It’s still a lie, even if it’s the law

Not so long ago, I wrote about why doctors shouldn’t lie to their patients.  Frankly, I still find it rather baffling that a truth that seems so self-evident to me would need stating.  Baffled as I may be, however, clearly it does need stating, because it seems the good people of South Dakota are going to start forcing doctors to lie.  From Mother Jones (tip o’ the hat to an old friend’s Facebook page):

A federal appeals court this week upheld South Dakota’s law requiring doctors to tell women seeking abortions that they will face “increased risk of suicide ideation and suicide.”

The “informed consent” law, which required doctors to read a formal script to all women seeking an abortion, has been in litigation since it passed in 2005. (The state drew much of their ideas from the legal writings of Harold Cassidy, who was profiled in Mother Jones last year.) A court had previously upheld other portions of the script, but the part about increased risk of suicide—a claim based on dubious medical research—was the last portion stuck in legal wrangling. The 8th Circuit Court of Appeals voted 7 to 4 to uphold that part of the script. From the Star Tribune:

“On its face, the suicide advisory presents neither an undue burden on abortion rights nor a violation of physicians’ free speech rights,” the court wrote in its majority opinion.

The court is, of course, wrong.

If you choose to click through the quote’s link under “dubious medical research,” you’ll find another nifty little piece that explains why the link between abortion and suicidality is tenuous, at best.  It is certainly not an established fact, and presenting it as such is a falsehood.  South Dakota is forcing abortion providers to lie to their patients.

The court is wrong on both counts.  First of all, it focuses far too much on the “burden” part of “undue burden.”  It is not especially onerous to listen to a scripted speech, I suppose, though I’ve never been forced to sit through one so I don’t really know how it feels.  But, pretty much by definition, being told a lie is absolutely “undue.”  It is coercive and unethical and simply, plainly wrong.  What could be more “undue” than that, even if the lie itself takes little time and no effort to hear?  A wrong doesn’t become less wrong just because the state calls it right.

And I’d be delighted if someone could explain to me how it is not a violation of a physician’s freedom of speech to be forced to say something she believes to be false.  We commonly understand our freedom of speech to be a positive right, one that allows us to say what we please.  But it also includes a right not to be forced to say what we don’t want to say.  If you’re not free to be silent when you choose, then you’re not fully free.  And the freedom of these doctors to be silent regarding a medical problem they understand to be illusory is obviously abrogated by this law.  How can anyone say otherwise and keep a straight face?

I’m sure the doctors in South Dakota who perform abortions (at just one center in the entire state) will do their very best to communicate truthfully with their patients.  If I were in their position, I would make every effort to violate the spirit of the  law, if not the letter.  But it is disgraceful in the extreme that they find themselves in that position in the first place.  Doctors mustn’t lie to their patients, even if the government tells them they have to.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.

47 Comments

  1. Sigh.

    Scenarios like this make me wish that, along with a mandatory course in statistics, a course in critical thinking and evaluation were available in the US school system.

    I can’t tell you how many times I’ve seen someone put up a ‘study’ which ‘proves’ “X” or “Y” and when I read it, think to myself, “How the hell did this pass review? Who was asleep at the peer-review wheel and let this go by??” or, “How can people not realize how absolutely SHITTY this ‘study’ is?”

    It is a violation of your rights, to be forced to read that letter – especially when it’s based on faulty science.

    I remember when I had my first child at a hospital in Kansas – I was curious about having a tubal ligation and asked the doctor about it. He informed me that, “You’ll need to get your husband’s consent for that.”

    That lit a fire under my ass, and my comments to the doctor could be heard the entire length of the birthing wing at that hospital.

    • I remember when I had my first child at a hospital in Kansas – I was curious about having a tubal ligation and asked the doctor about it. He informed me that, “You’ll need to get your husband’s consent for that.”

      That’s not uncommon, actually.

      • It’s a farce is what it is.

        Since when do I need permission from my spouse to have surgery performed on my body?

        He asked about getting a vasectomy and was asked when he wanted to come and get snipped. Nothing about getting MY permission.

        • If it makes you feel any better, it is a common requirement for vasectomies, as well, even if it wasn’t where you had this experience. The only data I found on it was from 1985, and vasectomies were actually more likely to require spousal consent than tubals. Five in ten tubal docs required it, eight in ten vasectomy docs did. I suspect those numbers are lower now for both sides.

