Wednesday, November 30, 2005

The elected legislature in New Hampshire has passed a law requiring "parental notification" and a 48 hour waiting period before a minor could get an abortion. Pro-abortion advocates are up in arms and have sued, claiming the law doesn't provide for exceptions to protect the health of the mother.
The New Hampshire case is being closely watched by the dozens of states that require minors to tell a parent or get permission before having an abortion.

Justices were told that 24 states mandate a parent's approval and 19 states, including New Hampshire, demand parental notice.

The court is considering whether the 2003 New Hampshire law puts an "undue burden" on a woman in choosing to end a pregnancy. O'Connor is an architect of the undue burden standard, and was the deciding vote in the last abortion case five years ago, when justices ruled that a Nebraska law banning a type of late-term abortion was too burdensome.

That law, like the one at issue Wednesday, did not have an exception to protect the mother's health. New Hampshire argues that exceptions are permitted when the mother's health is at risk, and that should be enough.

The law requires a parent or guardian be notified when an abortion is planned for someone under 18, followed by a 48-hour waiting period. A judge can waive the requirement.

"In an emergency, a woman needs to go to the hospital not a courthouse," justices were told in a filing by Jennifer Dalven, attorney for Planned Parenthood of Northern New England which challenged the law.
Without specific comment on the subject of abortion, I would like to discuss the concept of abortions to save the life of the mother and the concept of emergency care.

I am at a loss to imagine a scenario whereby a normal intrauterine pregnancy is dangerous to the life of the mother or an emergency scenario involving a normal intrauterine pregnancy that would be treated with an abortion.

In today's world of emergency medicine, if a minor presents for medical care with a life threatening condition, she would be treated even if the guardian could not be reached. In the ED, we are careful to get, at a minimum, phone consent before treating non-life threatening things, but if a minor presented in extremis with a ruptured appy, for example, she would be given the appropriate life saving treatment.

I can't imagine any "emergency" condition of pregnancy that would be treated with an abortion, anyway. What are the "emergency" conditions of pregnancy, anyway? Uterine rupture, ectopic, abruption, hemorrhage, for example. None of these are treated with abortion.

So, if we cannot identify an "emergency" condition of pregnancy that would be treated with an abortion and no "life-threatening" condition of pregnancy that could not wait for parental notification, what's the problem?

The abortion advocates just don't want any restrictions on abortion at all. What's so special about abortion, anyway?

The abortion advocates object to spousal notification before an abortion, because "it's the woman's body to do with as she wishes." So telling a man that his pregnant wife is about to abort his child violates her right to privacy. If the objection to parental notification is that this violates the child's right to privacy, where does this right come from? Where does this right end?

Again, what so special about abortion, anyway? Name any other surgical procedure where a physician isn't required to get parental consent. Heck, I can't prescribe antibiotics for strep throat or give Tylenol to a minor for a headache without parental consent. This law doesn't even require parental consent, just parental notification.

Perhaps New Hampshire should just state that any physician/medical provider that wishes to provide medical services/treatment to a minor must obtain parental consent, unless there is a reasonable opinion that the delay would result in irreparable harm to the minor.

Above, I quoted Jennifer Alven stating, "In an emergency, a woman needs to go to the hospital not a courthouse," Referring to the option of judicial consent, as opposed to parental notification. In an emergency, there is not requirement to present to a courthouse. As an ER doc, I would call the judge on the phone and get consent to treat that way. Meanwhile, it is my understanding that presentation to an ER with a life-threatening condition is implied consent to treat, at least to stabilize the emergency condition.

If anyone out there can identify an emergency condition of pregnancy for which an abortion is therapeutic, please let me know. I'm not talking about induction and delivery, like for a severe abruption, but an abortion, as it is commonly considered.