbia, I think that shouldn't be affected much at all by the decision. - Yeah, that's what I heard is four, New York, Washington, Alaska and Hawaii will not be affected. - In the district of Columbia. - Let's try once again on this call. Hello? - Hi. - No, that's fine, I can hear you now. - Okay, I was intrigued with your discussion in the earlier part of the hour, linking technology with the Supreme Court's decision. In other words, regarding the time at which a fetus can be maintained artificially. And what I'm wondering is, say 30, 50 years since, if a breakthrough in technology occurs, is this going to invalidate the Supreme Court's decision or in effect make abortion once again illegal? Say for example that a fetus, if you would call a fetus an organism that's two weeks old was able to be maintained, will that do away with the Supreme Court legalization? - We'll ask Dr. Buck to respond. Could you hear the question? - That's more a legal question that Dean probably could answer, I would say from a medical point of view, there have been attempts to maintain a placenta artificially on a machine which works very much like the heart lung machine that are used in open-heart surgery. To date this has not been successful, but there are certainly from a technological point of view and a medical point of view, the caller's supposition is entirely possible. The legal implications, I would prefer not to comment. - Do you have an opinion on that Dean? - Well the court does rely on medical advances. And so I would presume that as new advances are made, that they will have some effect on this decision. It's very speculative to say what sort of effects advances will have. Now, as I understand, we have another call. Hello? Hello? - Go ahead please. - Hello? Could you go ahead, please? - Hello? - Hello? Could you go ahead with your question or comment? - Go and go ahead, please. - Okay, I have this question about the equal rights amendment, I mean about abortion laws and is it legal in Kansas? - Is abortion legal in Kansas, is that your question? You wanna comment on that? - I think that was the question, abortion is legal in Kansas under certain conditions. Recent changes in the law have released many of the regulations. And I'm not right up to date with some of these court decisions there, I think Dr. Buck has kept up with those. Do you have any comments on what restrictions there are now? - It's my understanding that the requirements that have indications for abortion, which in Kansas include the impairment of physical or mental health of the mother, pregnancy as a result of rape or incest, felonious intercourse, which is defined is that prior to the age of 16, and have the baby might be born with serious mental or physical defects, such as the product of a mother who had German measles during the first trimester, particularly the six to eight week of gestation, these requirements were all in the law. And it's my understanding that with the Court of Appeal's decision in Kansas city, these are no longer applicable. Also the requirement that two additional positions, and I'm told of three positions, including the one performing the procedure, had to write a consultation to state that the abortion should be done. This requirement has been strict and it was strict from the Kansas law prior to the Supreme Court decision. So in Kansas, that amounted in practice to a situation between the patient and her physician. - Since the caller did mention equal rights amendment, so far as I can see that this constitutional decision was made on another constitutional right, the right of privacy which already obtains. - That's correct, it relies on the bill of rights and specifically in the 14th amendment, a person's right to liberty, let's see, a person's liberty cannot be denied with that due process of a life, I think that is how it reads. - And they have not defined the fetus as being a person. - No, under past decisions, the legal rights that accrue to a person as is stated in the constitution begin at birth, at live birth. - We have another call here, hello? - Yes, I would like the panelist to comment on the relatively high cost on abortion in Kansas compared to the relatively low cost of New York, particularly on the ethics of this, I'm gonna hang up so I can hear you. - All right, fine. She wants, the caller wants the panelists to comment on the cost of abortion relative more one state to another, do you wanna- - I would like to make one comment on this because I feel that, in my reading that I was doing, was that in the past, abortion was always available to those who could afford it. This was always the comment that was made, that those who could afford it could always find someone that would perform the abortion that hopefully this amendment, which will make it legal for doctors to perform that may help in reducing the overall cost. I don't know, Dr. Buck may have more on that as far as what the cost is and so forth and how these are sad. - Well, in some ways, mentioning the difference between New York and Kansas, you're talking about the difference between apples and peaches, and it's a little bit difficult to make a comparison. In New York, freestanding clinics are available and the vast majority of the patient care is done by paramedical personnel, social workers, Aryans, and so forth. The physician involved actually spends a very minimal amount of time. Now, up until the present, Supreme Court decision in Kansas, it has been a requirement that they be done in their licensed hospital. Okay, when you start talking about licensed hospitals, you start talking about much more expense because these patients have to pay the same operating room fee, the room charges, the laboratory charges, the things that