Mr. Speaker, this bill is unconstitutional. The bill before us will not prohibit any abortions. Its supporters claim it prohibits a procedure, but the abortion will still take place involving another procedure, and I will not inflame the…
Mr. Speaker, this bill is unconstitutional.
The bill before us will not prohibit any abortions. Its supporters claim it prohibits a procedure, but the abortion will still take place involving another procedure, and I will not inflame the debate by describing in detail the alternative procedures that may be used. But I will point out that Nebraska had a law banning the same procedure. Nearly 3 years ago the United States Supreme Court held in Stenberg v. Carhart that that law was unconstitutional.
The Supreme Court said five times in its majority opinion and other times in concurring opinions that in order to make a partial-birth abortion ban constitutional, the law must contain a health exception to allow the procedure, quote, ``where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.'' That is what five Supreme Court justices said was necessary to make the bill constitutional. All five are still on the Supreme Court.
In that case, the Court said:
The question before us is whether Nebraska's statute making criminal the performance of a partial-birth abortion violates the Federal Constitution as interpreted in Planned Parenthood v. Casey and Roe v. Wade. We conclude that it does for at least two independent reasons.
They said the first reason was that the law lacked an exception for the preservation of the health of the mother. The Stenberg court reminded us what a long line of cases has held, that, and they say, ``subsequent to viability, the State may, if it chooses, regulate and even proscribe abortion,'' and they put this in italics, ``except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.''
It goes on to say, in quotes, in case we did not understand the italics, that the governing standard requires an exception, quote, ``where it is necessary in the appropriate medical judgment for the preservation of the life or health of the mother.''
The Court continues talking about the health exception by saying and mentions another quote:
Justice Thomas said that ``The cases just cited limit this principle to situations where the pregnancy itself creates a threat to health.'' He is wrong. The cases cited, reaffirmed in Casey, recognize that a State cannot subject women's health to significant health risks both in that context and also where State regulations force women to use riskier methods of abortion. Our cases have repeatedly invalidated statutes that in the process of regulating the methods of abortion imposed significant health risks. They make it clear that the risk to a woman's health is the same whether it happens to arise from regulating a particular method of abortion or from barring abortions entirely.
Finally, the Court says:
Nebraska has not convinced us that a health exception is, quote, ``never medically necessary to preserve the health of women.'' Rather, a statute that altogether forbids the partial-birth abortion creates a significant health risk. The statute subsequently must contain a health exception.
And if we did not get it, the Court reiterates again:
``By no means must a State grant physicians unfettered discretion in their selection of methods. But where substantial medical authority supports the proposition that banning a particular method could endanger women's health, Casey requires the statute to include a health exception when the procedure is, quote, 'necessary in appropriate medical judgment for the
preservation of the life or health of the mother.' Requiring such an exception in this case is no departure from Casey, but simply a straightforward application of its holding.''
Mr. Speaker, whatever our views are on the underlying issue of abortion, we ought to read the decision and apply the law. The Supreme Court in one opinion said at least five times that a health exception must be included for the statute to be constitutional. Furthermore, they put the exact phrase to be used, ``necessary, in appropriate medical judgment, for the preservation of the life or health of the mother'' in italics and quotations.
The majority proposes that we consider a bill without this unqualified health exception. The Court made it clear that such a health exception is required and, therefore, this rule that requires us to consider a bill without that exception ought not pass.
Mr. Speaker, I ask the House to defeat the rule so that we can have a bill considered with a health exception that might possibly be constitutional.
Mr. Speaker, I include for the Record a Statement of Policy from the American College of Obstetricians and Gynecologists which says that this procedure may be necessary in some circumstances.
The American College of Obstetricians and Gynecologists Statement of
Policy on Abortion
The following statement in the American College of
Obstetricians and Gynecologists' (ACOG) general policy
related to abortion, with specific reference to the procedure
referred to as ``intact dilatation and extraction'' (intact D
& X).
1. The abortion debate in this country is marked by serious
moral pluralism. Different positions in the debate represent
different but important values. The diversity of beliefs
should be respected.
2. ACOG recognizes that the issue of support of or
opposition to abortion is a matter of profound moral
conviction to its members. ACOG, therefore, respects the need
and responsibility of its members to determine their
individual positions based on personal values or beliefs.
3. Termination of pregnancy before viability is a medical
matter between the patient and physician, subject to the
physician's clinical judgment, the patient's informed consent
and the availability of appropriate facilities.
4. The need for abortions, other than those indicated by
serious fetal anomalies or conditions which threaten maternal
welfare, represents failures in the social environment and
the educational system.
