"After then-governor Ronald Reagan signed California’s 1967 abortion act, his daughter said, he began to regret it when he learned that 'psychiatrists were diagnosing unwed mothers-to-be with suicidal tendencies after five-minute assessments so that they could get abortions.' Thirty years ago, shortly after the Supreme Court reaffirmed Roe’s central holding by a single vote in Planned Parenthood v. Casey, the psychiatrist Paul S. Appelbaum speculated that returning to restrictive abortion laws 'will confront psychiatrists with dilemmas from which there is no clear escape.' Recently I asked Dr. Appelbaum to update his prediction. 'Given understandable sympathy for a woman who does not want, and may not be able to care for, a baby, and lacks other options, psychiatrists will be under intense pressure to make such judgments,' he told me. Mental health exceptions will be one of the only ways of gaining access to abortion in some states. This means that my profession will surely assume the troubled role of gatekeeper once more, feeling pressured by a woman’s circumstances, and often by their own conscience, to label her as disturbed when in reality she is sane."
From "The ‘Open Secret’ on Getting a Safe Abortion Before Roe v. Wade" by psychiatry professor Sally L. Satel (NYT).
That is, it's rather clear that if the state makes psychiatrists into abortion gatekeepers, they will not exercise their power according to professional ethics. That offers a strong foundation to lawmakers who oppose a mental health exception. It's also a good foundation for those who want to permit access to abortion without any need to pass through gates that are only a restriction for those who restrict themselves to honesty.
Here's the Wikipedia article for Satel. There's nothing there about abortion, but I see that she's a resident scholar at the American Enterprise Institute . And:
In her book P.C. M.D., Satel critiques what she sees as the burgeoning phenomenon of politically correct (PC) medicine, which seeks to address what its proponents view as social oppression by reorganizing the distribution of public health resources. She argues that incorporating social justice into the mission of medicine diverts attention and resources from the effort to prevent and combat disease for everyone. She is considered a political conservative, a description she rejects.
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It's also a good foundation for those who want to permit access to abortion without any need to pass through gates that are only a restriction for those who restrict themselves to honesty.
Now do gun laws.
or mental health
gotta kill the baby, otherwise the mother might get upset. Don't want any suicides, do we?
gotta give puberty blockers, otherwise the "girl" might get update. Don't want any suicides, do we?
gotta give top surgery, otherwise the "girl" might get update. Don't want any suicides, do we?
gotta give bottom surgery, otherwise the "girl" might get update. Don't want any suicides, do we?
Sure seems like there would be a LOT more suicides than than there are (or were, before)
Summarizing the elephant in the room: "We can't have laws that depend on the honesty of the medical profession in this country because they aren't ethical people and we all know it."
They'll deliver whatever opinion (for a fee of course) that advances their own personal beliefs about abortion (in both directions). It won't be long before women have access to a database of "good" doctors (you know, the corrupt ones, willing to lie, for a fee). Emily's New List.
That's a pretty damning indictment of our entire culture.
I am sure we're going to see and hear all kinds of stories coming out of the Times and virtually all publications leading up to, and after the actual Supreme Court opinion is released. I am also sure that, whatever the opinion, this will not end. This is the debate that will continue forever, until babies are not being killed en masse and we've found a way to allow women in true need to have an out from this. There is no good middle, but a middle must be found.
That said, a healthy society cannot look at abortion as a contraceptive option. And a healthy society should not put this sort of final decision in the hands of psychiatrists. For many reasons- among them that psychiatrists are not always the best at determining your future. To put it mildly. They are human and swayed as we all are by human emotions, opinions, and motives.
Interesting that Sally Satel's book, "P.C., M.D." was published 20 years ago. Today the American Medical Association has clear DEI standards and the medical schools are taking them to heart. First, Brook no dissent. She was prescient in her views back in 2001/2002.
Getting an abortion might become secondary to getting a competent medical professional in short time. If you look around at other industries, other businesses, you've seen the creep of mediocrity take hold in virtually every one of them. And you've probably seen it already in some ways in your medical care. Look at today as the 'good old days' when it comes to your medical care. Remember what you have today and get prepared to stand in line waiting for much worse in a few short years.
