Sunday, November 15, 2009

Abortion and Health Reform

The current clash about abortion and health reform is a tragedy. It reflects the breakdown of civil national discourse.

Although I'm a strong supporter of accessible abortion services, I see abortion as a a sad human event, to be avoided as much as possible.

And I respect the views of the majority of the "pro-life" community who oppose abortion in a thoughtful, conscience-driven manner and who respect those who hold the "pro-choice" position in an equally thoughtful, conscience-driven manner. Unfortunately the hate-laden screamers and the madness of committing murder on behalf of purported "reverence for life" has tainted the anti-abortion position, just as suicide bomber-murderers have tainted the noble traditions of Islam.

If Representatives Stupak and Pitt, their supporters, and the Conference of Bishops, were simply trying to ensure that health reform would continue the 33 year history of the Hyde amendment in prohibiting direct federal funding of abortion, I would be with them. (See here for the wording of the Stupak-Pitt amendment.) Abortion is currently an unresolvable moral conflict in the U.S. about which people of conscience cannot agree. Protecting access to abortion when states wish to fund the services or private insurance contracts include them while not allowing federal tax money to pay for abortion is a fair resolution. It won't leave anyone fully happy. That's something a mature democracy must be able to accept.

But Stupak-Pitt appears to have a much wider scope than the Hyde amendment, including prohibiting abortion in private insurance sold through any "exchange" created by the legislation. If the amendment is trying to extend constraints on abortion by hijacking health reform to achieve that aim the supporters ought to put their cards on the table and acknowledge that blackmail is their aim: "We think further restraint of abortion is more important than reforming our health system, so unless we get our way we'll block any legislation." If that's not their intent they should work with leadership to achieve a fair resolution.

Threatening to kill health reform unless abortion constraints are extended would be a misguided way of witnessing one's conscience. If abortion opponents take this path "pro-choicers" will take an equally hard line. The U.S. would miss a rare opportunity to tip toe towards greater social justice in health care.


Ashley B. said...

here here!

Well said-- I think that the vast majority of all pro/anti-choicers are fairly respectful in their views and motivated by what they believe really is the best possible outcome. However, a small minority have made clinic defenses, posters, and screaming the rule rather than the exception (at least in public debates about abortion).

It would be a shame to see health reform derailed over a legal medical procedure that a large portion of women go through at some point in their reproductive lives.

Jim Sabin said...

Hi Ashley -

Thanks for your comment. Abortion is a truly difficult area of public policy. The principled "pro life" folks you and I recognize see abortion as a form of murder. Accepting something they interpret that way can feel impossible to them. But how are they to think of equally principled "pro choice" folks? I think the correct response is to recognize moral complexity, and to retreat from an absolutist stance, even if one doesn't explicitly acknowledge that this is what is happening.

I share your hope that we don't see health reform derailed. We count on creative legislators to find ways to recognize competing moral views and come up with a path that brings enough support to allow health reform to proceed.