by Terry Bellamak
National MP Harete Hipango spent last week peddling the myth that because we reformed our abortion laws, people will get abortions right up until birth. It follows that she does not trust health practitioners or pregnant people.
Those who followed the abortion debate last autumn will be aware that pregnancies that last 20 weeks are most likely wanted pregnancies, and that sometimes they must end because of a medical crisis. Those who paid attention will dismiss Hipango as an anti-choice extremist. But her lack of trust in health practitioners is not unique.
Parliament itself has shown it does not trust health practitioners to practice medicine without input from lawmakers, at least when it comes to reproductive health. If they did, they would leave them to it, like they do for other medical specialties.
This is not optimal. When lawmakers try to practice medicine, it never ends well. This is because lawmaking and medicine have fundamentally different alignments.
Medicine is individual – doctors make decisions about the individual person in front of them, the patient, based on their unique circumstances. What is right for one person may not be right for another person, even in an identical situation. The job of a doctor is to serve both of those patients in the best way possible for them as individuals, even if it means treating them differently.
Lawmaking is focused on aggregations of people, broad groups for whom they make rules. The rules are general and apply to everyone in the designated group. The law has a natural propensity to treat two people in similar circumstances the same, whether it is best for them or not.
This is why hard cases make bad law. The majority of people in a group may be served, or at least not harmed, by the rules affecting that group. But people at the edges may find the rules work against them in ways lawmakers did not intend.
For example, let’s say Parliament decided no abortions would be permitted after 20 weeks unless the pregnant person’s life was in danger. So if a foetus’s lung development was compromised such that it would asphyxiate shortly after birth, the parents would be required to give birth at the natural time and watch their baby die.
For some parents, this would be their choice – a chance to meet their baby and hold it while it receives palliative care to ease its passing. But other parents would rather spare their child suffering by ending the pregnancy. For them, it would be a nightmare to carry their child to term knowing they would have to watch them smother to death.
And just how close to death would the pregnant person need to be to allow abortion after 20 weeks? In Ireland, before the 8th amendment was repealed, abortion was allowed to save the mother’s life. But that did not save Savita Halappanavar – doctors did not understand or trust the law. So they let Savita die.
It turns out doctors are just as bad at practicing law as lawmakers are at practicing medicine.
Tempting as it might be for lawmakers to jump in and make medical decisions themselves by passing laws, the result is not good medical care. It forces a one-size-fits-all approach to decisions that should be tailored to the person or persons involved.
ALRANZ Abortion Rights Aotearoa deplores the statements of National MPs Harete Hipango and Simon O’Conner on Facebook, alleging New Zealand’s reformed abortion legislation allows full term babies to be aborted.
“What they are saying is wrong on so many levels,” said ALRANZ president Terry Bellamak. “In the first place, abortion is about embryos and foetuses, never babies.
“In the second place, the old legislation also allowed abortions after 20 weeks. But here’s the important thing: a pregnancy that lasts for 20 weeks or more is a wanted pregnancy. If that pregnancy has to end in abortion, it’s because the pregnant person’s health is in danger, or the foetus has a fatal anomaly.
“If the foetus is viable, the health care team waits as long as possible to give it the best chance of survival before inducing labour. When a foetus proceeds from the uterus in a living state, that is called ‘birth’.”
Prime Minister Jacinda Ardern, when asked for comment on Hipango’s post, gently suggested it would be better if MPs based their views on facts.
Justice Minister Andrew Little was blunter, calling Hipango’s comments “silly.”
He added, “If Judith Collins is happy to have a bunch of radical, anti-abortion extremists running the show on social media, that’s a matter for her.”
Bellamak concluded, “This kind of scaremongering insults the intelligence of everyone they expect it would work on.”
New Zealand reformed its abortion laws in March of 2020, decriminalising the procedure and aligning it with other health care.
by Terry Bellamak
The United States Supreme Court has struck down Louisiana’s law requiring abortion providers to have admitting privileges at local hospitals – a requirement made both unnecessary and impossible to fulfil by the very safety of early medical and surgical abortions. To maintain such privileges, doctors have to admit a certain number of patients each year, but complications requiring hospitalisation are extremely rare – too rare to maintain their admitting privileges.
If the facts of the case sounds familiar, well spotted. This law is almost identical to the one the Supreme Court struck down in Whole Women’s Health v Hellerstadt in 2016.
Chief Justice Roberts cast the deciding vote. But please, don’t make the mistake of imagining for a minute that this means his heart is in the right place. His concern is not for anyone’s bodily autonomy or moral agency, but for his court’s standing in the eyes of the world, and its legacy in the eyes of history.
Roberts cast his vote on the strength of stare decisis – the legal principle that courts should decide similar cases in similar ways, so that people can have a reasonable expectation they know what the law is. The Supreme Court reversing itself in such an obviously indistinguishable case would have brought the court into disrepute amongst those who still believe legal principles should not give way to political considerations, at least in the courts.
Abortion cases that arrive on the court’s docket in future may not fare so well. American conservatives, like those on the court, seem hell-bent on returning the USA to the 1950s. As Mary Ziegler notes in her New York Times op-ed of 29 June 2020, modern conservatives demonstrate
“a candid willingness to ‘legislate morality,’” including in cases of abortion, sexual liberties, free speech and contraception.
Some are attacking Roberts and the court for not having overturned Roe v Wade already.
But with this decision, defenders of reproductive rights live to fight another day.
by Dame Margaret Sparrow
I first met Rex soon after the opening of the Auckland Medical Aid Centre in May 1974. It was a great relief to those of us who were having to refer women to Australia at that time and I wanted to see for myself to where I was referring patients. I was impressed with his openness and humility and greatly admired his initiative in establishing the clinic. It was a courageous act in the face of huge opposition. As a lecturer in Community Health he had been asked to identify issues that needed attention and he identified two – homosexuality and abortion. But he didn’t just identify a problem, he did something about it.
Rex preferred to be independent and never joined ALRANZ but was always supportive. He had the support of a number of ALRANZ members: inaugural President Isobel Stanton worked at the clinic as social worker, counsellor and supervisor, ALRANZ secretary Anna Watson became clinic administrator and Professor John Werry became an operating doctor.
It was frustrating when the clinic was raided by the police in September 1974 and even though the confiscation of patient files was later deemed illegal, police were able to use the files for prosecuting the operating doctor, Dr Jim Woolnough. Twelve selected cases were brought to trial and as I was involved I saw more of Rex at this time. He was stalwart in defence of the clinic and had always maintained high professional standards. He introduced suction curettage, sending Dr Woolnough overseas to learn this technique. He was the first to introduce abortion counselling and this remained a priority. After two High Court trials, the first resulting in a hung jury, Dr Woolnough was acquitted and the not guilty verdict was upheld by the Appeal Court.
Then came the Royal Commission and the December 1977 legislation which closed AMAC because of the Wall clause “and the danger cannot be averted by any other means”. We were back again referring women to Australia until the law was modified in July 1978. However even then there was a legal battle to restore the licence to AMAC and this did not happen until August 1979. Having endured all the upheavals of the 1970s it was understandable that Rex then moved on to other less controversial areas of medicine. Rex was respected and admired and an inspiration to those of us who followed in his footsteps.
He wrote of his strict upbringing and how difficult it was for him to come to terms with abortion but how “gradually I came to realise that only the woman herself can know the correct course of action.” New Zealand women owe a great debt to this very caring physician. His death cannot pass without paying a tribute to his long lasting influence.