have to be done amount to a greater expense. In addition, more physician time is required because the patient is seen in the office, a complete physical examination is done, the patient is followed after the abortion. So actually there's a great deal more physician rendered service in the Kansas situation and hospital rendered service. And these are costs which everybody knows have been going up. Now, it is true that abortion does cost more in terms of the physicians price than those at D&C. However, it's been well shown that uterine perforation, as an example, just one complication, is 10 times more possible in the therapeutic abortion than it is in a D&C which is done for some other reason. So the physician is dealing with a higher risk when he's doing an abortion as opposed to when he's doing a D&C. and in most situations where a higher risk is involved or greater a charge is involved. So I would say as far as the local situation here in Lawrence is concerned, that the same as quite honestly from having been involved in this from the beginning with the hospital and with the physicians at the hospital, that every effort has been made to keep the cost in Lawrence as low as possible. And it is very definitely on the low end of the range in terms of the totals state. - We'll have to take a station break for a moment at this time. - As you know this year, KANU was again bringing you the Saturday afternoon broadcast. - To "A Feminist Perspective." We always hear the best in Public Radio, KANU. Here again is KAU Dean of Women, Emily Taylor. - Welcome to the second part of "A Feminist Perspective." Tonight, we are discussing the ramifications of the new, relatively new Supreme Court decision on abortion. I'd like to ask, what do you people think, particularly in a point of view of a doctor and a lawyer will be the ramifications for at least the first three months where hospitalization is not required? First of all, what do you think will happen and secondly, what do you think is desirable or not? Lemme go with Dean or Dr, Buck, do you want to start there? - Well I think we will probably mirror the initial experience in New York that abortion clinics will be set up and then at some point along the line, it will be found that they probably are running a higher complication rates than is desirable than would be present in an hospital. And then you'll have the state intervene much as the city of New York intervened when this became a problem. - Will they be in a position to intervene now? - I'll refer that to the lawyer. - Well, as a law student, after reading the case, according to the decision, it does not provide for state regulation during the first three months, and then continue at greater state regulation after the first three months. However in a newspaper article that I've seen, Attorney General Miller said that according to his preliminary view of the situation that the current Kansas law comes within the bounds of the decision. And I presume that now, during the first three months or at anytime, the state can regulate the conditions under which an abortion is given, is that correct? - If that's the interpretation that would still mean that they'd have to be performed in a licensed hospital as well. - We have another caller, hello? - Hello, can you hear me? - Yes. - All right. My question has to do with the viability issues you were discussing earlier. About two years ago, the Washington Post reported an incident that occurred at DC General Hospital, in which a legal abortion was performed. However, an intern in disposing of the fetus noticed that it was whimpering. And so all the hospital services went into effect to try to save the baby. It lived for about 18 hours, but finally died. And I have two questions, first of all, for Dean, what is the legal implications of an incident such as this? And secondly for Dr. Buck, what personally happens to the physician who finds his priority is reversed, or do they become reversed from performing an abortion to suddenly being called upon to try to save the fetus? - On the legal implications of that, I really don't know. I don't have the expertise to tell you off the top of my head and I don't know if the Supreme Court could tell you off the top of its head, what the implications are. It speaks in approximations, it says in the period up to approximately the end of the first trimester or approximately the beginning of the third trimester in terms like that. And I don't think that the court, I'm sure that the court has not tried to come up with an absolute formula for this. It didn't make any pretenses to, but under normal medical conditions and under the medical conditions that now exist, it tried to get as close to the viability issues that could. Of course there's no absolute involved there. And the legal implications, I simply don't have the equipment to tell you what they are. - We are about to apply here your medical profession. - Well, this obviously is a difficult situation and I think most physicians attempt to avoid the situation by not getting involved in abortions after the first trimester. This has been the case with most physicians whom I know. And so just try to prevent the problem and I think also from a medical point of view, we know that the morbidity and mortality statistics are so much higher in mid trimester abortions that they are than would be if the patient would carry the baby to term, that we've got pretty good medical reasons not to get involved after the first trimester. - But if a doctor was involved and faced with this situation, what would be the medical ethics say that they ought to do about it? To try to save the life of the child? - I think that would probably be true, yes. - And do you know anything about