site banner

Culture War Roundup for the week of September 16, 2024

This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.

Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.

We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:

  • Shaming.

  • Attempting to 'build consensus' or enforce ideological conformity.

  • Making sweeping generalizations to vilify a group you dislike.

  • Recruiting for a cause.

  • Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.

In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:

  • Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.

  • Be as precise and charitable as you can. Don't paraphrase unflatteringly.

  • Don't imply that someone said something they did not say, even if you think it follows from what they said.

  • Write like everyone is reading and you want them to be included in the discussion.

On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.

6
Jump in the discussion.

No email address required.

I need to fisk this article.

Recently I have been faced with repeated assertions by people in my social circles, both offline and online, that "at this point the only possible reason to not vote for Kamala Harris is that you're an irredeemably evil human being." Now, I'm no stranger to extreme political rhetoric! Demonizing "the other side" is nothing new. But in the past month or so I have been getting it from people who are not usually prone to that sort of thing, even in an election year. These are people who have tended to say things like "I wouldn't vote for Trump, but I understand why someone in $CIRCUMSTANCE might." They are people who have at other times bemoaned growing partisanship and the death of discourse, or praised charitable reading and balanced presentation. Somehow, after making it through 2016 and 2020 without ghosting me and blocking me on social media (like a fair few others in my life), somehow 2024 has finally managed to convince them that Trump is a political emergency against which no exigency is forbidden.

I say "somehow" but truly, for most of them I think the real explanation is Dobbs. Or rather--not Dobbs itself, but the absolutely panicked response the progressive news media is having over the existence of any corner of the country in which any baby in utero, and a not-insignificant number of babies ex utero, is protected from destruction against its mother's wishes or whims.

I am myself weakly pro-choice, in the libertarian "decriminalize but don't legalize" sense--at least in the first few weeks of pregnancy. I oppose any sort of government spending on abortions, but I tend to oppose government spending on damn near anything, so that shouldn't surprise anyone. However, I simply will not vote for anyone who advocates abortions in the third trimester, much less the euthanization of born-alive botches. I find that level of pro-abortion sentiment to be astonishingly ghoulish.

So: the article. When I saw the headline "2 women die in Georgia after they couldn't access legal abortions and timely care," my first thought was, "Damn, seriously? That's really surprising!"

My second thought was--"Wait a minute..."

In her final hours, Amber Nicole Thurman suffered from a grave infection that her suburban Atlanta hospital was well-equipped to treat.

She’d taken abortion pills and encountered a rare complication; she had not expelled all of the fetal tissue from her body.

Ohhhh. So the headline could literally have been, "woman in Georgia killed by abortion pills" with no noticeable loss of information?

She showed up at Piedmont Henry Hospital in need of a routine procedure to clear it from her uterus, called a dilation and curettage, or D&C.

But just that summer, her state had made performing the procedure a felony, with few exceptions. Any doctor who violated the new Georgia law could be prosecuted and face up to a decade in prison.

Thurman waited in pain in a hospital bed, worried about what would happen to her 6-year-old son, as doctors monitored her infection spreading, her blood pressure sinking and her organs beginning to fail.

It took 20 hours for doctors to finally operate. By then, it was too late.

How do we know it wasn't too late, 20 hours earlier? Answer: we don't! Of course, I'm happy to point a finger at government bureaucracy as a contributing cause, as was the committee from which these two women's stories very conveniently leaked:

The otherwise healthy 28-year-old medical assistant, who had her sights set on nursing school,

Lest ye be tempted to believe we're talking about a low-value citizen! She was gonna be a nurse someday, probably maybe!

should not have died, an official state committee recently concluded.

Tasked with examining pregnancy-related deaths to improve maternal health, the experts, including 10 doctors, deemed hers “preventable” and said the hospital’s delay in performing the critical procedure had a “large” impact on her fatal outcome.

Their reviews of individual patient cases are not made public. But ProPublica obtained reports that confirm that at least two women have already died after they couldn’t access legal abortions and timely medical care in their state.

There are almost certainly others.

Did you catch that? There are almost certainly others! That's the sound of a journalist telling you "I could find no evidence that my beliefs are true, so I'm going to make shit up instead."

Thurman’s case marks the first time an abortion-related death, officially deemed “preventable,” is coming to public light. ProPublica will share the story of the second in the coming days. We are also exploring other deaths that have not yet been reviewed but appear to be connected to abortion bans.

Why would we report the news today, when we can drip-feed you artificially inflated horror stories once a week from now until the Fifth of November? Why would we tell you the facts we know, when we can wait for an unnamed "official committee" with unknown political biases to give us speculative inquiry into the hot topic du jour? Stay tuned for your daily dose of rage bait! (I say without a hint of irony, surely.)

Doctors and a nurse involved in Thurman’s care declined to explain their thinking and did not respond to questions from ProPublica.

No fucking shit they declined to explain their thinking, even if HIPAA didn't exist they probably wouldn't have deigned to defend their medical judgment to a muckraker.

Communications staff from the hospital did not respond to multiple requests for comment.

Good.

Georgia’s Department of Public Health, which oversees the state maternal mortality review committee, said it cannot comment on ProPublica’s reporting because the committee’s cases are confidential and protected by federal law.

Shocking.

But Republican legislators have rejected small efforts to expand and clarify health exceptions — even in Georgia, which has one of the nation’s highest rates of maternal mortality and where Black women are three times more likely to die from pregnancy-related complications than white women.

Remember, it's not enough to be pro-choice; you have to be anti-racist. But let's not be unsympathetic, here: a woman is dead, and so is her baby. Or, it turns out, babies--

Thurman, who carried the full load of a single parent, loved being a mother. Every chance she got, she took her son to petting zoos, to pop-up museums and on planned trips, like one to a Florida beach. “The talks I have with my son are everything,” she posted on social media.

But when she learned she was pregnant with twins in the summer of 2022, she quickly decided she needed to preserve her newfound stability, her best friend, Ricaria Baker, told ProPublica.

We're talking about a woman who was already raising one baby on her own, so there's no question that she understood the consequences of sexual activity. Imagine if someone had suggested to her that she could "preserve her newfound stability" by finding a stable partner before engaging in sexual activity. Here is another equally-accurate alternative headline: "woman dies in Georgia as a result of premarital sex!"

On July 20, the day Georgia’s law banning abortion at six weeks went into effect, her pregnancy had just passed that mark, according to records her family shared with ProPublica.

Thurman wanted a surgical abortion close to home and held out hope as advocates tried to get the ban paused in court, Baker said. But as her pregnancy progressed to its ninth week, she couldn’t wait any longer. She scheduled a D&C in North Carolina, where abortion at that stage was still legal, and on Aug. 13 woke up at 4 a.m. to make the journey with her best friend.

On their drive, they hit standstill traffic, Baker said. The clinic couldn’t hold Thurman’s spot longer than 15 minutes — it was inundated with women from other states where bans had taken effect.

