The Virginia ultrasound bill

Driving to Charlottesville yesterday for a talk at U. Va., I got to listen to a local radio show focused on the ultrasound bill. Turns out that Jon Stewart wasn’t exaggerating.

Here’s the technical scoop, per a professor of OB/GYN: The bill requires an ultrasound before any abortion. For a second-trimester abortion, the fetus is large enough to be seen on a standard “jelly-on-the-belly” external ultrasound, of the kind that’s routine for any pregnancy. But in the first trimester, that sort of ultrasound shows nothing at all. So requiring a technically adequate ultrasound for a first-trimester abortion means using the transvaginal technique: yes, the one opponents keep comparing to rape. Apparently the comparison isn’t out of line: someone who had had one described it as extremely uncomfortable, invasive, and humiliating.

Apparently the dimwit Republican legislator who sponsored the bill – a woman, as it turns out – has said that she didn’t understand what her bill would require of women seeking abortions. The dimwit Governor, hoping for a spot on the Republican national ticket, says that he, too, supported the bill without knowing what it was about.

And no, the bill didn’t have either a rape exemption or a conscience clause for doctors who believe that doing a painful and pointless procedure would violate the Hippocratic Oath. But the right-wing, including some who call themselves libertarian, leaped to its defense anyway, because it was a Red Team effort.

Tyler Cowen, for example, is often interesting and thoughtful. I wonder if he’d regard requiring a proctoscopy for anyone voting Republican – because they ought to feel what it’s like to have Republican policies actually applied to you – would also help create fully informed consumers. I assume he meant to make fun of consumer protection, rather than defending the forced vaginal penetration law, but his comment was the sort of astoundlingly heartless and tasteless remark that even otherwise decent people can find themselves making in the heat of partisan fury. Of course an ultrasound is utterly irrelevant to women whose decision to have an abortion depends on their social circumstances rather than the state of the fetus, so the Virigina bill has absolutely nothing in common with a law requiring that banks disclose the interest rates on credit cards or used-car dealers disclose the defects in the cars they sell.

It appears that Jon Stewart and a bunch of fired-up Virginia women have managed to stop this monstrosity. But the substitute the Governor is pushing to save face would still require the utterly pointless abdominal ultrasound even for very early abortions, where it won’t show anything. But that doesn’t mean it won’t add to the cost of the procedure; of course the bill doesn’t have any provision for paying for the ultrasounds.

Let’s not forget that gross, idiotic, cruel stuff like this is what today’s Republican party is about, that anyone who votes, donates, writes, blogs, or tweets for the Red Team is, will he nill he, contributing to it. In Virginia, it was the Tea Party faction in the legislature that pushed this bill. So can we please, please, never hear again the canard that the Teahadis are in favor of small government?

Comments

  1. says

    I fully agree. However, I find it objectionable when pro-choice advocates express outrage that bills such as this don’t contain an exception for rape. Making such a distinction implies that, while rape victims are morally blameless (which, of course, they are), women who become pregnant through voluntary sexual activity are, somehow, less worthy. In other words, they are not entitled to the same treatment as rape victims. That distinction is offensive; either women should have no right to an abortion or they should all be entitled to make that choice. The circumstances under which they became pregnant should be totally irrelevant. The moral judgment implicit in making a distinction such as this is inappropriate.

    • larry birnbaum says

      It’s important as a wedge both conceptually and politically. Politically, it separates the most radical anti-abortionists from the rest, as well as helping to make them look radical to the rest of the country. Conceptually, it demolishes the ostensible “pro-life” rationale for being against abortion. And these functions are related. Because while you’re right that it’s inconsistent from both the “pro-life” and the pro-choice point of view, it undermines the first far more than the second. It makes it clear that for many or even most people who are against abortion, the issue isn’t life but the need to force women to bear the responsibility for their sinful behavior.

      • Ken D says

        It is important to realize that a very large bloc — certainly the balance of power, possibly an outright majority — do not sign on to either side’s core principles here, and by and large don’t spend a lot of time agonizing about it. Those principles would be on the one side that any interference with the reproductive process is murder of an independent human being, and on the other that a woman has an absolute right to control her own body even into the later stages of pregancy. I am confident that a solid majority ultimately do want abortion to be safe and available when the need strikes close to home, and that effective banning of abortion cannot and will not occur in this society. However, the alliance is fragile and needs tending. Those who buy into either principled credo had best not forget that.

