In vitro fertilization and the beginning of life

The Los Angeles Times (a one time free registration may be required) finally notices that couples who initiate in vitro fertilization are "finding themselves ensnared in a debate about when life begins."

The proposed Colorado amendment states, "The term 'person' or 'persons' shall include any human from the time of fertilization." If it is passed, the courts would have to interpret the meaning of those words, says Kristi Burton, sponsor of the initiative and founder of Colorado for Equal Rights, which focuses on the rights of unborn children. The goal of the amendment, says Burton, a college student, "is to respect and protect all life."

Fertility advocates are skeptical that "personhood laws" wouldn't limit their choices for reproductive healthcare. In August, Resolve released a statement opposing the Colorado amendment.

"The motivation is abortion," says R. Alta Charo, a professor of law and bioethics at the University of Wisconsin at Madison. "If the Supreme Court allows states to declare embryos as personhood, you would be in a position to say immediately that all abortions have to stop."

The reproductive rights of infertile women may not be the target, says Dr. William Schlaff, director of reproductive endocrinology at the University of Colorado Health Sciences Center, "but the implications are massive depending on how this law would be used if adopted."

For instance, what happens to embryos determined to be afflicted with serious genetic diseases? "What do you do with that embryo then?" Schlaff asks.

Says Burton of the initiative's possible ramifications: "All those things would have to be dealt with later on. . . . We don't see it as preventing infertility treatment."

As for the Rathans, over the course of several weeks, the couple ruled out discarding the embryos. They discussed donating them to research but heard that option was a logistical nightmare. They pondered giving the embryos to another infertile couple.

"Before I became pregnant, I thought the decision would be easier for me," Gina Rathan says. "But when it actually happened, I realized these are three potential lives."

Finally, the couple paid for three more years of cryopreservation.

Healthcare lottery

When you buy a lottery ticket, do you choose the cash option with its immediate payout of half the winnings or do you choose the payment of the full amount, doled out over 20 years?

I've found this question to be a good way to help other people understand the difference between conservativism and those who think that someone else can take care of them or the "totalitarian mamas" who believe that they can take better care of us than we could ourselves and for our own good. (Of course, some Conservatives tell me don't gamble, so they never buy lottery tickets.)

It's amazing how many people tell me that they always buy the "cash option." Some say they worry that their families wouldn't get anything if they die before the 20 years is up. Some tell me that they believe they can manage and invest the money to earn more than they would if they wait out the smaller payments. A few tell me that they would rather not have all the money at one time, preferring the guaranteed income over the years or fearing blowing the money.

The latter group never understands why I suggest that their health insurance should be something that they own and control, rather than something doled out by government and their employers.

A "right" is something that we each have without conditions and which we can call on society and government to enforce or punish if someone infringes that right. The right to life is actually the right not to be killed. We expect our fellow citizens to protect us through providing armies and law enforcement, a militia and by allowing self-defense. If another person infringes our right not to be killed, we expect society to punish him.

Last night, Democratic Presidential Candidate Barack Obama stated that health care is a right. I strongly disagree.

"Health" and "health care" are difficult terms to define. Instead of people and their actions, health is threatened by disease, age and injury. If I'm not well, how will society protect my health - and who or what will be held responsible as I inevitably age? If I have a "right" to health care, then I want everything possible to maximize my health. Rights can't be rationed.

What we're really talking about is health care funding. Funding certainly can be rationed. Take a look at Medicare, Medicaid, and the Veteran's Administration.

These systems work fairly well most of the time. However, they rely on limiting the costs of health care. The limitations fail when demand for cutting edge, expensive treatments or emotional arguments override them. That's why Medicare won't pay for a tetanus shot after a dirty wound, but will pay for annual physicals, screening mammograms and prostate specific antigen tests, although there's no evidence that these prolong life.

Or why Oregon Health sends notes telling patients that they won't pay for cancer treatments, but they will pay for assisted suicide.

For more on this subject, here's another opinion.