Perhaps the headline should be "woman dies in Georgia after getting stuck in traffic?" Or maybe "woman dies in Georgia after being turned away from a legal abortion clinic?"

Instead, a clinic employee offered Thurman a two-pill abortion regimen approved by the U.S. Food and Drug Administration, mifepristone and misoprostol. Her pregnancy was well within the standard of care for that treatment.

Getting to the clinic had required scheduling a day off from work, finding a babysitter, making up an excuse to borrow a relative’s car and walking through a crowd of anti-abortion protesters. Thurman didn’t want to reschedule, Baker said.

"I would kill my twin babies to preserve my newfound stability. But only if it's super convenient."

And of course: Thurman is given a legal option "well within the standard of care." It would appear that she accessed a "legal abortion" with no difficulty at all! Right, ProPublica?

Deaths due to complications from abortion pills are extremely rare.

Deaths due to complications from anti-abortion laws are extremely rare.

This was the point where I knew I had to react to this article in a public way. I recognize that ProPublica is an advocacy group and that RawStory is like, maybe on the level of the Daily Wire in terms of ideological bias and propagandizing. But the only reason I saw the article was that it was being shared by a couple of the aforementioned friends in my social feeds--people who I might even have described, in the relatively recent past, as political moderates. This is the new narrative, same as the old (pre-Roe) narrative: all restrictions on abortions are woman-killing laws!

Except, you know...

Baker and Thurman spoke every day that week. At first, there was only cramping, which Thurman expected. But days after she took the second pill, the pain increased and blood was soaking through more than one pad per hour. If she had lived nearby, the clinic in North Carolina would have performed a D&C for free as soon as she followed up, the executive director told ProPublica. But Thurman was four hours away.

On the evening of Aug. 18, Thurman vomited blood and passed out at home, according to 911 call logs. Her boyfriend called for an ambulance. Thurman arrived at Piedmont Henry Hospital in Stockbridge at 6:51 p.m.

Look, I'm not a physician, but if you are bleeding through more than one pad per hour you go to the fucking hospital. This woman was bleeding like crazy and just didn't do anything about it for days.

But sure--anti-abortion laws are what prevented her from getting timely treatment, totally. And I've got a bridge you might want to invest in.

ProPublica obtained the summary narrative of Thurman’s hospital stay provided to the maternal mortality review committee, as well as the group’s findings.

Apparently not a HIPAA violation?

The narrative is based on Thurman’s medical records, with identifying information removed.

Well that's alright then! But ProPublica somehow managed to identify her anyway. Interesting.

At least we finally got the name of the committee! Not that there's much information on the web about it. Who are its members? What are their politics? How often do they provide conveniently timed confidential medical information to partisan "investigative" reporters?

The world may never know. Also:

The committee does not interview doctors involved with the case or ask hospitals to respond to its findings. ProPublica also consulted with medical experts, including members of the committee, about the timeline of events.

Here I will excise the precise timeline of the woman's hospital experience. If any of our physicians would care to comment on it, I'd be interested to know what a medical mind makes of the timeline as presented. It sounds harrowing, but mostly it sounds to me like the primary causes of this woman's death were, in descending order of contributory effect: poor life choices, abortion pills, poor self-care, medical bureaucracy, and then maybe legal bureaucracy. Georgia's particular abortion laws barely have any role to play at all in this tragedy.

Until she got the call from the hospital, her mother had no idea Thurman had been pregnant. She recalled her daughter’s last words before she was wheeled into surgery — they had made no sense coming from a vibrant young woman who seemed to have her whole life ahead of her:

“Promise me you’ll take care of my son.”

There is a “good chance” providing a D&C earlier could have prevented Amber Thurman’s death, the maternal mortality review committee concluded.

Which she would apparently have received if she'd driven four hours to the followup she was duly informed might be necessary. When people die because the steps required to stay alive seem so inconvenient that a 28 year old woman with a son cannot even communicate the situation to her mother, it seems wildly irresponsible to suggest that the problem is with the law. Especially when you drop this nugget:

It is not clear from the records available why doctors waited to provide a D&C to Thurman, though the summary report shows they discussed the procedure at least twice in the hours before they finally did.

"The law totally did this! Well, in fact we have no evidence whether the law had anything to do with any of this. But you stopped reading eighteen paragraphs ago, so now we'll mention that fact for completeness. Wouldn't want a lawsuit to interfere with our 'reporting!'"

ProPublica asked the governor’s office on Friday to respond to cases of denied care, including the two abortion-related deaths, and whether its exceptions were adequate. Spokesperson Garrison Douglas said they were clear and gave doctors the power to act in medical emergencies. He returned to the state’s previous argument, describing ProPublica’s reporting as a “fear-mongering campaign.”

Sounds like Garrison Douglas knows what's up.

Thurman’s family members may never learn the exact variables that went into doctors’ calculations. The hospital has not fulfilled their request for her full medical record. There was no autopsy.

For years, all Thurman’s family had was a death certificate that said she died of “septic shock” and “retained products of conception” — a rare description that had previously only appeared once in Georgia death records over the last 15 years, ProPublica found. The family learned Thurman’s case had been reviewed and deemed preventable from ProPublica’s reporting.

If there were any HIPAA violations involved, well... I wouldn't count on an investigation from the federal government. I'm sure they've got their hands full shadowing James O'Keefe.

The sting of Thurman’s death remains extremely raw to her loved ones, who feel her absence most deeply as they watch her son grow taller and lose teeth and start school years without her.

They focus on surrounding him with love but know nothing can replace his mother.

On Monday, she would have turned 31.

Her twins, had they survived, would be nearly 2 years old.

At the encouragement of a different ProPublica writer, I've sent an e-mail into the author of the story (and now realize that I've made a typo in said e-mail, dammit). Will comment further if I get a response.

The New York Times reports:

Vice President Kamala Harris will give remarks in Atlanta on Friday focused on the stories of two Georgia mothers whose deaths she has argued show the consequences of the strict abortion bans passed by Republicans after Roe v. Wade was overturned.

The speech is part of an effort by the Harris campaign to push reproductive rights to the center of the presidential election, according to a person with knowledge of the event who insisted on anonymity because they were not authorized to speak publicly about the plans.

The deaths, reported this week by ProPublica, occurred in the months after Georgia passed a law banning abortion at six weeks. Amber Thurman died of sepsis resulting from an incomplete medication abortion after waiting 20 hours in a suburban Atlanta hospital for medical care. A second woman, Candi Miller, died after declining to seek medical care for complications from abortion medication.

Tactically, this is the sorta thing that's obvious logical: Harris is trailing Trump in Georgia in recent polls, it's a major state for many of her success paths to the Presidency, and abortion is one of strongest spaces Harris has. There's basically zero chance of the ProPublica article leaving the "There may be alternative explanations for that delay other than legal concerns. But I trust that the reporter on this asked those questions, and so far no one has offered any" zone before the election is over, if it ever happens, and even if final report drops and embarrasses ProPublica, there's minimal chance anyone going to a Harris rally will ever hear about it.

