Thursday, July 24, 2003

"...the difference between a fetus and a premature infant is a social distinction, not a biologic one" I don't normally post long essays -- especially from other sources -- but this letter to the editor of the Washington Times merits posting in whole:
According to The Washington Times, Senate Democrats are slowing progress of legislation banning partial-birth abortion ("Abortion bill faces conference setbacks" Nation, Monday). Both the House and Senate have overwhelmingly passed bills that ban this procedure, and President Bush has promised to sign such legislation. Here is my experience with this issue:
In 1976, I was a medical student on my first obstetrical-gynecological clinical rotation. In my second week on the gynecology service, I checked the operating room schedule and saw I was to assist with a hysterectomy/TAB. At the operating table, I learned that a hysterectomy/TAB was the surgical procedure where the pregnant uterus is removed. TAB stands for therapeutic abortion; the hysterectomy was for sterilization. I held the retractors as the professor methodically excised the gravid uterus.
I already had assisted on two other hysterectomies, one for endometrial cancer and the other for a benign tumor. I had been taught during those first two cases to "always open the uterus and examine the contents" before sending the specimen to pathology. So, after the professor removed the uterus, I asked him if he wanted me to open it, eager to show him I already knew standard procedure. He replied, "No, because the fetus might be alive and then we would be faced with an ethical dilemma."
A couple of weeks later, now on the obstetrical service, I retrieved a bag of IV fluid that the resident physician had requested. The IV fluids were to administer prostaglandin, a drug that simply induces the uterus to contract and expel. The patient made little eye contact with us. A few hours later, I saw the aborted fetus moving its legs and gasping in a bedpan, which was then covered with a drape.
Several years later, I had my only experience with a partial birth, or late term, abortion during my neonatology training.
One day, the obstetrical resident who was rotating through the neonatal intensive care unit (NICU) was excited that he was going to get to learn a new procedure, a type of abortion. This obstetrical resident explained to several of the pediatric residents and me that a woman in labor and delivery in her late third trimester had a fetus who was breech (a baby positioned buttocks, not head, first) and also was severely hydrocephalic.
The resident described how he was going to deliver the body of the baby and then, while the head was entrapped, insert a trochar (a long metal instrument with a sharp point) through the base of the skull. During the final portion of this procedure, he indicated that he would move a suction catheter back and forth across the brainstem to ensure that the baby would be born dead.
Several of the pediatric residents kept saying, "You're kidding" and "You're making this up," in disbelief. The pediatric residents all had experience caring for infants and children with hydrocephalus and had been taught that with any one infant the degree of future impairment is difficult, if not impossible, to predict.
Later that afternoon, the obstetrical resident performed the procedure, but unfortunately the infant was born with a heartbeat and some weak gasping respirations, so the baby was brought to the NICU. All live-born infants, even if it is clear that they were going to die in a short period of time, were always brought to the NICU so they could die with dignity, not left in the corner of Labor and Delivery.
I admitted this slightly premature infant, who weighed about 4 pounds or 5 pounds. His head was collapsed on itself. The bed was a mess from blood and drainage. I did my exam (no other anomalies were noted), wrote my admission note, then pronounced the baby dead about an hour later.
Normally, when a child is about to die in the NICU and the parents are not present, one of the staff holds the child. No one held this baby, a fact that I regret to this day. His mother's life was never at risk.
When I was in medical school, abortions were done up until 28 weeks (full term is 40 weeks). It was confusing that on one side of the obstetrical unit, pediatricians were placing extremely premature infants on warmers, intubating them to help them breathe, and rushing them off to the NICU, while on the other side similar premature infants/fetuses were being delivered in bedpans and covered with drapes. Most 28-week fetuses died back then, even with NICU care. Today, more than 95 percent of all 28-week premature infants survive and thrive. Most states won't do an abortion beyond 24 weeks now. However, today more than 50 percent of all 24-week premature infants survive if delivered in a hospital with an NICU, and infants as young as 22 weeks have survived and done well. Infants weighing as little as 9 ounces or 10 ounces have survived.
As a neonatologist who has cared for numerous spontaneously aborted and a few intentionally aborted fetuses in the past 20 years, I now realize that the difference between a fetus and a premature infant is a social distinction, not a biologic one.
If it is wanted, it is a baby; if not wanted, it is a fetus. When I started medical school, I viewed abortion as just another medical procedure and the products of conception as tissue. After 20 years of practicing neonatology, I now know this is not the case. I believe that after abortion became legal, the mantra of "it's just tissue" took hold in the medical and lay communities, and most never stopped to question if it were correct.
More than 1.2 million induced abortions are done annually in this country; roughly one out of every four pregnancies is terminated by abortion. Medical or social euphemisms such as TAB, D&C (dilation and curettage), choice, women's health or reproductive freedom don't change the fact that abortion is a violent and unethical — if legal — procedure. Elective abortions have degraded both the medical profession and the women who have made this choice.
Of course, partial-birth or late-term abortions constitute only a minute fraction of the abortions done daily in this country. Why should Congress and the president limit the few partial-birth abortions that are done? Simply because it is the right thing to do.