Half the abortion rate

That's a quote from NARAL ("National Abortion Rights Action League" ), in a report on the effects of the Hyde Amendment (a pdf document). The Hyde Amendment restricts federal funding of abortions, including those for women who are eligible for prenatal care funding by Medicaid. NARAL urges us to examine the record of John McCain and Sarah Palin on abortion and "reproductive health." (The numbers are actually 18%-35% of women, according to this report on line at the Alan Guttmacher Institute (AGI), the research and education arm of Planned Parenthood.)

Cutting the abortion rate in half is a good thing, and a benefit of the Hyde Amendment.

It will be interesting to watch the response to a National Review article, "Unholy Messaging," by Douglas Johnson, who does just that for Democratic Presidential Candidate Barack Obama, while pointing out the bias of the New York Times editors.

The focus of the article is three specific points denied in the editorial:

. . . (free one time registration)on September 21, titled “Right to Smear.” The editorial expressed the hope that the federal courts and the Federal Election Commission would prevent a group called The Real Truth About Obama, Inc., from disseminating an ad that, the Times said, “trashes the candidate’s nuanced position [on abortion]. It even employs an Obama-like voice pledging to make taxpayers pay for abortions, help minors conceal abortions from their parents, and legalize late-term abortions."

Mr. Johnson documents the truth, one by one, of what the NYT calls "these lies."

Is conscience solely a religious matter?

I've commented on the surprising accusation that protection of the consciences of physicians is anti-gay as well as anti-abortion by the pro-abortion faction. Now, the atheists are chiming in, claiming over and over that it's just the Christians who might refuse to perform abortions and object to calling abortion standard reproductive care.

"Pharyngula," is the blog of PZ Myers, who teaches biology at the Morris campus of the University of Michigan. Dr. Myers is one of the sources of the mocking of the Catholic communion and a "Red Letter," evangelical, atheist. He's also notorius for being banned from the local free showing of "Expelled, the Movie."

His blog post, "I don't want to be healed by Jesus, I want real medicine," advocates the view that "the religious" are the only people who would advocate for regulations protecting the jobs and licensure for people who conscientiously do not perform or refer for abortion.

If Roe Goes . . .

A Washington Post editorial (free registration required) is so outrageous in its appeal to the extreme that everyone who reads it should be offended.

If Roe Goes, Our State Will Be Worse Than You Think

By Linda Hirshman
Sunday, September 28, 2008

(First come the horror stories.)

In the 1980s, when abortion was severely limited in then-West Germany, border guards sometimes required German women returning from foreign trips to undergo vaginal examinations to make sure that they hadn't illegally terminated a pregnancy while they were abroad. According to news stories and other accounts, the guards would stop young women and ask them about drugs, then look for evidence of abortion, such as sanitary pads or nightgowns, in their cars, and eventually force them to undergo a medical examination -- as West German law empowered them to do.

. . . . Even Georgia, one of the two states involved in that case, allowed some abortions for the health of the mother.

(As did Texas. Two doctors were needed to sign off on an abortion.)

. . . their children would be deformed by the anti-morning-sickness drug thalidomide. . .

. . . religions weren't much engaged in politics. Today, the politics of abortion have changed. In addition to old laws that would spring back up should Roe be reversed, the nonpartisan Guttmacher Institute

(The Guttmacher Institute is the education and research arm of Planned Parenthood, focused on advocacy of abortion. Does it really matter whether or not the Institute is partisan?)

. . . lists four states -- Louisiana, Missisippi, North and South Dakota -- as having trigger laws explicitly aimed at making abortion criminal upon Roe' s demise, and seven others that have committed to acting to the extent that the court may allow.

(The criminal penalties are restricted to the person who performs the abortion.)

. . .The difference today is that some states with criminal abortion laws will almost certainly also forbid their residents to cross state lines to obtain an abortion. Missouri already allows civil litigation against anyone who helps a minor cross state lines to get an abortion without parental consent. Congress was well along to passing a law making it criminal to take a minor from a state requiring parental consent when the Democrats won in 2006 and stopped it.

