Abortion, Medicine and the Law

Now Marie's bearing is to tell us a story, not one doctor saying to another, about determination of a pregnancy, I want your opinion. The father was syphiletic, the mother was tuberculosis of the four children born, the first was blind. The second died, the third was deaf and dumb, the fourth also tuberculosis, what would you have done? The other doctor I would have ended the pregnancy. Then you would have killed Beethoven. To introduce our first speaker for the evening, Dr. Robert Hall. Mr. Chairman, ladies and gentlemen, I intend to talk to you about the medical aspects of the abortion problem. The precise incidence of therapeutic abortion in the United States is unknown.

Sufficient evidence is available, however, to make the following statements. One, the overall abortion rate is declining. In New York City where therapeutic abortions are reported to the Department of Health, the incidence in 1943-47 was one per approximately 200 live births. In 1951-1953, one per approximately 350 live births and in 1960-62 in New York City, one per approximately 550 live births, a decline of 65% in 20 years. Reports from individual hospitals elsewhere confirm this trend. At the Sloan Hospital for Women here, for example, there was one abortion per 69 deliveries in 1950-1955 and one per 225 in 1956-1960. Two, the reason for this decline is twofold.

One, the allegedly lessened need for aborting women with medical disease, to be sure medical care for the cardiac, the tubercular, the diabetic and the hypertensive has improved. But proportionately, these represent minor refinements. More fundamentally, there's been an additional change on the part of the physician. Hospitals which rarely perform abortions have shown that even the severe cardiac can be kept alive through pregnancy if placed on bedrest and given supportive therapy for nine months. Abortion has become regarded as the too easy solution to such problems, permitting the pregnancy to progress to terms has become an academic challenge. Consideration of the family's future has been become largely disregarded. And secondly, among the reasons for the decline in therapeutic abortions is the formation of therapeutic abortion boards. In 1952, Dr. Gutmacher established the therapeutic abortion board at Mount Sinai Hospital in New York City.

Since then, this system has been copied by most other major medical medical services. Today, it is even recommended by the American College of Obstetricians and Gynecologists. Abortion has become the only surgical procedure that usually requires the approval of a committee. In theory, these boards serve to police the abortion practices of staff physicians to prevent them from yielding to the pressure of undeserving patients and to protect them from possible litigation. In fact, these boards serve as medical tribunals which often serve merely to render moral judgment. Probably more than any other single factor, they, these boards, have been responsible for lowering the abortion rate. Since the establishment of such a board at Sloan Hospital, for example, the therapeutic abortion rate has declined by one third. A third fact that we know about the incidence of abortion is that the overall incidence is approximately one per 500 live births in 1966.

In 1960 to 1962, at New York City hospitals, with approximately a half a million live births, the incidence of abortion in hospitals was one per 555. In a 1963 review of 61 major American hospitals with approximately the same number of births, the incidence was one per 503. An abortion rate of one in 500 births means that approximately 8,000 therapeutic abortions are performed in this country every year. Fourth among the facts that we know is that abortions are more commonly performed on private patients. Between 1950 and 1960, at Sloan Hospital, the ratio of private toward abortions was four to one. In the 1963 survey, which I took of 60 other major American hospitals, this ratio was found to be 3.6 to one, approximately the same. In New York City between 1960 and 1962, there are a lot of statistics in this paper I'm reading, but these I want you to pay particular attention to as they are particularly shocking.

In New York City between 1960 and 1962, the ratio of abortions and live births in proprietary hospitals was one per 256. On the private services of voluntary hospitals such as this, one in 416, on the ward services of the same voluntary hospitals, one per 1,429, and in the municipal hospitals of the same city at the same time, one per 10,000. There are a number of possible explanations for this double standard. One is that the tendency for clinic patients to register for antenatal care later in their pregnancies than private patients. This could of course be overcome by patient education. A second possible explanation is the greater ignorance of clinic patients of their occasional right to be aborted. To be sure, the private patient is better informed on this score enhances more prone to request of therapeutic abortion.

This too could be rectified by education of the clinic patient. There is no reason why abortion requests need to originate with the patient. Three, the prior incidence of abortions for psychiatric indications are more common among private patients, whereas at Sloan Hospital one therapeutic abortion was performed for psychiatric indications per 1,149 deliveries on the ward service. The comparable ratio for the private service is 1 in 104. It would appear that private patients with unwanted pregnancies are more often referred for primary psychiatric evaluation and or the psychiatric justification for abortion is more easily obtained for private patients. For a more lenient abortion policy on the private service exists than on the clinic service, whether this is a result of better rapport between the private patient and her physician, greater pressure of the private patient upon her doctor, greater compassion of the obstetrician for his private patients, the greater motive of financial gain in private practice or a combination of these and other factors. The fact remains that abortions are more often performed for debatable reasons on the private service. This was also demonstrated in the Sloan Hospital study and confirmed by the fact that sterilization accompanied abortions more than twice often on the ward service than on the private service.

As for psychiatric indications for therapeutic abortion, it is well established fact that as the number of therapeutic abortions for medical reasons has fallen in recent past, the number for psychiatric reasons has risen. With few exceptions, the medical literature shows that prior to 1950, psychiatric indications accounted for less than 20% of abortions and since 1950 for 20 to 45%. This represents an absolute as well as a proportionate rise. Some hospitals have set policies against doing any abortions for psychiatric reasons, usually in the belief that emotionally disturbed patients may be harmed by an abortion or that they are certainly rarely helped by an abortion or that few of them undergo psychotherapy after an abortion. There is no doubt much truth in these assertions. Suicide is demonstrably rare in pregnancy. In New York City, the suicide rate among women in the reproductive age ranges 5.5 for 100,000 among pregnant women in 1950, 1953, it was 0.5 for 100,000.

Psychiatrists know that pregnant women rarely resort to suicide. They also know that it is usually impossible to assess the degree of suicidal risk in an individual case. But the psychiatrist is trained to assess his patient's problems in view of their complete psychological settings to weigh the various situational as well as the purely medical factors involved and to consider the future psychological interrelationships created by the birth of an unwanted child. Hence, the psychiatrist may well exaggerate the suicidal risk in order to give broader meaning to a restrictive law and the obstetrician meanwhile innocently hides behind the psychiatrist's pen. This sort of deception is more widely practiced in psychiatric cases because A, the risk of death is less clear cut than in purely medical problems and B. The psychiatrist is more willing to admit that the end sometimes justifies the means.

Once again, in many instances the clinic patient is not accorded the same treatment as the private patient abortions for psychiatric indications are almost exclusively a luxury of the rich. Psychiatric care is less common among clinic patients partly because they can't afford it, partly because they can't find it, partly because they are unaware of its benefits, and partly because they are less often referred for it by the other clinic doctors. Another indication for abortion is rape and incest. In 1964, 1,500 and four cases of rape were reported to the New York City Department of Police. One can only surmise how many rape cases were unreported, how many of the reported cases were authentic, and how many resulted in pregnancy.

