Subject: Planned Parenthood is Guilty of Negligent Screening
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For Immediate Release Planned Parenthood is Guilty of Negligent Screening Springfield, IL (December 29, 2015) -- Congressional hearings into Planned Parenthood should look beyond the deceptive fetal tissue donation forms they ask women to sign. These misleading disclosure forms typify a larger pattern of deception and exploitation. An even more shocking abuse lies in the fact that Planned Parenthood abortionists know that the majority of women entering their abortion clinics have multiple risk factors for psychological maladjustments following an abortion. But they don’t screen for these risk factors, much less give each patient a medically informed assessment of risks versus benefits based on each woman’s unique risk profile. Specifically, Planned Parenthood is guilty of negligent pre-abortion screening and counseling. This isn’t by accident. It’s not an oversight. It is a practice designed to advance their own financial and sociopolitical interests. Plus, under current law, they can get away with it. Loopholes in the law allow abortion providers to evade any financial liability for psychological problems that are triggered or aggravated by abortion. In short, while Planned Parenthood claims it is simply promoting a “pro-choice” alternative, what they are actually doing is promoting a “poor-choice” alternative. Women deserve better. Abortion Has Known Risks Compared to similar women who give birth, women who abort experience significantly elevated rates of psychiatric disorders [1],[2],[3],[4],[5],[6],[7],[8],[9],[10],[11] suicidal behaviors,[4],[5],[12],[13],[14],[15],[16] sleep disorders,[17] a worsening of general health,[18] and elevated rates of recourse to medical treatments.[19],[20] In addition, each exposure to abortion reduces a woman’s life expectancy.[21] Most notably, besides all these risks, abortion also lacks any measurable benefits. Specifically, not a single study has identified any statistically significant benefits for women who have abortions compared to women who give birth to unplanned pregnancies . . . or compared to any other group of women.[22] This is the conclusion of Dr. David Fergusson, a self-described pro-choice atheist,[23] based on his own systematic review of the literature, including his own 30-year longitudinal study of 1,265 subjects who have been studied from birth through 30 years of age. Fergusson isn’t a biased pro-lifer. In fact, his conclusions have not led him to advocate against abortion in any way. He has no moral objections to it. But as a scientist, Fergusson argues against the intellectual fraud of abortion providers who perform abortions based on the spurious claim that it will produce some hoped for or imagined psychological benefits for women compared to giving birth. There is not a shred of scientific evidence to support such optimism. No claimed benefits of abortion have ever been statistically validated. But abortion does have known risks. Some Women Are Known to Be At Higher Risk Research has consistently shown that there are certain groups of women who are most vulnerable to negative reactions to abortion. In fact, even the hand-picked team of pro-choice psychologists who issued the Report of the American Psychological Association Task Force on Mental Health and Abortion in 2008 acknowledged the following 15 risk factors which can be used to identify the women who are at greater risk of psychological problems after an abortion.[24]
Indeed, the above list makes clear that one needs to carefully parse the APA’s summary conclusion that “among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy.” This highly nuanced assertion was widely misreported as concluding that there are no mental health risks to abortion. Look again. First, the APA claims abortion has “no greater” risks compared to delivery— referring mostly to the incidence rate for post-partum depression. It doesn’t claim any benefits, only comparatively equal risks. Secondly, and more importantly, even this modest claim of “safety” is limited to adult women (excluding adolescents), those whose pregnancies are unplanned (excluding those who had any openness to or desire for pregnancy), those who have only a single abortion (excluding those with multiple exposures to abortion), those for whom the abortion is entirely elective (excluding those who experienced any pressure or coercion, or those for whom fears of health complications led to a therapeutic abortion), and those who abort in the first trimester (excluding those who abort after 12 weeks gestation). Notably, the vast majority of women having abortions have one or more of these risk factors. For example, approximately 64 percent of women with a history of abortion report that they felt pressured by one or more people to do so.[25] In addition, approximately half of all women aborting on any given day have a prior history of abortion.[26] Further, about 15 percent of abortions are for adolescents, and about 8 percent of abortions are after the first trimester.