(How many of us believe that there should not be a penalty for a sexual predator or the mother of our daughter's boyfriend if they take our daughters out of State for a surgical procedure without our permission or knowledge?

In any case, we have a precedent of sorts. 70% of Texas voters passed a State Constitutional Amendment to specifically forbid same sex marriage or civil unions. However, no one attempts to prevent anyone, including gays and lesbians, from traveling to California for the weekend. We won't allow for divorces or division of property in our courts and probably wouldn't allow a woman to sue for malpractice in our courts for an illegal procedure.)

It's easy to imagine the anti-abortion states pushing the envelope with once improbably restrictive laws, such as one requiring clinics to be licensed by the state and prohibiting women from getting abortions in unlicensed clinics, either in- or out-of-state.

(And how is it wrong to require that clinics are licensed?)

. . . How would state laws forbidding pregnant women to leave be enforced? The Hope Clinic in Granite City, Ill., is just 10 minutes from the Missouri border. Police from the prohibiting state can just take the license plates of local vehicles at the abortion clinics across the state lines and arrest the women when they re-enter the state. Or a traffic stop can produce a search. Tips from pharmacy workers, disapproving parents or disappointed boyfriends can alert the police to arrest the pregnant woman for intent to seek an abortion out of state. The state law may allow interested parties to seek injunctions to stop her from leaving.

(Here we are brought back to the fear that State police will not only forcibly examine women who cross the State lines, but that they will stalk all women who leave the State. First, I don't know how any State could afford all those wages, extra patrol cars or even the medical exam kits. Secondly, I can't imagine getting the law allowing such acts by law enforcement officers.

Please do write Ms. Hirshman at the address, below.)

linda@gettoworkmanifesto.com

Linda Hirshman, a lawyer and former professor of law and philosophy, is the author, most recently, of "Get to Work: A Manifesto for Women of the World."

Okay, how does she feel about a woman working as Vice-President with a husband and 5 kids?

The demented should want to die or feel guilty

Baroness Mary Warnock led the British ethics committee (named after her) which couldn't quite decide the status of human embryos, but allowed destructive research on them. (See this LifeEthics essay on the Baroness' 2007 apologia concerning the deliberations of her committee.)

This year, the Baroness told British journalists that she believes that the demented are wasting the lives and resources of other people and that they should be euthanized. According to the Daily Mail, she now supports a "duty to die."

Lady Warnock, 84, was the head of the committee which during the 1980s opened the way for legal research on human embryos.

Influential in education as well as in medical ethics, she became an open supporter of euthanasia after her ill husband was helped to die by his doctor in 1995.

She told the Church of Scotland's magazine Life and Work: 'I've just written an article called A Duty to Die? for a Norwegian periodical. I wrote it really suggesting that there is nothing wrong with feeling you ought to do so for the sake of others as well as yourself.'

She added: 'I am absolutely, fully in agreement with the argument that if pain is insufferable, then someone should be given help to die, but I feel there is a wider argument that if somebody absolutely, desperately wants to die because they are a burden to their family or the state, then I think they too should be allowed to die.'

There's more of the same at the BBC News.

Ignore the fact that a large part of our economy depends on the jobs created by the need to take care of people who can't take care of themselves, at all ages.

Please note that the Baroness is worried about the "wishes" of people that she dismisses as incompetent. She's proposing that other people determine when and how those wishes are implemented.

However, she also suggests that society should actually decide to go down the slippery slope of pressuring people into feeling guilty enough that they chose euthanasia.

Induced Pluripotent stem cells without viruses

"The adenovirus will infect the cells but then will clear themselves from the cells. After a few cell divisions there are no traces of the virus in the cell," Hochedlinger said. "You can't tell the virus was ever there."

Science Magazine has published a report on induced Pluripotent (iPS) stem cells from liver cells (hepatacytes) that do not show any trace of the viruses initially used to cause the regression from adult cells to embryonic-like stem cells. The report, by Hochedlinger's group at Massachusetts Gener al Hospital and Harvard, is behind a pay-wall, but there is a review here at the Washington Post.

