February 19, 2019
Joint
Medical Statement on S. 311
Born
Alive Abortion Survivors Protection Act
SUPPORT
Presented
to the 116th Congress U.S. Senate
Dear
Senator,
As medical
professional organizations and individuals representing over 30,000 physicians
who practice according to the Hippocratic Oath, we write in support of S. 311,
the Born Alive Abortion Survivors Protection Act.
Medical facts are important.
Fact 1. It is an undisputed scientific
fact that a distinct, living human being exists in the womb of a pregnant
mother.
From the moment of fertilization, a human being meets
all of the scientific criteria for a living organism[1]
and is completely distinct from her/his mother, not a part of her/his mother’s
body. This is scientific fact. It is therefore scientifically correct for S.
311 to identify the living survivors of abortions as human persons and afford
those human beings the full protection of the law in the same way that infants
of similar gestational ages are currently protected.
Fact 2. Abortion
is NOT healthcare, much less an essential part of women’s health care and
abortions in the third trimester are NOT done to save a woman’s life[2].
The fact that over 85% of ob-gyns in a
representative national survey do not perform abortions on their patients[3] is glaring
evidence that abortion is NOT an essential part of women’s healthcare. The vast majority of abortions are done by
abortion providers who do not provide any other kind of medical care for the
woman. Abortion treats no disease. Pregnancy is not a disease, and deliberately
killing the unborn child by abortion is NOT healthcare.
It is clear
from testimony by abortion practitioners during the Partial Birth Abortion Ban
hearings[4] that,
unlike a delivery which separates the mother and her fetus for the purpose of
life, an abortion separates the mother and the fetus with the purpose of
guaranteeing that the baby is born dead.
That’s why a fetus who survives an abortion is called a “failed
abortion”. The separation did not fail
to occur. What “failed” to occur in a
“failed abortion” is the guarantee of a dead baby.
There are rare circumstances in which a mother’s life is in
jeopardy due to either pre-existing conditions or pregnancy complications. It is extremely rare for this to occur prior to the point of viability (currently 22 weeks
after last menstrual period, 20 weeks after fertilization). After 20 weeks
fertilization age, it is NEVER necessary to intentionally kill the fetal human
being in order to save a woman’s life.[5] In cases where the mother’s life actually is
in danger in the latter half of pregnancy, there is not time for an abortion,
because an abortion typically is a two to three-day process. Instead, immediate delivery is needed in
these situations, and can be done in a medically appropriate way (labor
induction or C-section) by the woman’s own physician. We can, and do, save the
life of the mother through delivery of an intact infant in a hospital where
both the mother and her newborn can receive the care that they need. There is no medical reason to intentionally
kill that fetal human being through an inhumane abortion procedure, e.g.
dismembering a living human being capable of feeling pain[6]
[7] [8](Also see Appendix A), or saline
induction which burns off the skin (See
Appendix B), or feticide with subsequent induction.
Obstetricians who abide by the Hippocratic oath strive, to
the best of our ability, to save both lives when at all possible. There are two
patients under our care. We never
intentionally target the unborn child during the separation procedure in order
to guarantee that the baby is born dead.
Fact 3. No matter
the circumstances of their birth, infants who are born alive must be given
appropriate medical care.
Any infant who is born alive, at any stage of development, is a person
entitled to the protections of the law and appropriate care as a new
patient. There is no scientific or legal reason to distinguish between
human beings born after an attempted abortion and human beings born after
attempted live birth. A distressed newborn should get immediate emergency care
and a professional evaluation to determine appropriate steps to promote his/her
health and well-being. Obviously, a distressed newly born baby presents for
emergency medical care at the moment of her or his birth, regardless of whether
that birth results from an abortion attempt or attempted live delivery. EMTALA mandates hospitals to examine and
treat any person who presents for emergency medical care.
These same
principles apply in cases in which the human being in utero has a disability or
has been given a life-limiting diagnosis, such as anencephaly. Human beings who are disabled at birth
deserve the same respect and dignity afforded to able-bodied children at
similar gestational ages. The terms “incompatible with life” or “fatal fetal
malformations” are not medical terms. For many children with medical conditions
previously labelled as such, survival for years has been accomplished[9], and is
very possible when supportive care is provided.
