ProPublica writes here about the dilemma of doctors in Tennessee: The patient would die unles she had an abortion. There was no time to spare. But the state just passed a law to punish doctors who performed abortions. Should they let her die?
One day late last summer, Dr. Barry Grimm called a fellow obstetrician at Vanderbilt University Medical Center to consult about a patient who was 10 weeks pregnant. Her embryo had become implanted in scar tissue from a recent cesarean section, and she was in serious danger. At any moment, the pregnancy could rupture, blowing open her uterus.
Dr. Mack Goldberg, who was trained in abortion care for life-threatening pregnancy complications, pulled up the patient’s charts. He did not like the look of them. The muscle separating her pregnancy from her bladder was as thin as tissue paper; her placenta threatened to eventually invade her organs like a tumor. Even with the best medical care in the world, some patients bleed out in less than 10 minutes on the operating table. Goldberg had seen it happen.
Mayron Michelle Hollis stood to lose her bladder, her uterus and her life. She was desperate to end the pregnancy. On the phone, the two doctors agreed this was the best path forward, guided by recommendations from the Society for Maternal-Fetal Medicine, an association of 5,500 experts on high-risk pregnancy. The longer they waited, the more complicated the procedure would be.
But it was Aug. 24, and performing an abortion was hours away from becoming a felony in Tennessee. There were no explicit exceptions. Prosecutors could choose to charge any doctor who terminated any pregnancy with a crime punishable by up to 15 years in prison. If charged, the doctor would have the burden of proving in front of a judge or jury that the procedure was necessary to save the patient’s life, similar to claiming self-defense in a homicide case.
The doctors didn’t know where to turn to for guidance. There was no institutional process to help them make a final call. Hospitals have malpractice lawyers but do not typically employ criminal lawyers. Even local criminal lawyers weren’t sure what to say — they had no precedent to draw on, and the attorney general and the governor weren’t issuing any clarifications. Under the law, it was possible a prosecutor could argue Hollis’ case wasn’t an immediate emergency, just a potential risk in the future.
Goldberg was only a month into his first job as a full-fledged staff doctor, launching his career in one of the most hostile states for reproductive health care in America, yet he was confident he could stand in a courtroom and attest that Hollis’ condition was life-threatening. But to perform an abortion safely, he would need a team of other providers to agree to take on the same legal risks. Hollis wanted to keep her uterus so she could one day get pregnant again. That made the operation more complicated, because a pregnant uterus draws extra blood to it, increasing the risk of hemorrhage.
Goldberg spent the next two days trying to rally support from his colleagues for a procedure that would previously have been routine.
Vanderbilt declined to comment for this article, but Hollis’ doctors spoke to ProPublica in their personal capacity, with her permission, risking backlash in order to give the public a rare view into the dangers created when lawmakers interfere with high-stakes medical care.
First, Goldberg and a colleague tried the interventional radiology department. To lower Hollis’ chance of bleeding, Goldberg wanted doctors to insert a special gel into the artery that supplied blood to her uterus to reduce its flow. But that department’s leadership didn’t feel comfortable participating.
As the saying goes…’the law is an ass’. Besides, what right do men have to regulate a woman’s life or body? Don’t let her die and defy the law.
“The doctors didn’t know where to turn to for guidance.”
I dunno, their conscience? The oath they took? Really doesn’t seem like a hard call to me. Save a life or blindly go along with immoral laws? Hmm, lemme think….
says the person whose “conscience” tells her that Putin’s annihilation of Ukraine is totally justified. hmmmm, lemme think……
Dienne’s comment is spot on. There is no dilemma. The docs/medical personnel should do the right thing and perform whatever procedure is needed to save her life. You’re bringing in Putin is a worse than a crock of . . . .
Here is my facetious question of the day for you: So I guess you believe that following the law trumps morals and ethics. Have you joined the Republican party?
Duane,
I find it the height of hypocrisy for people who CHOSE to make Roe v. Wade expendable for their own self-righteousness to turn around and criticize doctors for not saving the women whose lives they found expendable.
If you didn’t vote for a Democrat to fill an OPEN Supreme Court seat with the court tied 4-4 because you didn’t think abortion rights were all that important, but you blame doctors or hospitals for not breaking this law that you decided was not very important, you have a lot of chutzpah.
I voted for a Dem to STOP the Republicans. Some people didn’t think that mattered even though they were well aware that THIS was a very likely outcome, especially in very conservative states.
At least own it, instead of looking for scapegoats. You are better than that.
Just curious, NYCPSP, for all your ranting at me, do you actually disagree with me? Are you saying the doctors should have let her die because of abortion laws?
