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Kermit Gosnell's Pro-Choice Enablers (Is This What an Industry That Self-Regulates Looks Like?)

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The ultimate non-partisan body – a criminal grand jury – has supplied us with the graphic, 261-page horror story of Kermit Gosnell, M.D., who stands accused of butchering seven babies – yes, after they were born alive -- and fatally doping a refugee from Nepal with Demerol in a clinic that smelled of cat urine, where the furniture was stained with blood and the doctor kept a collection of severed baby feet. As often as possible, the report says, Gosnell induced labor for women so pregnant that, as he joked on one occasion, the baby was so big he could "walk me to the bus stop." Then, hundreds of times over the years, he slit their little necks, according to the grand jury report:

[He] regularly and illegally delivered live, viable, babies in the third trimester of pregnancy – and then murdered these newborns by severing their spinal cords with scissors. The medical practice by which he carried out this business was a filthy fraud in which he overdosed his patients with dangerous drugs, spread venereal disease among them with infected instruments, perforated their wombs and bowels – and, on at least two occasions, caused their deaths. Over the years, many people came to know that something was going on here. But no one put a stop to it.

And the kicker? This nightmare facility had not been inspected in 17 years – other than by someone from the National Abortion Federation, whom he actually invited there. For whatever reason, Gosnell applied for NAF membership two days after the death of the 41-year-old Nepalese woman, Karnamaya Mongar. Even on a day when the place had been scrubbed and spiffed up for the visit, the NAF investigator found it disgusting and rejected Gosnell's application for membership. But despite noting many outright illegalities, including a padlocked emergency exit in a part of the clinic where women were left alone overnight, the grand jury report notes that the NAF inspector did not report any of these violations to authorities:
So too with the National Abortion Federation. NAF is an association of abortion providers that upholds the strictest health and legal standards for its members. Gosnell, bizarrely, applied for admission shortly after Karnamaya Mongar's death. Despite his various efforts to fool her, the evaluator from NAF readily noted that records were not properly kept, that risks were not explained, that patients were not monitored, that equipment was not available, that anesthesia was misused. It was the worst abortion clinic she had ever inspected. Of course, she rejected Gosnell's application. She just never told anyone in authority about all the horrible, dangerous things she had seen.

The report says outright that the lack of oversight after pro-life Democrat Bob Casey left the Pennsylvania governor's office in 1993 was overtly political. When pro-choice Republican Tom Ridge took over for Casey, the report says,
...[t]he Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all. The politics in question were not anti-abortion, but pro. With the change of administration from Governor Casey to Governor Ridge, officials concluded that inspections would be "putting a barrier up to women" seeking abortions. Even nail salons in Pennsylvania are monitored more closely for client safety. Without regular inspections, providers like Gosnell continue to operate; unlawful and dangerous third-trimester abortions go undetected; and many women, especially poor women, suffer.
This is where those of you who are pro-choice may well want to cross your arms over your chest, but the kind of regulation that if enforced might have prevented this atrocity is in all cases seen as an infringement by abortion rights advocates, and thus is strenuously opposed. In Evansville, Indiana, for instance, the pro-choice community was outraged in 2008 after county commissioners passed an ordinance requiring abortion clinic doctors to have hospital admitting privileges. As an Evansville Courier editorial decrying the ordinance put it, "Abortion rights groups see it as an attempt to harass abortion providers and to limit women's access to legal abortions.'' But wouldn't such a requirement also provide a degree of protection to women – particularly the poor, immigrant population Gosnell preyed upon? Not surprisingly, Gosnell had no such hospital admitting privileges, though he was well known to local hospital doctors who, the report says, regularly had to clean up after him, and treat patients like the 19-year-old who had to have a hysterectomy after Gosnell punctured her uterus.

Abortion-rights activists call such regulations "TRAP laws" – short for Targeted Regulation of Abortion Providers; these laws attempt to regulate abortion clinics at the same level of other outpatient surgical centers, for instance by requiring that hallways be wide enough to get a gurney through if something goes wrong. What difference could that possibly make? Well, it took Emergency Medical Service workers 20 minutes to get Karnamaya Mongar out of Gosnell's clinic and into an ambulance because the hallways were blocked and the emergency exit padlocked. (Here, Tarina Keene, the executive director of NARAL Pro-Choice Virginia, registers the standard complaint that such regulation is too costly and is "really just designed to shut these places down. It has nothing to do with medical care.")