Now they abort just for fun.
There will not be pressure on psychiatrists in general. Rather, there will emerge a certain number of psychiatrists willing to certify any woman for an abortion, even over the phone or online.
Karl Menninger famously said, "Mental health problems do not affect three or four out of every five persons, but one out of one." When personal responsibility doesn't get the results one expects, one understandably seeks psychiatric counsel. But, it doesn't mean one gets to abandon personal responsibility....
And a healthy society should not put this sort of final decision in the hands of psychiatrists.
True for many issues.
Just another example of how we place too much trust in “experts.” They’re people, subject to all the foibles and failings the rest of us are. And they are predominantly on the left—meaning that they subscribe to a political philosophy that says their personal value system is more important than the limits placed on us by history, experience, and the broader society.
Include a mental health exception and we really will return to a pre-Roe state, meaning that people with money will have nice clean comfortable abortions at will and people without money will scramble for whatever they can get.
In this day and age, everyone has a mental issue, particularly (and specifically) the current crop of young adolescents.
Once again showing that the whole pro-abortion agenda is built on frauds and duplicity.
Another BIG lie from the pro-abortion crowd is that "no one" would ever get a late abortion in the 7th, 8th, 9th month. That even if they did, it would only be for life-saving health reasons.
When they know damn well that there is an entire industry of abortionists who will abortion into the 9th month -- and evade whatever slim restrictions that have been judicially allowed -- by simply saying that the woman would suffer from some mental distress, she would be slightly bothered, if she did not abort her child (kill her child, because the objective to relieve the distress is the elimination of the baby), a child who would thrive if delivered at that point.
"sympathy for a woman who does not want, and may not be able to care for, a baby"
What about sympathy for the baby? As in, first do no harm?
"lacks other options"
Like, adoption?
"label her as disturbed when in reality she is sane"
Right. Since there is no standard, and much psychiatry is quackery, any mental health standard invites PC corruption.
Am I the only woman commenter here now?
Besides Althouse of course.
Put “politically correct medicine” together with Ezekiel Emanuel’s dicta that people should not live past 75, and the end point is determined for the lives of Althouse and the rest of us septuagenarians.
Or abortion supporters can band together and pay to transport pregnant women to New York, California, New Mexico, Colorado, Illinois, Michigan, Vermont, Maine, Massachussetts, Rhode Island, Connecticut, Washington D.C., Delaware, Oregon, Washington, Hawaii, Maryland, Minnesota, Wisconsin, Nevada, Pennsylvania, Ohio, or Iowa and pay for their abortions. Again- money where mouth is.
What Rusty said. They abort for fun and then they SCREAM their abortions because they are proud that they legally murdered their own child!!! Progressivism is a mental disease.
NPR ran a story in May about the rise in popularity of telehealth abortions, in which after the consultation, pills are sent so a woman can terminate at home. The story includes this ghoulish quote: "The most common feedback we get is: 'I can't believe this is so easy. I'm crying because this is so easy.'" This model will likely boom even more, since many abortions are done with these pills anyway.
Remember, marijuana was only going to be legalized for medical reasons.
You needed a doctor to prescribe it as treatment for your valid medical condition.
Around the same as California's abortion law was passed, armies of shrinks were pressed into service to get young men out of being inducted into the Army for possible service in Vietnam.
Morals and ethics get no traction, much less respect.
Now do guns and red flag laws.
If you don't think it will be abused you are nuts...
Religion (i.e. behavioral protocol), includes morality in a universal frame, ethics its relativistic sibling, and law their politically congruent cousin. People... persons should be wary of the primitive practice of normalizing elective abortion a.k.a. reproductive rites a.k.a. "burden" relief for social progress, redistributive change, clinical cannibalism, and fair weather causes.
Bus tickets are what? 100 bucks. I suggest all of the abortion advocates get together, fundraiser, make an NGO that has multi-million salaried employees and pay for people to either move to a state that aborts up to delivery or pay for their trip.
Be part of the solution.
Not all that different from “medical” marijuana.
"In this day and age, everyone has a mental issue"
Ain't it the truth. If their brain chemistry wasn't really "off" at the beginning it will be after a few years of Rx cocktail.