      • says

        Of course, as with most compromises, it’s a double-edged sword and you run the risk of watering down sharply defined principles. You cede ground to the idea that a fetus is a child with rights that extend beyond the womb, as well as the larger idea that abortion is something that is so wrong that only in the most severe cases should it be allowed.

        • larry birnbaum says

          I just don’t agree. People on the pro-choice side who want to see exceptions in cases of maternal life or health or more critical to the point in cases of rape or incest written into laws that put a burden on people exercising their right to an abortion aren’t implying, logically or morally, that they are OK with the burden in the general case, or that they have ceased to advocate that all people should have those rights. And in fact none of them, as far as I know, are OK with this or cease to advocate that the burden is wrong in general.

          On the other hand if you believe that a fetus is a person, and that abortion is murder, you might similarly decide you have to live with this for political reasons, even as you continue to insist that it’s wrong. But that’s not what’s going on here. This isn’t a compromise between sets of people who both think there’s something wrong with the compromise. The fact is that a lot of people who are against abortion generally aren’t against it if the pregnancy was a result of rape or incest. The compromise is INSIDE them as individuals as it were, not externally in the political world. In fact I believe they don’t even view it as a compromise, they view it as the right position, the morally optimal one as it were. But that can only be true if there’s something else motivating your belief that abortion in general is wrong or that people should bear some additional societally-imposed burden, some stigma, for exercising their right to have one — something other than the belief that a fetus is a fully-fledged human being. The burden being imposed and the nature of the exception both make it clear what that underlying belief is — viz., that the woman has done something shameful and must be made to feel shame.

  2. politicalfootball says

    I assume he meant to make fun of consumer protection, rather than defending the forced vaginal penetration law

    There’s simply no evidence for this whatsoever. If he’s snarking about consumer protection, what’s he trying to say? That the recipients of consumer protection rightly find it invasive? Huh?

    No, his langauge is unambiguous, and if his language were ambiguous, his record is clear. Cowen is like most libertarians: more than happy to have the government insert objects – even bullets – into people, as long as it’s clearly other people and not him or people he identifies with.

    If he eventually offers an apology, then you’ve got some grounds to pretend he didn’t mean what he clearly meant – but you’d still be pretending. As it is, though, Cowen likely won’t even feel the need to even appear remorseful, because people in the Civility-Based Community are only too willing to ignore reality and give him the benefit of the doubt even when there is no doubt.

  3. politicalfootball says

    I mean, you can call the Virgnia governor and and the bill’s sponsor “dimwits” because at least they have enough decency to pretend to be idiots once their villainy is exposed. But that’s not Cowen; he’s not even pretending to be something other than contemptible.

    If you genuinely prize civility over decency or factuality, you’ve still got to insist that people behave in a minimally civil fashion. Otherwise, you’re not asking for anything of your fellow citizens.

  4. Freeman says

    If anyone is still unsure what the controversy’s all about, here’s a picture of the device, (dubbed “Blue Phantom”). And before the Red Team pipes up with “but it’s not any more invasive than the abortion procedure”, check here for the facts about 1st-trimester procedures, which are the only ones where the transvaginal ultrasound would be used.

    That said, I agree that politicians have no business requiring ANY unnecessary medical procedure for ANY reason. The Libertarians should be all over this, but a lot of them are defending it. If this isn’t an example of the horrible evil of government-run health care, what is? Partisans (on both sides) have incredibly elastic situational ethics.

    I’m not saying the Democratic Party is much better, but the Republican Party has a tendency to defile everything they touch. Libertarians should have seen how things have gone for the Christian Right before they decided they needed the weight of a major party to align with instead of keeping to their own ideals. “They shall know we are Christians by our love” gets subverted when the most vocal among them are putting partisan concerns above the teachings of their faith, convincing themselves the two are in alignment, and demonstrating anything but an attitude of love in the process. And now the Libertarian message of defense of individual liberty is subverted as well. Can’t say I’m surprised to see it.

    I’ve always been an independent voter, and I used to lean heavily Libertarian. Not so much any more. Like the old saying, I didn’t leave them, they left me. These days I’d be ashamed to identify as a Libertarian or a Christian, precisely because of what their alignment with the Republican Party has done to their public image.

  5. Freeman says

    BTW: Loved this little bit of snark: because they ought to feel what it’s like to have Republican policies actually applied to you

  6. says

    I think if Mark checks the history of commentary of Tyler Cowen, Mark might revise his charitable comment about that particular commentator. Cowen’s refusal to inquire about the nature of a first trimester procedure is par for his political golf course. He and Todd Zawycki are prime examples of the dumbing down of the discourse on the libertarian and right wing side of the political ledger.