Only, on the day of the annual marches marking the 38th anniversary of Roe v. Wade, I want to ask my pro-choice friends whether opposing all regulation is in fact in the best interest of the women I know you care about. Wherever you stand on this issue – and I am a liberal Catholic who is not pro-choice – we agree that what Gosnell is accused of doing exceeds all bounds of decency. But without regulation and enforcement, how can we be sure there aren't other Gosnells out there?

Other kinds of free-standing ambulatory clinics are inspected periodically by state health departments, but abortion clinics are not, says Mary Spaulding Balch, of National Right to Life, who tracks legislation and regulations in all 50 states. And, again quoting from the grand jury report, here is what the lack of enforcement of regulations already on the books looks like:
Almost a decade ago, a former employee of Gosnell presented the Board of Medicine with a complaint that laid out the whole scope of his operation: the unclean, unsterile conditions; the unlicensed workers; the unsupervised sedation; the underage abortion patients; even the over-prescribing of pain pills with high resale value on the street. The department assigned an investigator, whose investigation consisted primarily of an offsite interview with Gosnell. The investigator never inspected the facility, questioned other employees, or reviewed any records. Department attorneys chose to accept this incomplete investigation, and dismissed the complaint as unconfirmed.
Shortly thereafter the department received an even more disturbing report – about a woman, years before Karnamaya Mongar, who died of sepsis after Gosnell perforated her uterus. The woman was 22 years old. A civil suit against Gosnell was settled for almost a million dollars, and the insurance company forwarded the information to the Department of State. That report should have been all the confirmation needed for the complaint from the former employee that was already in the department's possession. Instead, the department attorneys dismissed this complaint, too. They concluded that death was just an "inherent" risk, not something that should jeopardize a doctor's medical license.

The same thing happened at least twice more: The department received complaints about lawsuits against Gosnell, but dismissed them as meaningless. A department attorney said there was no "pattern of conduct." He never bothered to check a national litigation database, which would have shown that Gosnell had paid out damages to at least five different women whose internal organs he had punctured during abortions."

Though we're constantly told that there are only a handful of brave doctors performing late-term abortions, an '06 survey by the pro-choice Guttmacher Institute in New York found that about 1.5 percent of the 1.2 million abortions performed annually – in other words, about 18,000 abortions a year -- are performed at 21 weeks or later. Nearly a quarter of providers, according to Guttmacher, offer abortions after 20 weeks, and slightly more than 1 in 10 will perform an abortion after 24 weeks. That translates to 140 known providers doing truly late-term procedures. But as the National Right to Life's Douglas Johnson asks, "Do you suppose this guy in Philadelphia was dutifully filling out the Guttmacher reports and turning them in?"

I'm well aware that the counter-argument is that if late-term abortions in particular were more readily accessible and less stigmatized, there would be fewer Gosnells in this world. But how stigmatized was he, pocketing $1.8 million a year while allegedly maiming women and killing their living, breathing children with no apparent fear of detection from officials who according to the grand jury feared that inspections would pose obstacles to choice?

Though I've never heard of any case this grisly, Johnson says it's "not all that isolated a case, but usually they're just local news stories.'' Last year, the license of New Jersey abortion doctor Stephen Brigham was pulled after authorities learned he was routinely starting illegal late-term abortions in New Jersey then transporting the women to Maryland to finish the job. And how was he discovered? Again, by accident. According to a recent story by The Associated Press, "Brigham's practices first caught the attention of Maryland regulators after a patient was hospitalized with a ruptured uterus and small intestine.''

This story reports on the owners of several shoddy Florida clinics, including the one in Hialeah where in 2006, an 18-year-old who was 23 weeks pregnant gave birth to a child whose body was discovered, according to the police, after someone reported hearing crying coming from a trash can. Officers who searched the clinic said they finally found the body where it had been moved -- in a biohazard bag stashed on the clinic's roof.

