Virginia Governor Bob McDonnell has decided it isn't necessary to force a transvaginal ultrasound on a woman seeking an abortion. His new perspective is a surprise, since he had previously backed a Republican sponsored bill which requires women to get an ultrasound prior to receiving an abortion. In order to capture a useable image, the bill requires a transvaginal ultrasound for women in the first trimester of their pregnancies. A Democratic sponsored amendment that would have requested a woman's consent prior to the transvaginal procedure was defeated by the legislature's Republican majority.
Evidently, the widespread attention the bill has received, heightened no doubt by Presidential election-year politics, and McDonnell's own ambitions to be selected as a Vice Presidential candidate, shifted his thinking. Now he says, “Mandating an invasive procedure in order to give informed consent is not a proper role for the state." He's OK mandating an ultrasound, and requiring the doctor to offer a transvaginal option, but if the patient says no thanks, he wants to leave it at that.
This is where things get weird. After all, a law requiring a doctor to provide images of your uterus, whether the images are produced from a transvaginal procedure or merely by waving the wand over a blue-goo covered belly, seems awfully intrusive to me. Nevertheless, one of the migraine-inducing inconsistencies in the modern-day GOP is this: Looking at someone's uterus is OK. But looking at me in my underwear isn't. This is the party, after all, who got worked up over the Transportation Security Administration's decision to roll out full-body scanners at America's airports because these scanners were "too intrusive." In fact, even Virginia Governor Bob McDonnell, who evidently thinks taking snapshots of women's uteri is OK, is on record saying the body scanners are "over the line" and unnecessarily intrusive. As Jon Stewart has helpfully pointed out, maybe someone should explain to McDonnell that his bill is like requiring a pat down of a woman's uterus.
Update: March 1. Dahlia Lithwick adds a helpful perspective to the analysis of Virginia's mandatory ultrasound bill. From her essay in Slate:
State Sen. Ralph Northam, who is a pediatric neurologist, tells me today that the amended bill doesn’t solve the underlying problems of the original ultrasound law. “This will be the first time in the history of the Commonwealth,” he says, “that a group of legislators are telling doctors how to practice medicine.” He adds that by making the transvaginal procedure optional, the bill forces doctors to do a trans-abdominal ultrasound even in the early weeks of a pregnancy, before anything can even be seen. “They are telling us to do a costly and unnecessary procedure that won’t even work,” he explains. In the end, he says, calling it an “informed consent bill” is misleading.
And indeed it is misleading. It is more than that. Pretending that the bill's intention is to give women "more information" about a medical procedure is transparently phony. Hospitals and clinics already have in place carefully structured processes to guarantee that patients know what they need to know about medical procedures, potential risks, and likely side effects. The American Hospital Association's Patient Bill of Rights has become the template for how most care-givers approach these questions. Among the protections the AHA's Bill of Rights provides is this:
The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information concerning diagnosis, treatment, and prognosis. Except in emergencies when the patient lacks decision-making capacity and the need for treatment is urgent, the patient is entitled to the opportunity to discuss and request information related to the specific procedures and/or treatments, the risks involved, the possible length of recuperation, and the medically reasonable alternatives and their accompanying risks and benefits.
So why does Governor Bob McDonnell think he needs to get involved? It is inescapably clear this is about making abortions harder to get. Poor women without insurance will have to pay for the procedure - the state mandates the procedure but doesn't pay for it. Women will need to wait for 24 hours after the procedure to have an abortion. This imposes an unacceptable burden on all women, but especially low-income women working hourly jobs, who will need to give up two days of work, or portions of two days, to have the ultrasound and the abortion done.
Strangely, there is a golden lining in all of this, if you squint hard enough. McDonnell has been careful to position all of his rhetoric about this in the landscape of medicine. Does that mean we have turned a corner, and the political conversation about abortion is now taking place in the realm of medical science, not morality? Much of what politicians say about abortion now, and the justifications for their legal obstacles that aim to prevent women from getting abortions, involves concerns about the "psychological and emotional health" of women who get abortions or, as in this case, concern about women "as patients." Clearly this is tactical. Abortion opponents still oppose abortion on moral and religious grounds. But the fact that the argument is now taking place in a new space, in the secular world of medical care and patients' rights, is a good thing. It is impossible to win an argument about what God wants. It is simple to win an argument about whether or not we have adequate protections for patients in place. We may not, but that is a dispute that can be addressed with evidence, rather than theological insight, and through established mechanisms, rather than intrusive laws.
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