[27] Throw in the need for secrecy, ambivalence, or any of the other 15 risk factors acknowledged by the APA, and it’s clear that most women having abortions have two or more of these risk factors. Planned Parenthood’s Own Research on Risk Factors and Screening The APA Task Force was by no means the first to recognize that negative reactions to abortion may be anticipated on the basis of prior personality traits (such as low self-esteem or prior history of depression) or identifiable circumstances (such as feeling pressured to abort or feelings of commitment to the pregnancy). For example, in 1973, Planned Parenthood itself published a study identifying several pre-existing risk factors that could be used to identify the women who were most likely to experience subsequent psychopathology and other negative symptoms as measured 13-16 months later.[28] Based on these findings, the researchers recommended that computer-scored “screening procedures to identify such [higher risk] patients could easily and inexpensively be instituted by hospitals and private physicians” at a cost of less than a dollar each. Did Planned Parenthood implement these pre-abortion screening recommendations? No. In fact, they are opposed to screening for statistically significant risk factors.[29] Negligent Screening Hurts Women But Enriches the Abortion Industry Bottom line: Planned Parenthood knows that the majority of women coming into abortion clinics have multiple risk factors for post-abortion psychiatric distress. But there is no systematic screening for these risk factors. Why? First, because abortion providers have a financial incentive to spend the least amount of time with each woman. One of their highest goals is to provide fast, cheap abortions. Planned Parenthood’s one-sized-fits-all abortion counseling is incompatible with individualized screening that would then require individualized counseling.  Second, from the viewpoint of population control zealots, many of the same risk factors that predict which women will have the most emotional problems after an abortion actually align with the same criteria for women they historically argued should be sterilized—including, for example, women with prior mental health issues.[30]Third, the goal of providing cheap, no-questions-asked abortions is an integral part of Planned Parenthood’s historic and deeply-rooted eugenic population control agenda. After all, if abortion, as a social engineering tool, can be used to reduce the burden on society caused by the birth of “unfit” children, keeping abortion on request affordable to the poor is a “social good.” Advancing the “social good” of fewer births, especially among the marginalized, may explain why Planned Parenthood’s counseling practices minimize disclosure of abortion risks.[31] It may also explain why some abortion counselors deliberately reinforce the arguments of the partners, parents, employers or others pressuring women to abort in order to persuade ambivalent patients that abortion is the “best option” for everyone.[32] Negligent Pre-Surgical Screening is Unique to the Abortion Industry Everywhere else in medicine, doctors screen for risk factors . . . precisely to identify those subgroups of patients for whom a possible treatment option may be contraindicated or is unlikely to produce the desired benefits. For example, Lasik surgery is a common elective procedure performed nearly four million times per year. But ethical physicians do not perform it without appropriate pre-surgical screening. Indeed, pre-surgical screening for Lasik patients results in approximately 25 percent of patients being declined for Lasik treatment on the initiative of the attending physician[33]—precisely because the doctor’s own best medical judgment is that it will not benefit the patient. But do abortionists turn away women with multiple risk factors for abortion complications, or even discourage these most vulnerable women from having abortions? No. The simple fact is that abortionists seldom turn away patients. If you have the money, they will do the abortion. In fact, abortionists will typically deny any responsibility for determining if an abortion is more likely to benefit or harm a woman’s well being. They insist they are not social workers. The choice is the woman’s alone and they are just there doing her bidding. But such a “buyer beware” medical service is an inversion of normal medical ethics. It is analogous to a woman walking into a doctor’s office and saying, “I have a lump in my breast and need a mastectomy,” and the doctor responding, “Okay. Jump up on the table and I’ll take it right off.” Simply doing what a patient asks for, without any evaluation of risks or options, is not the practice of medicine . . . it is medical malpractice. But this is exactly what Planned Parenthood and other abortion providers are guilty of. They are facilitating and encouraging women of all ages and education levels to self-diagnose. Moreover, they do not even assist in the self-diagnosis process! Instead, abortionists insist that women seeking abortions already know everything they need to know . . . as if an innate knowledge of abortion’s risk factors and risk/benefit ratios is embedded in women’s DNA. They even go so far as to insist that laws requiring full disclosure of all statistically significant medical research on risks and risk factors associated with abortion are an insult to women’s intelligence. In short, Planned Parenthood believes in abortion on request, no questions asked. No matter the circumstance, whenever a woman asks for abortion, their response is, “Jump up on the table and we’ll take it right out.” Is such blind obedience to this self-diagnosis what women really want from their doctors? Many, perhaps most, are highly uncertain what to do. And clearly the vast majority have no prior education regarding abortion risk factors and all the medical studies examining risks associated with abortion. What we do know, with certainty, is that women overwhelmingly want to be informed of all statistically significant risks, especially when considering elective surgeries like abortion.