Additionally, as health care professionals, we are notoriously
poor predictors of whether infants will live or die when supportive medical
care is offered[10]. If a
fetus has a potentially life-limiting diagnosis which is expected to result in
death shortly after birth, families should be presented with the potential
benefits of medical care and, accepting that such care might only prolong an
inevitable death, be offered perinatal hospice. [11]
[12]
Perinatal hospice respects the human dignity of the newborn and
allows the family to hold and care for their child after birth, celebrating the
precious time they have together as well as allowing them to grieve the brevity
of this same gift. Perinatal hospice provides optimal care for the mother,
honors the life of her child and allows the family the opportunity to
acknowledge, love, and mourn its newest member. Literature comparing outcomes
of delivery and perinatal hospice care with abortion in cases of anencephaly
reveals significantly better mental health outcomes for mothers who do not
abort. [13] [14] [15] Perinatal
hospice is compassionate and comprehensive health care for women whose fetuses
have life-limiting diagnoses.
S.311 provides a scientifically sound, medically accurate, and
respectful approach to ensure that the innocent human being who survives an
attempted abortion will be treated with the same human dignity and respect that
similarly aged human beings receive in the course of good neonatal medical
care. S. 311 ensures that human beings
with disabilities are not targeted for intentional killing at the moment of
birth.
For all of these above reasons, we, the undersigned medical
organizations and individuals, strongly urge you to pass S. 311. Thank you for your consideration of these
views.
Respectfully submitted,
Donna J. Harrison M.D.
Executive Director
American Association of Pro-Life Obstetricians and Gynecologists[16]
American Association of Pro-Life Obstetricians and Gynecologists[16]
Michelle Cretella M.D. Executive Director
American College of Pediatricians[17]
John Schirger, M.D. President,
Catholic Medical Association[18]
Dr. Carolyn Laabs, PhD, FNP-BC, RN
Chair, Ethics and Spirituality Committee
National Association of Catholic Nurses, USA[19]
David Stevens, CEO
Christian Medical Association[20]
Jane Orient, Executive Director
Association of American Physicians and Surgeons[21]
National Catholic Partnership on Disability[22]
Robin Pierucci, MD, MA
Neonatologist
Catholic Medical Association
Martin J McCaffrey, MD, CAPT USN (Ret)
Professor of Pediatrics
Division of Neonatal-Perinatal Medicine
Department of Pediatrics
UNC School of Medicine
Chaple Hill, North Carolina
[1] Condic M. When Does Human Life Begin? The
Scientific Evidence and Terminology Revisited. University of St. Thomas Journal of Law and
Public Policy 8(1) Fall 2013 Article 4. Available at embryodefense.org/MaureenCondicSET.pdf (accessed 2019 02 18)
[2] Greene-Foster D and Kimpart K. Who Seeks
Abortions at or After 20 weeks? Perspectives on Sexual and Reproductive Health
2013 45(4):210-218 doi:10.1363/4521013.
[3] Stulberg D, Dude A, Dahlquist B, Curlin
F. Abortion Provision Among Practicing
Obstetrician-Gynecologists Obstet
Gynecol. 2011 September ; 118(3): 609–614. doi:10.1097/AOG.0b013e31822ad973.
[4] Gonzales v Carhart USSC. Available at supremecourt.gov/opinions/06pdf/05-380.pdf
(accessed 2019 02 18)
See page
9: “Yet one doctor would not allow
delivery of a live fetus younger than 24 weeks because “the objective of [his]
procedure is to perform an abortion,” not a birth. App. in No. 05–1382, at
408–409. The doctor thus answered in the affirmative when asked whether he
would “hold the fetus’ head on the internal side of the [cervix] in order to
collapse the skull” and kill the fetus before it is born. Id., at 409; see also
Carhart, supra, at 862, 878. Another doctor testified he crushes a fetus’ skull
not only to reduce its size but also to ensure the fetus is dead before it is
removed.”
See also page
11: “(b) As used in this section— “(1) the term ‘partial-birth abortion’
means an abortion in which the person performing the abortion— “(A)
deliberately and intentionally vaginally delivers a living fetus until, in the
case of a head-first presentation, the entire fetal head is outside the body of
the mother, or, in the case of breech presentation, any part of the fetal trunk
past the navel is outside the body of the mother, for the purpose of performing
an overt act that the person knows will kill the partially delivered living
fetus; and “(B) performs the overt act, other than completion of
delivery, that kills the partially delivered living fetus;…” [emphasis added]
[5] Dublin Declaration on Maternal Health.
Available at dublindeclaration.com (accessed 2019 02 13).
Excerpt: “As experienced practitioners and researchers
in obstetrics and gynaecology, we affirm that direct abortion – the purposeful
destruction of the unborn child – is not medically necessary to save the life
of a woman. We uphold that there is a fundamental difference between
abortion, and necessary medical treatments that are carried out to save the
life of the mother, even if such treatment results in the loss of life of her
unborn child. We confirm that the prohibition of abortion does not
affect, in any way, the availability of optimal care to pregnant women.”
