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Tilting at Windmills

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June 1, 2009
By: Hilzoy

Terror Should Not Pay

Ezra Klein, about the murder of George Tiller:

"As The American Prospect's Ann Friedman writes, this has to be understood in context. It is the final, decisive act in "an ongoing campaign of intimidation and harassment against someone who was providing completely legal health-care services." That campaign stretched over decades of protests, lawsuits, violence, and, finally, murder. The different elements were not always orchestrated. But the intent remained constant: To counter the absence of a statute that would make Tiller's work illegal with enough intimidation to render it impossible.

This was, in other words, a political act. Tiller was murdered so that those in his line of work would be intimidated. In conversations with folks yesterday, I heard well-meaning variants on the idea that it would be unseemly to push legislation in the emotional aftermath of Tiller's execution. I disagree. Roeder was acting in direct competition with the United States Congress. And it's quite likely that he changed the status quo. Legislative language and judicial rulings had made abortive procedures legal and thus accessible. Yesterday's killing was meant to render abortive procedures unsafe for doctors to conduct and thus inaccessible.

If a woman cannot get an abortion because no nearby providers are willing to assume the risk of performing it, the actual outcome is precisely the same as if the procedure were illegal. Roeder has, in all likelihood, made abortion less accessible. It would be, in my view, a perfectly appropriate response for the Congress to decisively prove his action not only ineffectual, but, in a broad sense, counterproductive."

I agree completely. I would recommend the following:

(a) Repeal the ban on dilation and extraction. The Congress should not get into the specifics of what procedures can be used when. If it must, it should broaden the set of cases in which dilation and extraction can be used to include not only cases in which the life of the mother is in danger, but cases in which her health is in danger, or in which the child has a serious and incurable medical condition that would make its life short and miserable. It ought to be possible to draft this in such a way that Down Syndrome did not count, but the cases I wrote about earlier would: "a brief and painful life filled with surgery and organ transplants"; "her babies developed with no faces, with no way to eat or breathe."

(b) Require training in late-term abortion techniques for Ob/Gyn certification. Note that these techniques are also used when the fetus has already died. Read this article to see why this matters.

(c) Require that any hospital provide any woman whose fetus has died, whose life is in danger, or whose fetus has developed the kind of medical problem described in (a), with appropriate treatment to remove that fetus, and that that treatment be fully reimbursable by the federal government. If they have no one on staff who can provide that treatment, they should get someone. See (b) above. There should be religious exemptions, but they should not extend to the treatment of women whose fetus has already died.

One way to stop terrorism is by enforcing our laws. We should absolutely do that. But another is to make it clear that terrorism doesn't work. We should do that too. And the best way I can think of is to change our present situation, in which only a handful of doctors perform late-term abortions. We can keep whatever strictures we want* on the cases in which we think abortions should be permissible after viability while also ensuring that no one person has to take on him- or herself the risks that militant anti-abortionists want to subject them to.

Hilzoy 12:01 PM Permalink | Trackbacks | Comments (44)

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I agree. The Nazis proceeded on the same principle as the extremist anti-abortion proponents who try to intimidate abortion providers. Hitler enumerated it specifically in Mein Kampf: By creating physical terror in its opponents, the Nazi party was able to make it seem too dangerous to politically oppose them. Had their tactics been met with an organized, legal response and consequences, they might not have ever taken over Germany. The same would be true of any organization, whatever its mission.

Terrorist acts must be seen to be counterproductive, so that the terrorists are at least less likely to take the risk.

Posted by: Wally on June 1, 2009 at 12:14 PM | PERMALINK

Repeal the ban on dilation and extraction.

Shame on you, hilzoy, for using the correct term for the procedure, instead of the bogus and emotionally loaded "partial birth abortion" adopted throughout the so-called "liberal media"! You'll never get on TV that way!

Posted by: Gregory on June 1, 2009 at 12:17 PM | PERMALINK

As an unfunny response to your serious commentary, everyone knows that a woman's medical decisions should be determined by old white men.

It is possible to be against abortions without having to be against choice. This is why the 'Pro-Life' movement is a misnomer. They are not Pro-Life, they are anti-choice. Regardless of MSNBC, persons in favor of choice are not 'Pro-Abortion'.