they didn't use it at Denmark at any time? Does this mean after labor pains began or there's no cut off at all? - To my knowledge, there is no cutoff. Now, of course, the procedure that's used in the mid trimester is the solving out procedure. And generally the placenta and the infant are killed in uterus by injection of the hypotonic salt solution. So I would think this would be a fairly rare situation. - When you spoke of the D&C, did you I mean that this is a common method of performing an abortion rather than the suction method or the saline solution? - Well, when I mentioned D&C, I was comparing the D&C for a reason other than abortion as compared with what generally is the suction method for abortion in terms of perforation. Suction method is just a variation of the D&C, really. - I see, we had a question phoned in but the caller couldn't hold the line. So I'll read it to you. When a child would be born out of wedlock and the parents do not want the child, could this be considered mental or physical detriment to the mother, or just what heading would this situation come under and how does this relate to the discretion in between the doctor and the patient? You understand the question? I presume that means at the present time, under the present law, if the child is going to be born out of wedlock and is not wanted, it's unwanted pregnancy, is this enough to be considered mental or physical detriment, well certainly wouldn't be a physical detriment necessarily, would it? - No. - It'll be a mental detriment to the mother, or of course now under the Supreme Court decision it really is necessary for it to be a mental or physical detriment to the mother, isn't it? - Not during the first six months approximately. In fact, the case that arose in Texas was brought to court by an unwed mother who subsequently had the child before the decision could be made but regardless, the court did say that in generalizing about some of the reasons for having abortions, they did mention unwanted pregnancy and childbirth out of wedlock. But I can't recall that they definitely put it under a cause or classified it as in cause of impairing mental health. I'm not sure in the first six months there's been a problem, then in the final three months, these are approximations again, in the final three months, then it is a weighing of the potential of life and the health and life of the mother. And I'm not quite sure how that would fit in. It would be instructive, I think, to look at how that's fit into some of the laws that are on the books now. - Well, mental health has been used as the predominant by far reason for abortion in Kansas during the time that an indication was required, something like over 90%. I think the last three months of pregnancy that mental health probably would not be used very much. And it would probably, here, we'd be talking about a situation where there was a severe medical problem on the part of the mother. - Do you have another question or comment? No, thank you for calling. The implication in the first part of the question, that if a child would be born out of wedlock and the parents do not want the child don't necessarily go together, do they? I mean, one who is not going to be born out of wedlock might also be an unwanted pregnancy. So the same thing, I should think, would be obtaining in either case, because there's sort of a moot Christian, I guess, at the present time, except in the last, what the courts have called trimesters, is that the term's used in by doctors, trimester? - Trimester. There are three, three month periods where they're called trimesters. - I see, I understand that the justice who wrote the decision, I spent a long time at Mayo Clinic really studying the entire history of the situation and before he wrote the decision so I take it that you have some kind of medical reliability to it. - I was interested to discover that Justice Blackmun was the house counsel for Mayo Clinic as one point. He's from Minnesota and I also understand that he spent his one or two week vacation last summer at the Mayo Clinic doing research. He did an extensive amount of research into not only the medical history and medical implications involved, but also the legal history and the social history involved with abortion. - I'm concerned about one thing and that's this question, this last question sort of brought it to my mind and of course, no doctor or anyone is going to be obligated to perform an abortion or be involved in one. But with the relaxed abortion rule on a nationwide basis, I know there has been some concern about things may be getting back to what it was like before abortion was legal, shopping for a doctor that's going to perform the abortion and so forth. And I wondered, if any way, and you may, we've already touched on this in a way in discussing licensing and stuff with the facilities, if you foresee this as a problem, Dr. Buck. - Well, I think the states and I believe Kansas is in the process of doing this now or at least there has been legislation introduced, we'll definitely make some regulations regarding the practice on abortion under the medical practice act. And this is just a function of the state, again, to protect the lives of the people that are involved, just like the state licenses the physicians that practice in the state. - How will this affect like public health facilities as far as whether or not they should have this service available if they're a public municipal health facility? - That is a very difficult question. - We really knew that she would take it home how it will affect it. I was wondering back there and the question on the fetus that turns out to be viable, is that really the correct word? If that happened a great many times, would