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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..."
Ohhhh. So the headline could literally have been, "woman in Georgia killed by abortion pills" with no noticeable loss of information?
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:
Lest ye be tempted to believe we're talking about a low-value citizen! She was gonna be a nurse someday, probably maybe!
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."
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.)
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.
Good.
Shocking.
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--
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!"
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?"
"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 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...
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.
Apparently not a HIPAA violation?
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:
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.
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:
"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!'"
Sounds like Garrison Douglas knows what's up.
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.
Her twins, had they survived, would be nearly 2 years old.
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'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:
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:
What is 'medical emergency' defined as?
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.
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," orAnyway, 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.
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.
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