With regard to the last speculation, however, Dr. Teachy of New York has provided us with a calculation of 2 to 4 percent as a likelihood of pregnancy resulting from a single random act of quotas. Application of the lower, that is 2 percent of these figures, would suggest the 30 pregnancies resulted from reported rape every year in New York City. Needless to say, very few of these cases are aborted, and when an abortion is performed in these cases, it is done ostensibly. For psychiatric reasons, based upon even less knowledge of incidents, the same statements probably apply to cases of incest. And now for the fetal indications for therapeutic abortion, the first being Rubella, or the occurrence of German measles in the first three months of pregnancy. In recent years, growing numbers of abortions have been done for fetal indications, principally maternal Rubella. During most of the 25 years at the embryonic ravages of Rubella have been known, American obstetricians remained aloof to their responsibility in this matter.

The first abortions for this reason were done under psychiatric guise, upon the wives of insistent physicians. Now, as the knowledge of Rubella deformities has become widespread, the general public has become equally insistent, and obstetricians have been forced during recent epidemics to comply with their demands in openness. Their demands in open defiance of the law. The prevailing practice of ignoring this problem in the 1940s and 50s is evidenced by the reports during those years from six major American obstetrical services which cite Rubella as the indication for only 2% of their abortions. The new reversal in this policy has shown by the fact that between 1959 and 63, 4 to 7% of the therapeutic abortions in New York City were done for Rubella, and yet during the recent epidemic of Rubella in 1964, in New York City 329 or 57% of the therapeutic abortions were done for this reason. My second and last slide was to have shown the list of minor indications, rather than frequent for the so-called fetal indications for Rubella again, I will not take the time to list them for you.

Finally, we come to the issue of various hospital policies with regard to therapeutic abortions. In relation to hospital policies, this I think deserves considerable discussion. Occasionally authors actually define what the ideal abortion rights should be. Although most hospitals do not set a numerical limit, their policies result in intramural consistency and intramural chaos. Generally speaking, hospitals with therapeutic abortion boards have lowered their incidence of abortions, and those without boards have not. More specifically, however, some hospitals permit abortions for Rubella or for psychiatric indications and others do not. Many are reluctant to allow abortions on women not previously cared for within their own walls, and of course the attitudes of their individual physicians within the same hospital is often at variance. Inevitable as this heterogeneity may seem to the medical profession, it is indefensible in terms of overall medical care.

How can it be justified, for example, for one hospital to accept the cancer patient transferred from another hospital, and yet to refuse a legitimate candidate for abortion because she comes from out of town? Further refinements in this system have been applied to the validation of cases of maternal Rubella. Many hospitals require the patient to have been previously registered on their files, and the disease to have been diagnosed in its eruptive phase by some designated authority. Sometimes, however, the patient is unable to see a doctor when she has her rash, yet the diagnosis is obvious in retrospect from the history and residual adenopathy. Sometimes to her original physician or hospital is unsympathetic. Thus, measures designed to deter the devious may also deprive the deserving. And lastly, we come to the matter of the law. There is no federal law governing the practice of abortion. Each of the 50 states has such a law. In 45 states, abortion is illegal unless necessary to preserve the life of the woman.

In Alabama, Oregon and the District of Columbia, abortion may be performed in order to preserve the mother's health. In Colorado and New Mexico, in order to prevent serious or bodily, permanent bodily injury to her, and in Maryland, when no other method will secure the safety of the mother. The first state statute on abortion was enacted in Connecticut in 1821. The other states soon followed. No significant change in the structure of these laws has occurred in the past century. The penalty for performing an illegal abortion ranges from one year in prison in Kansas to 20 years in Mississippi. No doctor, however, has ever been convicted of having done an illegal abortion if he did it in a hospital. In actual practice, these abortion laws are interpreted solely by the medical profession without any interference from the courts. That they are interpreted liberally, is it illustrated by statements such as, Dr. Gutmockers, to the effect that 85% of the therapeutic abortions performed at his hospital, my son, I hear in New York, were strictly speaking illegal.

And by many other, less specific admissions to the same effect. That the medical profession's interpretation of these laws has supplied interstate uniformity lacking in the laws themselves, is illustrated by the fact that in the above mentioned survey of 61 hospitals, the major ratio of abortions to deliveries at the 53 hospitals in states permitting abortion to preserve the mother's life is actually higher than the rate of abortion in the eight other states. Where the abortions are permitted to preserve the mother's health. The nature of this discrepancy is of course due to unintentional bias in sampling, but the overall fact remains that the physician standard for practicing abortion is not determined by law. More specifically, this means that abortions are done in all 50 states in order to preserve maternal health as well as life. That these laws are recognized as unrealistic by prominent members of the legal profession is illustrated by the 1959 recommendation of the American Law Institute to the effect that quote, a licensed physician is justified in terminating a pregnancy if A, he believes there is substantial risk that continuation of the pregnancy would gravely impair the physical or mental health of the mother or that the child would be born with a grave physical or mental defect.

Or the pregnancy resulted from rape or incest and B, that two physicians concur in this, etc. That these laws are recognized as unrealistic by the medical profession is illustrated by the 1943, 59 and 65 recommendations of the New York Academy of Medicine and 1966 recommendations of the New York State Medical Society and others that the law be changed substantially in accordance with the American Law Institute's recommendations. And by the 1964, a 1964 survey of 2,285 obstetricians in New York State showing that 85% of them prefer the American Law Institute's version of the abortion law to the one that presently exists in our state. That these laws are recognized as unrealistic by many of the clergy is illustrated by the 1963 resolution of the Unitarian Universalist Association citing these laws as an affront to human life and dignity and recommending their liberalization.

And also by the writing and speaking of prominent ministers and rabbis such as Dr. Joseph Fletcher and Boston Dr. Lester consolving of Los Angeles and Rabbi Israel Margles of this city, that these laws are recognized as unrealistic by the laity at large is illustrated by the estimate that about 20% of all pregnancies in this country are aborted illegally every year. That such restrictive laws are not necessary in contemporary society is illustrated by the legalization of abortion in Japan and most communist countries and by the liberalization of abortion laws in Sweden, Norway, Denmark, Finland and Iceland. The present practice of therapeutic abortion in the United States is inequitable, inconsistent and hence inexcusable. Medicine and the law are not to mention the clergy share in the responsibility for creating this situation, they should therefore share in the responsibility for rectifying it.