Too often, the Reich-Wing and their corporate media echo chamber get to define the words used in a debate. This is why 'Dilation and Extraction' became 'Partial Birth Abortion'. Until these issues can be debated in emotion neutral terminology, the Reich-Wing is never going to participate in meaningful dialog.

Posted by: SadOldVet on June 1, 2009 at 12:18 PM | PERMALINK

Pardon the snark, but if the correct response to acts of terrorism is to do the opposite of what the terrorists want, what happens when the terrorists catch on? After a year or three of *not* murdering abortion doctors, will anti-abortion forces demand that their agenda be addressed as a reward?

Posted by: Grumpy on June 1, 2009 at 12:22 PM | PERMALINK

It totally agree, but it will never happen. A congress of Democrats that can be intimidated by lame Gitmo commercials would never have the cojones to do this, the obviously right thing.

This man saved women's lives.

Posted by: Travis on June 1, 2009 at 12:23 PM | PERMALINK

Any surgery that opens the abdomen is serious. My wife developed an infection after the laparoscopic removal of her gall bladder and ended up in the hospital for three days. Anyone who would force a woman to have a C-section to remove a dead fetus is cruel and has contempt for women.

I would love to see the pro-choice side use this tragedy for good. But unfortunately, our president would prefer to find common ground with the anti-choice terrorists. Heck, he may even decide to pardon Roeder so the country can "look forward, not backward."

Posted by: SteveT on June 1, 2009 at 12:34 PM | PERMALINK

I have arrived at the opinon where I believe that if any sort of democratic process is to impose constraints on women's reproductive health considerations, ONLY women get to participate. That means only women patients, only women physicians and only women legislators.

Men must stop regarding women as herds of cattle and baby making factories. It must stop. Enough, already. An enlightened appreciation of the situation is possible. Males really have no rights in this regard that I can see. Period.

Posted by: c4logic on June 1, 2009 at 12:37 PM | PERMALINK

I also think that we should become much less measured in what we call these organizations. they are Murder organizations, not Pro-Life. They support murder of people to accomplish their goals. If Christian, they are Christians for Murder. Operation Rescue is Operation Murder. the blogs and so called legitimate media should be labeled Murder sympathizers.

These organizations are filled with sick people with major mental problems and poorly controlled impulses for violence. They are succored and encouraged by legitimate organizations who use their focus on so called saving fetuses as a nice little emotional hook while ignoring their murder and terrorism. This has to stop and these organizations need to have their associations and incitements highlighted. Their sponsors also need to be given a little heads up that we will no more tolerate their little game.

We will never stop the crazies who have been made stronger and stronger by now multiple years of slimmy so called news organizations and blog sites that have basically encouraged their agenda.
Lets call it and them what they are -- supporters of murder and torture sympathizers -- as sick as the sickest of the sickos who have murder as their explicit objective..

Posted by: Elie on June 1, 2009 at 12:49 PM | PERMALINK

Has anyone ever researched racism and the role it plays in the abortion debate (debate...war?)?

For a long time I've been saying I personally think the right wing's rabid, anti-abortion stance has more to do with preserving the white race (to maintain dominant population levels) than it has to do with genuine religious or moral principles. I don't mean necessarily that every pro-choice nut has white supremacy in mind; rather, they are being manipulated by a larger force, much in the same way repuboicans use divisive wedge issues to get people to vote against their self interests.

Think about it. Why is there such a tremendous disconnect from a pro-choicers anti-abortion stance, and their stance on post birth child care?

Do you see abortion clinics in predominantly poor black or Hispanic neighborhoods targeted?

Who generally can afford this procedure, poor women or women with access to decent health care?

What color would a poor woman with no access to health care be as opposed to a woman with health care and financial resources?

These are questions I have always asked, and still do. It's just a theory of mine, there may be statistics that blow holes in my argument, but I can say one thing with confidence:

If abortion were illegal, it would go on in the lower socio-economic areas with a wink and a nod.

Posted by: citizen_pain on June 1, 2009 at 12:51 PM | PERMALINK

Think about it. Why is there such a tremendous disconnect from a pro-LIFERS anti-abortion stance, and their stance on post birth child care?

One more note on my last post: If you remember back in the 90's, there was a big sterilization/birth control debate regarding poor black women.