          Katie Granju wrote on the subject a while back, when her husband’s doctor wouldn’t give him a vasectomy without her consent. There is no legal requirement for either procedure (such a requirement would not pass constitutional muster), but it’s sometimes policy as part of the screening process.

      • Mandatory courses do not work when the intent is to lie, to subvert truth, in order to advance a political agenda.

    • Haven’t you seen the GOP platforms?

      Critical thinking and evaluation are something they are absolutely opposed to. It gives kids ideas, you know. Makes them question the bullshit their partisan parents have fed them through their formative years.

  2. Can they say it and then say, “FYI, that was bullshit”?

    • You’re gonna have to give more than that for your point to make any sense.

      • “Public Interest” groups have a reliably liberal political bent and have been peddling junk science warnings for over 25 years now. (they’ve been involved in a 6 year legal battle over labeling fried chicken, in this case)

        So people shouldn’t really be shocked as government gets more and more involved with health care, that conservatives, when they come into power, play the same exact game.

        Like I’ve said, the power of government becomes crystal clear to everyone when abortion involved. (and it’s not like this a particularly new thing for abortion either; the Mexico City policy is what, almost 30 years old now?)

        • You’re not making a very persuasive case for equivalency here.

          Admittedly, my exposure to Prop 65 is limited to how we incorporate the requirements into our standards and labelling in my line of work – but it is a line of work heavily affected by Prop 65 and similar pieces of legislation. I’m just not an expert on all of it, so if you want to anyone else to enjoy your tu quoque, you’re going to have to actually make the case instead of assuming anyone knows what aspects of it are parallel enough to get it.

          As far as I’ve dealt with it, Prop 65 requires disclosure of the presence of certain material components in products sold to consumers on our product labeling. It does not require us to stop every consumer and say ‘by the way, the product you’re buying causes cancer’ before they’re allowed to purchase anything. That would be a decent equivalent case.

        • Forcing companies to label their products truthfully is exactly the same as forcing doctors to label their services falsely.

          • No, though it’s not too much of a stretch to say that one can lead to the other. Previously, we started requiring cigarette packs to carry warning labels. Then, it was passed that their packs should essentially have anti-smoking propoganda (in the form of photoshopped images).

            The existence of the latter does not make the former a bad idea, but there is a pretty clear relationship. It becomes a disagreement as to what truth is. We can never agree on what truth is (the photoshopped images were “true” in their own way).

            Of course, the photoshopped images were struck down by the courts, so there are evidently limits. But with regard to the requirement, the problem is not that saying things is an imposition (which is what the courts have decided) but that what they are disclosing is hotly contested. I think the court was looking at the wrong part. Or alternately that I am unclear on the requirement.

          • Fair enough- I actually agree that the more recent cigarette warnings cross a line from true to outright advocacy. Although it could be said that its pretty difficult to overstate the health dangers of smoking.

            But I think its important to maintain the clarity that objective truth does exist, all the postmodern prattle to the contrary.
            And if there is disagreement to be had, as a matter of law and policy we should defer to a consensus of science whenever it can be had.

            The TRUTH as espoused by a consensus of scientists is not the same as the TRUTH espoused by a group of legislators. Sorry, it just isn’t.
            It may later be proven to be wrong, but it still has an authority that laypeople can’t challenge.

            If the concept of Burkean conservatism has any meaning at all, it is with this, that there is a knowable order and structure to truth. Its pretty daming to see self-described conservatives embracing post modern confusion with such gusto.

  3. if i were one of those doctors, i would simply tell the patient, before i read the speech that it was entirely untrue, they shoudl ignore it, i am only reading it because the state law says i have to, even though it is wrong

  4. Not a lie. A scandal that Fergusson, et al. [2006], that abortion harms many women, has been shouted down.

    http://200.16.86.38/uca/common/grupo54/files/new_zealand_abortion_study.pdf

    New Zealand Abortion and Mental Health Study Exposes Unfounded Claims of Pro-Abortion Organizations

    Although published seven months ago, a comprehensive study led by New Zealand researcher Dr. David Fergusson that linked abortion to various mental health problems continues to spark heated discussion by scientists, health care professionals, news media, and activists throughout the world.