    Unlike those two commentators, David Frum is neither shallow nor unthoughtful. He knows what’s happening and what the motives are in this latest sexual political issue. See here:

    http://www.thedailybeast.com/articles/2012/02/09/the-contraception-fight.html

  7. Freeman says

    Apparently the dimwit Republican legislator who sponsored the bill – a woman, as it turns out – has said that she didn’t understand what her bill would require of women seeking abortions. The dimwit Governor, hoping for a spot on the Republican national ticket, says that he, too, supported the bill without knowing what it was about.

    Wait, what??? Their excuse is that they gave uninformed consent to a bill that they claim is all about requiring informed consent? There goes another irony meter.

  8. Paul Gottlieb says

    Cowen’s remark was one of those self-revealing moments when a man suddenly lets you see the utter darkness of his soul. I’m sure that he has acquaintances and colleagues who never suspected what was hidden behind his seemingly normal facade. Now they know, and so do we

    • Barry says

      I’ve watched Tyler Cowen (whom, by the way is frequently a hack, and is a paid Kochist) snark what he snarked, I’ve watched Megan McFullofit McArdle go full statist (until her Koch masters told her to go back to climate lying), and seen Gene Healy write a destruction of Santorum which didn’t mention his sexual politics (guess CATO doesn’t care about that, because their corps don’t care).

      My conclusion about this is the that the professional libertarian movement is really just a fraud.

  9. bobbyp says

    Cowen is an idiot. A fully informed consumer would stick a probe up the doctor’s rear to verify their medical competence to perform the procedure she (that would be the customer, Tyler) already knows she wants.

  10. kevo says

    I agree: A vote for a Republican is a vote for the Tyranny of the Dimwits! Nobody deserves the hurt the Tea Partyers are aput’n on the rest of us!

  11. Benny Lava says

    You should focus on this sentence more: “In Virginia, it was the Tea Party faction in the legislature that pushed this bill.”

    In fact the Tea Party has set a record for abortion legislation. Remember when the Tea Party claimed that they weren’t social conservatives but fiscal conservatives? You and I knew that it was shallow rebranding, but with the internet a “reality based” person like you can simply gather the quotes and youtube clips and compare their rhetoric with reality. What happened to the fiscal conservatives in the Republican Party? I believe they always were illusory. Why else would people who advocated for the individual insurance mandate in the 90s suddenly demonize it?

  12. chrismealy says

    Tyler Cowen is as interesting as a plain old college sophomore econ major. He’s nearly as bad as McArdle. I can’t figure out why so many liberal bloggers let him get into their head. He also works for the worst people in the world, the Koches.

    I made a little rule for myself: write off anybody who says how smart Tyler Cowen is. I ditched Yglesias and Ezra Klein in 2010 and 2011, but I let this blog slide for a long time because it was my favorite. I give up.

    • MobiusKlein says

      I think you are wrong about Yglesias / Klein – they are at least worth disagreeing with. Well, I’m reading the big Y less, but mostly caus I’m tired of the teacher bashing & park bashing.

      • Andrew Sabl says

        chrismealy: “Smart” is not the same thing as “right.” You’ll find that a great deal of the time when I quote Tyler–which is not that often anyway–it’s either on a non-policy topic or in order to say that he’s wrong about something. But when he is wrong, he has often articulated something in a clear and clever way that makes it possible to see why it’s wrong. It’s not in my opinion a good idea to judge bloggers by whom they quote as opposed to what they say. That’s a recipe for ending up as far inside a left-wing echo chamber as conservatives are inside their right-wing one.

        I would stress that I don’t regard this as an instance in which Tyler said something either clear or clever. I originally missed his comment on the ultrasound but don’t dissent from the view that it was extraordinarily callous and unhelpful. Of course if he explains and apologizes–perhaps he intended some arcane reference not suited to Twitter (though in my mind that’s a good reason to lay off tweeting it)–I’ll consider what he has to say.

        • politicalfootball says

          See, this is what I’m not getting. What has Cowen done to deserve the benefit of the doubt? And what doubt is there? What was ambiguous about his comment?

          As for his tweet not being “clear and clever,” what has he ever said that was more clear? What has he ever said that was more clever? This is an entirely clear and at least middlin’ clever way of expressing contempt for women who seek abortions and people who favor providing consumers with information. People who say loathsome things with style have always been okay in a certain type of elitist polite society, but those who value genuine decency are going to push back against it.

