So, over on Feminist Philosophers, I claimed that health carers have an ethical problme: Whether to comply or defy the various unnecessary ultrasound (and other horrible) laws. Amanda Marcotte argues that it’s not much of a dilemma:
The anon doctor suggests that abortion providers reject the mandatory ultrasound law by refusing to do it, and doctoring patient files to make it look it was done, if necessary. This is characterized as “civil disobedience”, but it’s really not in the same way that getting arrested at protests for moral but illegal trespassing is. Civil disobedience works best if it has a public component, to draw attention to your issues in hopes of changing the law. Privately doctoring files doesn’t accomplish that.
While it’s always theoretically possible that doctors who do this will get away with it, the result if they get caught will not be that they generate outrage in a complacent public and get the law changed. No, they’re probably just going to get their license stripped, and be unable to perform legal abortions. Which is what anti-choicers want. They would be delighted if doctors refused to obey the law, and could be stripped of their licenses. Giving the oppressor what they want most in the world isn’t effective action. It is, in a word, counterproducitive. The reason anti-choicers pass laws like this is, I believe, they know that women will jump through any hoop to get rid of an unwanted pregnancy, and they want to maximize the pain and suffering of the whole ordeal. Pro-choicers should take that knowledge and realize that depriving women of safe, legal providers is about the worst possible thing you could do under these circumstances. Yes, a non-consensual procedure is a horrible thing, but if you look at the choices women make, not being able to get a safe, legal abortion is more horrible.
Let’s distinguish the question of whether doctor non-compliance with such laws is effective civil disobedience from whether the doctor ought to perform the unnecessary mandated procedure. Clearly, many doctors are not culpable for being required to perform the unnecessary procedure (which, as many have pointed out, meets many legal definitions of rape (I’m being rather more neutral than I feel about this; it’s sufficient to cause an ethical problem that the procedure is invasive, unpleasant at best, not medically required, not otherwise helpful to the patient, and not desired by the patient): They didn’t support the law.
I think it’s clear that the medical profession as a whole is not responding vigorously enough. These sorts of regulation should be toxic and cause systematic outcry from the profession. But given that that’s not happening and that it’s not clear if it would change anything, what should the provider do? Marcotte claims, I think correctly, that many women seeking abortion will prefer to undergo the unnecessary, abusive procedure and get the abortion to not getting the abortion. That women got tremendous numbers of truly horrible and highly risky back alley abortions under the criminalization regime certainly supports that.
And maybe that’s enough. It must surely take a fairly tough psychic toll on both the patient and the doctor. Maybe the doctors get used to it, I don’t know. But it’s hard to blame doctors for choosing other specialities. Even putting aside the threat to their lives, it takes a very tough person to deal with being compelled to do this sort of awful thing in order to help people. (And, of course, this is part of the point of such laws.)
So maybe the dilemma isn’t there. Maybe the right thing is clear and it’s just hard. Awful.