But I remember when a federal candidate repeating rumors under the aegis that they weren't disproved yet was a bad thing. Scroll up in that twitter thread, and you'll find that a ProPublica writer brought it up as a counterexample in response to a conservative comparing fearmongering over ectopic pregnancies to the "eating cats" thing.

...

Maybe I'm wrong. Maybe the sorta people who were found it atrocious when Trump squirmed to mock a disabled man but couldn't care about Biden calling an innocent guy a white supremacist are going to find their gumption here. I'll post one if I can find it.

The New York Times reports...

Huh. I admit I did not expect the article I was fisking to turn out to be at the start of a chain of information laundering for Kamala's campaign, but I guess I should have.

It's amazing to me how transparently false the narrative is, that these deaths are directly downstream of Dobbs. There seems to be more evidence that these deaths are directly downstream of the news media's scaremongering; I'd bet that both women honestly believed abortion laws in Georgia to be far more restrictive than is actually the case.

If there were any HIPAA violations involved, well... I wouldn't count on an investigation from the federal government.

ProPublica's website has the below addendum, it is not included on RawStory.

https://www.propublica.org/article/georgia-abortion-ban-amber-thurman-death

How We Reported the Story

ProPublica reporter Kavitha Surana reviewed death records and medical examiner and coroner reports to identify cases that may be related to abortion access. She first reached out to Amber Thurman’s family and friends a year ago. The family shared her personal documents and signed a release for ProPublica to access her medical information. The maternal mortality review committee reviewed Thurman’s case at the end of July 2024.

Interesting to me is the article's inclusion of Will Brewer, lobbyist from Tennessee. Yes, a totally different state than the death.

The state’s main anti-abortion lobbyist, Will Brewer, vigorously opposed the change. Some pregnancy complications “work themselves out,” he told a panel of lawmakers. Doctors should be required to “pause and wait this out and see how it goes.”

The above quote is the only time Brewer is mentioned in this particular article, and I got the feeling that ProPublica butchered whatever Brewer actually said. So here is what is the full quote, (with emphasis mine) courtesy of...Kavitha Surana via Oklahoma Voice:

https://oklahomavoice.com/2023/11/27/some-republicans-willing-to-compromise-on-abortion-ban-exceptions-activists-ensured-they-didnt/

When Tennessee Republicans introduced a bill to give doctors more protection to offer terminations when a pregnant patient faced a condition that could become life-threatening, Will Brewer, the lead lobbyist for Tennessee Right to Life, testified against it, arguing the patient’s condition needed to deteriorate before a doctor could intervene.

“There are issues with pregnancy that could be considered an emergency — or at least could possibly be considered an anomaly or medically futile — that work themselves out,” Brewer, who has no medical training, testified on the House floor. “I’m not talking about an eleventh hour, you know, a patient comes into the ER bleeding out, and what do we do? I’m talking about (a situation when) there is a condition here that some doctors would say constitutes an emergency worthy of a termination and other doctors would say, ‘Let’s pause and wait this out and see how it goes.’ I wouldn’t want the former to terminate when the latter says there’s room to see how it goes before this is urgent enough.”

So Brewer explicitly says that he wants to allow an exception in Thurman's exact situation! And Kavitha, the ProPublica reporter, knew he wanted an exception for this exact situation because she quoted him saying exactly so in an article she herself wrote less than a year ago! All on top of the guy being from a totally different state! Why include this detail in the article?

ProPublica has published their promised follow-up story describing the other death related to the Georgia abortion ban, and as you may have expected, the connection is even more tenuous than in the story you critiqued here.

Wow. Sure enough, another case of (headline font!) woman likely killed by abortion pills has death blamed on unrelated abortion laws. But also, good heavens:

An autopsy found unexpelled fetus tissue, confirming that the abortion had not fully completed. It also found a lethal combination of painkillers, including the dangerous opioid fentanyl. Miller had no history of drug use, the medical records state; her family has no idea how she obtained them or what was going through her mind--whether she was trying to quell the pain, complete the abortion or end her life. A medical examiner was unable to determine the manner of her death.

Her family later told a coroner she hadn't visited a doctor "due to the current legislation on pregnancies and abortions."

Of course, it seems unlikely to me that she knew anything about such legislation beyond what panicky, sensationalist journalists told her. To say nothing of the fentanyl (huh!?) and the possibility that she committed suicide.

This second article also repeats the "almost certainly other deaths" canard. Apparently ProPublica now exists to spread blood libel against conservative legislators.

Honestly? Strongly in favour of! Particularly if they're from groups as well-regarded as ProPublica. I am always in favour of poor/yellow journalism being torn apart.

So you agree the ProPublica article is garbage? Interesting.

Breaking down bias or bad epistemology is certainly within the scope here. Per the rules you can't simply be dunking on some fringe loon, of course. But effortful, sourced, particularized commentary that refrains from taking broad swipes at general groups is basically welcome, though, yeah. The rules do not forbid criticism of anyone's ideas, in- or outgroup. It's the approach that matters.

You can find writing with poor epistemological standards produced by any group.

But of course--my post was not about a group (except, perhaps, "journalists") per se. It was about a particular kind of argument that is driving huge chunks of American political discourse, of which this article was a particular examplar. In other words--

I'm not sure what is to be gained by dissecting arbitrary examples.

There was nothing arbitrary about this example, and instead of engaging on the substance you decided first to try meta, and failing that you're now retreating to "eh who cares it's not interesting."

On this forum, especially, the most common assumption is that every news article is trash

Sure. But as you observed--90% of everything is trash! So it must be a safe assumption, right? But also, if we're going to talk about anything at all, part of that conversation is going to involve sifting through the presumptive trash, or better yet--trying to transform that trash into treasure, through our own effortful engagement!

so I don't know what insight there is to be gained.

Maybe none? But you would have to actually try to engage on the merits to decide that, and so far you've made two comments declining to even try. Which is of course your prerogative! You are under no obligation to try to understand, or to find things interesting. But your commentary thus far has been even less worthwhile, or so it seems to me--wouldn't it be more interesting to actually engage on substance?

Yes.

Sounds like a great idea! Why not fisk any outgroup news article that's from the same tier as ProPublica on Wikipedia's "reliable sources" list. That should make it a fair comparison, right?

(That's "generally reliable for all purposes because it has an excellent reputation")

Can't wait to read your post, am sure it will be just as insightful as the OP.

My God, I can't believe it's really there after seeing such an atrocious article from them.

I'm more shocked that Al Jazeera has a green rating, to be honest.

That's why I said to pick a green outgroup source from this objective list to avoid any bias on my part.