The most effective way to reduce the number of abortions is
to prevent unwanted and unintended pregnancies. This can be
accomplished by open and honest education, beginning in the
home, religious institutions and the primary schools. This
education should stress the biology of reproduction and the
responsibilities involved by boys, girls, men and women in
creating life and the desirability of delaying pregnancies
until circumstances are appropriate and pregnancies are
planned.
In addition, everyone should be made aware of the dangers
of sexually transmitted diseases and the means of protecting
each other from their transmission. To accomplish these aims,
support of the community and the school system is essential.
The medical curriculum should be expanded to include a
focus on the components of reproductive biology which pertain
to conception control. Physicians should be encouraged to
apply these principles in their own practices and to support
them at the community level.
Society also has a responsibility to support research
leading to improved methods of contraception for men and
women.
5. Informed consent is an expression of respect for the
patient as a person; it particularly respects a patient's
moral right to bodily integrity, to self-determination
regarding sexuality and reproductive capacities, and to the
support of the patient's freedom within caring relationships.
A pregnant women should be fully informed in a balanced
manner about all options, including raising the child
herself, placing the child for adoption, and abortion. The
information conveyed should be appropriate to the duration of
the pregnancy. The professional should make every effort to
avoid introducing personal bias.
6. ACOG supports access to care for all individuals,
irrespective of financial status, and supports the
availability of all reproductive options. ACOG opposes
unnecessary regulations that limit or delay access to care.
7. If abortion is to be performed, it should be performed
safely and as early as possible.
8. ACOG opposes the harassment of abortion providers and
patients.
9. ACOG strongly supports those activities which prevent
unintended pregnancy.
The College continues to affirm the legal right of a woman
to obtain an abortion prior to fetal viability. ACOG is
opposed to abortion of the healthy fetus that has attained
viability in a healthy woman. Viability is the capacity of
the fetus to survive outside the mother's uterus. Whether or
not this capacity exists is a medical determination, may vary
with each pregnancy and is a matter for the judgment of the
responsible attending physician.
Intact Dilatation and Extraction
The debate regarding legislation to prohibit a method of
abortion, such as the legislation banning ``partial birth
abortion,'' and ``brain sucking abortions,'' has prompted
questions regarding these procedures. It is difficult to
respond to these questions because the descriptions are vague
and do not delineate a specific procedure recognized in the
medical literature. Moreover, the definitions could be
interpreted to include elements of many recognized abortion
and operative obstetric techniques.
ACOG believes the intent of such legislative proposals is
to prohibit a procedure referred to as ``intact dilatation
and extraction'' (Intact D & X). This procedure has been
described as containing all of the following four elements:
1. deliberate dilatation of the cervix, usually over a
sequence of days;
2. instrumental conversion of the fetus to a footling
breech;
3. breech extraction of the body excepting the head; and
4. partial evacuation of the intracranial contents of a
living fetus to effect vaginal delivery of a dead but
otherwise intact fetus.
Because these elements are part of established obstetric
techniques, it must be emphasized that unless all four
elements are present in sequence, the procedure is not an
intact D & X. Abortion intends to terminate a pregnancy while
preserving the life and health of the mother. When abortion
is performed after 18 weeks, intact D & X is one method of
terminating a pregnancy.
The physician, in consultation with the patient, must
choose the most appropriate method based upon the patient's
individual circumstances.
According to the Centers for Disease Control and Prevention
(CDC), only 5.3% of abortions performed in the United States
in 1993, the most recent data available, were performed after
the 16th week of pregnancy. A preliminary figure published by
the CDC for 1994 is 5.6%. The CDC does not collect data on
the specific method of abortion, so it is unknown how many of
these were performed using intact D & X. Other data show that
second trimester transvaginal instrumental abortion is a safe
procedure.
Terminating a pregnancy is performed in some circumstances
to save the life or preserve the health of the mother.
Intact D & X is one of the methods available in some of
these situations. A select panel convened by ACOG could
identify no circumstances under which this procedure, as
defined above, would be the only option to save the life or
preserve the health of the woman. An intact D & X, however,
may be the best or most appropriate procedure in a particular
circumstance to save the life or preserve the health of a
woman, and only the doctor, in consultation with the patient,
based upon the woman's particular circumstances can make this
decision. The potential exists that legislation prohibiting
specific medical practices, such as intact D & X, may outlaw
techniques that are critical to the lives and health of
American women. The intervention of legislative bodies into
medical decision making is inappropriate, ill advised, and
dangerous.
Approval by the Executive Board. General policy: January
1993. Reaffirmed and revised July 1997. Intact D & X
statement: January 1997. Combined: and reaffirmed September
2000.