    It is not as though Dr. Fergusson’s study, published in the Journal of Child Psychology and Psychiatry and Allied Disciplines, was the first to document abortion’s negative mental health consequences for women. There have been many.

    Fergusson and colleagues showed that compared both to women who carried a pregnancy to term and to those who had never been pregnant, young women who aborted were at a greater risk for depression, anxiety, suicidal behaviors, and substance-use disorders. Dr. Fergusson and his colleagues sternly challenged the American Psychological Association’s now 17-year-old conclusion that “well-designed studies of psychological responses following abortion have consistently shown that risk of psychological harm is low.”

    However, this study has commanded far more attention due to the self-acknowledged “pro-choice” perspective of the lead researcher, the methodological strengths of the study, and the courage and determination of the research team in getting the findings published against much resistance.

    Fergusson told the New Zealand Herald (January 5), “I’m pro-choice but I’ve produced results which favor a pro-life viewpoint. It’s obvious I’m not acting out of any agenda except to do responsible science about a difficult problem.”

    Screw Mother Jones, Dr. Saunders, with all due respect. Choosing it as a source speaks of ideology, not concern for the mother.

    “It borders on the scandalous that one of the most common medical procedures performed on women is so poorly researched and evaluated,” Fergusson told the Washington Times (January 21). “If this were Prozac or Vioxx, reports of associated harm would be taken much more seriously with more careful research and monitoring procedures.”

    According to the New Zealand Herald, 98% of the abortions in New Zealand were carried out to preserve women’s mental health. Commenting on this, Dr. Fergusson stated the law allows for abortion if continuing a pregnancy endangers a woman’s mental health and is “based on a conjecture” since the costs and benefits were never examined scientifically. According to Fergusson, “the health aspect was always secondary to personal choice.”

    I don’t expect to convince anybody of anything. But they should investigate for themselves
    toward what is called an “informed conscience.” Here is the pain, and it is real and it is human, Russell, despite what Mother Jones and politics of the medical profession say.

    http://afterabortion.org/

    • Thanks for sharing your perspective, Tom. After some of your recent comments in other threads, I’m afraid my interest in engaging with you has waned dramatically.

      [I have decided to edit this comment because I fear my original response would give the impression of running away from the question. The study linked above appears to be a well-designed study, and one that does find a link between abortion and adverse mental health outcomes. However, it is just one study, and has the author himself concedes there have been other studies that came to different conclusions. Furthermore, there was at least one significant limitation to the study, which the author readily concedes:

      The role of contextual factors: An important threat
      to study validity comes from the lack of information on contextual factors associated with the
      decision to seek an abortion. It is clear that the
      decision to seek (or not seek) an abortion following pregnancy is likely to involve a complex process relating to: a) the extent to which the
      pregnancy is seen as wanted; b) the extent of
      family and partner support for seeking or not
      seeking an abortion; c) the woman’s experiences
      in seeking and obtaining an abortion. It is possible, therefore, that the apparent associations
      between abortion and mental health found in this
      study may not reflect the traumatic effects of
      abortion per se but rather other factors which are
      associated with the process of seeking and
      obtaining an abortion. For example, it could be
      proposed that our results reflect the effects of
      unwanted pregnancy on mental health rather
      than the effects of abortion per se on mental
      health. The data available in this study was not
      sufficient to explore these options. However, it is
      our intention to study this cohort at age 30 and at
      that time it may be possible to gather further
      contextual information on the factors associated
      with decisions regarding abortion.

      That is a very, very large gap, one which confounds any kind of reliable conclusion that it is abortion itself that leads to depression, suicidality, etc. Without data that account for those contextual factors, linking the negative mental health outcomes with abortion per se remains highly controversial, and far from established fact. Presenting it as such is a lie. — RS]

        • From this “Chris” person’s own link. His personal attack on me is of course out of line, and a violation of any decent comments policy. Doctor.

          ” Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however.”

          From his/her own link.

          http://psycnet.apa.org/journals/amp/64/9/863/

          As for you, Dr. Saunders, I cannot make you look at that which you do not want to see, but perhaps your readers will. The damage is real.

          http://jenniferoneill.com/

          [Mysteriously, the silentnomoreawareness.org and priestforlife.org websites seem to have been hacked, so I shall not link them. There are many other stories—this is no fiction, or “lie.”]