And a case that made the news 20 years ago now involved New York's Abu Hayat, whom the tabloids dubbed "The Butcher of Avenue A." As it happened, I knew Hayat by sight – and talk about the banality of evil -- because he lived in my building, where I frequently wound up sharing a lap lane with him in the pool.

In each of these well-known cases, many more victims came forward after some particularly gruesome event brought these doctors' methods to light; how many more like them go undetected?

In 2002, a piece of legislation called the "Born-Alive Infant Protection Act'' began requiring doctors to treat children born alive during abortions the same way they treat other newborns. Initially, advocates for choice adamantly opposed that legislation, too, as an assault on Roe v. Wade.

But what about assaults on children who, having somehow gotten out of the birth canal alive, we agree are children? And what of the assaults on women, who uniformly deserve sterile conditions and an unlocked emergency exit? How can we know they are treated competently without the regulation and oversight of this, as any other industry? Just like other industries, the abortion industry prefers the self-policing that in the Gosnell case did not prevent tragedy any more than the self-regulation and lax enforcement of the oil industry prevented the BP oil spill.

On Saturday, President Obama affirmed his support for Roe v. Wade by saying that "government should not intrude on private family matters." But it's a hands-off lack of oversight that allowed Kermit Gosnell to do so much damage before he was finally stopped – by accident, by authorities investigating him for over-prescribing OxyContin.

Perhaps Gosnell himself best summed up the underlying problem at his arraignment, where he reportedly seemed confused by the proceedings: "I understand the one count, because a patient died,'' he told the court, "but I didn't understand the seven counts.'' It apparently never occurred to him that the dead infants – one of them photographed in a plastic shoe box, another kept frozen in a gallon of spring water – were people, too.


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Filed Under: Abortion, Woman Up

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202 Comments

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marcie

I feel as though articles such as these try to deter people and their beliefs for pro-choice. Instances such as these are tragic, and those not following regulations should be persecuted (Including the states, and organizations incharge of making sure regulations are followed). Just as any clinic should follow regulations, and assure quality care for individuals, abortions clinics should as well. There are a gazillion stories of malpractice and maltreatment of patients. Organizations, Certificate Boards, State, and Federal contictuants need to assure quality health care is being provided. This article makes it seem that pro-choice is wrong because every clinic is like this. When this is not the case, instead of targeting abortions and pro-choice rights as a whole, we should be looking at health care as a whole and how clinics and hospitals are providing unsafe conditions- and should be shut down or reevaluated immediately. It seems from this article that much of this maltreatment could have been avoided if concerns upon first reports would have been taken seriously, and people were doing their jobs.

February 14 2011 at 2:05 PM Report abuse rate up rate down Reply
jgb662

I'm more apt to believe that this is due to the pressure by the Anti-Choice lobby to keep these things out of light - and therefore in the dark until something like this happens.

No pro-choice person is anti-life; symantics; they just refuse to speak for God and make judgements on his behalf - if that's what YOU believe. Pro-choice - is choice for the individul - not for government and not for religulous nutz to regulate.

January 26 2011 at 11:24 AM Report abuse -1 rate up rate down Reply
notherposter

Gosnell's acts were evil, but apparently he did not believe they were. He appears to have believed that it was more important to end as many fetus' existences as possible than to strictly adhere to good medical practices. The arguments against regulation of abortion providers seem to follow the same logic: ensuring safe, sanitary medical care is not necessary in this one area. The argument that healthcare providers in other areas are exempt from review is false: witness Octomom's doc; or Kanye's mother's doc (resulting in "Donda West's law"); or Anna Nicole Smith's; or Michael Jackson's. Only this one area of medicine requires the patients to assume unknown risks, without prior protection from any regulatory body, and without full malpractice recourse, as it is very difficult to prove malpractice when there are no acepted standards of practice.

January 26 2011 at 12:22 AM Report abuse rate up rate down Reply
skytel9

Melinda, their trying to wash their hands of this industry, because both sides are ashamed of it's existence. One side wants it to go away the other is too afraid to regulate and enforce it, so this kind of sh*t happens.