And who was behind this? The right wing of course. The same people who say life starts at conception, and that ALL contraceptives should be banned.

Posted by: citizen_pain on June 1, 2009 at 12:56 PM | PERMALINK

"I also think that we should become much less measured in what we call these organizations. they are Murder organizations, not Pro-Life."

I agree with your first sentence, but I don't think "murder organization" is quite the right phrase.

Yes, they do use murder, but they also use all kinds of other techniques to achieve their ends of interfering with women's CONSTITUTION RIGHT to privacy in reproductive decisions.

They are using terror tactics against our Constitution and they should be called what they are: Domestic Terrorists.

If arrested, they should be held without trial until the end of the War on Terror.

Posted by: Sarah Barracuda on June 1, 2009 at 1:23 PM | PERMALINK

let's just call roeder and his ilk what they are: terrorists. If the assassination of Tiller isn't terrorism, I don't know what is. And since we all know that our legal and prison system can't handle terrorists, we have no option but to send roeder to an offshore military detention facility (perhaps that nice one in Cuba?) where he can be subject to 'enhanced interrogation' to find out what his fellow terrorists are planning. Seems reasonable to me, Mr. Cheney, what about you?

Posted by: Northzax on June 1, 2009 at 1:26 PM | PERMALINK

The murder (and all his associates: his terror-cell, including its leaders and vocal supporters) ought to be in Guantanamo getting waterboarded right about now.

Why not? Because he's white and not muslim.

Posted by: osama_been_forgotten on June 1, 2009 at 1:27 PM | PERMALINK

These wingnuts are killing the wrong people by killing the doctors who perform abortions. It's only a matter of time before they realize that if they want to truly stop abortions, they need to start stalking and killing the mothers who go to the office, ask for the procedure and sign the form to have this done to them.

Then, after a whole bunch of them are dead, the rest will be scared to have them, right?

Because clearly, the only way you can save lives is by taking them.

Posted by: Steve on June 1, 2009 at 1:28 PM | PERMALINK

"...it would be unseemly to push legislation in the emotional aftermath of Tiller's execution."

If I'm right in guessing that the proponents of this "idea" are the usual rightwing pundits and the mass media's "sensible liberals," you just have to ask if they felt it would be "unseemly" to push legislation (Patriot Act, AUMF, the torture memos, etcetc) in the "emotional aftermath" of 9/11.
And if that is who's pushing this obscenity, it's just another in the never-ending manifestations of rightwing hypocrisy.

Posted by: smartalek on June 1, 2009 at 1:29 PM | PERMALINK

I wonder...

The strategy of the anti-abortion right has been to do numerous state-level challenges of the law. Could the pro-choice movement do the same thing? I realize it will be very tough to get any legislation through Congress, but could it get through a state legislature? Could the Constitutionality be challenged that way again?

Posted by: Unstable Isotope on June 1, 2009 at 1:37 PM | PERMALINK

Men must stop regarding women as herds of cattle and baby making factories.

. .. and also (tragically) women, must stop this as well. (I know far more women who seem to hold this attitude, than men). Personal anecdote, I suppose I'm just in a "special" demographic social group. But it really is sickening in the extreme. Most guys I know just want their 2.5 kids, and a pair of golden retrievers, and a bass-boat or hot-rod; and it's their wives who are pushing for these extreme litters of 4, 5, 6 kids. Like it's the only thing they believe validates their self-worth. . .

Posted by: osama_been_forgotten on June 1, 2009 at 1:38 PM | PERMALINK

Because clearly, the only way you can save lives is by taking them.

I know what you wrote was snark, but someone on the left is listening to you:


Posted by: Anon2 on June 1, 2009 at 1:47 PM | PERMALINK

If abortion were illegal, it would go on in the lower socio-economic areas with a wink and a nod. - citizen pain

no, if abortion were illegal it would go on as it does now. the difference would be that poor women would risk their health and their lives betting that the backroom abortionist (who may or may not be a doctor) actually knows what he or she is doing. the rich would continue to have legal (and safe) abortions by crossing borders, if necessary. my guess is the effect that abortions have on race and population is negligibl. as far as conspiracy theories this one is lame ...

and stevet is right. c-sections are surgeries. routine surgeries but surgeries nonetheless. an amazing number of things can go wrong. banning a non-surgical alternative is wrong. not only does it unnecessarily add risks to the current pregnancy, it adds the same risks (and more) to any future pregnancies, since it most likely will prevent the mother from carrying to term and delivering vaginally.