          I’ve had my say. Thank you, sir.

          • His personal attack on me is of course out of line, and a violation of any decent comments policy. Doctor.

            Nice blog you’ve got here, Doctor. Shame if anything happened to it…

          • Tom, did you forget to look at the other fact? Some women who have babies do not experience mental health problems. Some women do, however.

            Here’s another personal attack: you are a sophist, and I always feel ashamed when I take you seriously long enough to respond. I apologize to everyone but you for doing so.

          • ” Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however.”

            This is a cherrypicked sentence from the abstract.

            Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women’s responses following abortion…The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. [Emphasis added] Evidence did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se as opposed to other preexisting and co-occurring risk factors. Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however…

            It is not a personal attack to note that principles of fair and reasoned debate are violated in taking one sentence of the abstract out of context, and presenting it in a way that would seem to imply that the study shows something different than what it does show. It seems, if I may say so, self-serving to complain about others’ inappropriate commenting behavior while simultaneously engaging in this kind of disingenous presentation.

            There are many other stories

            Indeed. But should we rely on stories or should we rely on studies?

          • I had my say and was encouraged to depart with Dr. Saunders’ “goodbye.” I’m satisfied that those interested in the truth of the matter, and how studies like Dr. David M. Fergusson’s [of New Zealand] have been distorted and shouted down, will study the whole picture, not just the side they’re comfortable hearing.

            Russell Saunders clearly does not welcome my input, and I’ve been a gentleman about this and tried to slip away without causing a scene. [I do appreciate your saying I’m not a troll, Russell. Really I do.]

            But as usual, unless I stand my ground, I’m gonna get steamrolled and slimed behind my back, and Russell, I won’t have it, unless you permit it.

            To the substance, then. I’m interested in people informing their consciences and search for the truth themselves. I have not cherry-picked. To win cheap points on a sub-blog is not worth anyone’s time and serves no higher purpose.

            [Pro-choice advocate Dr. Brenda Major*, quoted by James Hanley here, in particular has misused Fergusson’s 2006 study.]

            Fergusson responds:

            http://wthrockmorton.com/2008/08/13/david-fergusson-reacts-to-the-apa-mental-health-and-abortion-task-force-report/

            I asked New Zealand researcher, David Fergusson, about the APA Mental Health and Abortion task force report out today. He was one of 20 reviewers who commented extensively on the draft report. I specifically asked him what he thought of this statement from Task Force chair, Brenda Major in a Reuters’ report:

            “The best scientific evidence published indicates that among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion or deliver that pregnancy…”

            In addition, he commented on the report as a whole:

            “By the admission of the report, studies in this area (including my own) have significant flaws relating to sampling, measurement and confounding. What this means is that “the best scientific evidence” to which they refer, is really not all that good. Given that this is true then it would be inappropriate to draw strong conclusions on the basis of such limited evidence. The APA report, in fact, does draw a very strong and dogmatic conclusion that cannot be defended on the basis of evidence since this evidence is lacking by the admission of the report. As I stated to the APA committee in my review [of an earlier draft], the only scientfically defensible position to take is that the evidence in the area is inconsistent and contested. Under these conditions the only scientifically defensible conclusion is to recognise the uncertainty in the evidence and propose better research and greater investments in this area. What the Committee has, in effect, said is that until there is compelling evidence to the contrary, people should act as though abortion has no harmful effects. This is not a defensible position in a situation in which there is evidence pointing in the direction of harmful effects. In this respect, the response of the APA committee to this situation appears to follow the type of logic used by the Tobacco industry to defend cigarettes: since, in our opinion, there is no conclusive evidence of harm then the product may be treated as safe. A better logic is that used by the critics of the industry: since there is suggestive evidence of harmful effects it behooves us to err on the side of caution and commission more and better research before drawing strong conclusions. History showed which side had the better arguments.

            What I also think the APA committee has failed to recognise is the size of the research investment needed to pin these issues down thoroughly. The tobacco example is a clear one: there have been literally tens of thousands of studies in this area (I have in fact published over 10 papers on tobacco related topics). This amount of research is needed in an area in which there are strongly divided opinions and deeply rooted agendas. The moral of all of this is very simple: In science drawing strong conclusions on the basis of weak evidence is bad practice. The APA report on abortion and mental health falls into this error.”