Do you believe Wikipedia's list is fair? That's what matters for picking a source from it. My opinion about the list doesn't mean anything if I'm wrong about it (and by extension the quality of ProPublica)

Thanks for looking into this. I already suspected something contrived when reading the headline, but this is on the level of blaming a drunk driving accident on prohibition.

I think that there exist abortion rules which 80% of the country would find acceptable, but as it is a partisan topic, there is a lot of signaling value in either side making extreme demands. "abortion should always be illegal, no exceptions" to "abortion should be legal until the separation of the naval cord after birth".

A six weeks ban means that women has about two weeks after missing her period (per Wikipedia) to get an abortion. Now, a woman with regular periods and high executive function will notice that something is amiss within a week, and then can conveniently schedule her abortion.

But not every woman, and especially not every woman likely to have unwanted pregnancies will make it in that time frame. Perhaps her periods sometimes are a week late due to stress or whatever, and then it only takes a few more days of distraction to miss her window. (I don't have a very high executive function myself ('is it my week to deal with the garbage cans again?', 'I should really schedule a dentist appointment soon', etc), so I am sympathetic.)

Ethically, I am a Singerian who does not find anything fundamentally wrong with baby-killing, but politically that is not a hill I would be willing to die on. In practice, I would be fine with banning abortions without medical indication after a few months of gestation -- give the woman a bit of time to notice 'well, I did have sex and my period stopped, perhaps I should buy a pregnancy test'.

Now, there will be people who think that ensoulment happens at conception (I am not clear how this works with monocygotic twins, do they each have half a soul or is one of them soulless?) and people who have or perform abortions should always go to prison for murder. But I am somewhat hopeful that these are a fringe minority. On the other hand, the number of people who believe that killing what might already be a viable baby is wrong is likely much higher.

In a way, this is a late fallout of Roe v Wade. If the SC had not legislated that abortions are always legal, there might have been room for a sane compromise federal law before the issue became hopelessly soaked with partisan politics to the point where half the raison d'etre of the Republican party was to elect a president who would appoint justices who would overturn Roe.

Of course, opinion articles on both sides will try to dig up the most extreme cases imaginable. 'Woman living in a state with harsh abortion laws lost her life in a way related to her attempt to abort. This is why abortion should always be legal until your kids are of legal age.' or 'look at this poor baby being born alive in a botched abortion in the third trimester. This is why we must ban any abortions everywhere (and perhaps let's ban contraceptives too)!'

So this woman suffered a complication from legal abortion. It’s unclear whether the hospital screwing up the treatment caused it to turn fatal or whether she wouldn’t have survived. Either way, hospital care was indisputably legal.

This is, as you accurately note, 0% about Georgia’s abortion laws. But, of course, just like Kate Cox was going to die if she didn’t get an abortion(she wasn’t), that’s the narrative the media has to run with. And it’s right before an election, so the media needs to ham it up, constantly lying, for 6 weeks. Left wing misinformation it is.

Well as the right is so often doing, they are 'directionally correct', abortion bans do cost the lives of mothers the world over.

This is the first time the news media is claiming a woman died from an abortion ban. It is, of course, a lie- this doesn’t have anything to do with Georgia’s abortion law- but there seemingly haven’t been any previous cases of women dying in ways more plausibly connected to red state abortion laws.

When you get down to it, pro-choice arguments that women are dying are some sort of unfalsifiable motte retreated to when an individual woman turns out to be dead of her own bad decisions(as with this woman’s decision not to seek medical care during multiple days of bleeding through her pads hourly). If there are women dying from red state abortion laws, show me the receipts. The media’s eagerness to- falsely- tie this to Georgia’s heartbeat law is evidence that there aren’t any.

It might not be the perfect case, but maybe black people shouldn't have ride in the back of the bus.

  • -13

What the fuck does that have to do with anything? By all appearances of the case, this woman would still be dead if the same scenario happened in New York State.

My point was you won't always have the most sympathetic or logical subject to prove your policy goal. You just take what you've got and run with it. Blocking abortions does indeed kill mothers, even if it didn't in this case.

Blocking abortions does indeed kill mothers

Again, show me the receipts. The fact that the media hasn’t already done so points to it being because there aren’t any.

There is a history of famous cases of women in pro-life jurisdictions dying of pregnancy related complications, and without exception the care that would have saved them was legal, it just wasn’t administered either due to malpractice(the Irish case used as justification for repealing the 8th) or the woman’s own poor decisions(if this woman had gone to the hospital when she started experiencing complications she would probably be alive right now). The media clearly wants to point to unambiguous cases of pro-life laws killing women and it’s not doing so; the most plausible reason is because there aren’t any.

Wait what? Every abortion ban country has a ton of related deaths. What are you on about?

More comments

Really great write-up. Thank you.

Your response is valuable because it demonstrates the mix of slippery-slope, bad faith reporting, and sleight-of-hand that poisons the abortion debate. Americans are notoriously self-contradictory in their opinions on abortion. Thus, re-framing an issue has an outsized impact on changes in opinion. I like your consistent use of alternative headlines to point that out.

There are very few pro-life folks who are zero-exception pro-life. Rape, incest, and life of the mother are the default exceptions. But the focus shouldn't be on the exceptions (which will always be a small percentage) but on the modal abortions and the contexts that produce them. The article (and your response) do a good job of highlighting that abortions are often the product of repeated bad life choices and general irresponsibility. I don't think being generally kind of a fuck-up should be a life long sentence for poverty, but there is a limit to what you can be absolved of. Denying a child from being born is far, far past that line.

Going back to the culture war angle, it gets difficult to even "hear out" pro-life arguments because they get so slippery. Obama used to take the median liberal position on abortion that was summarized as "safe, legal, and rare." That last part made the conversation at least possible. It wasn't like we were having parades for abortion or anything. The median liberal position today seems to be on-demand abortion access for any reason, potentially into the third trimester or even at birth. Point out how crazy that is and you get responses like the ProPublica article - "women are literally dying because of these anti-abortion laws." It isn't moving the goalposts, it's making up new rules as you go while also manipulating the score.

If you bring up the fact that there's only one way to make a baby (sex) and suggest abstinence and/or sexual discipline, you aren't looked at as extreme, but as childishly out of touch. What, go without sex? Yes. Yes, that's exactly what I'm saying. No one has ever died from not fucking. In the most dishonest and illegitimate response to that idea, there are people who will say that practicing and preaching abstinence is actually some sort of reverse sexual-slavery that dehumanizes specifically women. Once we linked sexual activity to the amorphous "personal expression" we let the genie out of the bottle. The argument goes: "Anything you tell me to do is oppression and potentially violence. Anything I demand from society is actually a guaranteed human right that has been withheld because of systemic oppression." Heads-I-win-tails-you-lose.