And they will go through life announcing their maladies to all who will listen.
Doesn’t this analysis ignore the massive growth in availability of birth control alternatives and over-the-counter abortion pills? Why is it society expects people to pay their mortgage and utility bills, manage a household budget, bathe and practice personal hygiene, get a job and meet work expectations, etc. but not to be responsible when it comes to having unprotected sex? A tiny fraction of conception occurs from failed birth control or rape, yet this tiny percentage seems to dominate thinking of abortion lovers. What if Planned Parenthood did what it claims and actually provided excellent training on how to avoid unwanted pregnancies? But it doesn’t and it won’t because abortions are a money machine and fulfill their mission to reduce births among “those people”. Thinly described racism and elitism. Yet I would rather society see more of “those people” than the likes of Ezra Klein. It’s called faith in humanity.
Abortion has always been an act of hope...
Carol asked, "Am I the only woman commenter here now?"
Why would that matter?
I was a surgery resident when CA legalized abortion. I was on my GYN rotation and even did a few abortions. (Inga was outraged) None of us liked doing them and the County soon hired doctors to do them so GYN residents didn't have to. A lot of us wondered about the mentality of someone who take that job.
All the girls had had a psych evaluation and I never heard of one being denied.
I did get a bit of followup on the mentality of abortion doctors. A classmate of mine in freshman year medical school, flunked and repeated the first year. I didn't see him much after that but I did hear about him. He was running an abortion clinic in the San Fernando Valley when he shot his girlfriend. I think he said it was an accident but he had shot her multiple times. He went to prison. He was weird when I did know him.
That is, it's rather clear that if the state makes psychiatrists into abortion gatekeepers, they will not exercise their power according to professional ethics.
I mean, there's no reason to think they're going to be any more ethical in this context than they are in the pill mill context. A handful of psychiatrists have been penalised in recent years for overprescribing controlled substances, but my impression is that this hasn't done much to deter the profession as a whole. Of course, there are ethical psychiatrists out there -- probably the majority -- but people who just want the prescription can still find a psychiatrist who will write it for them. If psychiatrists become gatekeepers in the abortion context, patients will turn to crooked psychiatrists to circumvent restrictions the same way they do when looking for drugs -- that's just how gatekeeping works when everyone knows that there are unethical "gatekeepers" to be found.
Blogger Carol said...
Am I the only woman commenter here now?
I don't know, I'm not a biologist
Carol, you are AFAB: Assigned Female, Althouse Blog.
That is, it's rather clear that if the state makes psychiatrists into abortion gatekeepers, they will not exercise their power according to professional ethics.
I should have thought that there would be plenty of professional ethicists, probably a majority, who would argue that refusing to do a proforma "threat to mental health" certification to allow a woman to get what was in reality an elective abortion was, ipso facto, a breach of professional ethics. A good shrink should not be in the business of helping to sustain an oppressive patriarchal law. Professional ethics are somewhat more goal orientated than they used to be.
And on the subject of "give 'em a tiny loophole and they'll be through it with an armored division" I recall that about fifteen years ago, a British MP asked an interesting question to a Minister in the House of Commons.
About ten years before the question, the Brits had introduced a sort of three strikes law for home burglary. Three convictions and the judge was compelled to sentence you to a minimum 2 year jail term. But there was a rider - the judge had latitude to waive this mandatory sentence in "exceptional circumstances." Because, well, there will very occasionally be exceptional circumstances.
So the MP asked - since the 3 strikes law took effect 10 years ago, how many burglars have in fact been sentenced to the mandatory jail term ? The answer was ....wait for it.... six.
Why would that matter?
6/5/22, 10:57 AM
Oh, makes no diff at all. But the site has more of a Heartiste vibe now.
Civil disobedience and nullification of the law are part of the free market check and balance system. Sovereign citizens acting in their own interests will always piss someone off.
In the Vorkosiverse :
Beta Colony [also called The Old Sandbox] is accepted as founded by Americans on Martian type planet in a far away star system. People live underground in closer quarters. Freedom reigns for all things except reproduction. Women are required to get contraceptive implants at puberty and can opt to 'removal' when they qualify for parent-licenses etc.
so will USA society opt for such simple solution? why would American birther-people resist any such?
