Ethics question on abortion?

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ranviernode

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I have an interview coming up and am reviewing some ethical questions. If an ethical question came up asking whether you would give a minor an abortion without parental consent, yet the particular state I am interviewing requires parental consent by law, should you answer the question in terms of what the state mandates or should I answer it based on my opinion or would it be better to address both viewpoints?

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I think the right answer is to follow the law. In this case, no ones life is at risk. As Docs, we don't get to pick and choose which laws we want to follow and which we don't. No adcom will choose someone who is willing to break the law in order to satisfy their personal morals. Don't like the state's laws? Then move.
 
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legality is a different thing than morality.

true but laws follow ethical trends (of course there is a lag in their time frame because laws have to be updated through a generally rigorous process)
 
You need to find a balance between following the law and being an advocate for your patient. Each ethical scenario bears some unique problems that's why no two scenarios can result in the same outcome given differences in variable. What you should do is to stick with what you think is right based on what information you have. Interviewers want to see an applicant with a strong conviction and who will stick with it, not one who will be easily swayed by a slight obstacle.

My advice: research the situation on the internet and form your own views about it and be able to defend it. Not only will this make you unique to the interviewer (no cookie cutter answer) but it will impress them enough to have something to talk about to the committee.
 
say you would be obligated to follow the laws, but that you do what you could to help the patient in other ways. Counseling to help her tell her parents, inform her of all her options, etc.

The law is the law and you won't be practicing long if you choose not to follow it. Since everyone's opinions vary on abortion I think the interviewer is more looking for you to say you'll do what's legal, but you'll do what you can to help the patient in a way consistent with your own morals while still doing what is legal.
 
IMO in this situation the minor IS the parent. The parents of the minor are the grandparents.

Also, if parents can force their daughter NOT to abort HER kid, can they force her to have an abortion if she doesn't want one?

You should always follow the law, but it's a sticky situation fo sho.
 
I have an interview coming up and am reviewing some ethical questions. If an ethical question came up asking whether you would give a minor an abortion without parental consent, yet the particular state I am interviewing requires parental consent by law, should you answer the question in terms of what the state mandates or should I answer it based on my opinion or would it be better to address both viewpoints?

both are relevant!!! It's more impressive if you know the law but also have a differing opinion.
 
The easy answer is to follow the law - however, you may be faced with a follow up question regarding your own personal beliefs and feelings.

There is no blanket response - the issue is highly charged with emotions and religious convictions. In the end, you can only do what is applicable with the law and your own views.

If abortion is something you struggle with, it would be best to choose a field without the possibility of facing those views.
 
I was asked in a couple interviews this year about abortion, and all interviewers seemed very pleased to hear the truth spoken with conviction. Obviously be yourself and tell the truth in all interviews, so say exactly what you would do, I really don't see the problem this question poses for anyone in an interview. Say, "The law prohibits it and I (dis)agree with the law because..." If you have an opinion on beginning (and end of) life issues, that's what they want to hear, and if you don't have an opinion on these issues, you better re-think your decision to attend medical school.
 
I was asked in a couple interviews this year about abortion, and all interviewers seemed very pleased to hear the truth spoken with conviction. Obviously be yourself and tell the truth in all interviews, so say exactly what you would do, I really don't see the problem this question poses for anyone in an interview. Say, "The law prohibits it and I (dis)agree with the law because..." If you have an opinion on beginning (and end of) life issues, that's what they want to hear, and if you don't have an opinion on these issues, you better re-think your decision to attend medical school.
Not really true. My opinion follows the law because that protects my license. That's all that matters.
 
Not really true. My opinion follows the law because that protects my license. That's all that matters.

Sorry, but adcoms want to see who you are and that you're not some pre-med drone that has no opinions and are just like everyone else applying. Nobody's opinions follow just the law, that is ridiculous. There is such a thing as absolute truth, not everything can be relative. Your opinions are based on your understanding of absolute truth, not some changeable law. You may obey the law because that protects your license, but by no means does your opinion HAVE TO follow the law for you to keep your license.
 
Hrm good question. Consult Lolcats

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PERFORM!
 
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If the law said that you could not perform an abortion under circumstances x, y and z, you would be putting your license in jeopardy to do an abortion under those circumstances -- even if you thought that the law was unjust.