The medical profession cannot dictate abortion policy, neither its national societies nor its local therapeutic abortion boards have this right. It is debatable whether even the individual physician is better qualified than his patient to determine whether an abortion is justified, rarely as such a judgment rendered on purely medical grounds. The legal profession cannot dictate abortion policy either and undeniable is the fact that the present laws are flagrantly flouted more often for the rich than for the poor. Surely this situation is untenable. If there must be abortion laws and this is debatable, there are several alternatives. One is to outlaw abortions altogether or to enforce the present laws, neither of which solution is feasible. Another is to liberalize the laws along the line, suggested by the American Law Institute, in other words, to legitimize current medical practice.

Thirdly, it is the possibility of legalizing abortion which would be tantamount to legitimizing current public custom. It is clear that the lawmakers will not act without provocation. Logically, this provocation should arise from the medical profession. As the time not come, in other words, for physicians to preach what they practice. Thank you very much, Dr. Hall. Next speaker will be Dr. Edwin Scher.

Ladies and gentlemen, when a rule appears on balance to be socially harmful in its effect, it is only reasonable that we should expect by way of justification, something more than an appeal to tradition or abstract moral principle. We may also insist that those who view the criminal law as a means of control in the realm of private morality as in the abortion situation should carry the burden of justifying such interference with individual behavior. This, I would submit, cannot be done satisfactorily with respect to our current abortion laws. The plain fact is that quite apart from the restrictions they impose on what many physicians consider to be proper medical practice, these laws do infinitely more harm than good. It is worth stressing at the outset that these laws are patently unenforceable.

The abortion situation represents but one of a number of instances of what I have elsewhere termed crimes without victims in which an attempt is made to control by the criminal law, the willing and private exchange between adults of socially disapproved, but widely demanded goods or services. Prohibition was of course a classic example, but current efforts to regulate prostitution, homosexuality, gambling, and drug addiction would all fall into this category. Now, it could be objected that in the case of abortion there is a victim that is the fetus, but from the standpoint of law enforcement consequences, the fact that the transaction between the abortion-seeking woman and the abortionist is a consensual one is crucial. Quite simply, for this type of law violation, there is no complainant. Even the woman who has found the experience of abortion extremely distasteful and frightening as illegal abortions often are will rarely wish to bring a complaint against the person who has provided her with the operation she desired.

Thus, the problem of securing evidence in abortion cases is a formidable one. Usually, information about abortion comes to the attention of law enforcers through the death of an aborted woman or through clear evidence of criminal abortion in a woman who has subsequently been hospitalized. It is sometimes possible through long-term surveillance of suspects and a well-timed, well-organized raid to come into court with a strong case against an illegal practitioner. But these procedures are extremely costly and time-consuming and one should consider whether they represent a sensible disposition of law enforcement resources, particularly in view of the widespread unwillingness of juries and judges to convict and pass harsh sentences upon abortionists, especially those who have formal medical training.

All that can really be hoped for is occasional successful prosecution of a small number of the most flagrant and persistent violators. As you probably know, in many jurisdictions, the woman submitting to an illegal abortion also is guilty of an offense, but these provisions are almost entirely unenforced. It is most unusual to proceed against the woman in such cases and conviction is virtually unknown. Far from curbing the illegal abortionist, our present policies actually establish the economic basis for his success.

As Stanford Law Professor Herbert Packer has noted, repressive legislation such as this establishes a kind of crime tariff through which the entire illegal enterprise is enriched and strengthened. Abraham Ranji put it this way in a 1933 study of abortion, and I quote, an endless circle was set in motion. The ready-willingness of women to visit an abortionist brought him immense profits. A fraction of these profits made it possible to cause an abortion with a greater degree of safety to the woman and a smaller chance of exposure of either the woman or the doctor. This led to a further appeal to women who wished to bring an abrupt termination to their pregnancies, and so the chain was complete. Furthermore, many law enforcement personnel accept the fact that the abortionist is performing a socially useful service and are well aware of public indifference to strong enforcement of abortion laws.

Under such circumstances, it is not surprising if officials find it easy, as one analyst has stated, to convince themselves that there is nothing morally reprehensible in accepting bribes or protection money from abortionists. Some officials insist that there is no longer extensive police corruption connected with abortion, but it is widely accepted that a fair amount does in fact exist. A recent account supposedly based on an abortionist's own experience states, again I quote, one reason fees are high is because the patient must absorb the payoff to police and top officials. Abortionists tell of judges, lawyers, jellers and police who may pay for protection some of whom have brought their wives, daughters or mistresses to the abortionist. Graph is accepted by all abortionists as a necessary annoyance and added expense passed on to the patient. Although some abortionists may be sufficiently well organized, cautious and mobile to persistently evade detection, it seems reasonable to assume that any abortionist who operates for any length of time undetected in a metropolitan location is in fact paying for protection.

Given the widespread and relatively inelastic demand for abortion, which generates somewhere between 200,000 and 1.2 million such operations in the United States each year, are restrictive laws simply divert abortion seeking women from legal to illegal channels. In many instances, perhaps particularly among women of the lower socioeconomic strata, the first step is an attempt at self-induced abortion, which typically is either totally ineffective or else extremely hazardous. The next step is to seek out someone who will perform an illegal operation. At this stage, particularly, we see a major social dysfunction of present policy, the very close relation between the woman's socioeconomic position and the quality of the care she receives.

We know that social positions sometimes influences a woman's chances of obtaining a therapeutic abortion, and some of the statistics Dr. Hall presented bear on that point. With respect to illegal abortions, the social class factor is even more blatant. In almost all cases, the quality of illegal services varies directly with the woman's ability to pay. While a $5 abortion performed by an untrained operator is highly likely to lead to serious complications, even death, the patient who can afford a high fee can most likely obtain the services of a skilled physician abortionist. I think we should give serious thought to the question of whether we can tolerate laws which impose such discriminatory variations in what is, after all, an area of potentially legitimate medical practice.

All abortion seekers, whatever their social status, face a highly unpleasant as well as possibly dangerous experience. It goes without saying, I think, that a woman who is blindfolded and taken to a strange place where she must admit to a frightening ordeal at the hand of a stranger who himself may be masked is bound to find the experience degrading and disturbing. There are, of course, wide variations in the kinds and degrees of shadiness and sortiness to which abortion seekers are subjected. But, except where an abortion is obtained as a favor from an otherwise legitimate practitioner or in some cases of abortion in a high-priced abortion clinic, considerable unpleasantness can be expected.

The woman is extremely dependent and vulnerable. Financial exploitation is, of course, common, but other types, including even sexual exploitation, may well occur. And, preventing the entire proceeding is the woman's knowledge that she is committing a crime that technically she herself has become a criminal. Now, it is true that some sophisticated women of means can go through abortions with a minimum of adverse impact on their self-images. And widespread belief that abortion should not really be a crime, probably minimizes guilt feelings in many women. However, knowledge of and cultural conditioning to the view that abortion is a crime, coupled with the sorted conditions under which the illegal operation often is obtained, cannot help but make for severe guilt feelings and unhappiness in many aborting women.