@Carol, re "Am I the only woman commenter here now?"
I'll identify as a woman, if that will make you feel less outnumbered. In fact, I recommend every male commenter do the same.
As a woman, I'm offended by this post. I'm also offended by the comments. Men just don't get it.
"they will not exercise their power according to professional ethics."
Hmmm.. Perhaps they see enabling their "patients" to obtain the abortions they claim to desire as precisely a case of exercising their power according to professional ethics.
"Why would that matter?"
And how would you know?
I would be interested to know whether any of the states that seek to prohibit or seriously restrict abortion are going to put in that mental health exception that RWR came to regret. I kind of doubt they will.
Also, I'm not sure how much difference it's going to make as a practical matter if a state has some kind of limited exception permitting abortions under certain narrow circumstances. If the overall effect of a state's laws are to reduce the number of legal abortions by 80-90%, there probably won't be sufficient demand for abortion services in that state for abortion providers there to remain in business.
I am a woman but a very occasional commenter —and avid reader of everything Althouse.
I get the feeling that the commentariat skews male—conservative, law school educated male.
I am a physician but my three sons are lawyers. One son clerked for Justice Kavanaugh when he as on the DC Circuit and then for Justice Kennedy on the Supreme Court. Hence my fascination with this blog and the erudite commenters.
No, Carol. Some of just have nothing left to say about abortion. We were lied to with "safe, legal, and rare". Why trust anyone who tries to convince us abortion is a necessity?
An ounce of prevention conserves human dignity, agency, and value, and makes a pound of wicked solutions go away.
What’s the affluence good for if we assume that the middle class won’t adopt unwanted babies?
I remember reading a similar discussion about how the psych profession facilitated the big divorce boom in the 60s and 70s by telling parents what they wanted to hear, which was that divorce was better for the children than an unhappy marriage, even though in most cases that wasn’t true. But couples wanting to end their marriages rather than keep it together for the sake of the children got their consciences eased. Now we know (and of course we always knew) how bad divorce is for children, but the children weren’t the ones paying for the marriage counseling.
Thanks to everyone who contributes to the diversity in the comments here. I certainly don’t intend for it to become dominated by one type of person.
Reagan didn't want to sign a Pro-choice bill, but Nancy and MIke Deaver convinced him to do so. Its amazing how many Republicans were pro-choice back in the 70s. Jerry ford, bush, dole, don't know about nixon, but he was pro-choice by the time he died. Romney didn't flip till about 2000.
And how will they handle the additional job of gatekeeping for gun ownership when "red flag" laws are enacted?
Well, let's see...
Male, check (with the caveat that I'm not a biologist. Perhaps I should ask my daughter?)
Conservative. Probably.
Law school? Nope.
Are we supposed to keep score, or file a form, or something?
What Eleanor said. What science and statistics say.
I am woman, hear me roar . . . unless another life is at stake.
Pre-Roe, the State where I grew up prohibited abortion except where it was "necessary to preserve the health" of the pregnant woman. The applicant needed three physicians to certify that she needed an abortion to preserve her health, and had to pay for them to do the examination and certify to the medical necessity. Of course, even in those old days. most unhappy pregnant young women didn't have physical conditions that seriously threatened their physical health. But the State law also allowed abortion to preserve the "mental" health of the pregnant woman, but this required that one of the three certifying physicians was a psychiatrist. If the pregnant girl (or her family) had the money to pay for two GPs and one psychiatrist, that was all it took.
My father was a psychiatrist, and he refused to play that game (no we weren't Roman Catholic). My father believed that you were better off facing and dealing with the consequences of your actions. In those days, there were facilities that would take in unmarried women and see them through their pregnancy and arrange adoption for their children. That infrastructure may need to be reestablished -- bet it won't take long.
Given understandable sympathy for a woman who does not want, and may not be able to care for, a baby, and lacks other options
Since she can ALWAYS put the baby up for adoption, there is NO woman who actually "lacks other options", and to pretend otherwise is to establish one as a total liar
Buckwheathikes said...
Summarizing the elephant in the room: "We can't have laws that depend on the honesty of the medical profession in this country because they aren't ethical people and we all know it."