You have me all wrong NYCpsp in your 3:20 comment. All wrong.
Duane,
I will have to take your word for it.
I can’t believe that Diane Ravitch posts an article about a doctor fighting to do the right thing when horrible people have passed a law that they were able to pass because RvW was repealed by the Supreme Court. And someone tries to scapegoat the doctor!
Just curious, dienne77, for all your ranting at me, do you actually disagree with me? Are you saying the Supreme Court that struck down Roe v Wade and the people who kept telling us to calm down because sending a message was far more important than protecting Roe v. Wade or repealing Citizens United aren’t to blame for the fact that MOST women won’t have even this kind of doctor caring for them and many will die?
(FYI,if you read the article carefully, this is about saving her uterus and the doctor is clearly NOT going to let her die.)
People who said the Supreme Court didn’t matter in 2016 should at least be consistent instead of hypocrites now looking for someone else to save the lives of the women who sure didn’t matter to them when they chose to send a message instead of protecting their right to choose.
In 1986 EMTALA Laws were put into place. All Dr’s know about these laws put in place for emergency medical treatment. This sounds more like the board of a hospital along with its lawyers trying to dodge a lawsuit at the expense of a human life or to play to the media.
“Goldberg spent the next two days trying to rally support from his colleagues for a procedure that would previously have been routine…But that department’s leadership didn’t feel comfortable participating.”
The latter didn’t feel comfortable because it was an experimental procedure designed to replace a routine one. The analogy is so easily applied to governing today, and to what draws here, the fate of public education. I am reminded of a quote Bergson’s comment on two Molière plays:
“Hi, Attorney Bob? Administrator Sally? Yeah, hi, this is Firefighter Joe down at the station. We have a building on fire and people inside, but I’m afraid if we go put it out, some of our guys might get hurt. What do you think we should do?”
Said no firefighter ever, and firefighters get paid a heckuva lot less than doctors.
I thought the doctor was willing but nurses and other medical staff were not. You going to attack nurses, now, too? How about all the other staff?
If you knew anything about firefighters versus doctors you would know that if you calculated their per hour rate (and I am including being on call in firehouses), firefighters don’t get paid “a heckuva lot less than doctors”.
But their work is dangerous, of course, in a way that (most) doctors are not. However, have any firefighters been intentionally killed for doing their job? How many abortion providers have?
Finally, give me a break. Doctors are some of the lowest paid professionals versus the amount of training they need. After college, they are in med school another 4 and then long residency programs where 2 years is a “short” residency. And remember the debt for 4 years of med school.
If you are smart enough to get into med school, there are many higher paid jobs you could do with fewer hours.
Why would your first response to this to be to blame the DOCTORS?
You are so fast to pile on anyone but right wing Putin-loving Republicans no matter how bad they are. But doctors?? Really?
Are you going to bash planned parenthood, too?
I am so flattered that you find me so irresistible.
OB/GYNs in Chicago make upwards of $300,000/year. Firefighters in Chicago make $85,000/year (with overtime, about $120,000/year). I’m sure other jurisdictions vary widely, but I’d say that’s substantially less.
Firefighters don’t hesitate to put their lives on the line. Doctors can’t even seem to fight for basic medical things like M4A or reproductive rights where they would have the greatest influence.
So, yeah, I stand by my comment.
NYCPSP,
That’s a very harsh response to Dienne. Cut her some slack.
Infuriating. Evil.
We are all of the age where we have friends and family who have a cancer or chronic disease and also happen to be in the cult. Try this one on them next time you have the opportunity: “If your doctor thinks you should have a medicine or treatment, but your insurer does not, who do you side with?” Now you have your opening to thrust the rhetorical dagger.
Or a tx isn’t even offered because you have no insurance…I seem to remember some cries about ACA creating death panels. We already have them i one form or another.
Decisions about what is best for patients should be in the hands of doctors in collaboration with patients. The state should not be allowed to politicize treatment for any patient. Doctors take an oath to “do no harm.” They should not be faced with having to harm patients, losing a license or going to jail. These laws are designed to deny women equal treatment under the law. No woman should have to keep a dying or non-viable fetus inside of her until sepsis sets in. This is “cruel and unusual punishment,” It is barbaric, IMO.
The situation is outrageous. Why should legislators tell doctors or teachers what they are allowed to do. The politicians are unqualified to intervene.
This isn’t pro-life when there is not life to save in a non-viable fetus. It needlessly punishes the mother for no reason and puts her through needless pain and suffering. I thought we were better than this.
Hippocrates, meet hypocrites.