Pediatric Fellow
University of Iowa
Iowa City

Two Good Links. As always, if you want good news about the Anglican Communion, your starting point must be Classical Anglican Net News or CANN:

Second, this website developed by the American Anglican Council looks promising:

Two More: Titusonenine and MCJ.

Wednesday, July 23, 2003

Advance. There was a big convocation -- an advance, I think you'd have to call it -- of Anglican ministers at my church today. It looked more like a UN meeting. Actually, I take that back -- it had a very third world flavor (the UN being very European). As I understand, the gist of the meeting was that the confessing church members in the Anglican communion agreed to meet after the Episcopal General Convention if (1) it authorizes any same sex blessings or allows Gene Robinson (the fellow who left his wife and kids for a same sex lover) to take a seat as bishop, or (2) it takes action to bless same sex unions.

It must be recognized in the days ahead that the Episcopal Church in America is just a small part of the Anglican body.* It is a hand, if you will. The Anglican Body, speaking in unison at Lambeth reconfirmed that the union of a man and a woman is the only biblical standard -- only a man and woman may be joined in holy matrimony and santified by the Church as Christ's representative. If the Episcopal Church were to take one of the two steps I noted above, it would be affirmatively separating itself from the Anglican Body.

It would be like severing a hand from the body.

Those of us remaining in the Episcopal Church who are standing for the standard endorsed by the Anglican body may be just a finger on the hand, but we will do what we can to see to it that the hand remains firmly attached to the body. I think we may be that opposable thumb that makes the hand so useful -- if so, we will stay. God willing.

*I must acknowledge that in reality the Church of Christ universal, as the Bride of Christ, is so much greater than the Anglican communion -- Thanks be to God. In truth, the Anglican Communion may come closer to being the skin on the left shin. Nevertheless, when you bang the shin, it hurts and the body may stumble.

More: Here, a news report from the WaPo. Here, from the NY Times.
Shields Up. I noticed today, driving by the Pentagon, that the levels of defense are definitely way up. For example, just the number of police parked on the shoulder has at least doubled. But more noticeable where the humvees and jeeps with mounted guns, each staffed by at least three soldiers. This had been scaled back over the past few months -- don't know if there is any connection with the deaths of EBay and Queasy, but I wouldn't doubt it. Also, they are wearing the dark green BDUs and cammies (Woodland style, I think) -- not the lighter cammies, which blends better with the Virginia shrub brush. They've also dispensed with the military camouflage netting. They are projecting a prescence.

More It looks like that was just a one day deal.

Sunday, July 20, 2003

Feed the people. Archbishop Peter Akinola, the Prelate of the Anglican Church in Nigeria, spoke at worship this morning. In Nigeria they have 17 million communicants, more than the Anglican communion has in England, Canada, and the U.S. -- combined. This branch of the Church is quite strong and healthy, albeit materially poor. He is in America to give support and sustenance to those members of the confessing church who remain in the Episcopal denomination. I can not begin to tell you how wonderful it was to listen to the spiritual strength and vitality of this man. I've heard Billy Graham preach and this man outdoes him -- not that it's a competition.

He spoke on the feeding of the 5,000 and also participated in a number of baptisms.

I believe we are on the verge of a historical shift -- a turning point.

More later.
Adios. Well done, Bill Bright.