there be any, say in the same clinic, would there be questions raised by medical associations themselves concerning the ethics of the situation? - There are very likely could be medical associations per say are more advisory groups in this area, organizations like the Kansas Medical Society, the American Medical Association, the American College of Obstetricians and Gynecologists, the latter to the AMA and the ACOG have both issued statements sort of in the middle ground in terms of abortion. Many physicians bolted the AMA when they came out with sort of the middle of the road thing which was permissive in terms of abortion, but in many other news, the hippocratic oath that physicians take as a reason the AMA should never have come out in allowing abortion or in considering abortion proper. But it's interesting that they actually hippocratic oath at the time it was written, abortions were performed up until three or four months of gestation and it was considered to be okay. So when the word abortion is used in hippocratic oath, it's being used for pregnancies beyond the fourth or fifth month. So this really isn't a very good argument. - How long has the abortion methods been known or used. - Well at least from that time they were done. - I mean when was the hippocratic oath, that back in BC or AD or when? - 250, 300 BC, something like that. - So they weren't techniques known at that time. Certainly we know they didn't have pagan world, not only abortion, but when they decide what is considered appropriate, to decide child was born, whether it should should live or die. So it's a part of the Judeo-Christian ethic that brings question concerning the ethical decisions that have to be made. - I think that Blackmun in part of his statement touches on this in a way. I'm reading from an article that was in the January 31st, Christian Science Monitor, Justice Blackmun surveyed his opinion, public attitudes towards abortion from ancient to modern times. He recognized that, "One's philosophy, one's experiences, one's exposure to the raw edges of human existence, one's religious training, one's attitudes towards life and family and her values and the moral standards when one establishes and seeks to observe are likely to color or uncolor one's thinking about abortion." And I think he was relating back to when, way back, probably even today on how people's attitudes and so forth towards abortion are developed. - I think that still would be true today. - Oh, right. - Some people who would look upon abortion at any stage of pregnancy, even the morning after pill, which would cause a real early abortion as infanticide. And I think the significant thing is that the court has opened the situation up to the point that individuals are allowed to practice as their beliefs dictate, and that other individuals are not allowed to impose their own principles on other people. And this to me is very important that this happened in terms of birth control or in the state of Connecticut until 1965, the one couldn't purchase or sell birth control devices or pills of any kind. - Wasn't also illegal even to give advice? - Yes. - Or show methods of birth control. Now that was also declared illegal, wasn't it, by the Supreme Court? - Yes, on nearly the same grounds, right to privacy. - C. Lee Buxton, the late chairman of the Department of OBGYN at Yale was the one who spearheaded this test case in the court back at that time. - And then they do it, the Supreme Court also say, and in this case that they were not going to deal with the issue of when life begins. - Yes, they scruited that expressly and went to the issue of viability more saying that there were, that there is a controversy that has existed from almost time immemorial to today based on on religious and philosophic grounds and they weren't going into that arena. And tried to scruit it as well as they could and still deal with the issue of abortion. - But I think it's extremely important in any discussion of abortion to bring out the alternatives to abortion. One of which is adoption. We know from a medical point of view that this may be safer than abortion, depending upon when the abortion is proposed. It also allows couples who are not able to have their own children naturally to raise children. There's been a great effect on the number of adoptable babies since the Kansas abortion law went into effect. The second thing that I think is essential from a medical point of view, and that is a prevention of pregnancy to begin with and adequate birth control counseling, and the use of birth control hopefully prior to the need for an abortion is, would be ideal. Secondly, it's essential that any woman who has an abortion, who seeks an abortion for whatever reason, be very strongly counseled in regard to birth control at a future time, whether that be birth control pills in a younger woman, or whether, perhaps be a sterilization procedure in an older woman who for sure doesn't want to get pregnant ever again. So I think physicians feel this responsibility very strong. - Well, I think those are two very important points because one of the things that sometimes gets forgotten is that so far as I know, nobody thinks that abortion is a good method of birth control except the Japanese, is that right? That they don't believe in birth control, but they do permit to abortions, which is rather than comprehensible. - The American medical community is extremely opposed as you indicate to the idea of abortion as a primary means of birth control. - Is repetitive abortion sort by the same woman a common or uncommon procedure? - Relatively uncommon, I've seen several cases in this area, but it's relatively uncommon. - And also, the question mentioned raised by implication as