Sunday, May 31, 2015

Scott Walker's Really Cool Sonogram Idea

Not a Real Cowboy
Gail Collins alerts us to a remark by the governor of Wisconsin, Scott Walker, who is running for President, in defense of his support for a law which requires a woman who is scheduled for an abortion to undergo a sonogram, so she can see what it is inside her she is "killing."
Of course, the intent of this law is confront the woman with something that looks alive, looks human, looks like a miniature baby, so she will decide against the abortion.
Not An Actual Calf
But Scott Walker denies he is trying to shame or guilt anyone, and he points out that sonograms of pregnant uteri are done all the time and parents carry them on their smart phones and post copies on their refrigerators, which is a really cool part of pregnancy. The parents start bonding at six or eight weeks with their unborn children.

The problem is:   sonograms are not babies. 

They may, with some imagination, look like babies, but they do not actually even look a lot like what is inside that uterus, which is about the size of a lima bean and very red and undifferentiated looking. 

Clouds may look like babies, or cowboys or calves but they are none of these things. An image is not the object it looks like. It is just an image. 

Not An 8 Week Fetus

Sonograms magnify and schematize the objects they penetrate.

6 weeks

Not to mention, they are black and white, except for the Doppler flow parts, which are orange and blue.  They require a mental reconstruction to make anyone bond with them. 

8 weeks

As the fetus gets older, the sonogram may look more like a baby, but what they are actually imaging would surprise most people, if they actually saw the real thing imaged--at 6 weeks the conceptus looks more like a red lawn grub, fairly difficult to imbue it with much humanity, on a visual basis.
7 weeks 

And the photos here do not even really convey how much like a clot of blood much of this material actually looks like. 
Having said all this, I'll never forget seeing a 21 week fetus delivered in what was then called a "salting out" procedure when I was a medical student. That  looked like a baby to me. The procedure which was done in those days was called an "abortion" but it looked more like infanticide to me. The fetus could not have survived outside his mother's body in those days, but the reason it was outside his mother's body was because they had pumped in a concentrated salt solution into the uterus.  I found that profoundly disturbing. They whisked the thing away from the operating room so the mother did not see it. I could see why. I stood in an adjoining room with it and half expected it to take a breath. Of course, if it had been anencephalic (without a brain) I would have hoped it would never take a breath. Some deformities are so horrific, you just think it a blessing if that breath is never taken or is it's last.  
8 weeks

So, I am not in favor of everything which is called an abortion. As my favorite ethics professor once asked me, "If you meet a fetus on the way down the birth canal with a scalpel, is that an abortion?"

His point was the difference between an abortion and infanticide is all about drawing lines. 

One way of doing that is to try to assess how much potential the conceptus has actually realized and how much it is just a mass of tissue with a lot of potential, mostly unrealized. 

But showing untutored women ultrasound images is an exercise in deception. You can instruct her however you want but they haven't really been educated until they've seen the real tissue. 

The reason parents are shown all those ultrasounds in their private obstetricians' offices?  Commerce, not medicine. There is demand for those ultrasounds, but most often, no good medical reason for doing them--unless you are looking for substantial abnormalities, which might prompt a decision for...abortion.

There are no easy answers, when it comes to abortion. The only real answer is we are poorly served whenever we have simple, mindless answers. Those are almost always wrong.

One of the great virtues of absolutism is clarity and elimination of ambiguity:  If you believe life begins at the two cell conceptus, that makes everything an abortion after conception. It's simple, clear and, at least to my mind, incorrect.

Likely 40% of conceptions are lost early, before more than a thousand cell divisions, before the mother is even aware she is pregnant. Is this a natural process wasteful of life? And, if you're Catholic, what about all those souls who have not been given last rites (because nobody knew they existed in the first place)?

Abortion is not one of those topics which affords a lot of middle ground. Never has. For centuries, defining when life begins has vexed theologians. Scientists do not define when life begins. They simply describe what they see. But sometimes, what they see is not what you think you see. 

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