[6] Testimony of Dr. Maureen Condic, District
of Columbia H R.179J, 2013 05 23. Available at: govinfo.gov/content/pkg/CHRG-113hhrg81175/pdf/CHRG-113hhrg81175.pdf, pp 36-46
[7] American Association of Pro-Life
Obstetricians and Gynecologists Practice Bulletin 2: Fetal Pain. Available
at
aaplog.org/wp-content/uploads/2019/02/PB-2-Fetal-Pain.pdf (accessed 2019
02 18).
[8] American Association of Pro-Life
Obstetricians and Gynecologists Fetal Pain Fact Sheet. Available at
aaplog.org/wp-content/uploads/2019/02/2019-02-13-AAPLOG-fact-sheet-fetal-pain.pdf (accessed 2019 02 18).
[9] Wilkinson DJ, Thiele P, Watkins A, De
Crespigny L. Fatally flawed? A review and ethical analysis of lethal congenital
malformations. BJOG. 2012 Oct;119(11):1302-8. doi:
10.1111/j.1471-0528.2012.03450.x.
[10] Meadow W et al. Just, in time: ethical implications of
serial predictions of death and morbidity for ventilated premature infants.
Pediatrics. 2008 Apr;121(4):732-40. doi: 10.1542/peds.2006-2797.
[11] Perinatal Hospice and Palliative Care. Available at perinatalhospice.org (accessed 02 18 2019).
[12] American Association of Pro-Life
Obstetricians and Gynecologists Practice Bulletin 1: Perinatal Hospice.
Available at aaplog.org/wp-content/uploads/2019/02/PB-1-Perinatal-Hospice.pdf (accessed 2019 02 18).
[13] Cope H, Garrett ME, Gregory S, Ashley-Koch A.
Pregnancy continuation and organizational religious activity following prenatal
diagnosis of a lethal fetal defect are associated with improved psychological
outcome. Prenat Diagn. 2015 Aug;35(8):761-768. doi: 10.1002/pd.4603.
[14] Calhoun BC, Reitman JS, Hoeldtke NJ.
Perinatal Hospice: A Response to Partial Birth Abortion for Infants with
Congenital Defects. Issues in Law and Medicine 1997; 13(2):125-143.
[15] Calhoun BC, Hoeldtke NJ, Hinson RM, Judge
KM. Perinatal Hospice: Should all centers have this service? Neonatal Network
1997;16(6):101-102.
[16] The American Association of Pro-Life
Obstetricians and Gynecologists is a 4,600 member organization consisting of OB/GYNs and other physicians
and medical professionals who work in the field of reproductive health, and who
practice according to the Hippocratic Oath. The mission of AAPLOG is to provide
an evidence-based defense of both our pregnant patient and her unborn child.
[17] The American College of
Pediatricians is a Hippocratic medical organization dedicated to using the best
available science to promote the optimal health of all children from their
conception until natural death.
[18] The Catholic Medical
Association is a national, physician-led community of over 2,300 healthcare
professionals consisting of 109 local guilds. CMA mission is to inform,
organize, and inspire its members, in steadfast fidelity to the teachings of
the Catholic Church, to uphold the principles of the Catholic faith in the
science and practice of medicine.
[19] National Association of Catholic Nurses, USA
gives nurses of different backgrounds, but with the same Roman Catholic values,
the opportunity to promote moral principles within the Catholic context in
nursing and stimulate desire for professional development. This approach
to Roman Catholic doctrine focuses on: educational programs, spiritual
nourishment, patient advocacy, and integration of faith and health.
[20] The Christian Medical
and Dental Associations is a 19,000+ member organization in the United States,
consisting of healthcare professionals from multiple disciplines including
medicine, dentistry, physician assistants, nurse practitioners,
physiotherapists, optometrists, pharmacists, and many others. The mission of
CMDA is to motivate, educate, and equip Christian healthcare professionals to
glorify God by serving with professional excellence as witnesses of Christ love
and compassion to all peoples and by advancing biblical principles of
healthcare within the church and to our culture.
[21] AAPS was founded in 1943 to preserve and
promote the practice of private medicine. It upholds the sanctity of the
patient-physician relationship and the ethical principles in the Oath of
Hippocrates.
[22] Rooted in Gospel values that affirm the dignity of every
person, the National Catholic Partnership on Disability (NCPD), founded in
1982, works collaboratively to ensure meaningful participation of people with
disabilities in all aspects of the life of the Church and society.
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