          • Andrew Sabl says

            I don’t think it is ambiguous. I think it’s disgraceful. The fact remains that if, contrary to all appearances, he has something to say for himself, I’ll be prepared to listen to it. I only mentioned the (admittedly unlikely) possibility because so many people here seem determined not only to judge Tyler harshly–which he fully deserves on this one–but to rule out in advance anything he might say to alter that judgment, and (see Barry just below) to tar by association anybody who thinks Tyler may have something to say on other subjects.

        • Barry says

          “It’s not in my opinion a good idea to judge bloggers by whom they quote as opposed to what they say. That’s a recipe for ending up as far inside a left-wing echo chamber as conservatives are inside their right-wing one.”

          Bull. If they quote people who have clearly discredited themselves, then the quoter is joining on in.

      • larry birnbaum says

        I got fed-up with his totemic Israel-bashing, which managed to combine being boring and disingenuous.

  13. sd says

    The only problem with your narrative is that, according to one DC-area Planned Parenthood official recently interviewed, that organization requires vaginal ultrasound of all patients receiving an early term surgical abortion via their standards of care:

    http://www.commentarymagazine.com/2012/02/22/planned-parenthood-abortions-ultrasounds/

    Key graphs:

    ““That’s just the medical standard,” said Adrienne Schreiber, an official at Planned Parenthood’s Washington, D.C., regional office. “To confirm the gestational age of the pregnancy, before any procedure is done, you do an ultrasound.”

    According to Schreiber, Planned Parenthood does require women to give signed consent for abortion procedures, including the ultrasound. But if the women won’t consent to the ultrasound, the abortion cannot take place, according to the group’s national standards.

    Schreiber said there are several options at that point. If the woman is uncomfortable with a transvaginal ultrasound, which is more invasive, she can wait until the fetus is large enough to opt for a transabdominal ultrasound.

    “But if she’s uncomfortable with a transvaginal ultrasound, then she’s not going to be comfortable with an equally invasive abortion procedure,” Schreiber told me.”

    This is consistent with a 2003 study, which generally found the same thing on a national basis:

    http://www.lifenews.com/wp-content/uploads/2012/02/ultrasoundstudy.pdf

    So if you still think that its akin to “rape” to require a vaginal ultrasound before an early-term abortion procedure (Note to self: call the police to report widespread rape at Planned Parenthood clinics), then I’ll be very happy to support a compromise law that should smooth over your concerns: Namely, I’d be very happy to support a law that simply said that IF an ultrasound (vaginal or abdominal as the case may be) is performed prior to an abortion procedure that the provider of the abortion is required to show the ultrasound image to the patient receiving the abortion before moving forward with the procedure. No required medical procedure whatsoever, just a requirement that the patient be provided in real time with the fullness of diagnostic information already being collected.

    Somehow I doubt that PP would be thrilled about that though. After all – a very large % of the organization;s clinical income derives from making sure that women who come in requesting elective abortion go through with the procedure.

    • Freeman says

      repost, eh?

      After all – a very large % of the organization;s clinical income derives from making sure that women who come in requesting elective abortion go through with the procedure.

      Framing. A very small % of the organization’s total income derives from abortion procedures. Abortion is also a very small % of the organization’s total services offered and provided. You want to limit the debate to clinical income because abortion services and bundled services attached to those abortions (which you are no doubt counting in your assessment) are among the most expensive services offered by PP, thereby pushing the percentage equation upwards. Abortion and related services obviously cost a lot more than contraception and pap smears. They also cost a lot more to provide. Are you insinuating that PP has some great profit margin in the area of abortion services that they would wish to protect? Prove it!

      • sd says

        Yes repost – as noted on the other thread.

        I’m not implying that abortion is a source of “profit margin” for PP – that would be wrong insofar as PP is a non-profit entity. But even non-profit entities, concerned as they tended to be with their own growth, power and security, are motivated to keep their revenue streams flowing.

        You are correct that clinical income is not the whole of PP’s total income. But its a very sizable chunk. PP gets a lot of government money and a lot of charitable contributions, but the income it derives from clinical services is significant. Indeed the typical PP clinic would likely need to downsize significantly if it dried up. And abortion services are almost certainly a very large % of clinical income, given that, as you point out, the price point on an abortion is much higher than the price point on the other things that a PP clinic does.

        The often-repeated factoid that “only 3% of Planned Parent’s services are abortions” is thus deeply deceptive. Yes, if you count a surgical abortion costing hundreds of dollars as “1 service,” while you count 12 months of contraceptive pill refills with a combined cost of ~$100 as “12 services” you are likely to show a count of abortion services that is small relative to “total services”. And yes, if every patient who comes in for an abortion is also given, as a matter of course, a pregnancy test, a blood test for STDs and a go-home package of condoms (each of which separately counts as “1 service”), then you are similarly likely to show a count of abortion services that is small relative to “total services.”