The simple explanation is that viruses are used to carry copies of genes that turn on proteins which cause the cells to divide and produce embryonic-like stem cells. Prior research used viruses that might become permanently inserted into the DNA of the cells. These viruses did not cause an infection in the culture because the viruses used were not good at causing themselves to be reproduced or inserting themselves into neighboring cells. However, because they inserted themselves into the DNA, there was a risk that the cells could become mutated or even cause tumors due to the abnormal DNA that resulted. In the case of Hochedlinger's cells, the adenovirus used does not insert into the DNA nearly as often, and when it does, the cell is able to repair the DNA in subsequent copies of the DNA as it reproduces the nucleus of the cell in order to divide to become two cells.

The cells are infected, they change because of the infection, but their granddaughters are able to get rid of the infection, while continuing to act like embryonic stem cells instead of grown up liver cells. The new "adeno-iPS" cells pass all the tests for "stemness."

Just think, no need for egg cells, no cloning, no destruction of embryos, and we're one step closer to healing within the body - to learning how to heal without transplant rejection or tumors due to the treatment. One day, we may be able to regenerate organs and tissues in place, as needed.

"iPS cells would have never been discovered without human embryonic stem cells"

In fact, Mr. Siegal, without the objection to cloning and embryonic stem cell research, iPS cells researchers might have taken a little longer to develop therapy that holds promise for regeneration and healing in the body, without transplants, intermediate cells and without costing the life of another human being.

Bernie Siegal, that lawyer who sued the Raelians for custody of their supposed cloned children and who lauded Hu Wu Suk for his own cloned children, is hosting one of his "World Stem Cell Summits" in Madison, Wisconsin next week. He is joined by Robin Alta Charo in promoting the Summit and reminding all of us that the push is not over for more clone-and-kill embryos and federal tax funded research depending on embryo creation and destruction. No matter how successful induced Pleuripotent Stem (iPS) cells are turning out to be.

Siegal founded the Genetics Policy Institute, with the help of the National Heritage Foundation Inc:

The GPI is funded by individuals, foundations, academic institutions and scientific societies, including the American Society For Cell Biology, the American Society for Biochemistry and Molecular Biology, the Michael J. Fox Foundation for Parkinson's Research and the Huffington Foundation, according to Siegel.

R. Alta Charo (for some reason, she drops the "Robin") is a lawyer/bioethicist ( "for Hire")will deliver a keynote address at the Summit. She lobbies against physicians with consciences and in favor of abortion, cloning and embryo stem cell research. She's especially fond of the latter two, because (as she says in this audio copy of her lecture at the American Society of Bioethics and Humanities convention in 2006)she believes they will support her Progressive politics and belief that the research will support her personal belief that there is no Creator, so humans aren't so special, after all.

For a brief review of the history of "ethics for sale," look at this set of my posts.)

Camille Paglia: abortion is murder

Just, "Wow!" Ms. Paglia and I have many points of common ground. I've admired her honesty and linear logic, even though I most certainly disagree with some of her views that are (as she says in this column) informed by her atheism.

Read the whole essay, when you can. But, for the moment, let's look at the comments on the ethics of abortion.

Let's take the issue of abortion rights, of which I am a firm supporter. As an atheist and libertarian, I believe that government must stay completely out of the sphere of personal choice. Every individual has an absolute right to control his or her body. (Hence I favor the legalization of drugs, though I do not take them.) Nevertheless, I have criticized the way that abortion became the obsessive idée fixe of the post-1960s women's movement -- leading to feminists' McCarthyite tactics in pitting Anita Hill with her flimsy charges against conservative Clarence Thomas (admittedly not the most qualified candidate possible) during his nomination hearings for the Supreme Court. Similarly, Bill Clinton's support for abortion rights gave him a free pass among leading feminists for his serial exploitation of women -- an abusive pattern that would scream misogyny to any neutral observer.

