...Life or Health of the Mother...
Dec. 15th, 2009 04:27 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
beccastareyesFollowing post is political. You can disagree, or not, but keep things polite.
So, I saw this post on my feedreader today. For those of you who don't follow the link, it talks about a New York Emergency Room nurse who is suing her employer because she was required to assist in an emergency second trimester abortion. She claims that the hospital should have found another nurse to assist.
Obligatory disclaimer: I'm not a doctor, and most of the details seem to be coming from the nurse and the pro-life folks (who are Morally Outraged).
But, here's the deal. ER folks are driven by the need for speed. Frankly, folks don't go to the ER if they can wait a shift*. A doctor looked in and decided that this woman:
A) Needed an abortion to survive.
B) Was a Category II, which I'm told means 'can wait, but not more than six hours'.
A) puts this fairly into 'life of the mother', which many pro-life folks allow for. Which makes sense -- if a pregnant woman die in under a day if her pregnancy isn't ended, then either way, the fetus is a dead man walking... er, floating. And, ER doctors/nurses and first responders do have to make these calls in general -- triage -- since what they do is time sensitive. If you have one person not breathing, and one still breathing but bleeding in a life-threatening way, you sometimes have to accept that if you try to stop the bleeding of the second person, the first person is going to die -- and that if you try to help the first, the second will die.
Yes, it stinks. Proof that being at the scene of trauma is a hard job and not one I'd want to do -- even if these folks are the difference between one death and two. But... well, these calls have to get made to save as many people as possible.
Furthermore, I have every reason to think that if the doctor could have saved the fetus, s/he would have not made the call for an abortion. ERs (and hospitals) can perform abortions -- they generally have to be ready for anything -- but it's not what they're designed to do. Which makes me wonder about the nurse's moral objection -- was she willing to let two people (the mother and her unborn child) die on the table rather than to act to save one by killing the other because a sin by omission was better than a sin by commission in her mind? Or was it just an 'abortion bad' thing?
(Digression: the blog where I read this made the analogy of Orthodox Judaism and working on the Sabbath. She noted that being unwilling to do things that could wait a day on a religious holiday was perfectly acceptable, but that refusing to save someone's life was generally not considered morally acceptable. Someone in the comments noted that traditionally Judaism had the rule that you were allowed to throw out the other rules if it would save someone's life, so sacrificing someone else because God tells you you can't even flip a light switch one day of the week would be morally unconscionable. Which I approve of -- a sort of Moral Good Samaritan Clause.)
As for the second category, the nurse-plaintiff and the blogosphere seems to assert that the woman could wait six hours for another shift to come on. She may have, but generally speaking, the longer you wait, the worse your odds get. She might have been placed in Category II because the doctor could take a pee break or if a schoolbus went off a bridge, and twenty Category I teenagers came in, the staff could be spared for a couple of hours. It also would have given the hospital a bit of time to make an effort to see if another competent ER nurse was free, which they say they did. It does not give them time to call in someone else from home or something -- really, 'can wait, but not more than hours' does not mean 'futz around for five hours'. This isn't a video game where all that matters is that you do it before the clock reaches zero. This is a person's life -- survival chances and survival-without-complications chances go down if you wait. If I was the patient's family, and I discovered that the hospital was slow to respond because a nurse refused to do her job, even if she was doing so on religious grounds, and my loved one died or was permanently injured, I could sue the hospital and the nurse for wrongful death/negligence. Because... that is part of their jobs.
Ironically this brings back memories of Dr. George Tiller's murder and the reaction to Dr. Leroy Carhart's decision to start performing late-term abortions at his clinic. I remember thinking that there was something deeply ironic** about that. Late-term abortions are gruesome-looking, and usually sad, but they also only occur when either the mother's life is sufficiently in danger that she can't wait until she can give birth to get treatment, or that the baby is inviable outside of the womb. Both of those are sad, in that they were wanted pregnancies, and the parents were probably well into the 'OMG, we're going to have a baby' stage, and either way, the baby was going to die. The main concerns was making sure the mother's life and health were taken care of -- sad, but not as morally controversial as abortion for other than health reasons.
And yet, this is what gets death threats (sadly, not just threats in the case of Dr. Tiller) and national attention. Cases that are gruesome and sad, but not morally controversial in the abstract when people outline their views on abortion. Instead of taking it as a matter or triage -- saving one life but not two -- we get the belief that it's better to kill by medical neglect than by commission. Or, when we do get triage, it's by lunatics that think by killing one doctor, they will save the lives of thousands of babies, rather than just send the early-term cases elsewhere and the complicated, late-term cases, the ones where someone is dying anyway, no matter what the doctor does, suffer.
I feel like I need to quote Cordelia Vorkosigan here -- a book character from Lois Bujold's Vorkosigan Saga. She once said that she believed in a god and immortal souls, which meant that she always put people before ideas. Because if some part of people lived forever, they were more important than ideas, which didn't.
* Except maybe for people who cannot afford anything else, since ERs are obligated to treat everyone, regardless of payment ability. But my thought on Health Care are another rant entirely.