        But organizations know where their money comes from and act accordingly. Say I owned a car dealership. And in my car dealership was a Coke machine. And let’s say that 40% of people who came through the front door bought a Coke, while only 10% bought a car. I could in theory say that cars are only “20% of the products I sell.” But I assure you that my behavior would not be driven to optimize the number of Cokes I sold.

        • Freeman says

          But organizations know where their money comes from and act accordingly. Say I owned a car dealership. And in my car dealership was a Coke machine. And let’s say that 40% of people who came through the front door bought a Coke, while only 10% bought a car. I could in theory say that cars are only “20% of the products I sell.” But I assure you that my behavior would not be driven to optimize the number of Cokes I sold.

          Why not? Because you make much more profit from the car sales. How does this analogy fit a non-profit organization with a humanitarian purpose? Answer: Not at all!

          Now let’s say anyone coming to buy one of your cars has to run a gauntlet of angry protesters making moral judgments on their exercise of free will, nobody really wants to have a car but some people find themselves in a situation where they deem having one is their least objectionable option, you’re willing to supply expensive cars without a profit incentive and in the face of much political opposition only because if you don’t they will try to make their own cars out of coat hangers risking serious injury or death, and Coke, if taken as prescribed, can eliminate the need for cars in the first place. Now, how does that factor into your behavior? Tell the truth now!

  14. kathleen says

    If they’re all about “informed consent,” they should require that pregnant women be informed that pregnancy is more dangerous to their health than abortion and that pregnancy has the higher mortality rate.

    They should also require that pregnant women be shown videos of: a C-section; an episiotomy; a woman in prolonged labor; toddler and teenager temper tantrums; and that they be given a spreadsheet of 18+ years of costs.

    In fact, there is NO interest in “informed consent”; they are just trying to vastly increase the dollar cost (and time cost) of abortion, to the point that it’s not an option. Transvaginal ultrasounds are expensive, as well as being state-ordered rape–”penetration with a foreign object”–and difficult to schedule in time (I waited a few weeks for a medically-indicated one, in large urban area, and it cost nearly $1000.)

    I wonder what they’ll come up with next. When a front-runner presidential candidate refers to rape-caused pregnancy as a “gift from God,” something is wrong with the society.

    • Democrat 4eva' says

      And thus, with just 2 sentences (the 1st 2), the “informed consent” / “informed consumers” argument has been slayed. Nicely done.

  15. Democrat 4eva' says

    I was about to point to the 2003 article sd cites, but that is no longer needed. (Starting with a proper empirical picture is generally a good thing.)

    Of course, whatever term we use (‘rape’ or something else), we are constantly reminded (correctly) by those on the right that it is one thing for someone to agree to something in the context of a private transaction, and something completely different for the government to require it. I would guess that over 99% of people getting their teeth pulled use novocaine; yet I can’t imagine anyone supporting a law that requires the use of novocaine when getting a tooth pulled. I’m not saying that that comparison provides a slam-dunk argument against the VA law; just saying that simply because the procedure is extremely common does not morally (or legally) justify requiring it.

    What should be getting more discussion is a very similar law in Texas — as far as I can tell one that does require the transvaginal ultrasound — that has been OK’d by the 5th US Circuit Court of Appeals:

    http://www.msmagazine.com/news/uswirestory.asp?ID=13472

    • Anomalous says

      There has been mention of the Texas law in media with a bewildered, ‘how come nobody cared then?’ After a blink and a shrug they move on.
      I think the difference is that Texas is, well TEXAS. No surprise with Texas doing something grosesque and mean spirited. The media perception of Texas is: third world, anybody fool enough to live there deserves what they get. But Virginia crosses into the DC beltway teritory. National media movers and shakers live there. Now even well insulated men are forced to think of wives, daughters and sisters being traumatized when they are vulnerable. That’s very different.

  16. Andrew Laurence says

    A colleague told me his wife was required to undergo amniocentesis even though she would never consider aborting even the most horribly deformed fetus due to their religious beliefs. I suspect this was (a) untrue, or (b) a Kaiser requirement rather than a legal one, but either way it seems pretty pointless. Amniocentesis carries risks and provides no relevant information for the radically anti-abortion woman.

    • larry birnbaum says

      I suspect your colleague is hallucinating. Or, alternatively, his wife wanted the amnio and fed him this baloney.