responsibilities of schools and parents and of doctors and anyone really who is concerned and in case of an unwanted pregnancy to make sure that the woman is aware of all the possibilities. You spoke of adoptability and I presume that you would agree that no one should be forced to have a child in order that somebody else might adopt it. But that certainly the woman who is making the decision and effort should be made to make sure that she knows what all the options are that are available to her and that she is making this decision of her own free will. What do you consider to be the actual, under the the new decision, what do you consider to be the actual role of the doctor and the woman with the wanted pregnancy? Is his decision to be strictly a medical decision? It says in consultation, something of the sort, with her physician, what does that actually mean in practice? - Well, in practice, most women who present for abortion have already been through a considerable degree of agony in counseling and discussion. And by the time they arrive at the office, their minds are pretty well made up that that's what they want and then they feel that it's the right thing for them. Now, from a psychological point of view, it's been found that the long term risk from abortion on a patient whose desire is having abortion is extremely low. So this business about getting psychiatric consultations is really not a very domain and that's been well shown in some really good studies. Now, the patient who is told to have an abortion, say because of German measles or say she's 16 years old and her mother brings you to the office and says, you must have an abortion. Well, she may have gotten pregnant to try to prove something to her parents. In essence, then the patient who is told to have an abortion is the one who is most likely to develop psychological complications in these patients. I think generally physicians have seen mostly characters to assess the psychiatric aspect of it. - From a legal point of view, would do you anticipate that this might lead to people with, let's say a welfare situations, being required to have an abortion whether they want or not? - The decision doesn't implicate that at all. The basis, once again for the decision is a right to privacy, which is an individual person's right. And essentially the decision at the basis without consideration to abortion, but consideration to this right to privacy would be diametrically contrary to that forced abortion. - And I'm , and then you folks seemed to be about the decision always being that of the, or granted bill is being that of the woman herself. If she really was mentally distressed by the unwanted pregnancy, she would also be there praying for someone else like the father of the child to put her in a position where the decision was not her own, I'll marry you later, if you have the abortion now, kind of a blackmail procedure, or telling her that this is the thing that you really ought to do. And it seems to me that the counseling becomes tremendously important as it always has been, but remains very important to make sure that the privacy that we're talking about is the privacy of a woman with the unwanted pregnancy and not of anyone else who has a vested interest in these situations, the parents. - Except in the situation of a married couple and in that situation, we require the husband's signature on the operative permit. And I think most physicians do. - When you say you require, you mean in your particular office? - Yes, in Lawrence. - Will I be able to stay in there? What if the woman doesn't want to do that? - Well the decision as I read it and there may be hidden in it somewhere, terms could include the father, but it speaks of the woman in consultation with her physician. This case and it's important to consider the facts in this case, it was an unmarried woman who brought this case to the court. And when they gave a decision, it's impossible to look at it without looking also at the facts. And so they were speaking to an unmarried woman when they wrote this decision. So the case of a married couple has not been presented to the court. It was presented, but they determined not to decide that issue, they may decide it sometime in the future, but as far as that particular incident, it was not decided in this decision. - This seems to have much broader implications though, than just the unmarried woman. - But the physician wants to protect himself from possible liability from this husband. - Except what I'm wondering too is that what do you do in cases where there's non-legal separation, that the woman is legally married but she desires, and she is separated and she does desire an abortion, does that require the husband's signature? - Unless she is divorced. This pertains to sterilization procedures too, this is not something peculiar to abortion. This is something that's just pretty standard practice on hysterectomy and any operation that will affect her fertility. - Just out of curiosity, would that mean that a wife would have to sign if her husband, a vasectomy is performed on her husband? - These generally are not done in hospitals. So this would be, I think, up to the physician in his own office. I'm not sure about what the practices on hospitals and vasectomies. - What about the physician in his own office or the clinic in the event that you were at times the same with the hospital situation? I'm sorry to say this our time is up. We appreciate your joining us for this program tonight on the implications of Supreme Court decision on abortion. And we hope that you can join us again next Monday at the same time from 7:00 to 8:00 for "A Feminist Perspective." - Listen again next Monday at 7:00 for "A Feminist Perspective."