Taking a look at my own history that went from casually pro-choice to rigid pro-life, I'd assert that if you draw any firm line in the sand you are setting yourself up for a slow (though possibly accelerating) drift towards a pro-life stance because the opposite end keeps getting more extreme. Yes, I know this is a version of the "we're the normies; they just keep getting crazier!" argument, but ... I think the craziest are saying their quiet part out loud.

suggest abstinence and/or sexual discipline

Or suggest an IUD implant, those are super effective, last for a decade, and don't require sticking to a schedule (like with pills) or proper use (like with condoms). Also, IUD effectiveness leaves those others in the dust even with proper use.

Would you support making a free IUD implant to any female who wants one?

Potentially.

But an IUD doesn't deal with the social, interpersonal, emotional consequences of sex. One of the big lies of the sexual revolution is that you can divorce sex from emotion. I don't think that's true between healthy and reasonable adults. I think the only way to do that is to dehumanize one or both of the participants. This is what happens with prostitution. Outside of that, both men and women who are really into casual sex often fall into deep existential crises. This is the end to The Game by Neil Strauss, I think it's a subplot of Magic Mike (I've never seen it, but I remember this popping up in conversation when that movie came out).

I would worry that IUDs would function as (literal) talismans in the minds of some women and men. "You have an IUD? Great, sex has no consequences!" Not true on a physical level (STIs/STDs) and not true on the mental/emotional/social level.

Again, I'm not recommending puritanical sexual codes for society at large. I'm advocating for the hard re-linking of consequences with sex. You can have lots of sex with many partners if you want, but be aware of and accept the consequences. If you don't like the sound of those consequences, abstinence is a good option, and shouldn't be pilloried as some sort of "internalized sexual repression."

I would worry that IUDs would function as (literal) talismans in the minds of some women and men. "You have an IUD? Great, sex has no consequences!" Not true on a physical level (STIs/STDs) and not true on the mental/emotional/social level.

That's a good point. The consequences you list are serious, and they are carried by the person having sex (and that person's sexual partner). But if the woman has an IUD, the consequences of her sexual act won't be carried by a baby.

When I was a teen, it was generally known that one can drop by a Planned Parenthood and grab some free condoms, no questions asked. Quite a few of us availed ourselves of that option. Some didn't, but that didn't stop them from having sex. (They did ask friends for condoms sometimes.) Having a well-known option of easy-to-get free condoms didn't eliminate unprotected sex, but it reduced it.

I propose that if there was a well-known option of easy-to-get free IUD implants, then many more women would use that option, and that would greatly reduce the number of babies who must bear the consequences of their mother's sexual choices. The women who make poor life choices would still have plenty of natural consequences to deal with.

I would further propose valorizing the act carrying a baby to turn to give it up for adoption. Like in the 2007 film "Juno", for example. I honestly can't think of another popular movie, show, or book that presented giving-birth-for-adoption in a positive light, but I can think of tons that are from the child's perspective about the emotional pain of finding out you're adopted. I know some adopted kids, and they're fine. The whole mother-didn't-love-me-so-she-gave-me-up trope needs to die.

Again, I'm not recommending puritanical sexual codes for society at large. I'm advocating for the hard re-linking of consequences with sex. You can have lots of sex with many partners if you want, but be aware of and accept the consequences.

There's only one consequence of sex that conservatives seem to actually try to hard re-link to sex, though, that is having the baby. You can't force people to feel proper emotions when having sex, but you sure can deny them abortion and slut-shame them (the "social consequences").

I'm not sure what you're saying here.

Are you for slut-shaming? Or are you more pro free love? Genuinely confused.

I'm pro-emotional connection and anti-slut shaming, inasmuch as birth control makes chastity obsolete.

I'm pro-emotional connection and anti-slut shaming

These aren't mutually exclusive in your model?

If you bring up the fact that there's only one way to make a baby (sex) and suggest abstinence and/or sexual discipline, you aren't looked at as extreme, but as childishly out of touch. What, go without sex? Yes. Yes, that's exactly what I'm saying. No one has ever died from not fucking. In the most dishonest and illegitimate response to that idea, there are people who will say that practicing and preaching abstinence is actually some sort of reverse sexual-slavery that dehumanizes specifically women.

This is something I've always found odd, both from personal experience and more generally.

As far as personal experience goes, I am a single Christian who observes traditional Christian teaching on sexual morality, which is to say that I don't engage in it outside of marriage. As such I am functionally and voluntarily celibate, and have been for a long time. As far as I can tell my quality of life has not suffered significantly from this. Sex is not required for a fulfilling, satisfied life. It is not! Yes, you can go without sex. It is not difficult. Unless I'm some kind of bizarre mutant who feels sexual attraction much less intensely than most people (I definitely experience it), I take my own experience as evidence that it is possible. You can just not have sex! It's just one instance of the much wider principle that any good life will require some exercise of personal discipline, no different to avoiding overeating, or making yourself get enough exercise, or forcing yourself to roll out of bed and go to work even when your head is screaming that you'd rather sleep more. Life is a long exercise of self-disciplining. Why should sexual urges be any different to other urges?

Of course, it probably isn't just sex. Anecdotally I'd argue that the whole concept of discipline or self-control is suffering. I think of how Tanner Greer described the temperance movement, and how much voluntary self-control, in the form of things like pledges, was significant. Either making yourself do something unpleasant, or making yourself refrain from doing something pleasant, is a skill that you can practice and learn. But, not to sound too much like a grouchy old man, I feel like that's less the case now, and we have more focus on immediate, rapid gratification.

Now on the broader scale...

I feel obliged to note that in the wider culture, sex is decreasing in frequency, primarily among younger generations. It would appear that just having less sex is viable, because people are having less sex, to the point that conservatives worry about the sex recession (yes, The Atlantic, but Wilcox and Stone are both on the conservative side). If anything, we're probably having too little sex, collectively. So the idea that it's just impossible to avoid sex seems counter-intuitive. People aren't going outside and suffocating in constant opportunities for sex - rather, sex is happening less frequently than in supposedly more puritanical times.

Historically, I'd argue that the idea that abstaining from sex is dehumanising seems rather absurd - the counter-example to come to my mind is the liberatory effect of vowed celibacy or virginity for Christian women in the Roman Empire. Under the crushing weight of social expectation, renouncing sexual and family life in favour of pure devotion to God could be very attractive. Moreover, today, if you feel that marriage is an oppressive patriarchal institution that dehumanises women by reducing them to the role of baby factories or housebound servants, then the idea of renouncing sex might indeed appear liberatory on similar grounds? We might compare something like Korea's 4B movement. I'm not saying all those things are equally good (I think there's obviously a huge difference between voluntary Christian celibacy as commitment to God, and radical feminist celibacy as secession from patriarchal society); just that they seem like cases where deliberate abstinence from sex is experienced as humanising.

So I find the two implied arguments here - that abstention from sex is impossible, and that abstention from sex is oppressive - to be implausible.