Undoubtedly, there are basic psychological processes that partly account for such guilt, but women may indeed feel that she is in a way killing something that is part of herself. At the same time, studies made in societies where less punitive abortion policies and attitudes prevail indicate that when the operation is legally and competently performed, guilt feelings and post-abortal maladjustment may be minimized. Knowing the serious conditions which in most cases give rise to the desire for an abortion and knowing the fact that relatively few women obtain such operations on purely frivolous grounds or without much soul searching and anguish, perhaps we should ask ourselves whether it is really appropriate that such women be labeled as criminals. The case in favor of such stigmatizing seems to me to be very slight indeed.

There are, of course, those who insist that any liberalization of current policies would be socially disastrous and morally untenable. The basis for such reasoning are not, I would submit, substantial and convincing. Most reform proposals urge nothing more than a widening of the already existing exception for therapeutic abortion to include indications already accepted by leading medical authorities. Dr. Hall has presented to you some of the reform proposals. I might just reiterate the wording of the American Law Institute Model Penal Code proposal which is one of the most influential. A licensed physician is justified in terminating a pregnancy if he believes there is substantial risk that continuance of the pregnancy would gravely impair all the physical or mental health of the mother or that the child would be born with grave physical or mental defect or the pregnancy resulted from rape, incest or other felonious assault.

There are some additional explanations of that and administrative points that are gone into also. It should be emphasized in considering such reform proposals that such new provisions in the law would be purely voluntary. Abortion simply would be permitted in such cases, thus, as I've indicated, bringing the statues into line with prevailing medical opinion and probably with public opinion as well. Such a modest liberalization of existing law hardly seems to constitute a drastic change which might, as Professor Byrne has suggested elsewhere, somehow weakened the moral force of the law in our society and which might be, and I quote, followed by an even more far reaching breakdown in public morality. There is little basis for believing that a vast increase in the abortion rate would follow such reform.

We do not know definitely just what would happen to the overall and illegal abortion rates under a liberalized policy. There is some dispute, for example, among students of Scandinavian abortion policies as to whether liberal legislation there has or has not appreciably reduced the incidence of illegal abortion. It is quite possible that with broad indications for therapeutic abortion, the overall abortion rate would increase somewhat and also that a fair number of illegal abortions might still be performed. However, it does seem reasonable to assume at least that with such a change, a vastly increased proportion of abortions would be performed under optimum conditions. Furthermore, liberal abortion legislation may be accompanied as it is in Scandinavia by educational guidance and welfare programs designed to encourage child rearing.

And there is every reason to believe that increased knowledge of contraceptive techniques will operate to substantially reduce the demand for abortions, though obviously some types of cases will persist. Certain observers seem to feel that liberalizing abortion laws will in some manner open the floodgates and lead to widespread sexual immorality. Yet surely realism suggests to us that few women who do not now engage in pre-marital or extramarital relations would rush into such behavior if only the indications for therapeutic abortion were broadened. Indeed, considering the rapidly widening knowledge of contraception, availability of abortion should become an even less significant factor than it now is in influencing sexual activity. Let me emphasize that no responsible person views abortion as a positive good to be actively encouraged. Abortion should be kept to a minimum and when necessary performed under proper medical auspices.

As I have tried to indicate, our present laws simply make the problem worse rather than better. We are all mindful of the fact I would assume that the value of life in some form or to some extent at least is always involved in considering the question of abortion. But this does not mean that the moral issue is a clear cut and simple one. Even if we were to assign a right to life to the fetus, we would also have to consider the life, health and sanity of the mother and in some extreme situations the reasonable prospects for health and happiness of the child. Actually, of course, individual decisions on these issues are being made continuously by the hundreds of thousands of American women of all social classes, races and religions who feel compelled to obtain abortions each year and who are not significantly deterred from this step by our repressive laws.

Under these circumstances, the real moral issue here, it seems to me, is simply this. How can we best adopt a sensible and humane approach to the practice of abortion? An approach which recognizes the widespread and often legitimate demand for terminations of pregnancy and which at the same time seeks to minimize the social harms now often associated with the performance of such operations, most of which are not inevitable but rather have been imposed as consequences of present public policy. Assigning to the abortionist rather than to the medical practitioner, the task of managing this significant medical problem is I would contend morally evasive as well as socially disastrous.

Our next speaker will be Dr. Harold Rosen. Thank you. We have just heard two speakers who, without using these terms, have indicted our present abortion practices as well as our present abortion laws as the hypocrisy of our medical, of our legal and of our lay morries. Now, if these charges be true, then it behooves us to investigate them in detail and to give them the thought and the consideration they merit.

If these charges be false, then they should be repudiated and rejected. We need, in order to discuss this in the detail at merits, to consider how charges of this type have been made over the years, who has made them and who is involved. We need to consider who gets abortions, what hospitals give them, where they're obtained, the stated and the actual reasons for them, who performs them, how much they cost, and what the legal and then legal aspects of this happen to be. Now to consider some of the earlier statements, charges were made as far back as 1936, 30 years ago this month, when one of America's greatest obstetricians published a book on therapeutic abortion, I'm referring to Towson, who in no uncertain terms spoke about the flagrant, open, and universal violation of our criminal codes. And by implication, he castigated the abortion laws.

More recently, in 1955, the state's attorney in Chicago stated that he was convinced that the vast majority of a medical profession is winking at the state abortion laws. And in exactly the same year, in 1955, in the ladies' home journal, our abortion laws were castigated as the hypocrisy of modern medicine. Four years later, in 1959, in red book, Dr. Allen Goetmacher, the chairman of the department of obstetrics at the Mount Sinai Hospital here, whom Dr. Hall earlier had mentioned, stated that the abortion laws are the laws that most physicians disobey. And he added that these are laws that make hypocrites of a soul. And in exactly the same year, but one month later, Dr. Nicholson J. Eastman, at that time, chairman of the department of obstetrics at the Johns Hopkins University School of Medicine, and now Professor Emeritus of obstetrics there, made this statement, and I'm quoting. These laws may have had some pertinence in the 1800s, but they have no pertinence whatsoever medically today.

And we're talking about noted positions and what they've sent. We need to consider this, therefore. Dr. Hall has commented about the abortions performed in hospitals on a therapeutic basis in this country, somewhere between 8 and 18,000 are performed each year. The year's vary. Now, those that he have mentioned, a few hundreds, or perhaps more than a few hundreds, were performed because women contracted a specific kind of problem during their pregnancy. Rubella, for instance, or there was a radiation to the pelvic organs in cases of unsuspected early pregnancy. Now, these abortions were performed not in the, what should I say? In adherence to the laws of the states in which they were performed, they were extra legal, because the laws of no state take into consideration, interruption of pregnancy,

for eugenic reasons. Now, there are, I think, eight states that do mention the offspring. There are eight states that do make it legal for physicians to perform abortions for the sake of the life of the mother or the fetus. Now, I don't know how they can do this. I don't understand how you can abort a pre-viable pregnancy for the sake of the life of the fetus. You can't kill the fetus to abort it. You're one of your neighboring states has this law, by the way. Connecticut, New York does not. I can list the states if you would want it. But the nonsense, the arrogance, and the inanity are the laws of all 50 states can best be seen by the laws of these eight states that were it in different ways. Let's continue, though.