[34] Abortionists Use Unified Negligence to Evade Liability Ironically, Roe v Wade rejected the idea that women have an absolute right to abortion precisely because it is a medical procedure that inherently has risks. The Roe decision concluded with the emphatic statement that “the abortion decision in all its aspects is inherently, and primarily, a medical decision, and basic responsibility for it must rest with the physician. If an individual practitioner abuses the privilege of exercising proper medical judgment, the usual remedies, judicial and intra-professional, are available.”[35] [emphasis added] Put another way, if abortion is contraindicated due to any physical, psychological, and social reasons,[36] the Supreme Court recognizes that physicians have a right and duty to refuse to perform an unsafe or unnecessary abortion. In this regard, if doctors fail to exercise “proper medical judgment,” the Roe Court declared, they should be exposed to “the usual remedies” of lawsuits, loss of their licenses, or even criminal prosecution. So, if abortionists aren’t screening for known risk factors, as I have asserted, why aren’t they being sued by the hundreds of thousands of women entering post-abortion counseling programs every year? Unfortunately, abortion providers are protected from any meaningful liability because of two loopholes in tort law. First, the “standard of care” for pre-abortion screening is defined by the common practice of abortion providers themselves. So, as long as all abortion providers agree to ignore the psychological risks of abortion, or at least refuse to testify against other abortion providers who neglect to screen for these risk factors, it is nearly impossible for injured women to prove that they were given substandard, much less negligent, medical care. As long as abortion providers all simply perform abortions on request—without screening and without offering each woman a medically informed risk/benefit analyses—it is extremely hard for a malpractice attorney to prove negligent screening. If the standard of care is low enough, there is no risk of plaintiffs proving negligence. Second, and even more problematic, tort law generally precludes recovery of damages for emotional distress unless it is the result of physical injury. For example, if you suffer emotional distress after almost being hit by a car, you can’t sue. Only if you are hit are you then entitled to damages for pain, suffering, post-traumatic stress and sleep disorders. Thus, absent any physical injury following an abortion, abortionists are shielded from any liability for psychological injuries attributed to abortion. This simplifies the math: no liability = no need for screening + more abortions + more profit + more injured women. The Solution: Put the Standard of Care for Screening into Statute As we have seen, even pro-abortion mental health professionals, and Planned Parenthood’s own publications, have acknowledged the existence of risk factors for post-abortion psychological problems. For the reasons discussed above, these risk factors are routinely ignored by abortion providers, at least in part because there is no financial downside, only an upside, for doing so. It doesn’t have to be that way. The standard of care for pre-abortion screening can be put into statute.[37] This would eliminate the burden on plaintiffs to find abortion providers to testify that the defendant’s pre-abortion screening was negligent. At the same time, tort law can be amended to require doctors to give women an informed medical opinion based on their unique risk profile and to give women a right to sue for negligent screening and psychological injuries associated with abortion. Bill Clinton famously opined that abortion should be “safe, legal, and rare.” It is obvious that pre-abortion screening should be employed to identify the women at greatest risk of unsafe abortions.[38] If it so happens to be true that the majority of women are at risk, then perhaps this will also make abortions rare. What I do know is this: "poor-choice" advocates are profiting from countless women who will continue to undergo unwanted, unsafe, and unnecessary abortions. Planned Parenthood officials should be grilled by congressional investigators on why and how they justify their failure to establish a systematic methodology for pre-abortion screening and counseling which will properly protect women from unwanted, unsafe, and unnecessary abortions.
[5] Coleman PK. Abortion and mental health: Quantitative synthesis and analysis of research published 1995-2009. Br J Psychiatry. 2011;199(3):180-186.
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