Now I will grant that there are specific circumstances in which abstention from sex might be practically impossible or oppressive. If it were demanded of a married couple for an unlimited time, it may well be destructive to that relationship to the point where I would say it's not reasonably possible. Likewise abstention can be enforced or imposed externally in unreasonable ways - someone whose vocation is to marry might be forced into religious life inappropriately, for instance. But the fact of abstention by itself is not enough to conclude oppression or harm or anything unhealthy.

It’s possible to never take a nice, hot shower. You can live fine and happy without ever doing that!

Of course. Lots of people do and have done that.

I'm not sure what the point is?

Obviously I'm not arguing "it's possible to live without sex, therefore it is good to live without sex". I'm not asserting the superiority of celibacy as a state. I'm saying that living a good life requires some measure of self-control around sex in the same way that it requires self-control around food, or alcohol, or anything else. Whether necessity or luxury, self-control is an important virtue. Food is necessary, but we still expect people to exercise judgement and prudence around what to eat, where, when, and so on. Alcohol is not necessary but can be pleasant; we then expect people to show judgement and responsibility when indulging.

Likewise for sex, I would say. There's nothing wrong with desiring sex in itself, but of course judgement, discipline, etc., need to be applied to the choice we make around that desire. Thus the entire field of sexual morality.

As such, I submit that there are times, perhaps even extended periods of time, where "just don't have sex" is a viable course of action. You can just not, and depending on the circumstances, it may be prudent for you to just not.

Yah might be a mutant. I require sex at least once a week and usually much more. Have you been checked for low T?

Also, why do you want people to suffer for things? Isn't having things come easy a great joy?

I don't know how I'd even go about testing my level of testosterone, and to be honest I find the idea of doing so pretty weird. I know there are people who are, from my perspective, strangely invested in their hormone level, but I don't think that's a very wise approach to take to life. I eat well, exercise, and feel energetic and healthy. That's enough for me.

I'm aware that I have a lower libido than some (I once knew a friend who admitted to masturbating daily, which sounds very uncomfortable to me), but it's definitely not non-existent. I do get attracted to people in daily life, have idle sexual fantasies, and so on.

In any case, as far needing sex goes, well, I confidently predict that if you were trapped on a desert island with a supply of food and yet no sexual partners, you would survive more than a week. You may strongly desire sex once a week or more, but I think you could go without it. It's not like food or water.

For the last point - I don't see where I said that I want anybody to suffer? I said that I think self-discipline is a good thing, to the point of being able to make yourself do unpleasant things, or resist pleasant things, but that shouldn't be taken to mean that I think unpleasant experiences are to be desired. I don't think it means that I want people to suffer if I think that people should be able to make themselves do hard yard work, or refrain from pigging out on an entire chocolate cake. I'd argue that this kind of self-control is actually essential for having a happy life overall.

I mean you can technically go without a lot of things. You don't need food 3 times a day, or water. But life is much better if you get those. Jerking off daily is also not odd, why would it be uncomfortable? Why not enjoy all life has to offer, we're only here for a short time and then back to nothing.

See above. I'm not asserting that celibacy is a superior state to marriage. Sex is pleasurable and there's nothing wrong with pleasurable experiences. I'm asserting that sexual self-control is both possible and necessary.

(I do think there are other conditions that apply to sexual morality - I'm pretty negative on casual sex, for instance - but you can just take as read that I have a Christian sexual morality. That's not necessary for my general point. Even if you have a much more robustly progressive sexual ethic, I think self-control remains a necessary virtue not only in one's sexual life but in all of life. If your ethics have any concept of illicit or inappropriate sex at all, you'll need some kind of guardrail or discipline between you and doing it.)

Sexual mores are byproducts of evolutionary kinship knowledge creation and gene propagation. Without being hijacked by culture or religion you should be negative on casual sex for your mate and positive for yourself. You have been deeply hijacked if I recall correctly.

Well, I'm a Christian, which I was quite open about. But I'd rather this discussion not be some kind of referendum on the existence of God. My point is just that - regardless of where you are on the God question - sexual behaviour can and should be limited in certain circumstances, and the idea of going without sex, whether temporarily or over the long term, is not so ridiculous as to be dismissed out of hand.

Yah might be a mutant. I require sex at least once a week and usually much more.

Or what? You explode?

You might want to have sex multiple times a week and you might be unhappy if you don't get it, but you don't require it. Even high-T very horny men are perfectly capable of going without sex. They might not enjoy it, but it won't harm them.

Right, but you're at least going to jerk off in the shower right? Like sheesh. I am typical minding it again, I know. But really I've been scolded enough times by people saying we are only here to have kids. How do they think that happens and why do they think humans want or need sex? You can't have it both ways.

Jerking off in the shower is not sex for the purposes of this topic, because showers can't get pregnant nor impregnate you.

We were talking about abstinence for birth control purposes. Any act that can't produce a baby is still available.

You don't have access to the こんにちは、尊敬するお客様、どうぞ中に捨ててください。Auto Shower 3000? A kid every 10 months or your yen is refunded.

I'm sure most people would, but I am very confident the guys who do "No-Fap November" do not explode or die.

You're not typical-minding; you're hyperbolizing.

A bit of both I am sure. But damn, some folks need to eat some red meat and bust a nut, or get on Test.

https://youtube.com/watch?v=BR4R6kPI2g0

Should the tip of the spear of the hard right be lead by sexless online incels?

What, go without sex? Yes. Yes, that's exactly what I'm saying.

I don’t think it’s practical to expect humans, which natural selection has caused many to be horny, to avoid fucking entirely. And if they do fuck recreationally, there’s bound to be accidents.

Even Christian teens “sin” with premarital sex. I don’t see abstinence as a workable strategy for anyone but the asexuals and others who don’t enjoy or care for sex.

Metabolic syndrome and obesity are the leading causes of death in the western world. This says nothing of the economic and healthcare drains also caused by poor diet and overeating.

Is "eat less / eat better" invalid as a prescription? Is the hardwired need for food - especially carbohydrates - any less compelling than the sex drive?

The modern condition is one of hyper abundance among a species - humans - adapted for scarcity. Successful life strategies in the modern world mostly revolve around discipline and not doing xyz bad thing.

I agree that there will still be many, many humans who choose irresponsible sexual behavior. Teaching abstinence will not directly solve the problem, but it will open up a new approach to directly solving the problem. Specifically, social pressure. Right now, there is zero mainstream social pressure to support sexual self-discipline. "As long as it's safe and consensual" is the median take. I would argue that this is the equivalent to "eat whatever you want whenever you want" which is not the median recommendation of any doctor, dietitian, or even woo-woo online YouTube "wellness" influencers.

Teaching abstinence will not directly solve the problem, but it will open up a new approach to directly solving the problem.

Fair enough. I actually do agree with this take. But

Is "eat less / eat better" invalid as a prescription? Is the hardwired need for food - especially carbohydrates - any less compelling than the sex drive?