** Not funny. More along the lines of 'making me want to punch people.
So, I saw this post on my feedreader today. For those of you who don't follow the link, it talks about a New York Emergency Room nurse who is suing her employer because she was required to assist in an emergency second trimester abortion. She claims that the hospital should have found another nurse to assist.
Obligatory disclaimer: I'm not a doctor, and most of the details seem to be coming from the nurse and the pro-life folks (who are Morally Outraged).
But, here's the deal. ER folks are driven by the need for speed. Frankly, folks don't go to the ER if they can wait a shift*. A doctor looked in and decided that this woman:
A) Needed an abortion to survive.
B) Was a Category II, which I'm told means 'can wait, but not more than six hours'.
A) puts this fairly into 'life of the mother', which many pro-life folks allow for. Which makes sense -- if a pregnant woman die in under a day if her pregnancy isn't ended, then either way, the fetus is a dead man walking... er, floating. And, ER doctors/nurses and first responders do have to make these calls in general -- triage -- since what they do is time sensitive. If you have one person not breathing, and one still breathing but bleeding in a life-threatening way, you sometimes have to accept that if you try to stop the bleeding of the second person, the first person is going to die -- and that if you try to help the first, the second will die.
Yes, it stinks. Proof that being at the scene of trauma is a hard job and not one I'd want to do -- even if these folks are the difference between one death and two. But... well, these calls have to get made to save as many people as possible.
Furthermore, I have every reason to think that if the doctor could have saved the fetus, s/he would have not made the call for an abortion. ERs (and hospitals) can perform abortions -- they generally have to be ready for anything -- but it's not what they're designed to do. Which makes me wonder about the nurse's moral objection -- was she willing to let two people (the mother and her unborn child) die on the table rather than to act to save one by killing the other because a sin by omission was better than a sin by commission in her mind? Or was it just an 'abortion bad' thing?
(Digression: the blog where I read this made the analogy of Orthodox Judaism and working on the Sabbath. She noted that being unwilling to do things that could wait a day on a religious holiday was perfectly acceptable, but that refusing to save someone's life was generally not considered morally acceptable. Someone in the comments noted that traditionally Judaism had the rule that you were allowed to throw out the other rules if it would save someone's life, so sacrificing someone else because God tells you you can't even flip a light switch one day of the week would be morally unconscionable. Which I approve of -- a sort of Moral Good Samaritan Clause.)
As for the second category, the nurse-plaintiff and the blogosphere seems to assert that the woman could wait six hours for another shift to come on. She may have, but generally speaking, the longer you wait, the worse your odds get. She might have been placed in Category II because the doctor could take a pee break or if a schoolbus went off a bridge, and twenty Category I teenagers came in, the staff could be spared for a couple of hours. It also would have given the hospital a bit of time to make an effort to see if another competent ER nurse was free, which they say they did. It does not give them time to call in someone else from home or something -- really, 'can wait, but not more than hours' does not mean 'futz around for five hours'. This isn't a video game where all that matters is that you do it before the clock reaches zero. This is a person's life -- survival chances and survival-without-complications chances go down if you wait. If I was the patient's family, and I discovered that the hospital was slow to respond because a nurse refused to do her job, even if she was doing so on religious grounds, and my loved one died or was permanently injured, I could sue the hospital and the nurse for wrongful death/negligence. Because... that is part of their jobs.
Ironically this brings back memories of Dr. George Tiller's murder and the reaction to Dr. Leroy Carhart's decision to start performing late-term abortions at his clinic. I remember thinking that there was something deeply ironic** about that. Late-term abortions are gruesome-looking, and usually sad, but they also only occur when either the mother's life is sufficiently in danger that she can't wait until she can give birth to get treatment, or that the baby is inviable outside of the womb. Both of those are sad, in that they were wanted pregnancies, and the parents were probably well into the 'OMG, we're going to have a baby' stage, and either way, the baby was going to die. The main concerns was making sure the mother's life and health were taken care of -- sad, but not as morally controversial as abortion for other than health reasons.
And yet, this is what gets death threats (sadly, not just threats in the case of Dr. Tiller) and national attention. Cases that are gruesome and sad, but not morally controversial in the abstract when people outline their views on abortion. Instead of taking it as a matter or triage -- saving one life but not two -- we get the belief that it's better to kill by medical neglect than by commission. Or, when we do get triage, it's by lunatics that think by killing one doctor, they will save the lives of thousands of babies, rather than just send the early-term cases elsewhere and the complicated, late-term cases, the ones where someone is dying anyway, no matter what the doctor does, suffer.
I feel like I need to quote Cordelia Vorkosigan here -- a book character from Lois Bujold's Vorkosigan Saga. She once said that she believed in a god and immortal souls, which meant that she always put people before ideas. Because if some part of people lived forever, they were more important than ideas, which didn't.
* Except maybe for people who cannot afford anything else, since ERs are obligated to treat everyone, regardless of payment ability. But my thought on Health Care are another rant entirely.
** Not funny. More along the lines of 'making me want to punch people.