Posted by: mudwall jackson on June 1, 2009 at 1:54 PM | PERMALINK

"There should be religious exemptions..."
The devil is in the details. What if it is the mother who dies and the baby dies soon after "birth"? My gut instinct is to let any sectarian service (school, church, hospital, etc) enjoy the right to practice their faith so long as no federal money is involved. But I'm guessing the separation isn't as easy in a hospital as in a school. Perhaps any hospital should be held liable when withholding procedure for ANY reason when not accommodated by diligent search for alternative care. Sure, like they won't call all the wrong places first and then fetch the ambulance transportation driver who suddenly finds a pressing need to swing by his/her church to seek absolution or runs out of gas or something (all the time stalling for time). This gets really interesting when the issue is no longer legislating but enforcement. Damned if I know a pragmatic solution.

Posted by: Chopin on June 1, 2009 at 2:06 PM | PERMALINK

Please please can we waterboard the terrorist who killed Dr Tillman?
Seriously - please can we now see the report on right wing extremism, the one they vilified Ms Napolitano about?

Posted by: JS on June 1, 2009 at 2:08 PM | PERMALINK

Hilzoy's comments remind me of Naomi Klein's "Shock Doctrine" - exploiting a tragedy to push through unwarranted change.

Isn't there anyone here who supports legal protections for a healthy, late-term, viable fetus, a.k.a. a baby? Or is abortion permissible right up until delivery?

Posted by: Chris on June 1, 2009 at 2:45 PM | PERMALINK

Mudwall, I'd hardly consider my tangential tirade a "lame" conspiracy theory, I was just iterating some long held thoughts.

But it's good to know we have people like you monitoring these posts, and we all welcome your definitive commentary.

Scratch that. You're an ass, and your rude post reflects that.

What you say about the abortion procedure going on whether it's legal or not is not arguable, a dunce could figure that one out.

I think that there should be more analysis on what role race, if any, plays plays in abortion. Not necessarily which race has more procedures and the impact on population levels, but specifically what position do these hard core pro-lifers have on black or hispanic abortions? And the leaders of these organizations, the monetary donors that keep them going. What is their opinion on the matter?

Posted by: citizen_pain on June 1, 2009 at 3:00 PM | PERMALINK

Chris: quick question. Did you bother to read *anything* that was written here before writing your comment? Because dilation&extraction is a procedure used only on fetuses that are already dead or otherwise not viable. Bringing up the extremist right-wing lie of healthy fetuses being disposed of shows that you are either ignorant, dishonest, or both.

It also shows that you are in league with these domestic terrorists who murder people.

Posted by: Shade Tail on June 1, 2009 at 3:21 PM | PERMALINK

This is for Chris. Women do not take these heart-wrenching decisions lightly. I have worked in family planning over 30 years and have never seen anyone who just decided to end a healthy pregnancy late term. It just doesn't happen. That is part of the misinformation being spread about this issue.

Posted by: pattywagn on June 1, 2009 at 3:28 PM | PERMALINK

Or is abortion permissible right up until delivery?

Yes, dumbass - it's called 'childbirth'.

Posted by: MissMudd on June 1, 2009 at 3:33 PM | PERMALINK

I agree with your post only in part.

That part I agree with is that late-stage abortion for medical purposes should be widely available and doctors should be widely trained to perform them.

However, I disagree with any initiative, legislative or otherwise, that has an implication of expanding access to late-stage abortion for purely so-called "elective" reasons.

Aside from the fact that I, personally, am opposed to non-medically necessary third trimester abortion; the simple truth is that the overwhelming majority of the US public is opposed to non-medically necessary late-stage abortions. Any initiative which goes against this sentiment is a lost cause and likely to do more damage to the pro-choice cause than to help it.

Let me put this a different way: Americans largely have reached a consensus on abortion. Americans want relatively easy access to first trimester abortions and want very narrow or no access to third trimester abortions. Second trimester is where opinion differs, though it can largely be understood as differing only in where people imagine the situation is more like first trimester and where they imagine it is more like the third.