            Abortion harms women. Not all of them, only some of them. But that it harms some is not anecdata, that is fact.

            http://www.facebook.com/silentnomoreawarenesscampaign

            So fine, Dr. Saunders, if you prefer to believe some assistant professor of something from somewhere and a Guttmacher fellow trashing an inconvenient study, Mother Jones is always going to find someone with an agenda and some credentials. I just hope to shake some people’s certainty when they find truths that are just too convenient.

            ______________
            *Dr. Priscilla Coleman is a Professor of Human Development and Family Studies at Bowling Green State University.

            http://www.lifenews.com/2010/11/12/opi-1006/

            *I would like to offer another perspective on dishonesty permeating the scientific study and dissemination of information pertaining to abortion and mental health.

            Dr. Major is absolutely correct; an informed choice regarding abortion must be based on accurate information.

            For abortion providers to offer an unbiased and valid synopsis of the scientific literature on increased risks of abortion, the information must include depression, substance abuse, and anxiety disorders, including Post Traumatic Stress Disorder (PTSD), as well as suicide ideation and behaviors.

            Over 30 studies have been published in just the last 5 years and they add to a body of literature comprised of hundreds of studies published in major medicine and psychology journals throughout the world.

            The list is provided below and the conscientious reader is encouraged to check the studies out. No lies … just scientifically derived information that individual academics, several major professional organizations, and abortion providers have done their best to hide and distort in recent years.

            Like Brenda Major, I too am a tenured, full professor at a well-respected U.S. University and I, too, have published peer-reviewed scientific articles in reputable journals. In fact, my publication record far exceeds that of Dr. Major on the topic of abortion and mental health. I am not alone in my opinion, which has been voiced by prominent researchers in Great Britain, Norway, New Zealand, Australia, South Africa, the U.S., and elsewhere.

            In publishing Major’s opinion without soliciting other voices on the topic, the Washington Post has perpetuated a serious injustice.

            Studies showing the abortion-mental health connection:

            • Bradshaw, Z., & Slade, P. (2005). The relationship between induced abortion, attitudes toward sexuality, and sexual problems. Sexual and Relationship Therapy, 20, 390-406.
            • Brockington, I.F. (2005). Post-abortion psychosis, Archives of Women’s Mental Health 8: 53–54.
            • Broen, A. N., Moum, T., Bodtker, A. S., & Ekeberg, O. (2006). Predictors of anxiety and depression following pregnancy termination: A longitudinal five-year follow-up study. Acta Obstetricia et Gynecologica Scandinavica 85: 317-23.
            • Broen, A. N., Moum, T., Bodtker, A. S., & Ekeberg, O. (2005). Reasons for induced abortion and their relation to women’s emotional distress: A prospective, two-year follow-up study. General Hospital Psychiatry 27: 36-43.
            • Broen, A. N., Moum, T., Bodtker, A. S., & Ekeberg, O. (2005). The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up study. BMC Medicine 3(18).
            • Coleman, P. K. (2005). Induced Abortion and increased risk of substance use: A review of the evidence. Current Women’s Health Reviews 1, 21-34.
            • Coleman, P. K. (2006). Resolution of unwanted pregnancy during adolescence through abortion versus childbirth: Individual and family predictors and psychological consequences. Journal of Youth and Adolescence, 35, 903-911.
            • Coleman, P. K. (2009). The Psychological Pain of Perinatal Loss and Subsequent Parenting Risks: Could Induced Abortion be more Problematic than Other Forms of Loss? Current Women’s Health Reviews, 5, 88-99.
            • Coleman, P. K., Coyle, C. T., & Rue, V.M. (2010). Late-Term Elective Abortion and Susceptibility to Posttraumatic Stress Symptoms, Journal of Pregnancy, vol. 2010, Article ID 130519.
            • Coleman, P. K., Coyle, C.T., Shuping, M., & Rue, V. (2009), Induced Abortion and Anxiety, Mood, and Substance Abuse Disorders: Isolating the Effects of Abortion in the National Comorbidity Survey. Journal of Psychiatric Research, 43, 770– 776.
            • Coleman, P. K., Maxey, C. D., Rue, V. M., & Coyle, C. T. (2005). Associations between voluntary and involuntary forms of perinatal loss and child maltreatment among low-income mothers. Acta Paediatrica, 94(10), 1476-1483.
            • Coleman, P. K., & Maxey, D. C., Spence, M. Nixon, C. (2009). The choice to abort among mothers living under ecologically deprived conditions: Predictors and consequences. International Journal of Mental Health and Addiction 7, 405-422.
            • Coleman, P. K., Reardon, D. C., & Cougle, J. R. (2005). Substance use among pregnant women in the context of previous reproductive loss and desire for current pregnancy. British Journal of Health Psychology, 10 (2), 255-268.
            • Coleman, P. K., Reardon, D. C., Strahan, T., & Cougle, J. R. (2005). The psychology of abortion: A review and suggestions for future research. Psychology and Health, 20, 237-271.
            • Coleman, P.K., Rue, V.M. & Coyle, C.T. (2009). Induced abortion and intimate relationship quality in the Chicago Health and Social Life Survey. Public Health, 123, 331-338.DOI: 10.1016/j.puhe.2009.01.005.
            • Coleman, P.K., Rue, V.M., Coyle, C.T. & Maxey, C.D. (2007). Induced abortion and child-directed aggression among mothers of maltreated children. Internet Journal of Pediatrics and Neonatology, 6 (2), ISSN: 1528-8374.
            • Coleman, P. K., Rue, V., & Spence, M. (2007). Intrapersonal processes and post-abortion relationship difficulties: A review and consolidation of relevant literature. Internet Journal of Mental Health, 4 (2).
            • Coleman, P.K., Rue, V.M., Spence, M. & Coyle, C.T. (2008). Abortion and the sexual lives of men and women: Is casual sexual behavior more appealing and more common after abortion? International Journal of Health and Clinical Psychology, 8 (1), 77-91.
            • Cougle, J. R., Reardon, D. C., & Coleman, P. K. (2005). Generalized anxiety following unintended pregnancies resolved through childbirth and abortion: A cohort study of the 1995 National Survey of Family Growth. Journal of Anxiety Disorders, 19, 137-142.
            • Coyle, C.T., Coleman, P.K. & Rue, V.M. (2010). Inadequate preabortion counseling and decision conflict as predictors of subsequent relationship difficulties and psychological stress in men and women. Traumatology, 16 (1), 16-30. DOI:10.1177/1534765609347550.
            • Dingle, K., et al. (2008). Pregnancy loss and psychiatric disorders in young women: An Australian birth cohort study. The British Journal of Psychiatry, 193, 455-460.
            • Fergusson, D. M., Horwood, L. J., & Boden, J.M. (2009). Reactions to abortion and subsequent mental health. The British Journal of Psychiatry, 195, 420-426.
            • Fergusson, D. M., Horwood, L. J., & Ridder, E. M. (2006). Abortion in young women and subsequent mental health. Journal of Child Psychology and Psychiatry, 47, 16-24.
            • Gissler, M., et al. (2005). Injury deaths, suicides and homicides associated with pregnancy, Finland 1987-2000. European Journal of Public Health, 15, 459-463.
            • Hemmerling, F., Siedentoff, F., & Kentenich, H. (2005). Emotional impact and acceptability of medical abortion with mifepristone: A German experience. Journal of Psychosomatic Obstetrics & Gynecology, 26, 23-31.
            • Mota, N.P. et al (2010). Associations between abortion, mental disorders, and suicidal behaviors in a nationally representative sample. The Canadian Journal of Psychiatry, 55(4), 239-246.
            • Pedersen, W. (2008). Abortion and depression: A population-based longitudinal study of young women. Scandinavian Journal of Public Health, 36, No. 4, 424-428.
            • Pedersen, W. (2007). Childbirth, abortion and subsequent substance use in young women: a population-based longitudinal study. Addiction, 102 (12), 1971-78.
            • Reardon, D. C., & Coleman, P. K. (2006). Relative treatment for sleep disorders following abortion and child delivery: A prospective record-based study. Sleep, 29 (1), 105-106.
            • Rees, D. I. & Sabia, J. J. (2007). The Relationship between Abortion and Depression: New Evidence from the Fragile Families and Child Wellbeing Study. Medical Science Monitor. 13(10): 430-436.
            • Suliman et al. (2007) Comparison of pain, cortisol levels, and psychological distress in women undergoing surgical termination of pregnancy under local anaesthesia versus intravenous sedation. BMC Psychiatry, 7 (24), p.1-9.