There were a few interruptions of pregnancy, if I'm not mistaken, because of patients who had rheumatic heart disease with a history of previous cardiac failure. So far as I know, that's the only medical indication if we interpret some states laws rigidly, because that's the only condition that I know of in which, without interruption, the mother may die. Because of the advances of medical science during the last 20 years, almost any patient with almost any other physical condition, if she wishes to carry the child the term, and if she has all the resources of modern medicine brought to bear to help her carry that child the term, we'll carry that child the term. And so practically every interruption of pregnancy for medical, not including psychiatric reasons, and any prestige or none prestige hospital in this country during the past year has been with few exceptions in violation of the laws of the individual states within those which these hospitals are located if those laws be rigidly interpreted. Now there are other medical, including psychiatric indications.

The life of a mother, according to the laws of some states, is the only factor. And so we have to consider the vast majority of interruptions for psychiatric reasons. As Dr. Hall has mentioned, the incidence of suicide among pregnant patients is less than that when we weigh statistics to be expected from a population at large. It's very low. Heckblad, in considering suicides in Sweden, listed it as 8% of the pregnant population on autopsy for the years between 1925 and 1944. Fisher, the chief medical examiner of the state of Maryland, has found only one case in 700 suicides. In my own series of follow-ups on patients for whom the recommendation of therapeutic interruption was rejected, there was only one suicide among nine patients. The suicide was preventable, as are all suicides to a large extent at least among pregnant patients.

The woman can be put in a psychiatric hospital or can be put in jail and watch carefully until she delivers. And of all what we wish to do is to prevent interruption of pregnancy among pregnant women, all what we need to do is to jail them. And believe me, I'm not being callous. I'm speaking in accordance with what I think the law of most states rigidly interprets demands. Now let's see what the actual practices are. I've commented about physician statements. I've commented about suicidal rape. I've commented about therapeutic abortions. A legislative hearing in California, a short time ago, considered a minor liberalization of a California state statute. If rape were involved, if incest were suspected, if the organic condition of a mother warranted that was dangerous to our health, or if perhaps there would be severe organic disease in the infant, then the problem was that of liberalization of the California state statutes.

Three quarters of all the physicians to testified stated that these were the policies being followed in their hospital. And it was for this abortions therapeutically were being performed. I'd like to emphasize that. You'll notice that this merely legalizes the reasons why abortions were performed in California. And it would merely legalize some of the reasons why abortions are being performed in New York City as well as in other states of the union. For they are performed, whatever the stated reasons are, and the stated reason sometimes are nonsense medically or psychiatrically, they are performed in cases of incest, in cases of rape, because of the severe emotional or medical disease of the patients, or for socioeconomic, eugenic, and humanitarian reasons.

And the physicians who state that they are not either do not know what they're talking about, or are as hypocritical as our state enforcement laws are. And some physicians are hypocrites and some are honest, some lawyers are hypocrites and some are honest, some jurists are hypocrites and some are honest, but the whole attitude towards our abortion laws are about as hypocritical as it can be. And I'd like to emphasize that as I get into the problem of criminal abortion. At least two thirds of all the physicians whom I see, obstetricians, psychiatrists, radiologists, dermatologists, and others, at least two thirds of all the lawyers whom I see, be they judges are merely practicing lawyers, at least two thirds of all individuals whom I see, who wish psychiatric investigation in order to determine whether the pregnancies of their wives or their daughters or their sisters can be psychiatrically, can be interrupted for psychiatric reasons,

at least two thirds of them in advance have made arrangements for criminal or illegal interruption of those pregnancies, if the psychiatric recommendation is not possible. And we can make that recommendation only for psychiatric reasons, and I'd like to emphasize that. This includes judges, it includes members of district attorneys, staves, it includes one priest, it includes rabbis for a sister, it includes ministers, I'm sorry. What toss they call the open and flagrant and universal violation of our criminal statutes is present. Now I don't know how many people are here this evening, but in each row in which you sit, there will be at least three or four who in their families, sometimes in their lives will have an abortion, and I'd like to emphasize that. Now this sounds like an incredible figure. Let me get into the problem of criminal abortion for a moment.

We need to know what the figures are, and of course there are no good figures for this, but there are some figures that we can at least utilize. Some figures that are at least slightly, what should I say, as thought provoking. Now first of all, I'd like to comment about criminal abortion, illegal abortion. There is no difference unless infection be present between spontaneous, legal and extra legal abortion. Nobody can tell the difference. Secondly, when it's done, when the abortion is performed by a competent medical man, let me emphasize that not by a bunch of work orders. Then the morbidity and the mortality is about that of a concelectomy. Thirdly, let me emphasize something else. Any pregnancy or most pregnancies can be interrupted any time between conception and natural delivery. The 12 month, I mean the 12 week, I'm sorry, that was a bad step. It's 12 week. Physiological time limit does not hold. Some physicians, however, use that just to keep the girl going.

As they use the need for two psychiatrists, and as I need to use the need for abortion boards, these prevent rather than make possible good medical care of a specific pregnant woman. But extra legal abortions, I prefer to use that term rather than criminal, are performed for the same reason as our, for the same reasons, are as, as our illegal ones. And abortions are interruptions that would be legal in one hospital or accepted as such in one hospital, are not accepted as such in an adjacent hospital, and interruptions that are criminal in one state are legal in another. Now let's get to some of the statistics first before we find out who do these. In the United States, as Dr. Hall said, about two, the figures are two to three out of every 10 pregnancies in an illegal abortion. Now these figures are fairly, are fairly good. They're the figures you have in most of the rest of the world. They have nothing whatsoever to do with the religious tenets and morals of a particular culture or a society to give you an illustration.

In Catholic Chile, 27% of all women surveyed had had abortions. The figure for France is slightly as a good deal higher. Friends is a predominantly Catholic country. The number of abortions is supposed to equal the number of live births. These are may sound like incredible figures. As you can see in this country, as well as in other countries, this is a problem of vast epidemiological proportions. In the United States, there are only 10 to 20 extra legal abortions every 15 minutes. This is all that amounts to 1,000 to 2,500 a day. The figures vary. Dr. Titzer, who is in New York, has done a study of this and could give you much more accurate figures than I can. But this brings us to the problem now. When we consider the vast number of abortions, it brings us to the problem of who do these abortions.