Let her die. . .it’s God’s will. In the meantime I’m sending thoughts prayers. And I’ll pray for her soul when she dies.
Just how stupid is that thinking?
Doesn’t get any stupider.
And the docs are cojonesless to not have provided the proper care as and when needed. WWJD?
Nothing, not even a law, is preventing teachers from working an extra hour every day or 4 hours a day during the summer to help at least some of the kids who are being greatly harmed by the laws passed that hurt public schools.
So why aren’t they? Too greedy? Teachers are all cojonesless?
This is so much more complicated as your “proper care” (which may not include a risky procedure to save her uterus).
And it would be moot if Roe v. Wade had not been repealed.
Blame the doctor is like blame the teacher. It’s what the far right does. I defend teachers who don’t get the resources they need. I don’t say that if they had “cojones” they would just work the same hours as charter school teachers.
This article is about how hard it is for doctors who want to help patients because of the draconian laws that very conservative states are passing because Roe v. Wade was repealed.And you turned it into a “blame the doctor”.
That’s what the pro-charter trolls do when the laws that hurt public schools are discussed. Blame the teacher. It distracts from what is clearly the problem.
The problem isn’t doctors who are afraid to break the law or union teachers who are too greedy to work as hard as charter teachers to help kids. It’s the law itself.
And I blame teachers and adminimals for not standing up and doing the right thing instead of implementing the standards and testing malpractices. Look at where that lack of resistance has gotten us.
I don’t agree with everything Harmann has to say in this article (especially glorifying the Dims when they have been a part of the problem over the decades but the title says it all:
https://www.counterpunch.org/2023/03/29/the-consequences-of-not-taking-on-bullies/
We have let the bullies dominate the educational policy landscape thinking playing nice would mollify, perhaps get rid of them. It didn’t and here we are.
Oh, and I never said anything about “teachers who are too greedy to. . . .” Not sure why you bring that up.
Duane,
I was the one who brought up the teachers reference because I think blaming the teachers is like blaming the doctors. It’s not so easy to risk having to fight getting jailed and it certainly isn’t cheap to hire a lawyer. And it’s a lot riskier than teachers standing up to the “adminimals”. But is it really fair to blame the teachers? Whatever motive those who blame teachers (or doctors) for their inaction – greed, cowardice, the enjoyment they get in seeing kids suffering – it just seems an attempt to distract from the real problem. The politicians or the voters who either vote for them, or are content to sit back and do nothing knowing that someone who is going to pass a horrendous law will win an election.
Basically what this says to women is that if you want to attempt to bear a child, the government will force you to (possibly) die even though doctors have the capacity to (possibly) save you. So you’re on your own. Take your chances.
Vote with your feet NY is a lovely state. And the per-capita murder rate in NYC is about 1/5 that of Memphis.
But on a serious note any unfortunate woman who goes to a Catholic Health Services Hospital puts her life at similar risk. Apparently they will put off doing a medically necessary abortion till the mother is almost bleeding out.
Sadly I believe they are the largest Hospital chain in the Country, especially in fly over country.
Just now on NPR there was a report about a law in Iowa where a guy with a trans kid was unable to get treatment recommend by their doctor. He was considering moving to another state, just as you suggest above. This coincidence made a light come on.
I have always assumed that laws restricting abortion or creating open carry gun regulation were about playing to the base, making people vote for the people who enact the legislation. Perhaps this is wrong. Tennessee has become wildly conservative in the twenty years of in-migration. In recent years, meeting a person who has moved here always seems to reference some conservative view as a motivation. Obviously, I do not meet people who leave my state.
I believe the Republican intent is to actually make people move. These laws intend to create majority Republican states that can politically dominate the cities in them, effectively canceling the vote of all who disagree with them, thus making it possible to rule with a minority of the people supporting them. Migration in America is making the division in our country more pronounced.
Migration out of Germany of the hated people was a fascist policy during the 1930s. Makes you think
I believe Ronald Reagan said vote with your feet in 1982.
Roy,
I have read severaral articles about Putin’s delight that about one million people have left Russia—intelligentsia, highly educated, free thinking, creative. He is happy to see them go. Makes for a more compliant population.
Perhaps Trump revealed the grand scheme when, at a recent campaign rally of his, he commanded: “Have more [white] babies.” By that grand scheme, the death of a White woman relatively infrequently due to complications of pregnancy won’t matter.
Nazis created incentives to have more babies. Mothers got extra pensions for each live birth (time of death was irrelevant, 1 day or 60 years were equal) which were honored by West Germany (I assume some payment was granted in East Germany, but it was surely lower) until the mother died. So there is a precedent in the favored ideology of the cult.