          • Tom, I do not welcome your input because you do not speak with others using the respect you demand for yourself. I do not welcome your input because I have come to question, quite seriously, the way you view certain kinds of people of whose lives you do not approve. I do not welcome your input because you clearly demonstrated in some of your more recent comments far more wrath than compassion, and far more self-righteousness than kindness, yet you would presume to lecture others about what can be found in the word of God.

            And finally, sir, I will thank you not to ascribe my professional medical beliefs to what I was told an assistant professor somewhere. I did not go to the trouble of getting appointed to the faculty at Harvard Medical School to be spoken down to by the likes of you. You do not know, Mr. Van Dyke, where I learned what I learned, who taught it to me, and how I came to decide for myself what was valid and what was not. If you would like to hold yourself in a position of lofty judgment over me because we differ on our views of certain fraught issues, I commend you to your pastime. But I consider it pointless to spend my time in conversation with you, when you are far too busy buffing your opinion of yourself to a high shine to pay the merest jot of attention to what anyone else thinks.

          • “…how studies like Dr. David M. Fergusson’s [of New Zealand] have been distorted and shouted down…”

            What evidence is there that the study was “shouted down”?

          • Thank you for the courtesy of printing my reply above, Russell. For the record, I do not speak publicly on the Word of God except in the academic sense. I do not interpret scripture in forums like this, I don’t even say it IS the Word of God.

            Examine the record. You must be confusing me with someone else.

            As for the rest of your remarks on a personal level, I will not retaliate, nor are they relevant.

            As for your remarks on the professional level, there is another side to this controversy, and that side may be right.

            In response to a Danish 2011 study,

            New Zealand researcher David Fergusson said, “As a research scientist who is a pro-choice atheist and whose research suggests possible small, harmful effects for abortion, I have been concerned at the ways in which the politics of these debates has colored and distorted the interpretation of the evidence.”

            This is my argument from the first, Russell, that Mother Jones can be relied upon only for half the story. Those who are interested in the truth will keep Fergusson’s words in mind as they inform their consciences.

            _____________________
            The Danish study compared 84,000 women who had first-trimester abortions between 1995 and 2007 with 280,000 who had children and a larger group who did neither. Factoring out women with any prior psychiatric history, it found that 1.4% of those who had abortions made a first psychiatric visit in the nine months before the operation and 1.5% did so in the year afterwards.

            Meanwhile, 0.4% of those who had children made a first visit to a psychiatrist in the nine months prior and 0.7% did so in the year after.

            This prompted an Associated Press story that declared, “The research by Danish scientists further debunks the notion that terminating a pregnancy can trigger mental illness and shows postpartum depression to be much more of a factor.”

            Fergusson, lead researcher in a 2008 study that interviewed women over a 15-year period and found those who had abortions 30% likelier than other women to have mental-health issues, said that the Danish study’s “greatest weakness is that it uses measures of medical contacts as a measure of psychiatric morbidity. The problem with this type of measure is that many people with mental illness do not seek treatment, and the study may have failed to detect differences for this reason.”

            An American researcher who does not hide her pro-life beliefs, Priscilla Coleman, faults the Danish study for cutting off the study period for each individual a year after the abortion. A professor of human development and family studies at Bowling Green State University, Coleman said, “They had data on these women for 40 years. Why didn’t they use it?”

            Coleman said most of the mental problems that show up in women who have babies do so in the first year, while the reverse is true for women who have abortions: “They block it out at first. They self-medicate. It shows up two to six years down the line, perhaps when they decide they want a baby.”

            Read more: http://www.ncregister.com/site/article/abortion-has-no-mental-impact/#ixzz22XaGAqCr

          • Fergusson said:
            “By the admission of the report, studies in this area (including my own) have significant flaws relating to sampling, measurement and confounding. What this means is that “the best scientific evidence” to which they refer, is really not all that good. Given that this is true then it would be inappropriate to draw strong conclusions on the basis of such limited evidence.

