On casting stones at patients in distress
Consider where the American Taliban wants to take this country. For anyone who missed it, this clip below is the Republican nominee for governor of North Carolina. He may sound like he is a member of the lunatic fringe, but he is not. Mark Robinson is just shoutier.
The lunatic fringe right has gone mainstream. In fact, they’ve made it to the U.S. Supreme Court several times already. Dahlia Lithwick and Mark Joseph Stern comment on Tuesday’s oral arguments in FDA v. Alliance for Hippocratic Medicine (AHM). They write:
In public, the plaintiffs in this case—a group of doctors and dentists seeking to ban medication abortion—have long claimed they object to ending “unborn life” by finishing an “incomplete or failed” abortion at the hospital. But in court, they went much further. Their lawyer, Erin Hawley, admitted at oral argument that her clients don’t merely oppose terminating a pregnancy—they are pursuing the right to turn away a patient whose pregnancy has already been terminated.Indeed, they appear to want to deny even emergency care to patients whose fetus is no longer “alive,” on the grounds that the patient used an abortion drug earlier in the process. And they aim to deploy this broad fear of “complicity” against the FDA, to demand a nationwide prohibition on the abortion pill to ensure that they need never again see (and be forced to turn away) patients who’ve previously taken it. This is not a theory of being “complicit” in ending life. It is a theory that doctors can pick and choose their patients based on the “moral distress” they might feel in helping them.
That is, AHM wants to define patients at risk of bleeding to death as medically untouchable based on subjective perceptions of their moral purity. No, they’re not joking.
The plaintiffs say they are terrified that one day, a patient may walk into their emergency room suffering complications from a medication abortion prescribed by some other doctor. This patient may need their assistance completing the abortion or simply recovering from the complete abortion, which these plaintiffs deem “complicity” in sin. And they say the solution is either a total, nationwide ban on mifepristone, the first drug in the medication abortion sequence, or a draconian (and medically unnecessary) set of restrictions that would place mifepristone out of reach for many patients. (The U.S. Court of Appeals for the 5th Circuit ruled to reinstate those restrictions at their behest.)
It is a twisted line of logic, one that should never have reached the Supreme Court in the first place. But it is also a product of the court’s past indulgence of outlandish claims about moral “complicity.” As was made plain in the oral arguments and briefing,activist doctors are no longer satisfied with personal conscience exemptions already granted under state and federal law; they now insist that nobody, anywhere, should have access to the abortion pill, in order to ensure that they themselves won’t have to treat patients who took one. At a minimum, they say, they should be able to radically roll back access to the pill in all 50 states to reduce the odds that one of these handful of objectors might someday encounter a patient who took it. This extremist argument lays bare the transformation of the idea of “complicity” from a shield for religious dissenters to a sword for ideologues desperate to seize control over other people’s lives and bodies.
Unclean!
Lithwick and Stern cover some of the back and forth of the arguments. This trend in the religious far right demanding the rest of America live by its most restrictive definition of fundamentalist freedom is not new:
All this is reminiscent of Little Sisters of the Poor, a case about a Catholic charitable group that was afforded an exemption from the Affordable Care Act’s contraception mandate. The Little Sisters were asked to check a box signaling to the government that they could not comply with the mandate, at which point the government would step in to cover their employees. But the Little Sisters refused, viewing this action—the checking of a box to opt out of coverage—as “complicity” in abortion because it would in turn trigger government payment for contraception (which they viewed as abortifacients). The Supreme Court and the Trump administration ultimately indulged the Little Sisters’ claim.
Here, we have emergency room physicians asserting that they will not participate in lifesaving medical intervention unless they approve of the reason for the pregnancy loss. Presumably, if the pregnant patient is an unwed mother, or a gay or transgender person, the doctor would be similarly complicit in sin and decline service. Seen through this lens, since one can never know which sins one is enabling in the ER, each and every day, a narrow conscience exemption becomes a sweeping guarantee that absolutely nobody in the country can ever have access to basic health care, let alone miscarriage management. (Of course, these plaintiffs might focus only on one set of “sins” they see as relevant.) In a country effectively governed by Kacsmaryk and his plaintiff friends, a gay person suffering a stroke could be turned away from any hospital because of his sexual orientation, all to spare a doctor from a glancing encounter with prior sin. As Tobias Barrington Wolff, a professor of law at the University of Pennsylvania Law School, put it to us in an email, this unbounded view of complicity “is part of enacting the social death of people and practices you abhor, which in turn can contribute to the material death of people and practices you abhor.”
Only the pure deserve to live, and that’s not you if you’re not them. You’re unclean, an untouchable.
One of the most exhausting lessons of post-Roe Americais that being “pro-life” definitively means privileging the life of the presumptively sin-free unborn—or even their “dead” remains—over the life of the sin-racked adults who carry them. This is why women are left to go septic or to hemorrhage in hospital parking lots; it is why C-sections are performed in nonviable pregnancies, at high risk to mothers; it’s why the women who sued in Texas to secure exceptions to that state’s abortion ban are condemned by the state as sinners and whores. And it’s why—in the eyes of the Alliance for Hippocratic Medicine—it is a greater hardship for a physician to “waste precious moments scrubbing in, scrubbing out” of emergency surgery, as Hawley put it, so long as they don’t believe that the emergency warrants their professional services, than it is for a pregnant person, anywhere in the country, including in states that permit abortion, to be forced to give birth.
Heaven forbid doctors should ritually cleanse themselves only to have to touch a female patient who may or may not have engaged in acts that render them biblically unclean. Stoneable.
These arguments are, of course, untangleable from the right’s less-public demand that the traditional male hierarchy be reinstated to assuage conservative men’s damaged sense of being atop it, and that Christianity, a specific, radicalized variety, be formally declared the official state religion. You will live by their code, one way or another, and women will know their places. Ask Mark Robinson.
Robert Reich opined on the Alabama “frozen embryo” case last month:
According to a new survey from the Public Religion Research Institute and the Brookings Institution, more than half of Republicans believe the country should be a strictly Christian nation — either adhering to the ideals of Christian nationalism (21 percent) or sympathizing with those views (33 percent).
This point of view has long been prominent among white evangelicals but is spreading into almost all reaches of the Republican Party, as exemplified by the Alabama Supreme Court’s ruling.
It is also closely linked with authoritarianism. According to the survey, half of Christian nationalism adherents and nearly 4 in 10 sympathizers said they support the idea of an authoritarian leader powerful enough to keep these Christian values in society.
During an interview at a Turning Point USA event last August, Rep. Marjorie Taylor Greene, R-Ga., said party leaders need to be more responsive to the base of the party, which she claimed is made up of Christian nationalists.
“We need to be the party of nationalism,” she said. “I am a Christian and I say it proudly, we should be Christian nationalists.”
Think they won’t impose their will at the point of a sword, or a bayonet? Look back at the Christian nationalist banners dotting the Jan. 6 mob and the violence now excused as patriotism by Trump.
Invest now in burkas.
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