But the pro-life position, whether or not it is based on religious orthodoxy, is more ethically highly evolved than my own tenet of unconstrained access to abortion on demand. My argument (as in my first book, "Sexual Personae,") has always been that nature has a master plan pushing every species toward procreation and that it is our right and even obligation as rational human beings to defy nature's fascism. Nature herself is a mass murderer, making casual, cruel experiments and condemning 10,000 to die so that one more fit will live and thrive.

Hence I have always frankly admitted that abortion is murder, the extermination of the powerless by the powerful. Liberals for the most part have shrunk from facing the ethical consequences of their embrace of abortion, which results in the annihilation of concrete individuals and not just clumps of insensate tissue. The state in my view has no authority whatever to intervene in the biological processes of any woman's body, which nature has implanted there before birth and hence before that woman's entrance into society and citizenship.

On the other hand, I support the death penalty for atrocious crimes (such as rape-murder or the murder of children). I have never understood the standard Democratic combo of support for abortion and yet opposition to the death penalty. Surely it is the guilty rather than the innocent who deserve execution?

Thanks to Vox Populi for the tip.

Pro-life Governor tapped for GOP VP

And she happens to be a woman who hunts and wants to drill for oil.

Governor Sarah Palin is a member of Feminists for Life who lives her values. A year after her election as Alaska's governor, the 44 year old Mrs. Palin, already the mother of 4 children, discovered she was pregnant. Prenatal testing showed that the little boy had Down's syndrome, which results from getting an extra copy of Chromosome 21 from either the mother or the father. The baby is nearly 4 months old now. He is cared for by both his mother and father, Todd Palin.

The Stem Cell Debate Heats Up

Here's a great review about those new "induced pleuripotent stem cells" (iPS) we've been hearing about. iPS's are truly "patient specific stem cells" since they come from the patient himself or herself. The cells are manipulated in the lab, using viral particles and specific environments to make the able to become many different types of cells.

It would be very difficult, in my opinion, to make these cells become embryos, with all the structures that would allow them to function as individual organisms. From what I understand, the cells return to a state that allows them to become tissues with several different types of cells and cell groups, but they are never organized.

In my opinion (again), the induction process can't be more of a problem than the risk of immune rejection and the manipulations that embryos derived from In Vitro fertilization go through or the changes that are bound to be inherent with cloned cells derived through Somatic Cell Nuclear Transfer. On the other hand, volunteers and tissue samples for IPC experiments ought to be abundant.

And no one has to die for it.

"Trained" (medical professionals) should shut up and perform

"Trained" medical professionals should just shut up and perform, according to the President of the National Family planning and Reproductive Health Association.

As mentioned in the last few posts, the right not to be forced to act against the conscience has been under attack by the American College of Obstetricians and Gynecologists. The Washington Post article mentioned in my last post linked to the blog of Health and Human Services Secretary, Mike Leavitt.

Today, the Secretary wrote that he's not used to having nearly a thousand comments and many more "hits" on his blog. Take a deep breath and read the comments on each page.

Take a look, also, at this quote, in today's post:

One thing I did find helpful was the clear explanation of the ideological basis of opposition to physician conscience. Mary Jane Gallagher, President of the National Family planning and Reproductive Health Association, was quoted in Congressional Quarterly’s HealthBeat saying,

“Family planning providers work to provide family planning services. So it’s really not acceptable to the people I represent that this administration is considering allowing doctors and nurses and pharmacists that have received their education to provide services to now be able to not provide those services if they don’t want to.”

“Who’s going to provide access to contraceptives services if the administration provides this large loophole to deny services?"

CQ reported Ms. Gallagher continued: “Providers are ‘given an oath—now they get to pick and choose what they want to do' if a regulation is issued, she said.”

The Secretary answers Ms. Gallagher better than I could. However, don't you wonder that the conversation has moved from "choice" and patients' rights ("If you don't believe in abortion, don't have/do one.") to threats that we who oppose abortion should give up our practices, to the declaration that we trained and obtained a license only to be forced to do what someone elsed demands of us?