Likewise, current US law prohibits employers from requiring employees to take part in an abortion if it is contrary to the employee's conscience. There is an OR nurse in NYC who has a case against her employer right now on this issue. Forcing your employee to take part when they have stated a moral objection would be a problem. You can think that the law is an ass but you would be wise to follow the law.

On the other hand, if the law permits an activity but you choose not to engage in that activity you are not failing to follow the law but you are recognizing that while the activity is not legally prohibited, you would not choose to engage in that activty. There is a difference. Furthermore, conscience laws still hold in the US such that physicians are not required by law to perform abortions or to refer for abortion. People may tell you otherwise but that is the law (Weldon Amendment).
 
The correct answer is to always follow the law.

You can then go on to discuss how you disagree with said law and how you might try to find work around the law solutions but I can't imagine anyone liking an answer of "I'll break the law".
 
Sorry, but adcoms want to see who you are and that you're not some pre-med drone that has no opinions and are just like everyone else applying. Nobody's opinions follow just the law, that is ridiculous. There is such a thing as absolute truth, not everything can be relative. Your opinions are based on your understanding of absolute truth, not some changeable law. You may obey the law because that protects your license, but by no means does your opinion HAVE TO follow the law for you to keep your license.
That's a nice lecture about the process to someone who went through it now 3 years ago.

You don't need to be a drone, but you should acknowledge that 100% you follow the law and exhibit common sense. In these ethical situations, check your idealism at the door. This will be addressed in your med school classes.
 
As far as abortion in general,

Is it morally inconsistent for me to say I would not take part in abortion, but I would refer a patient to someone else who would?

This seems like a reasonable stance to have, but if you really analyze it I think its somewhat logically inconsistent to claim its moral to pass what your judging an "immoral" act to someone else.


Any help here? Because I wouldn't take part in an abortion, but I would definitely refer a patient to someone else if they asked me to. I feel like in real life almost nobody makes decisions based on arguments that would hold up to rigorous philosophical testing, so what should I say?
 
As far as abortion in general,

Is it morally inconsistent for me to say I would not take part in abortion, but I would refer a patient to someone else who would?

This seems like a reasonable stance to have, but if you really analyze it I think its somewhat logically inconsistent to claim its moral to pass what your judging an "immoral" act to someone else.


Any help here? Because I wouldn't take part in an abortion, but I would definitely refer a patient to someone else if they asked me to. I feel like in real life almost nobody makes decisions based on arguments that would hold up to rigorous philosophical testing, so what should I say?

I think that this is not wrong to say. My opinion obviously, but it is so much better to say you're not able to do something for a patient but will send them to someone who can rather than say you're not able to do something for a patient and aren't willing to help them at all.

Granted, I'm very pro-choice and think since abortion is legal, if a patient wants one, physicians should at the very least be able to point them in the right direction. I think it's a perfectly okay answer to say you yourself don't think you can do the procedure, but want to care for your patients and keep them safe, therefore are willing to refer.

Beyond the ethics of it (and I know it is difficult for many to see past it), if you are not trained to provide abortions, you won't do them. Just like if you are not trained to do something like a joint aspiration, you won't do them and you refer to someone else. Should be the same thing.
 
I have an interview coming up and am reviewing some ethical questions. If an ethical question came up asking whether you would give a minor an abortion without parental consent, yet the particular state I am interviewing requires parental consent by law, should you answer the question in terms of what the state mandates or should I answer it based on my opinion or would it be better to address both viewpoints?

I kept expecting these kinds of questions to come up in my interviews. Never happened. If it were me I would ask them to specify whether they wanted to know whether I would obey the law or whether I agreed with the law. It is easy for some of the premeds to cry aloud with righteous zeal: "screw the law! I will do what is right for my patient!" It is another thing to have to choose between the 15 year old girl who couldn't figure out how to open the condom wrapper and your wife and kids who are depending on your paycheck, or the bank who is expecting your next loan payment. Obey the law. Don't like the law, then write your congressman, but obey the law.

If they ask you what you would do if the law was not an issue, then be honest. Defend your opinion with reasonable statements and don't knock the other side (since you don't know what side the interviewer is on).
 
It is another thing to have to choose between the 15 year old girl who couldn't figure out how to open the condom wrapper...

Bit pessimistic and one-sided there, don't you think?
 