That is why I don’t believe advice that’s valid for individuals is workable for society. The more you design a society to rely on individual discipline to function well, the more dysfunctional it’s going to become. Humans by and large haven’t yet evolved to be more disciplined over baser needs, although perhaps the 21st century would exert greater selection pressure than usual. But not if a ban on abortions cause greater numbers of children to be born from those who can’t control their sex drives.

The more you design a society to rely on individual discipline to function well, the more dysfunctional it’s going to become.

I don't think this was your intention, but that statement's logical extreme is authoritarianism. "We can't rely on people to make good decisions, therefore, we have to take aware their ability to make those decisions."

Again, I don't think this was your intention, so I'm not going to hammer that point.

Humans by and large haven’t yet evolved to be more disciplined over baser needs.

This is correct. But humans do have yet another base need that is nearly as strong as food/shelter/sex -- social esteem. Sure, there's a small fraction of a percentage of people out there who literally need zero human interaction, but we can safely round them off for the purpose of this argument. We all need some level of interpersonal approval to live happy and healthy lives.

Status and social esteem matter a lot. A core theme of Lorenzo Warby's "Worshipping The Future" is that our need for status can get warped so that we begin to not only beleive but champion all sorts of awful horrible causes. If a culture can status-associate and amplify a certain thing then that thing will become more valuable.

I believe that for much of human history, chastity was a valued thing. This is where you can cue some antagonistic screeds about "chastity was about ConTRroLLing WomEns BodieSS!!" et cetera. I don't buy it. Chastity was held in esteem because it signaled a lot of valuable, pro-social, and pro-evolutionary traits and conditions. Technology changed the equation.

Much like mass produced food high in simple carbs (i.e. sugar), we, as a species, created a hack for mal-adaptive sexual behavior with the Pill. We then shoe-horned our social reasoning to fit into this technological capability by advocating for "enlightened" free love. But that's a red herring - the number one method of female-to-female character assassination is still largely gossiping about sexual promiscuity. I'd submit that our closely held, personal beliefs about sex are far from the generally accepted popular stance on sex. If anything, it's abstracted into "personal choice" much like saying "I'd never drink and smoke pot everyday, but if someone else wants to do it - and be safe about it - I'm not going to step in their way." Sure, from an abstracted freedom of choice perspective, that's a cohesive argument. But, come on, confront the issue; is smoking and drinking every day a good thing to do? No. Is hopping into bed with someone you've known for a matter of hours a good thing to do again and again in your 20s and 30s ... often with alcohol involved? No. It isn't. Even if "no one gets hurt."

I'm not advocating for a full RETVRN to a virgin-until-marriage situation. I'd simply like to re-link sex to the consequence of pregnancy. On top of that, I'd like to add that sex is emotionally resonant and causes non-physical consequences. The fact of the matter is the plurality of people who hurt women are their intimate partners. Phrased differently, if you are a woman in the west today, the man statistically most likely to harm you (although the absolute probability is quite low) is the guy you're currently sleeping with. I haven't found hard numbers, but it stands to reason that if you're sleeping with multiple guys concurrently, those numbers go up. In short, sex matters in many, many ways. But we treat it like it's a fun little handshake.

Excellent point but I'm going to quibble about what is tradition, what is virtue, and what we're returning to...

Chastity was held in esteem because it signaled a lot of valuable, pro-social, and pro-evolutionary traits and conditions.

But, come on, confront the issue; is smoking and drinking every day a good thing to do? No. Is hopping into bed with someone you've known for a matter of hours a good thing to do again and again in your 20s and 30s ... often with alcohol involved? No. It isn't. Even if "no one gets hurt."

I recently had a drink with a friend of mine. She was upset because her second grade son, together with his second grade boy gaggle of friends, had convinced a retarded kid in their class to make a "naughty" hand gesture. The retarded kid got into trouble, but under interrogation, it became apparent that he had been baited and hoodwinked. Parents were called. She was almost in tears worried she was raising a "bully."

I said that the optimal amount of bullying for a kid to engage in isn't zero. A kid who never does anything bad is probably a herbivorous, smarmy, teacher's pet of a goody-two-shoes. Bullying isn't good in and of itself, picking on retarded kids isn't a good hobby to get into, and certainly she should discipline him for it. But at eight years old, this is a good sign of development in many ways. He's clever, he has a group of friends that have espirit together, he's spirited and engaging in mischief to amuse himself, he's getting along with people and landing towards the top of the hierarchy rather than at the bottom of it. Those are all good things! Discipline him, make sure he isn't growing up to be cruel and take advantage of others; but the alternatives to him growing through this phase probably weren't "he's perfect and would never say anything mean to anyone" but "he's such a teacher's pet that he never has an independent thought or the courage to pursue his own desires" or "he's such a loser that he has no friends that would want to do mischief with him" or "he's at the bottom of the pile getting bullied."

Chastity is a virtue, it shows discipline to make good decisions. But it can also, particularly when taken to extremes, be a result of and indicative of character flaws. It's a pretty frequent problem in evangelical communities that you have the teenagers who are really good at chastity, and then they never grow out of it. It turns out the good chaste boy who never hit on girls was just gay, or that the good chaste girl who never snuck out of the house at night to see her boyfriend is frigid and doesn't "snap out of it" the moment she gets married in a church. The dropping partner counts for young people don't represent good trendlines for society, and certainly not for traditional values.

Similarly, sexual incontinence is mostly a character flaw, and whoring leads to all kinds of bad outcomes. But it can also indicate virtues vs the control group. Seeing something you want and making the moves to get it requires courage and risk taking. Someone who is attractive, who has potential paramours drooling to get with them, is going to require more discipline to achieve chastity than someone who is unattractive; hence why I think celebrity marriages are simply a different animal than ordinary folk.

Truth and virtue exist in conflict, in tension which creates balance. We need to be seeking to set up a tension that produces the virtues we want to see.

I don't think this was your intention, but that statement's logical extreme is authoritarianism. "We can't rely on people to make good decisions, therefore, we have to take aware their ability to make those decisions."

Again, I don't think this was your intention, so I'm not going to hammer that point.

I appreciate that. What I was trying to get at was that if you have a society which assumes most people will act in a way contrary to their nature, that society is not going to work well. Eg the communists and how they expected people to contribute “according to their abilities” without responding to incentives. I don’t know if there’s a better way to word it, but to me you're expecting something similar, of the average person to practice rational discipline instead of succumbing to baser biological drives.

I believe that for much of human history, chastity was a valued thing

Chastity was more reasonable when people were regularly getting married off during their horny teenage years. Not so much these days when many are putting off marriage until their thirties, if ever.

Even back then, with all the pious Christian emphasis on family values, there was plenty of infidelity. So if we could magically make chastity a thing again, there’d probably be less sex, but I’d doubt the effect would be that major.

But let’s assume that we could greatly reduce the amount of sex in society by shaming those who have too many partners. How does less sex make society better?

Yes, I know this is a version of the "we're the normies; they just keep getting crazier!" argument, but ... I think the craziest are saying their quiet part out loud.