Washington Post Addresses Our "Birth Control Fears"

As well as our fear of death and homophobia, in today's article, "Birth Control fears addressed."

Health and Human Services Secretary Mike Leavitt has denied that a controversial draft regulation would redefine common birth control methods as abortion and protect the rights of doctors and other health-care workers who refuse to provide them.

In a statement posted on his blog on Thursday, Leavitt appeared to try to allay fears that the proposed regulation would create sweeping new obstacles to women seeking a variety of commonly used contraceptives, such as birth control pills and the Plan B emergency contraceptive.

"An early draft of the regulation found its way into public circulation before it had reached my review," Leavitt said. "It contained words that lead some to conclude my intent is to deal with the subject of contraceptives, somehow defining them as abortion. Not true."

Leavitt's statement, however, failed to alleviate concerns among members of Congress, family planning advocates, women's health activists and others.

At issue is the American College of Obstetricians and Gynecologists' Ethics Statement "Opinion #385, Limits of Conscientious Refusal in Reproductive Medicine," which states that

Providers with moral or religious objection should either practice in proximity to individuals who do not share their view or ensure that referral processes are in place. In an emergency in which referral is not possible or might negatively have an impact on a patient's physical or mental health, providers have an obligation to provide medically indicated and requested care."

It goes on to declare abortion “standard reproductive care” and demands that doctors who “deviate from standard practices” (object to abortion) “practice in proximity to individuals who do not share their views or ensure that referral processes are in place” (with a willing abortionist).

After publication of the Opinion, the President of ACOG then wrote letters asking Congress to pass laws to force these limits on our consciences: to force doctors who object to abortion to either change their practice so that they don't take care of women and girls of reproductive ages, or move close to a willing abortionist.

Somehow, the pro-abortion crowd has turned this into an "physician assisted suicide" and "gay, lesbian, bisexual, transgendered, transexual" issue as well as one of hyper-support for abortion and one more opportunity to bash the Bush administration.

Kathryn Tucker, director of legal affairs for Compassion & Choices, which advocates for physician-assisted suicide, said she remains concerned that the regulation could apply to health-care workers who refuse to participate in a variety of end-of-life care, including the withdrawal of unwanted feeding tubes and ventilators.

. . . and . . .

"Until the regulation removes the re-definition of abortion and it clearly states that it deals solely with abortion (and not with any other procedure, nor with any refusals based on the nature of the patient, such as single or gay), I would not be satisfied," R. Alta Charo, a lawyer and bioethicist at the University of Wisconsin wrote in an e-mail. "There is no reason to extend any benefit of the doubt to this administration when it comes to reproductive rights or the civil rights of gay people."

You want to talk about "alarmed"? If an ethicist like Charo can't distinguish between negative rights and positive rights, then the state of "ethics" is worse than I thought. (See "Ethicist for hire")

Remedial ethics 101: you have the right to expect someone not to act, but only in very rare cases can you force them to act when they don't want to. You have the right to liberty, meaning society will protect you from someone who wants to turn you into a slave. But you can't make others to do your will, either. You have the right to swing your arm if you want, but your right to swing your fist ends at the other guy's nose.

In case you're wondering, the Post took their only prolife quote from the Secretary's blog.didn't quote a single pro-life advocate. How hard would it have been to get a quote from the Christian Medical and Dental Association?

I would have never guessed that the attack on physician's conscience rights would somehow become a gay/lesbian/bisexual/transgendered/transexual/pea-green-with-lavender-stripes issue, although I predicted the involvement of "Compassionate Choices" and other pushers of intentional physician killing.

In Oregon, I have the right to a prescription of barbiturates if I want to die. The State limits that right and tells me when my right kicks in, of course. According to lawyers Charo and Tucker, I can go up to any MD or DO and demand that he or she write the prescription.

I ask again: "How far do you trust doctors who will violate our consciences?? How much practice will it take until we do what the State tells us to, rather than what our patients ask - without regard to silly notions of "right" and "wrong?""