January 25 2011 at 11:22 PM Report abuse +3 rate up rate down Reply
johmich5

Melinda thank you, good article. I too am Catholic. However, I am pro-life and agree with the Catholic and Biblical position on the issue; That unborn children are persons at conception. The churches position is not one of making abortion illegal but of making it a rare procedure used only to preserve life. Both lives must be considered. Science now disproves Roe v Wade’s ruling that human life and personhood begin at birth. Roe v Wade is state imposed religious belief that the unborn child is not alive nor human and is therefore ok to kill. Common sense proves what these liberal judges could not reason, that the unborn person is a person. Birth simply exposes the already alive existent person, it does not initiate life or personhood. The 2003 Illinois Born-Alive Infants Protection bill (SB 1082) would have passed the Illinois Senate in 2003, if Chairman Obama had not killed it in his committee. This bill defended the proposition, "A live child born as a result of an abortion shall be fully recognized as a human person and accorded immediate protection under the law." Obama voted to allow abortion of live born babies he has no intention of regulating the industry. To understand abortion we must consider the intentions of its founder and president of Planned Parenthood, Margaret Sanger. She was a racist and advocate of eugenics through abortion. Christian Republicans abolished the injustice of Slavery, Christian Republicans will abolish the injustice of abortion on demand.

January 25 2011 at 12:08 PM Report abuse +6 rate up rate down Reply
eh21168

This case has perhaps shaken my trust in governmental oversight, but, the horror of these incidences, if anything, affirms my commitment to removing all persistent economic, political, and social barriers between women and abortions.
The facts are that most(a little under 90%) women who get abortions do so within the first trimester or the first few weeks of the second trimester. The Guttmacher Institute, whom we have to believe this author trusts as a source as she's willing to quote their figures on late term abortion rates, also did a study on the multiple reasons women sought later-term abortion rather than earlier-term abortions. More than 50% of the polled group cited difficulties in arraigning an abortion any earlier, and 15% cited pressure from others not to have abortions as an additional reason for waiting. One can speculate about legitimate reasons why some of these women may not have been able to arrange an earlier abortion, but you don't need to, I can testify. I had a destitute friend whose was pregnant for 5 weeks when she decided to have an abortion. She had to wait another 3 before she had enough money together to get even a subsidized abortion at planned parenthood, and this was a woman who did not take stigma against it to heart and felt no shame reaching out to friends for help. Combine this difficulty with the social stigma generated by oft-proselytized ignorance about developmental differences between fetuses at various stages of gestation, and you can count on the delay being even longer. Every woman who gets shamed away from a clinic in their 6th week by a vitriolic protest is a woman who has a chance of returning in their 13th or 15th or 23rd week, at a stage in fetal development when the issue of a fetus being like a baby is a great degree less philosophical than it was when the fetus was half the size of a lemon.
So if you don't want to put women at risk, and you really want to shrink the already minute black market for illegal late-terms abortions for the sake of eliminating a measure of human suffering, stop picketing and politically obstructing the family planning centers that do their jobs well, encourage women to think of their pregnancies as a choices about potentialities to be made early on, without fear of stigma or reprisal either way, when the humanity of a fetus or zygote really is an issue of semantics more than an issue of location.
The answer most certainly is not a revival of hard-line pro-life policy. Under such a system you increase black market demand and hindrances to early-term abortion, thereby lengthening the amount of time women who WILL STILL SEEK abortions must wait before terminating pregnancy, almost definitely ensuring that more fetuses will be old enough not only to feel pain, but to experience it in a way not dissimilar to how a newborn would, and all at greater risk to the patients health and personal freedom.