Who's abortions are performed on married women between the ages of 30 and 40, who have two or more children and who have been impregnated by their own husbands. Furthermore, a great many abortions are performed on women who later on decide to have another child, a child for whom they have planned, and who do have that child and who rear it and rear it well. This also is, it seems to me, a prime importance. Now that gets us to still another problem, the problem, not a criminal abortion, the problem of what can be done. And all of us, I don't mean myself, at all of us as citizens and millions of citizens in this country, in one way or another have been so affected by it, but we've all considered it. And a number of, what should I say, solutions have been proper. One is that of, well, orphanage and foster home care adopting the child out. Now this is the most calmest recommendation that I've ever had the misfortune of hearing people make without realizing what it means.

I haven't seen anything about this. Print and these to be in it. I'm as guilty as everyone else because I've never written an article on it. And yet, 29 patients whom I've treated, whom I've seen either in consultation or psychiatric evaluation or for treatment in the past 15 years, 29 patients had their psychiatric symptomatology precipitated within periods of one to three years after they had farmed their children away. And in those 29 patients, I'm talking about 29 patients in whom the giving of a child away was one of the precipitating factors. In most cases, the precipitating factor in the onset of their acute psychiatric condition. Now this may sound strange to you, but let's take a few patients. Patients whom I'm now having reporting in an article now in publication, which will appear within a few weeks in the Western Reserve Law Review.

Of the last 44 patients whom we have seen who were unwillingly pregnant, 37 spoken almost the same words. Those 37 very adamantly and very indignantly resisted all pressure even to have anyone talk to them in terms of adoption of a child. One was an 18-year-old girl who had been raped, not too far from the city. Another was a taxi driver's daughter, a third was the sister of a physician, a fourth was the wife of the minister, and all refused. Oh, one was the wife of a jurist as well. They refused to consider this. They stated that it was not what would happen after the child was delivered, it was what it was doing to them right now. The minister characterized his wife as a warm person.

Men could think in terms that they carried that child for nine months of giving it away to strangers. Some stated that we had a civil rights movement in existence in this country that we don't take babies away from slaves anymore, and they compared this to a slave market. And I'd like to give this to you for your consideration. Women don't likely leave their babies in baskets on hospital doorsteps or in front of police stations, and they don't likely give babies away for adoption. Once they bear them, and that is not the problem, and that is not the solution. So far as forced or home care or orphanage care is concerned, we all know that this has never been a solution. We can go into this in detail, I won't comment about it at present, but adoption certainly is not. Now, if another solution is advanced or suggested, one is generalization of the laws. We, in the medical profession, have interpretive present laws so that we instead of liberalizing them, make them more reactionary than they are.

We have used certain procedures, some of us, to prevent abortion, therapeutic ones, even when they may be indicated. And Dr. Hollal has very specifically commented about that. When psychiatric indications seem to be in existence, two psychiatrists are asked to see the patient, after which, in a great many places, an abortion board functions. Now, originally, there was shared responsibility. Originally, this was a very progressive move. I disagree with Dr. Hollal on his respect to his former statement, but it's a binding, jailing move at present. It delays, it adds to the expense, and it gives some physicians a chance to tell the girl that she has passed the 12 weeks physiological time limit, which doesn't exist. It's happened frequently, not rarely, but very frequently. In the past four months, we've seen a few girls from this very city, where this has been done, and has been stated. This is a not uncommon practice in New York City, unfortunately, just as it's not an uncommon practice in Washington, in Baltimore, in Chicago, in Philadelphia, and elsewhere.

It's absolutely indefensible. We do not say that if a patient needs an appendectomy, if a patient needs a colostostectomy, after one surgeon recommends it, another surgeon will be called into check on that surgeon to see if he recommends it. Then if they both recommend it, our board will be appointed by the hospital, consisting of a pediatrician, an obstetrician, an internist, a psychiatrist, and sometimes someone else, who may take weeks before they can meet and pass on it, but who will consider whether or not the recommendations of the two surgeons will be followed. I feel very strongly about that. I agree with the recommendations of the two previous speakers that the recommendations of the American Law Institute are worth accepting with one very definite exception. The American Law Institute recommends two certificates from two physicians, and this, I think, is a very regressive, not progressive, but regressive recommendation. I come from a state which has, what should I say, more liberal interpretation of it, which allows a more liberal interpretation of the abortion laws, Dr. Hall, and allows for emotional reasons.

It considers that health and life cannot be separated, at least legally, and that when we speak in terms of life, we don't necessarily speak in terms of the immediate life and health of the individual, but it's a long term process. It does not officially make this recommendation, or does it officially allow it? I would think that if we asked the DA's office in that state, there's an other state that it would be repudiated, but it nevertheless is accepted. Now, our laws, even in a more liberal state, like Maryland or some of the others, are laws that, if they were rigidly applied, would fit the civilization of ancient Sparna, but which would be too reactionary for the more progressive democratic civilization of Athens, at the time of Pericles or of Sophocles.

They do not apply, in present day America, as you have pointed out, they are not accepted, they are not enforced or enforceable, and nobody in any prestige hospital, which does abortions, therapeutically recognizes them, they are unenforceable. With this in mind, I would like to read just the concluding paragraph of the other article, where you're dealing, so the paragraph runs, with mature human beings who shall be or should be accorded all of a dignity, the law otherwise allows mature human beings. Women in our society are no longer channels. Our abortion laws have long, faithfully usually, but sometimes faithlessly, and always and adequately, help teach them so. Mature and legal consideration of mother, children, family, and society would lead us not to pass more liberal abortion laws, but to relegate them the Balimbo forgotten waste baskets. Mature women, with all respect and dignity to be accorded mature human beings, should have the right to decide whether or not they wish to carry a specific pregnancy deterrent.

The responsibility and the decision right or wrong is theirs. The extra legal abortion rate shows that they have ill-legally already assumed this. They should assume it legally. Abortion is a medical procedure, advisable and indicated from medical, including psychiatric reasons, and for familial, sociologic, socio-economic, and humanitarian reasons as well. The hypocrisy should be taken out of our present medical and legal approach to the problem for our women are not channels, and human beings, though women, should be accorded, should be treated with the dignity and respect, even by our abortion laws. Thank you.

Thank you very much, Dr. Rosen. Our final speaker of the evening will be Professor Robert Perrin. Ladies and gentlemen, it may seem to you tonight that I stand against a veritable failings of opinion, which is of one mind on liberalization of our abortion laws, and this is not the fact. There are, in fact, two different groups among the liberalizers. There is the one group that will say that abortion is a positive evil, but in certain instances, the lesser of two evils. I think, perhaps, Dr. Schur reflected this point of view when he said, let me emphasize that no responsible person views abortion as a positive good to be actively encouraged abortion should be kept to a minimum and then on the medical lawsuits.