            Two points. First, Fergusson himself says it would be inappropriate to draw strong conclusions on the basis of limited evidence, yet we are encouraged by TVD to do exactly that, provided they are his favored conclusions.

            Second, the abstract quoted previously says explicitly, that “The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. ”

            In other words, while the authors admit that all the studies they reviewed had methodological problems, the best of those studies supported the conclusion that there is no link.

            Finally, to pull one convenient but non-representative sentence out of an abstract is cherrypicking, no matter how vigorous the denial. To complain about being called on it is to demonstrate the utter falsity of the claims of good faith and gentlemanliness. Gentlemen don’t purposefully distort and misrepresent others’ research for their own ideological purposes.

          • Something I’ve thought about for a long time, and see going on right here, right now (but also in tons of other places at tons of other times), is the weird tendency to hold up as sacrosanct the opinion of someone from the other side of the aisle when they cross the aisle and agree with you. Does this strike anyone else as a bit odd?

            Let me elaborate…

            If Dr. Fergusson, an admitted pro-choice advocate, found the exact opposite results, many (perhaps even Tom himself) would be less-than-convinced by the doctor in part because of the argument that he’s just a pro-choicer and those people are wrong about everything. But, when he crosses the line, suddenly he is a voice to take seriously! One that must not be “shouted down”… whatever that means. I do realize the potential for self-servingness and that this ought to be considered. But often I here, “Yea, well so-and-so agrees with me and he’s from YOUR side of the aisle, so I must be right,” when, in any other context, so-and-so would be dismissed by that same person precisely because they are from the other side of the aisle.

            Am I making sense here? Am I crazy in thinking this? I don’t mean to single out Tom here, as this is something I’ve actually thought about for years. And I realize that Dr. Fergusson himself is making much of his personal perspective and how it appears to be at odds with his study. But Tom also seems to be using it to bolster his case, as so many people do. Does it actually strengthen the case? Is this a viable tactic?

          • Kazzy, it’s the debating equivalent of “statement against interest“.

            It is given more credibility because you know that the person saying it is not saying it to advance a belief. It’s not so much that the person suddenly becomes a more credible individual, but the circumstances in which he was said make the statement more credible. Since they’re obviously not saying it as part of an agenda, then why would they say it if it were not true?

            It does not lend automatic credibility. For one, the person might be a double-agent. Or they could simply be wrong. But, on the whole, I am more likely to give credibility to someone that is disclosing something that is not in their personal or ideological interest to do so than if someone is saying something that you would pretty much expect someone with their views to say.

          • That makes sense. It just stands out in the way it is often done.

            Monday, 4PM: “Joe Blow is a conservative hack who couldn’t find a good idea if it kicked him in the teeth.”
            Tuesday, 7AM: “You know how I know you’re wrong about single-payer? Joe Blow supports it and he’s a Republican. I’m right, you’re wrong. Neener, neener, neener!”

  5. I imagine myself with a hand held sign that says “this part is bullshit” in flashing letters at the appropriate times.

  6. Dr. Saunders, you sir are a vainglorious slayer of trolls.

  7. Allow me to modify, masterful is more what I meant. Sorry.got carried away.

    • Heh. Thank you for clarifying. I assumed you meant to be complimentary.

      I do feel compelled to say that I don’t think Tom is a troll. It’s probably for the best that I leave things at that.

    • A word to the wise – glorious and vainglorious may be similar sounding, but they have very different meanings 🙂

  8. Ecchh. The issue isn’t whether the claim is true or not. In fact, we simply don’t know whether the claim is true; it might be, it might not be, further research is warranted. But to have the S.D. legislature tell doctors they have to act as though the claim is true is just bullshit. And in any case it totally violates the Dr.’s first amendment rights as well as interfering in her provision of care as best she sees fit. (Of course, that’s the whole point.)

    In the worst case, it seems like it may double the risk of suicide. OH, MY GOD! …. Oh. Wait. That ‘s a doubling of a very small risk in the first place, so it’s still very small. This is really the kind of information that should normally be taken into consideration for after-care. So the doc is aware of a slightly increased risk and can watch out for it down the road.

Comments are closed.