Americans are very opposed to restricting or eliminating access to first trimester abortions and they see those who oppose this positions as extremists. Similarly, they are opposed to so-called "elective" abortions in the third trimester, and see those who oppose this view as extremist. The trick for interest groups is to avoid running afoul of either of these sentiments.

The pro-lifers have successfully attacked broad abortion rights using the spectre of late-stage abortions as wedge. Most Americans are not aware that Tiller was only one of *three* providers in the US who performed abortions after the 21st (only the second trimester!) week. In the popular imagination, there's still a great many third trimester abortions performed when, in fact, there is approximately zero. This perception is a victory for the pro-lifers.

The right language for pro-chociers to use in doing what Hilzoy advocates would be to talk about guaranteeing access for second trimester abortions for women who medically require it, especially if their lives are in danger, when the fetus is dead, and similar. I suspect that the flip side of the perception that late stage abortions are ubiquitous in the US would be a surprise to find that medically necessary abortions during the second half of the second trimester *are not*. I'd wager that sentiment on this would be divided about evenly...but that's still much more supportive of abortion than are the numbers favoring late-stage abortions, in general; and that represents an opportunity for pro-choicer.

Posted by: Keith M Ellis on June 1, 2009 at 3:40 PM | PERMALINK

I am with pattywagn. I have worked in women's health since 1991, and I started my career not just in Wichita, but working for Dr. Tiller. I went to work for him mere weeks before the Summer of Mercy. I worked for him for several years. I saw women in distress from all over the country, and Dr. Tiller was the only person who could or would help them. In all that time I never saw a woman - or more commonly a couple - opt for a late-term abortion in circumstances that were not tragic beyond anything I would wish on my worst enemy.

And Chris is a moron if he thinks healthy fetuses are routinely aborted. It. Just. Doesn't. Happen.

Posted by: AnonyMs on June 1, 2009 at 3:44 PM | PERMALINK

I should have specified healthy late term fetuses in my previous comment.

Posted by: AnonyMs on June 1, 2009 at 3:47 PM | PERMALINK

A D&E is legal and is often used after a miscarriage. I think the point of contention is whether feticide occurs during the D&E.

Posted by: Neo on June 1, 2009 at 3:49 PM | PERMALINK

Allow me, then, to humbly ask: At what point in development, if any, should healthy fetuses be given legal protection?

Posted by: Chris on June 1, 2009 at 3:55 PM | PERMALINK

"Allow me, then, to humbly ask:"

No. Your question is beside the point, therefore you are not allowed to ask it. You are only attempting to muddy the water and you know it.

Posted by: Shade Tail on June 1, 2009 at 3:58 PM | PERMALINK

No, I am deeply conflicted over the issue, and it surprises me that more people are not conflicted about it.

Posted by: Chris on June 1, 2009 at 4:05 PM | PERMALINK

They are using terror tactics against our Constitution and they should be called what they are: Domestic Terrorists.

If arrested, they should be held without trial until the end of the War on Terror.

Posted by: Sarah Barracuda on June 1, 2009 at 1:23 PM

I agree completely. Is the nation fighting a "War on Terror" or not? Or is it just a War on Muslim Men?

Operation Rescue and the rest of these radical organizations -- the American Taliban -- should be classified as Domestic Terrorists, and their members ought to be rounded up and thrown in the nearest supermax prison. Or better yet, close Gitmo, take it apart, rebuild it here somewhere and throw them all in there.

Posted by: electrolite on June 1, 2009 at 4:13 PM | PERMALINK

I have worked in women's health since 1991

Wow, you've worked so many places, in so many fields, for so many years that never add up, in so many areas of fictional expertise. You're a busy girl.

Posted by: you know who posted it on June 1, 2009 at 4:13 PM | PERMALINK

it surprises me that more people are not conflicted about it.

A lot of us are conflicted about it, and yet manage to be so without posting nonsense like your comment of 2:45.

"Exploiting a tragedy to push through unwarranted change"? What a manipulative little sentence. This wasn't a personal tragedy that just happened to occur in a void. This was a political murder. The anti-abortion rights crowd thinks political and legislative pushback is tacky? The best way to avoid is is fucking assassinating people in the name of ideology.