Now, there is another group that views an abortion as the civil right of the pregnant woman. That is any pregnancy, which is not wanted, may be terminated, and that is right as long as it is done with proper medical procedure. And we have had one eminent physician in this city declare not so long ago that that society would be utopian and enlightened, which would permit a woman an abortion whenever she wanted it. Now, I think that these two groups share a very little in common, if anything. And I think with the first group, I share a great deal in common. Now, we are both, I think, greatly concerned about the great number of abortions that are performed, whether they be characterized legal or illegal.

And I think we are both interested in finding ways to minimize abortions, whether they be legal or illegal, but I put it to you that their way is not the right way. Now, let's clear the air a little bit about what will happen to the illegal abortions. If we adopt the liberalization of the American Law Institute, which you've heard the three speakers each in their turn mentioned. Now, a similar statute, almost the same statute, a little more detail, was enacted in both Denmark and Sweden. After 14 years of experience in Denmark, legal abortions had risen from 500 to 5000. After 14 years, illegal abortions were estimated as high as 12,000. And Sweden, where the same liberalization was adopted specifically to stem the tide of increasing illegal abortions over a somewhat longer period of experience.

No, no worthy reduction in illegal abortions could be found. In both countries, claims have been made that illegal abortions have increased. In Sweden, we are safe and safe, lacking statistics on illegal abortions anywhere we can only estimate. But one thing we do have statistics about, in which we are safe and safe, that in every country where a liberalization has occurred in the last 25 years, let's say, or beyond that in the last 50 years. Overall rate of abortions has risen dramatically. Now, you heard Japan mention in Japan is now estimated that abortions induce abortions outnumber live births by a ratio of two to one or perhaps more. Now, we've been hearing horror stories. Let me tell you one about Japan. Let me tell you about the pregnant woman who went to a hospital for medical advice was anesthetized and woke up aborted.

Now, this isn't an everyday occurrence. Perhaps it's the first day that it did occur. But if we're telling horror stories, let's tell the other side. Let's tell of the complete disregard for the fetus that results from liberalization. Now, what is the reason for this? Dr. Schur again has given it to us, I think. He says that knowledge of and cultural conditioning, to the view that abortion is a crime, contributes in part to severe guilt feelings in many aborted women, at least he put that as a partial cause. Well, isn't it necessarily a conclusion that the same cultural condition conditions other women not to seek an abortion? And if this conditioning is dissipated, then isn't it logical that more women will seek abortion? I think that that's the necessary answer. Now, how is that going to affect our country where we have variously estimated 200,000 to one and a quarter million abortions per year illegal and eight to 18,000 I should think more like eight legal abortions, 8,000 legal abortions every year.

Well, let's stop and think if we have a million and a quarter illegal abortions today before liberalization every statistic indicates we will have a million and a portion illegal, illegal abortions tomorrow after liberalization with these liberalizations the American Law Institute has proposed. Now, if we have a million, 268,000, overall abortions today before liberalization, what will we have tomorrow? Two million? Your guess is as good of mine, but it will be a great deal more than a million and a quarter. Now, I hope we have cleared the air on this. We are all worried about rampant abortion and this would seem not to be the cure, whether you call it legal or illegal.

Now, let's clear the air on something else and I'm not ashamed to mention it. Let's ask ourselves what it is we are killing. Now, let's not bandy about theology. Let's just ask ourselves what it is we are killing. Now, the ancients thought that in the early stages of pregnancy, the fetus was a vegetable, a part of the mother, and it progressed in scientifically the visible stages from vegetable to animal to human. Now, a more recent theory zoologists tell us that the fetus emulates the process of evolution of mankind, so that at a very early stage of the pregnancy or for some time thereafter, it is subhuman. Well, it seems to me that we know now that both of these theories are not correct. We know, first of all, that the fetus grows gradually, not in divisible leaps and bounds, from the moment of conception through quickening, through viability, through birth, and then the child grows.

We know it would seem that at the very moment of conception, the innate qualities of the ultimate postnatal child are established, not only physical qualities, but such things as talents, musical talent, intelligence, and the light. Now, Dr. A. C. Maietis, the late doctor, Maietis clinical professor of obstetrics and gynecology at the University of California at Los Angeles, put it this way. The embryo or fetus may be encoded, but it is indisputably complete and integrated in terms of its essential elements.

It requires nothing but food to grow. In terms of ultimate full development to maturity, the infant after birth is comparably an encoded creature. So, let's look at it this way. The person is individuated at conception. Now, if this person is going to be a musical genius because a musical talent, then the talent is there at conception, and it merely grows and develops through birth, through musical training, and into the great genius. So, we have to project, I think. We have to change our thinking a little bit. We have to start to project the adult, not from the moment of birth that arbitrary measure, but from the moment of conception. Now, this is not strange, although it may be new, it is not strange to either law or medicine.

The International Code of Medical Ethics, at the 3rd General Assembly of the World Medical Association adopted in 1949, contains this statement. A doctor must always bear in mind the importance of preserving human life from the time of conception until death, qualitatively human from conception until death. In New York, in a case involving a prenatal injury, a civil case, when it was claimed that at the time the injury was inflicted, no person was in existence in the 3rd month of pregnancy, this was said by a court in 1953. We ought to be safe in this respect in saying that legal separability should begin when there is biological separability. We know something more of the actual processes of conception and fetal development, now than when some of the common law cases were decided, some of the earlier cases. And what we know makes it possible to demonstrate clearly that separability begins a conception, that is the legal entity with the legal rights begins at conception.

Now, my answer to those who claim that the right to be aborted is a civil right of the pregnant woman is this, that as far as I know in our jurisprudence, and I hope it never enters into it, no one has ever had a civil right to destroy another innocent human life. Quite the opposite, every innocent human life is entitled to the equal protection of the law. So this is not a matter of a crime without a victim, it's not a matter of private morality, it's not a matter of bartering goods and services, unless we begin to look again at human beings as channels and part of them. No, nor is it an answer to say that this law, the repeal of this law will not force anybody to have an abortion. Well, a repeal of a law in child abuse won't force parents to beat their children.

The repeal of a law against robbery won't force anybody to rob. The nature of the criminal law is not to mandate conduct, but to forbid it where it is socially harmful. Now, is this socially harmful? Well, I will remind you, no matter what the mortality rate may be among women who have illegal abortions or legal, that the mortality rate in any abortion among the unborn children is 100%. And I think that any time we have 100% mortality rate, ensuring with deliberate destruction of human life, we have something socially harmful and not a matter of private morality. Now, let's look at some of the things that are proposed. Mental health is proposed as a reason for liberalization, preserving mental health.