January 25 2011 at 11:27 AM Report abuse -4 rate up rate down Reply
1 reply to eh21168's comment
johmich5

eh21168, You seem to overlook the obvious. The rights of the unborn child, which are central to the entire debate. Life is the first and greatest right, without it no other rights exist. The issue of the humanity of the zygote and of the fetus is not one of semantics nor is it one of philosophy anymore than slavery was and issue of semantics and philosophy. Advocates of slavery argued that black people were only 3/5ths human and as such were property to be sold or destroyed at will. The supreme court so ruled. Sound familiar? Human life is the process of human cells living, growing and dividing. That process begins at conception and will end at death. That is the scientific fact of the matter. It is philosophy and religious belief that argues otherwise. The zygote contains the complete genetic instructions and essential life force for the entire human person that it is becoming. Just like you, and me. Abortion needs to be regulated in a manor that will protect the rights of our youngest citizens, unborn children.

January 25 2011 at 1:16 PM Report abuse +3 rate up rate down Reply
n6fb

This writer is using several singular examples of abortion clinics and physicians who have not lived up to their obligations to provide sanitary and safe conditions to practice any kind of medicine. She completely ignores the 99.9% of abortion providers who do it the right way., ie, safe and sanitary.

Her real motivation is to make a case for outlawing abortion enitirely, but she fails completely because the article is so obvioulsy biased towards ant-abortion philosophies. She fails to do so because her arguments are incomplete and intellectually incompetent.


What does she think the illegal abortion facilities, that abounded before Roe Wade, looked like??

January 25 2011 at 8:58 AM Report abuse -4 rate up rate down Reply
3 replies to n6fb's comment
janedear9

A woman's right to choose...to murder their baby. How can any self respecting women fight for this...this choice, as they call it? Why is it sooooo hard to carry baby to term? How spoiled is this? Nine months and then you are free. These woman are hiding behind women's rights, using women's rights as a way to shirk their female RESPONSIBILTIES. Yes, female responsibilities. We have this wonderful gift, to bring life into this world, and what do some ding -bats want to do? Kill baby ON DEMAND, whenever they want. Spoiled and selfish, and evil. I am sorry, but that is what it is. There is NO nice abortion. It is an act of violation of the highest order. Abortion IS HORRIBLE AND GRUESOME. Because murder of tiny babies is horrible and gruesome. How can some woman not only defend this, but fight for this right? Would it be the end of the world if you'd carry him/her to term? Nine whole months. The difference between doing the right thing, and murder.

January 25 2011 at 1:52 AM Report abuse +3 rate up rate down Reply
dcdiggs525

I am very pro-choice, but can not understand why regular inspections of clinics that perform abortions can be seen as an attack on Roe v. Wade. It boggles the mind! There has to be some other reason behind this dangerous lack of regulation. There has to be!

January 24 2011 at 11:37 PM Report abuse +2 rate up rate down Reply
2 replies to dcdiggs525's comment
rjsparling

Yes, a lot of people are thinking the same thing.

The fact is that there are a few hack doctors in all areas of medicine - cosmetic surgery for instance. The difference is that cosmetic surgeons do not have people chasing after them to shut them down or kill them.

The stigma placed on doctors who perform abortions have forced them into the margins of the medical community, and when you are already on the margin, you don't have as far to go to get out of bounds.

Clinic inspection would not be nearly as threatening to abortion rights groups if there was no fear that they would be used to outlaw the practice.

January 25 2011 at 7:26 AM Report abuse +1 rate up rate down Reply
dwtn001

The point the author fails to make is that the stigmitization of abortion among providers allows this type of facility to flourish. Put it another way, if those who frequently argue for market solutions to problems would apply the principle to abortion, providers like Gosnell would not exist because the market would put them out of business. But because abortion has been so restricted in the country, women are denied a functioning market to ferret out the bad providers, and end up taking what they can get.

January 26 2011 at 8:13 AM Report abuse +1 rate up rate down Reply
BABA Barbara Ann

I believe reversing Roe vs Wade would make places like this more common not less, however, there would be no records and they would be more mobile. ER's would still be cleaning up the messes trying to save these young women's lives. They would all be illegal so there would be no governing agencies. I am not for abortion. I am for choice. This place was horrible I agree. Im sure there are clean good facilities in Pa. as well.

January 24 2011 at 11:18 PM Report abuse +1 rate up rate down Reply
3 replies to BABA Barbara Ann's comment

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