As far as abortion in general,

Is it morally inconsistent for me to say I would not take part in abortion, but I would refer a patient to someone else who would?

This seems like a reasonable stance to have, but if you really analyze it I think its somewhat logically inconsistent to claim its moral to pass what your judging an "immoral" act to someone else.


Any help here? Because I wouldn't take part in an abortion, but I would definitely refer a patient to someone else if they asked me to. I feel like in real life almost nobody makes decisions based on arguments that would hold up to rigorous philosophical testing, so what should I say?

Personally I've always thought the idea of refusing to participate but refering is inane. The central argument of the pro-life movement is that a fetus is a human life, possessed of a soul, and endowed with all the basic and inalienable rights which that implies. I can understand people who don't agree with that, but agreeing with it and then refering your patient to an abortion provider anyway seems like the height of moral cowardice. "I think you're murdering an innocent child and absolutely refuse to participate, but I hear the guy down the hall is great". What?
 
Personally I've always thought the idea of refusing to participate but refering is inane. The central argument of the pro-life movement is that a fetus is a human life, possessed of a soul, and endowed with all the basic and inalienable rights which that implies. I can understand people who don't agree with that opinion, but agreeing with it and then refering your patient to someone else seems like the height of either stupidity or cowardice. "I think you're killing an innocent child and absolutely refuse to participate, but I hear the guy down the hall is great". What?

As I was saying, from a philosophical sense I probably don't hold a defensible position.

But from an actual human sense, it seems perfectly reasonable to say "I feel this is an extremely complicated situation with valid arguements on both sides, I personally do not feel morally OK performing an abortion. That being said, I can understand how others would reasonably disagree and would not prevent a patient from seeking their counsel or services"
 
I kept expecting these kinds of questions to come up in my interviews. Never happened. If it were me I would ask them to specify whether they wanted to know whether I would obey the law or whether I agreed with the law. It is easy for some of the premeds to cry aloud with righteous zeal: "screw the law! I will do what is right for my patient!" It is another thing to have to choose between the 15 year old girl who couldn't figure out how to open the condom wrapper and your wife and kids who are depending on your paycheck, or the bank who is expecting your next loan payment. Obey the law. Don't like the law, then write your congressman, but obey the law.

If they ask you what you would do if the law was not an issue, then be honest. Defend your opinion with reasonable statements and don't knock the other side (since you don't know what side the interviewer is on).
I have to agree; I really never got ethical questions on my interviews.
 
Just a few quick thoughts on ALL ethical questions:

#1. Always play WITH-IN the law. Breaking the law for one patient may/probably means you can't help countless others in the future.
If you don't know the law, tell them you don't, but that you wouldn't break it. I don't think they really care if you know the ins-and-outs of medical law @ this point in your education.

#2. I'd start EVERY answer to an ethical question with I'd seek advice from another physician--unless you're in some dier emergency situation. Even then, go get advice about what you SHOULD have done in case it ever came up again. Don't take this as me giving you advice to BS an adcom, But in all honesty, if you REALLY put me in a sticky situation, I'm calling up every older doc in the community, and half the people I went to med school with. (Not literally, but you get the point)


A friend of mine said you don't ever have to answer the question, just keep introducing more things to think about. Being a Doctor is about thinking, show them you can think.

The closest I came to an ethical question was something like: You're a 3rd or 4th year, you wrote an order for way too much medicine, and the nurse didn't caught it, and you just realized it...what do you do?
 
#2. I'd start EVERY answer to an ethical question with I'd seek advice from another physician--unless you're in some dier emergency situation. Even then, go get advice about what you SHOULD have done in case it ever came up again. Don't take this as me giving you advice to BS an adcom, But in all honesty, if you REALLY put me in a sticky situation, I'm calling up every older doc in the community, and half the people I went to med school with. (Not literally, but you get the point)
What advice could an older physician give you that would possibly be relevant to the situation at hand? In this case you want a lawyer or a judge, not a doctor, especially considering in most states a minor can avoid consent if she can get court approval. Believe it or not, completing ~7 years of medical education doesn't make you an authority on moral, ethical or legal issues.
 