Whats the radical part of that sign?

Demanding for it to be free? I do agree that it should be the gentlemen’s responsibility to pay.

"On demand ... no apologies" is the radical part. Those folks are unapologetic (heh) about advocating for 9 month / partial birth abortions (for free) without any caveats like life of the mother, significant abnormality etc.

The Georgia law is a "heartbeat" law. If the fetuses are already dead, there should be no heartbeat and thus no issue. Of course, ProPublica might have mislead the reader about that too. Even if so, there's a "life or serious and irreversible impairment of a major bodily function" exception, and a "medically futile" exception. Both at the judgement of a physician.

We see it in every state with strict laws. Physicians refuse to perform the operation and declare that the mother's life is in jeopardy because of these laws, even though it directly contradicts the text of the law. Then, journalists run with it. I think physicians are using patients as pawns to further their own political beliefs. Plus, if you're a real believer, wouldn't you counteract unethical laws?

Her first pill was taken July 20, so according to Google she should have taken the misoprostol by about July 22.

According to the article, the first pill was taken on August 13th, at the clinic in North Carolina, after the missed appointment for the surgical procedure. She went into the hospital on August 18th.

Ah, thanks! I missed that detail, I will fix it.

So, after she arrived at the hospital, do you think they should have operated sooner or no? Or do you think we don't have enough information to make a determination?

(I'm not necessarily expecting a simple unqualified yes/no answer - I'm just curious about your take on the actual situation itself, independent of the issues you pointed out with the presentation in the article.)

I think it’s important to know how backlogged the hospital was. Some are chronically slow due in part to people using the ER as others would use a primary care doctor.

It could be the case that this was a triaging error that had nothing at all to do with the specifics of her case.

Or maybe it was actually good triage and there were even more urgent conditions occupying doctors before they could get to her.

What if it was slow because of an influx of Haitian refugees in the area?

So, after she arrived at the hospital, do you think they should have operated sooner or no? Or do you think we don't have enough information to make a determination?

I'm not a physician, so it's not clear to me whether the article gives enough information on this particular choice or not. The committee (which I assume includes some medical personnel, but which apparently does not consist exclusively of physicians) seems to think the operation should have occurred sooner, and that doesn't seem obviously wrong to me:

After reviewing Thurman’s case, the committee highlighted Piedmont’s “lack of policies/procedures in place to evacuate uterus immediately” and recommended all hospitals implement policies “to treat a septic abortion on an ongoing basis.”

The claim that Georgia's abortion law is specifically responsible for the "lack of policies/procedures" in question does not appear justified by the evidence available. Nobody in a position to know ever said, "we delayed this critical operation because of the law," and the article always stops just short of actually making that assertion. The whole essay is an exercise in suggesting a certain interpretation of events. From a purely technical standpoint, it's well-crafted propaganda. Ultimately, the story doesn't hold up, but in order to do the work it appears intended to do, the story doesn't have to hold up. It just needs the approximate "truthiness" of statements like "Haitian immigrants in Springfield, Ohio are eating cats."

There's... also a really morbid question, whether the law clearly excludes the D&C here from its coverage. The statute is available online:

No abortion is authorized or shall be performed if an unborn child has been determined in accordance with Code Section 31-9B-2 to have a detectable human heartbeat except when: A physician determines, in reasonable medical judgment, that a medical emergency exists; [rape or incest and genetic abnormalities exceptions not relevant here]

What is 'medical emergency' defined as?

'Medical emergency' means a condition in which an abortion is necessary in order to prevent the death of the pregnant woman or the substantial and irreversible physical impairment of a major bodily function of the pregnant woman. No such greater risk shall be deemed to exist if it is based on a diagnosis or claim of a mental or emotional condition of the pregnant woman or that the pregnant woman will purposefully engage in conduct which she intends to result in her death or in substantial and irreversible physical impairment of a major bodily function.

There are certainly some state laws that have overly restrictive rules, but these exceptions seem, at least to my layman's eyes, reasonably well-written to include serious dangers to physical health, while excluding mental health or suicide/self-harm risk. There are fair arguments regarding whether it is good policy. There are probably even non-crazy reasons to argue that some of the other exceptions are insufficiently clear -- there's some clear tradeoffs around the fuzzy area between 'spontaneous miscarriage' and 'tots not self-induced'.

I've not seen a particularly credible argument why this case doesn't fall under this exception, even well considering hindsight bias. ProPublica doesn't seem to link the leaked report (for some reason!), but I don't think you need to wait til 9AM ("organs failing") or 645AM ("taken to the intensive care unit") is necessary, and the doctors here waited until 2PM. I think there's a very strong support about medical necessity 930PM the night before. That seems especially true given that these laws have literally never been used against a doctor in Georgia, where we have countless examples of insufficient care medical liability in the same time period. I don't think anyone individually made cackling laughter and then wrote down 'kill her' on Thurman's medical history eight hours in, but there's pretty serious and systemic errors if 'vomiting blood' and 'acute severe sepsis' isn't being considered a medical emergency.

It's a really controversial claim to propose that hospital as systems are willing to fuck around in deniable ways to make politically-useful arguments, while playing with their patient's lives, and incredibly bad claim if true. I would like to get some set of more serious arguments against it than other ProPublica authors are willing to attempt, because I'm gonna make it.

Instead, a clinic employee offered Thurman a two-pill abortion regimen approved by the U.S. Food and Drug Administration, mifepristone and misoprostol. Her pregnancy was well within the standard of care for that treatment.

D&C

No abortion is authorized or shall be performed if an unborn child has been determined in accordance with Code Section 31-9B-2 to have a detectable human heartbeat except when

I am in agreement with you that there would have been no violation of the law as you have quoted, and that the hospital's behavior here sounds egregiously negligent. Under what circumstances is it permissible to wait 5 hours to treat acute sepsis? D&C is usually indicated when a fetus has no heartbeat, and the combination of mifepristone and misoprostol will stop the fetus's heart (mifepristone=shed uterine lining, killing the fetus, misoprostol=induce contractions to push the dead fetus out). So when she showed up at a clinic in Georgia, performing a D&C would have been within the letter of the law.

To steelman the opposing side, perhaps there is another exemption in the law for "care which aids and abets an illegal abortion," or the clinic was critically slow in offering treatment because there was no technician available to check for fetal heartbeats (ultrasound), and this nuance was lost on the journalist.

Anyway, after hearing about the sepsis the lesson is to never visit Georgia, and if you do, never go to Piedmont Henry Hospital in Stockbridge. Never know if doctors there will wait three hours to treat your heart attack because your wife is pregnant.

To steelman the opposing side, perhaps there is another exemption in the law for "care which aids and abets an illegal abortion,"

Don't steelman this. Let someone point to it, or check the law yourself. Otherwise you're simply failing to let yourself come to an accurate conclusion.

Fair point. That text is not in the law. Removing.