Mostly false
The issue is, your local "Planned Parenthood" will have on staff as many "doctors" as it takes to get whatever approval is needed.
The fact that the various "health" / "medical" associations won't expel those people is a result of the utter corruption of the political Left.
But it's why there should NEVER be a "health" exception for any abortion law, and demanding one is absolute proof that the demander is a vile person who acts in bad faith
Carol said...
Why would that matter?
6/5/22, 10:57 AM
Oh, makes no diff at all. But the site has more of a Heartiste vibe now.
6/5/22, 12:39 PM
Because most of us are against women murdering their babies??(especially after the first trimester?) And YES...I am a woman and I do have opinions that differ because I have my own mind.
Greg The Class Traitor said...
But it's why there should NEVER be a "health" exception for any abortion law, and demanding one is absolute proof that the demander is a vile person who acts in bad faith
I disagree. There are conditions in which a woman can experience severe physical harm from allowing a pregnancy to continue. It’s the “mental health” automatic-override that needs to go.
BTW, that’s why I’ve always been amused at the fuss over Roe v. Wade. All that phony reasoning about when an abortion could or couldn’t be performed, when they all along planned to proclaim that ‘potential harm to her mental health’ would be an automatic override of all other considerations.
Stephen St. Onge said...
Greg The Class Traitor said...
But it's why there should NEVER be a "health" exception for any abortion law, and demanding one is absolute proof that the demander is a vile person who acts in bad faith
I disagree. There are conditions in which a woman can experience severe physical harm from allowing a pregnancy to continue. It’s the “mental health” automatic-override that needs to go.
Whether or not that's true, what we know from recent history is that any exception based on the "opinion" of a "doctor" is worthless.
So unless the law says that any doctor who issues such a waiver can be prosecuted for doing so, and that the burden of proof will rest on the doctor giving the exception, not the prosecution, the purpose of the exception is to sabotage the law.
BTW, that’s why I’ve always been amused at the fuss over Roe v. Wade
The "fuss" is that the Left does not want their judicial dictatorship challenged, and is upset at the thought that one of their dictatorial orders can be overturned
Carol,
Just another woman here (the few, the proud, the female Althouse commentariat!). I'm around a fair bit, at that.
I'm tired of the debate over Roe (and Casey, which nearly everyone treats as basically the same as Roe, but which isn't, not at all). Oh man am I tired. I've been reading about this case for thirty years plus, all the way back to Bork and to Tribe and to Dworkin (Life's Dominion -- IIRC the short summation amounted to "Life hasn't got a dominion." Not at either end).
Ann has, in this post and especially in the one just above it about Ezra Klein, shown just how nuts basically-liberal women of a certain age can become when one of their holies of holies is threatened in any way. (By "women of a certain age" I am not excluding myself; I'm 54.) The point of the "health" exception is indeed almost entirely about mental rather than physical health. Very, very few people of either sex would force a woman to carry on with a pregnancy that endangered her physically. (I know such people do exist, but they're a tiny sliver of the electorate in any state.) But open this to mental health -- extended so broadly as to include "distress" -- and you are effectively saying that anything preventing Ms. Roe from vacationing on Crete for two weeks is a valid reason to allow her child to be torn into pieces.
To some of us (not all men; more likely majority-female), this doesn't make sense. We sometimes reject expansive declarations of rights just because the few genuine reasons for them are overwhelmed by the much more common dubious ones. And in this case, all we need to do, really, is to add supervision of some kind -- a second doctor's opinion, a review board, even just a freakin' questionnaire -- to insure that the law isn't being abused. This is how abortion is generally handled in Europe, which is the US's model for all right behavior, except where it isn't. :-)
In Georgia, it was often a black physician who provided abortions to black and white woman. Under Jim Crow, one doctor in Atlanta and another in Valdosta (Florida crossroads) were known practitioners. One wrote a book.
The same was true in New York City. Often the clinics were above barber shops and hair salons, providing some sanitary conditions and explanations for stocking certain items. Madam CJ Walker, the wealthiest black businesswoman of her era, was known to provide services, though this information is entirely purged from the internet, where it was once celebrated.
One of the many oddities of segregation.
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