Personally I've always thought the idea of refusing to participate but refering is inane. The central argument of the pro-life movement is that a fetus is a human life, possessed of a soul, and endowed with all the basic and inalienable rights which that implies. I can understand people who don't agree with that, but agreeing with it and then refering your patient to an abortion provider anyway seems like the height of moral cowardice. "I think you're murdering an innocent child and absolutely refuse to participate, but I hear the guy down the hall is great". What?

I agree with you, but then again like I mentioned above, at least he/she would be looking out for their patient.

Plus, there are some pro-choice people who just don't think they could "handle" doing abortions, or don't want to face the hardships that many providers face. Sure, it means they aren't living up to their convictions, but abortion is a pretty hard thing to do/watch. I mean, something like 2% of doctors nationwide are doing over half of the nation's abortions. No one is actually pro-abortion, and its not like providers don't get emotional over it.
 
If this was the 1950s and this patient's only choice were between a medically-supervised surgical abortion or a backalley coathanger? I would do it, and consider it an act of civil disobedience. 🙁
 
What advice could an older physician give you that would possibly be relevant to the situation at hand? In this case you want a lawyer or a judge, not a doctor, especially considering in most states a minor can avoid consent if she can get court approval. Believe it or not, completing ~7 years of medical education doesn't make you an authority on moral, ethical or legal issues.

Maybe nothing at all. But the 7 years of medical education has nothing to do with it. It's just nice to get an opinion from someone who's done it longer than you. Maybe they've been in a sticky situation. I think people with more experience than you can always offer insight.

I'm assuming at this point, one would know the law, so you're not necessarily needing a lawyer.

And the presented situation doesn't really sound like an ethical issue. It's more or less do you break the law. The minor girl isn't described as in a life or death situation.
 
Bit pessimistic and one-sided there, don't you think?

Why? Because I think that the only justifiable reason for abortion is in the case of rape, incest, or danger to the life of the mother? Because I consider people who view abortion as a means of birth control are arguing for nothing more or less than the right to have unprotected sex w/ people that they don't want to have children with?

Even if I am, it doesn't change the fact that these premeds that are saying "screw the law" have been watching too much TV. On TV such acts are rewarded, in real life, you are fired, sued, and your license is revoked. So congratulations, you enabled an underage girl to escape the consequences of her foolish actions while committing yourself and your family to financial ruin, but at least you kept your principles right?
 
Because I consider people who view abortion as a means of birth control are arguing for nothing more or less than the right to have unprotected sex w/ people that they don't want to have children with?
The majority of abortion patients I have spoken with were using protection that failed, and many of them do want children or in fact already have children.
So congratulations, you enabled an underage girl to escape the consequences of her foolish actions while committing yourself and your family to financial ruin, but at least you kept your principles right?
Is the slut-shaming really necessary? Last I checked there were at least two parties involved in creating the pregnancy.
 
Why? Because I think that the only justifiable reason for abortion is in the case of rape, incest, or danger to the life of the mother? Because I consider people who view abortion as a means of birth control are arguing for nothing more or less than the right to have unprotected sex w/ people that they don't want to have children with?

Even if I am, it doesn't change the fact that these premeds that are saying "screw the law" have been watching too much TV. On TV such acts are rewarded, in real life, you are fired, sued, and your license is revoked. So congratulations, you enabled an underage girl to escape the consequences of her foolish actions while committing yourself and your family to financial ruin, but at least you kept your principles right?

Actually, no. That's not what I was saying. I meant one-sided because you only blamed the girl for the contraception and pessimistic because you posed your answer in a way that sounds like all abortion occurs due to lack of contraception. 50% of pregnancies in this nation are unplanned... many of those women are not 15 and many are actually using contraception that was either misused or failed. So while your opinion on when an abortion should/should not occur is your opinion, I would argue that I highly doubt the good majority of women are using abortion as a form of birth control. Maybe you know some; it's anecdotal. Just as its anecdotal for me to say that the women I've come across/worked with find it an emotional process and weren't just okay as using it for contraception.

FWIW, yes, follow the law.
 
The majority of abortion patients I have spoken with were using protection that failed, and many of them do want children or in fact already have children.

