Thursday, August 6, 2009

One Medical Malpractice Attorney's View Of Abortion

Abortion. The word evokes strong emotion whenever it is uttered or written. As a trial lawyer representing persons injured due to shoddy medical care, I see it as a health care issue. Abortion is an invasive medical procedure. Physicians performing them owe a duty to their patients to do so with reasonable competence. The goal of the pro-choice movement has been to keep abortion safe and legal. They have argued that women will get abortions regardless of whether it is legal or not. If it is illegal women will seek out unscrupulous and less-than-skilled physicians in "back alleys" to perform them, placing their lives at serious risk. Therefore, they argue, abortion should be kept legal so that women need not undertake undue risk to have the procedure. The pro-life folks, on the other hand, tend to view abortion as murder pure and simple. I suspect that a pro-lifer would bristle at viewing abortion as a medical procedure at all. They believe that abortion should be illegal. Some pro-life advocates have used intimidation and violence to compel physicians to give up performing abortions. Not long ago I represented a client profoundly injured while undergoing an abortion. My experience with that case led me to conclude that we now have a situation that no one can be happy with: Abortion is legal, but it is often unsafe.

My client agonized over whether to terminate her pregnancy. She was from a good family, but like most they had their ups and downs. They did not have a lot of money. She and her loyal and decent boyfriend of many years had three young children together. When she became pregnant with their fourth child she felt that another would be too much for the family to handle financially and perhaps emotionally. Without her partner's knowledge she decided to terminate the pregnancy. Unfortunately, considerable time passed before she finally made her decision, and the fetus developed into its second term. Second term abortions are legal in Illinois. However, few physicians here perform them. She found a clinic in Chicago willing to do it. The outcome was tragic. The procedure she underwent was called dilation and extraction which requires that the patient be sedated. Anesthesia service at the clinic was not provided by a physician, but by a nurse. The nurse, evidently not knowing what he was doing gave the patient too much of a drug called Propofol and failed to protect her airway. As a result the oxygen level in her blood plummeted, causing a hypoxic event. In short, her brain was not receiving enough oxygen. She would never awaken and today remains in a vegetative state requiring 24/7 care.

My firm filed a lawsuit against the nurse anesthetist, the clinic and the surgeon alleging medical malpractice. In the course of the litigation which followed I immersed myself into the world of abortion; and "it" does seem to have its own world. Doing serious medical research on the topic was tough. I was constantly led to dark websites with photos of dismembered fetuses and containing ominous threats against doctors performing abortions. I learned that those willing to help me get information and find experts were often working with a political agenda I was not comfortable with. Apparently, parts of the pro-life movement support medical malpractice lawsuits against doctors who perform abortions. The strategy seems to be to try to sue them out of practice. The biggest obstacle I needed to overcome was just finding another physician somewhere in the United States who performed second term abortions. In Illinois, a plaintiff can only proceed to litigation against a physician with an expert who works in the same area of practice as the defendant doctor. I needed a physician with experience performing this procedure. There are very few anywhere.

From a lawyer's prospective, the case should not have been a difficult one to prosecute. The negligence was pretty apparent. In fact, not long into the discovery process I received a call from the defendants' attorneys, both very experienced and decent lawyers, who said they had been told by their own experts that the case was indefensible. To receive such an honest admission in a medical malpractice case from defense counsel is extremely rare. The case settled for the full amounts of the applicable insurance policies. However, I came away from that case horrified at the state of this area of medicine. With so few physicians performing abortions, especially second term abortions, one has to wonder whether women have access to the kind of good, competent physicians that are available for other kinds of gynecologic procedures. It's hard to blame doctors for not wanting to do pregnancy terminations. Given the threats -- sometimes carried out -- against the lives of abortion doctors, a physician would probably have to be nuts to want to have anything to do with the procedure.

So where does that leave the woman who feels compelled to terminate her pregnancy? In a difficult spot frankly. Be extra careful before having an abortion. You simply must take the time to look into the background of the physician who will perform the procedure. Click here for a list of good patient resources or look along the right side of this blog for helpful health care links. You should ask plenty of questions before hand. Understand the nature of the specific procedure you will undergo. All abortions are not performed in the same way and will depend on how far along the pregnancy is, as well as other factors. All surgical procedures come with risk, especially where sedation is necessary. Know who will will be responsible for administering anesthesia. If it is to be a nurse, will he or she be supervised by a physician knowledgeable in anesthesiology? Pregnancy termination seems at this time to be exceptionally risky so proceed if you must with extreme caution.
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