Forcing Pro-life Doctors Out of Baby Business?

Two writers from the Heritage Foundation have published an editorial on the Fox News Site that discusses the risks of the new ethics statement of the American College of Obstetricians and Gynecologists (ACOG). Daniel Patrick Moloney and Peter Reed appreciate that limiting obstetrics and gynecology only to those doctors who will do abortions or arrange in advance to refer patients to doctors who will abort, limits women who themselves believe that their children's lives begin at conception and who do not want anything to do with abortionists.

Should pro-life doctors and pharmacists be free to practice their profession according to the dictates of their consciences? Should a woman have the freedom to choose an obstetrician or gynecologist she trusts to provide care consistent with her beliefs?

Current federal law says yes. But many women may have that choice greatly restricted, and their doctors driven out of business, if a medical association is able to require that all doctors either perform abortions or make referrals for abortions.

In November 2007, the American College of Obstetrics and Gynecology (ACOG) announced that the ethical standards of the profession had changed. Its ethics committee stated that an ob/gyn who is unwilling to perform an abortion has an ethical duty to refer the patient to someone who will perform it. If the physician is unable to refer the patient in a timely manner, he would be required to perform the abortion himself.

This decision threatens the livelihood of pro-life doctors. Every ob/gyn who works in a hospital or clinic needs not only a license, but also certification that his skills are up to date and that he is aware of recent developments in the field. To be certified, he must follow the ethical standards of the profession, so under the new ethics policy a pro-life doctor risks losing his certification if his pro-life convictions don't allow him to perform or cooperate in an abortion. And if he loses his certification, a hospital or clinic won't let him deliver babies there.

The American Association of Pro-Life Obstetricians and Gynecologists has labeled the decision “a raw power play to cripple, and ultimately eliminate from practice, those doctors who hold a conscience conviction on the sanctity of human life.” Besides forcing current ob/gyns out of the profession, the policy would make any bright young pro-life student think twice about going to medical school for obstetrics or gynecology.

(More here.)

Besides limiting a woman's choice to have a doctor who shares her pro-life views, restricting all prolife doctors from obstetrics will adversely affect her access to health care in general. Few doctors are doing OB, now. The number can only decrease if the traditional, conservative, prolife man or woman is threatened by ACOG's insistence that conscience is merely a personal feeling and that we doctors can only practice if we promise to go out of our way to violate that conscience.

These ethical statements affect all doctors who care for women and girls through their reproductive ages. In fact, Family Physicians who deliver babies are also held to the same ACOG standards that the OB/Gyns must meet. (If anything, we had better be more careful, since any breech of protocol or "standard of care" may be thought of as due to our training.)

In many rural and underserved areas, the only docs around are the Family Physicians, who care for babies, kids, the elderly, and expectant mothers. In fact, I was the first FP in my small town ( just 20 miles from San Antonio but considered "medically underserved" as it had a large number of Medicaid, Medicare and indigent patients) who did not do "surgical OB," or do Cesarean sections and sterilizations. (I'm a wimp, not a cutter. Although I love to sew up and put back together, I even refuse to make the traditional, courtesy, "first cut" at appendectomies and other non-OB surgeries when the surgeon offers. I finally quit doing circumcisions on new born boys because it made me physically ill to cut perfectly healthy tissue.)

Okay, how far will you trust someone who trains herself to forget that she believes the Creator of the universe - the One who knows every thought and can send her to hell - hates what she's doing? Or even without a religious underpinning, a doc who believes he is killing a person at abortion, but does it anyway?

30 years: In Vitro Fertilization,Bioethics and Public Health

My own first child is a little older than Louise Brown, the first child born from in vitro fertilization (IVF). This incidental pioneer celebrates her 30th birthday this month, calling for reviews and editorials on what her birth has meant to culture and to individuals, such as this one from the UK's Telegraph.

It's good to hear that Ms. Brown has a child of her own, "naturally conceived" with her husband. Full circle.