Is the slut-shaming really necessary? Last I checked there were at least two parties involved in creating the pregnancy.

yep, definitely from the west coast :laugh:
 
Actually, no. That's not what I was saying. I meant one-sided because you only blamed the girl for the contraception (No, I blame the guy too, but the reality is that the woman is the one who gets pregnant. If she wants to avoid that, then she is going to have to take control of the situation) and pessimistic because you posed your answer in a way that sounds like all abortion occurs due to lack of contraception. (Nope. Just most of it.) 50% of pregnancies in this nation are unplanned...(What does this have to do with anything? unplanned =/= unwanted). many of those women are not 15 (right, some of them are 13, 14, 16, and 17, There exact age is unimportant, especially if they are a minor) and many are actually using contraception that was either misused or failed. (So how many is "many"? I know that according to hollywood all abortions are a result of lustful abusive daddies and broken condoms. The reality is much less so. Either way, it does not change the fact that the goal for those who support abortion on demand is to be able to have sex w/ a person with whom you do not want to have children. If that is the case, at least be honest about it.) So while your opinion on when an abortion should/should not occur is your opinion, I would argue that I highly doubt the good majority of women are using abortion as a form of birth control (If they are having an abortion because they are pregnant with a baby that they don't want, then it is birth control). Maybe you do; it's anecdotal (So is every thing you have said). Just as its anecdotal for me to say that the women I've come across/worked with find it an emotional process (good to hear that they weren't calloused about it) and weren't just okay as using it for contraception (what did they use it for then).

FWIW, yes, follow the law.
p
 
The majority of abortion patients I have spoken with were using protection that failed, and many of them do want children or in fact already have children.

Is the slut-shaming really necessary? Last I checked there were at least two parties involved in creating the pregnancy.

So your saying that the majority people who get abortions are couples who have children, but don't want any more, so they get an abortion.

First, as charming as your anecdotal evidence is, it is hardly relevant in a discussion about underage girls getting abortion without parental consent.

Also, isn't it interesting that the majority of the millions of abortions performed are due to the failure of a product that is supposed to have a 99% success rate?

Either way it doesn't matter. If a woman, Married or unmarried, children or no children, has sex, gets pregnant, doesn't want the baby, and has an abortion to get rid of said baby, then it is birth control. Sorry if that makes you uncomfortable.
 
But this thread wasn't about if abortion is right or wrong...

To the OP: like has been said above, law is law. If you don't agree, you still have to follow it because you'll have to follow the consequences if you break it... regardless of if you agree w/ those either.
 
Also, isn't it interesting that the majority of the millions of abortions performed are due to the failure of a product that is supposed to have a 99% success rate?

Ideal success rate =/= Typical success rate in many forms of contraception. The only times they are almost equal are in things like IUDs, Implanon, or tubals.
 
If you think I'm being purely anecdotal, then there is no need for me to respond to you.

You are being anecdotal. Is anything you said based on any kind of stats, or is it just stuff you made up to support your argument?

Just a reminder, the only argument I have made is that it is stupid to consider breaking the law in order to help a teenage girl keep from having to tell her dad that she got knocked up. In making that argument, I have made clear that I have very little sympathy for people who have abortions for lame reasons (the condom broke mom, I swear!). I find that people who do so, consider abortion (whether they explicitly admit it or not) as a form of birth control and I think that it is shameful course of action (my opinion) especially considering the large numbers of people who want children and can't have them and are willing to adopt. It is the pinnacle of selfishness.
 
I agree with you, but then again like I mentioned above, at least he/she would be looking out for their patient.

Plus, there are some pro-choice people who just don't think they could "handle" doing abortions, or don't want to face the hardships that many providers face. Sure, it means they aren't living up to their convictions, but abortion is a pretty hard thing to do/watch. I mean, something like 2% of doctors nationwide are doing over half of the nation's abortions. No one is actually pro-abortion, and its not like providers don't get emotional over it.

Alright, I understand the argument that even pro-choice providers wouldn't want to get involved in a procedure that guarentees them harassment and risks them becoming the victims of violence. However the rest of your statement: that no one is pro-abortion, that some people can't 'handle' abortion, and that providers still get emotional over the procedure, well that I just don't understand at all. The procedure is extremely safe (if you're not concerned about the safety of the child) and very simple. If you're not assigning any sort of humanity to the fetus you're taking out, which I would hope is necessary if you're going to be an abortionist, why is this any more emotional than removing a cervical hyperplasia or an endometrial polyp? Why, other than a slightly higher cost, is it any different than any other form of birth control?
 
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But this thread wasn't about if abortion is right or wrong...