Well, as to psychoses, Dr. Murdoch and Dr. Rosen's book said this, there was his impression that pregnant women are more apt to make a satisfactory recovery from their psychoses and to do so more rapidly, more promptly, than comparable patients who are not pregnant. Some psychiatrists tell us that inevitably, maybe not immediately, but at some time, inevitably, the psychological sequelae of abortion are much worse than whatever went before. Now, some disagree. Some say this is not always the case that you cannot make a general statement, that like that. And some say that it is a matter of weighing immeasurable factors. Perhaps the psychiatric community ought to heed what the chairman of the Department of Psychology at the University of San Francisco said not to long ago. In some respects, the psychiatrist is in a position similar to that of the obstetrician of 20 or 30 years ago, who is faced with choosing the simpler procedure of abortion or developing new techniques and chose the latter.

Now, I think perhaps it's a sad commentary that in certain psychiatric situations, all that can be offered to us is an abortion, or putting the woman in jail, that's a sad commentary, not on the abortion board. Now, again, some psychiatrists tell us we should take into effect social economic conditions, which seem to, of the family, into which the child will be born, which seem to account for about 90% of the abortions, both legal and illegal, I would assume, that are performed. Social economic reasons, not the horror stories, social economic reasons, which range from inconvenience to poverty.

And we are told in this whole area of the social economic, by some psychiatrists, that this is part of the total mental health problem of the woman. Other psychiatrists tell us that in taking into consideration such matters, the psychiatrist is imposing his own moral views, superimposing them on the situation. In connection with social economic reasons, we are told that the rich can afford an abortion, or they'll get it somehow, the poor have to go to the quack, or they don't get it. Well, we hear that argument in a number of areas these days. I should think that we can all come to the conclusion that if a rich man wants to avoid the law, he can do it with more facility than a poor man. That doesn't impress me. I think where the discrimination is to be found is in this that the rich man, his child, will not be aborted, but the poor man's child will be aborted.

The rich man, if he seeks an abortion, of his child will be violating the law. The poor man will not. Now, where is the discrimination? It seems to me it is in meeting out the protection of the law to unborn children based upon the socio-economic circumstances of their parents. The rich get it and the poor don't. Now, Dr. Schuhor tells us that liberal abortion legislation may be accompanied by educational guidance and welfare programs designed to encourage child rearing. Well, why the package deal? Why can't we have the latter without the former? This is as odious to me as the old package deal of abortion and compulsory sterilization. Now, he also says that as we get more and more used to contraception, abortions will go down.

Now, I ask those organizations who are perhaps doing a good job in this field that if they are interested in promoting contraception to consider this, that we are not yet a contraception-minded country, even among the poor who express the thought that they do not want more children. Those who are engaged in offering them contraceptive advice find it difficult to persuade them to use the contraceptive. Now, wouldn't it be even that more difficult if abortion becomes the answer to socio-economic problems as it did in Japan where we are told that one was looked upon as an alternative to the other, in fact people are careless and there is no need to be careful you can always have an abortion. I put it to you that perhaps that movement for why do you some contraceptives will be thwarted by wider acceptability of abortion.

And I also call to your attention now, I don't think any of us have in mind as an end in itself to limit the number of children in any particular family. That's not the end. What I think is the human dignity, that is the family unity, the family dignity in total. And I wonder what family can start off dignified and human with several abortions. And I would also point out that when we are talking about abortions for socio-economic reasons, perhaps we would not have had an Isler, perhaps we would not have had a Rothschild. The product of families ranging from 9 to 20 children in ghettos, in poor circumstances, if these were reasons for abortion.

Now the hardest one of all, and I'm going to admit it, is rape and incest. It's pretty hard for me to stand up here and hear the story of the 11-year-old girl who was raped and then say to you that we cannot have an abortion. We have compassion, natural compassion for such a girl. We do not, because we cannot see the child, we do not react to it in the same way. It doesn't look like the child. As Dr. Schur says, it does not complain. But perhaps it is just such people that we ought to protect. Perhaps the weak and any unfortunate, the non-complainers are the ones that the law is designed to protect. Certainly, we will protect the rapists, don't we? We say that he cannot be punished. Now, not put to death. We don't do that in this country anymore to rapists, or to hopefully we won't be doing it to anyone in the near future. Not put to death, but punished. He cannot be punished unless he is proved guilty of a crime beyond the reasonable doubt, but beyond the reasonable doubt, the child growing in the place which nature intended for its growth is not guilty of any crime.

There are hard cases. I didn't met it. I suppose it's a hard case too. When a criminal is let loose on society, on a legal technicality that overwhelming evidence was illegally searched, illegally seized, but we guard his rights jellously and rightfully. Now, the one that horrifies me the most is eugenic abortion. Now, this is proposed as an independent ground, independent of any mental health problems of the mother, an independent ground for terminating the life solely because prospectively it will be defective. Now, this I suppose is the final solution to the defective child problem, but I think we ought to have better solutions. Why don't we have a march of dimes for Rubella? Why don't we know more about these diseases?

Why aren't we studying harder? Isn't that the answer? You tell me, are you unwilling to be challenged? The answer it would seem to me is to find cures. The answer to socioeconomic ills is to find ways to do away with the socioeconomic ills. Now, maybe it's the way to take the easy way out these days. I don't know, but I don't think that that is what we look to for the great society. And I would ask you too, who is it that you are permitting to be killed? I'm re-sparing you to tell us a story, not one doctor saying to another, about the termination of a pregnancy, I want your opinion.

The father was sympathetic, the mother was tuberculosis, of the four children born, the first was blind, the second died, the third was deaf and dumb, the fourth also tuberculosis, what would you have done? The other doctor I would have ended the pregnancy, then you would have killed Beethoven. That musical talent was established at conception. Now, we hear all sorts of horror stories, there are horror stories on both sides, aren't there? But the horror, it seems to me, is not that abortions, 1 million illegal abortions occur, it seems to me that the horror story is that there are 1 million abortions, that there are 1 million abortions. Now, what can we do to minimize the number of abortions, changing the law won't do it? It seems to me it is the function of the law, however, in this situation to say to the community at large, that we have a general consensus in this country, that innocent human life is inalienable.

And we, that is the law, intend to demonstrate a particular application of this general consensus by virtue of the existence of this law. Now, this we are not without precedent for this, we have overturned the culture of an entire segment of our population, we have caused socio-economic dislocation, we have risked fleece corruption, clandestic murder, defiance of the law, costly and consuming time consuming procedures and unwillingness of judges and juries to convict, to teach the application of the consensus principle that all men are created equal. Now, I offer you as an alternative, first of all, let's unite for a direct attack on whatever is the cause of abortion, whether it be socio-economic disadvantage, whether it be mental illness or whatever.

Now, this is not going to do away with abortion altogether, no more than a law against murder is going to do away with murder. But I would ask that all segments of society bring to bear these powerful forces that apparently are involved in the abortion dispute, bring them to bear to the education of the public on the dangers of abortion, on the undesirability of abortion, and most of all, on the humanity of what is being killed. Now, if we can approach this as a civil rights matter, which I think it is, then I think we have a much better and more humane answer to the problem of abortion. Thank you.