Posted by: shortstop on June 1, 2009 at 4:20 PM | PERMALINK

Apologies for the confusing last sentence, which should have been: "The best way to avoid it is not fucking assassinating people in the name of ideology."

Posted by: shortstop on June 1, 2009 at 4:21 PM | PERMALINK

This is actually the second right wing gunmen with connections to O'Reilly and the gang.

Remember the church shooter last summer in TN?

Posted by: Chris on June 1, 2009 at 4:36 PM | PERMALINK

Fuck you, Chris. Or fuck someone, which is ultimately what it all boils down to: she may have fucked someone that wasn't you so gotta see that fetus. Plus, if she's got babies at her tits, she won't be screwing around on your lily-white ass.

Did I hit it home yet, Chris?

The larger point: It's none of your business. Just like I don't want to know what you discuss with your doctor, what I discuss with mine is not for you or America to decide. All my decision. Period.

Posted by: MissMudd on June 1, 2009 at 4:38 PM | PERMALINK

Chris, many ARE conflicted. But we don't use that personal conflict to inflict our wishes on someone else. That's where we part ways. You can be conflicted all you want, but that's YOUR problem and not one for you to use as a cudgel to deprive someone else of a right they wish to exercise.

Big difference, Chris baby. Learn it and live with it.

Posted by: dejah on June 1, 2009 at 4:43 PM | PERMALINK

My God, Actions like this brought us the Patriot Act. That creep from Operation Rescue announced on Thom Hartman that a woman "one day pregnant who has an abortion is murdering a child".

His rhetoric cultivated a murderer which he had direct contact with on many occasions on just such actions yet he has not been arrested and sent to Guantanamo for enhanced interrogation.

Domestic terrorism only counts when a Muslim is involved huh.

He called Dr. Tiller a baby killer and mass murderer...but he considers a handful of cells a baby. Dr. Tiller saved many a woman's life by his bravery not to be intimidated by these radical fanatics. Operation Rescue has no problem telling a 2yr old and 4yr old they let mommy die so a deformed dead or dying fetus could be delivered...calling it God's will. These priests who support these radicals like to call these Drs baby killers and would have those who masturbated thrown in prison for "casting their seed upon the ground" and preventing a child to be born. These are fanatics and terrorists and just because they didn't pull the trigger makes them no less guilty of murder by their authoritarian condemnation of these brave Drs. out to save women's lives.

The murder was a horrific tragedy...killed him in his church...but the rhetoric of Operation Rescue and that fanatic priest to justify such actions is pure outrage. These radical fanatics are domestic terrorists. a secret Taliban calling themselves Christians...murdering Drs. who save women's lives. Screw them and the Jeebus they rode in on. They don't even know what the Dr. they killed was doing, relying only on hearsay and fantasy..having never read the medical records of even one patient. Terrorists...threatening murder to anyone doing this medical procedure for any reason based on their extremist radical beliefs. Cells and fetuses are not babies anymore than menstruation is abortion. Terrorist fanatic violent radicals= Operation Rescue.

Posted by: bjobotts on June 1, 2009 at 5:02 PM | PERMALINK

"No, I am deeply conflicted over the issue,"

I don't care, Chris. Your "conflict" is completely beside the point of this article. This article is about Third-trimester Dilation and Extraction, which is *only* ever done to fetuses that are already dead or otherwise non-viable. It is *never* used as a form of birth control by women with healthy fetuses who just don't want to be pregnant.

Your propaganda about this is wrong and therefore completely irrelevant. Get that straight.

Posted by: Shade Tail on June 1, 2009 at 8:53 PM | PERMALINK

Reading the title I assumed I was going to see another post in favor of continuing the illegal and immoral war in Iraq, to make a point about the assassination in Arkansas today.

But I see that the same point was being made about a different situation.

Posted by: anon on June 1, 2009 at 10:22 PM | PERMALINK

Hilzoy, let's go one step further and make it explicitly legal, permitted and encouraged by law to remove a deceased fetus in whatever way will best support the mother's further health AND permit an intact body to be removed from the womb so that the parents can mourn their loss.

The ban on intact D&E sucks and is terrible in jsut about every detail, but this is one extra suckerpunch -- for families terminating a wanted pregnancy, they have no ability to see and hold the body in order to process their grief.

Posted by: Anne on June 2, 2009 at 10:38 AM | PERMALINK



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