To the OP: like has been said above, law is law. If you don't agree, you still have to follow it because you'll have to follow the consequences if you break it... regardless of if you agree w/ those either.

So we agree.
 
Either way it doesn't matter. If a woman, Married or unmarried, children or no children, has sex, gets pregnant, doesn't want the baby, and has an abortion to get rid of said baby, then it is birth control. Sorry if that makes you uncomfortable.
Actually it doesn't make me uncomfortable. Not in the least. 🙂

Although my inner grammar grinch wails and gnashes her teeth when people say "abortion as contraception" because that's just... semantically impossible. 🙄
 
Actually it doesn't make me uncomfortable. Not in the least. 🙂

Although my inner grammar grinch wails and gnashes her teeth when people say "abortion as contraception" because that's just... semantically impossible. 🙄

Is plan B considered a contraceptive?

(This isnt me trying to be tricky or something, I legitimately dont know what its considered)
 
You are being anecdotal. Is anything you said based on any kind of stats, or is it just stuff you made up to support your argument?

Just a reminder, the only argument I have made is that it is stupid to consider breaking the law in order to help a teenage girl keep from having to tell her dad that she got knocked up. In making that argument, I have made clear that I have very little sympathy for people who have abortions for lame reasons (the condom broke mom, I swear!). I find that people who do so, consider abortion (whether they explicitly admit it or not) as a form of birth control and I think that it is shameful course of action (my opinion) especially considering the large numbers of people who want children and can't have them and are willing to adopt. It is the pinnacle of selfishness.

Yes. Look at the Guttmacher Institute website.

Alright, I understand the argument that even pro-choice providers wouldn't want to get involved in a procedure that guarentees them harassment and risks them becoming the victims of violence. However the rest half of your argument: that no one is pro-abortion, that some people can't 'handle' abortion, and that providers still get emotional over the procedure, well that I just don't understand at all. The procedure is extremely safe (if you're not concerned about the safety of the child) and very simple. If you're not assigning any sort of humanity to the thing you're taking out, which I would hope is necessary if you're going to be an abortionist, why is this any more emotional than removing a cervical hyperplasia or an endometrial polyp? Why, other than a slightly higher cost, is it any different than any other form of birth control?

Oh no, I totally agree with you. It is a very safe procedure and very easy. I've seen them. I was just pointing out what the thought processes of people w/ this point of view might be. That's all.

So we agree.

On the law aspect, yes.
 
Is plan B considered a contraceptive?

(This isnt me trying to be tricky or something, I legitimately dont know what its considered)
There is a class of birth control that does not prevent conception, but rather operates as an anti-implantation mechanism.

Plan B and IUDs work this way, which is why some folks feel morally uncomfortable about the idea of choosing these as their birth control.

ETA: What I've said is based on defining "conception" as the fusing of a sperm+egg into an embryo. Some pharmaceuticals prefer to define "conception" as successful embryo implantation, thereby avoiding the stigma of being labeled an "abortive" method.
 
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There is a class of birth control that does not prevent conception, but rather operates as an anti-implantation mechanism.

Plan B and IUDs work this way, which is why some folks feel morally uncomfortable about the idea of choosing these as their birth control.

ETA: What I've said is based on defining "conception" as the fusing of a sperm+egg into an embryo. Some pharmaceuticals prefer to define "conception" as successful embryo implantation, thereby avoiding the stigma of being labeled an "abortive" method.

Additionally, Plan B will not abort an existing pregnancy.
 
Alright, I understand the argument that even pro-choice providers wouldn't want to get involved in a procedure that guarentees them harassment and risks them becoming the victims of violence. However the rest of your statement: that no one is pro-abortion, that some people can't 'handle' abortion, and that providers still get emotional over the procedure, well that I just don't understand at all. The procedure is extremely safe (if you're not concerned about the safety of the child) and very simple. If you're not assigning any sort of humanity to the fetus you're taking out, which I would hope is necessary if you're going to be an abortionist, why is this any more emotional than removing a cervical hyperplasia or an endometrial polyp? Why, other than a slightly higher cost, is it any different than any other form of birth control?

But to follow up on this since I didn't get through the whole post before responding... why do you not understand that no one is pro-abortion? Have you seen one performed? Namely, a 2nd trimester? Watch one and you will see how it is different.
 
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