Virginia governor Ralph Northam Discusses Current Virginia Abortion Law

[abj13]

Looking at this text, I do not like the bill at all. I don't think any hospital would expose themselves to the risk of performing the procedure based on single physician opinion for any deleterious reason. But I also think the existing language is terribly vague although quite common in my experience with the law intersecting with medicine, and to be honest I'm not sure how anyone could define things more precisely.

A couple of points:
Brain dead = dead. If you have no cerebral function, you're dead regardless of whether medical devices can sustain your tissues. There are some legal questions RE: whether this must also include lack of brainstem function, and some caveats to assessment in the setting of major metabolic disturbance (for instance), and I'm not expert in the finer points, but brain death is poorly understood from a lay perspective. If you are brain dead, hospitals can remove ventilators, etc. without anyone's consent because you are dead. It is not equivalent to persistent vegetative state.

Physicians can and regularly do (but not often enough or properly enough) assess capacity to make decisions in care, especially high risk (e.g. surgical) interventions. If it is not urgent, and capacity is not very straightforward, something with grave consequences like termination of a 3rd trimester pregnancy would probably benefit from a full ethics panel and possibly court determination.

Yeah, you raise some interesting points. I think the biggest is that for much of medical care, there isn't state legislature designating requirements that must be met in order for a medical procedure to be performed. It certainly becomes different when deciding DNR orders, or defining brain death when you can be more concrete. But there's no way legislatures can appropriately define what constitutes an "impairment of mental or physicial" health in any non-vague language. These laws are often pushing the limits of what can be defined as appropriate medical care, a realm that legislatures tend to stay out of and defer to physicians. Of course, we get scenarios like Terri Schiavo where the government's reach went too far.

 

[Viper1j]

LOL, "mental health" reasons, there's a high threshold, might as well say something equally vague and untestable as "lower back pain." Seems like if your mental health condition was bad enough to call for an abortion it's bad enough that you would be institutionalized and not judged of sound mind to consent to a medical procedure like an abortion.

At what point, did most of this country turn into Gladys Kravitz from Bewitched?

 

[glenn1]

Yeah, you raise some interesting points. I think the biggest is that for much of medical care, there isn't state legislature designating requirements that must be met in order for a medical procedure to be performed. It certainly becomes different when deciding DNR orders, or defining brain death when you can be more concrete. But there's no way legislatures can appropriately define what constitutes an "impairment of mental or physicial" health in any non-vague language. These laws are often pushing the limits of what can be defined as appropriate medical care, a realm that legislatures tend to stay out of and defer to physicians. Of course, we get scenarios like Terri Schiavo where the government's reach went too far.

Or doctors like Larry Nassar or Kermit Gosnell where a deliberately loose set of controls without oversight (such as what's being proposed in VA) allowed them to create horrific abuses. But it's way more important that a woman not be impeded in the slightest way in obtaining her abortion in the 40th week if that's what she wants since it's "her choice," just fire up the form letter saying it would create "mental distress" that she wasn't able to abort and proceed to putting scissors into skulls.

 

[abj13]

Or doctors like Larry Nassar or Kermit Gosnell where a deliberately loose set of controls without oversight (such as what's being proposed in VA) allowed them to create horrific abuses. But it's way more important that a woman not be impeded in the slightest way in obtaining her abortion in the 40th week if that's what she wants since it's "her choice," just fire up the form letter saying it would create "mental distress" that she wasn't able to abort and proceed to putting scissors into skulls.

Haha, you're going to use Larry Nassar as an example? You're sure on a recent rampage of making facepalm worthy posts.

 

[brycejones]

Haha, you're going to use Larry Nassar as an example? You're sure on a recent rampage of making facepalm worthy posts.

Nothing recent about that rampage, when glenn1 runs out of logic (which happens quickly) he just starts throwing bizarre shit at the wall.

 

[WelshBloke]

The concept of "circulatory death" has been generally replaced by the brain death definition."The Commission ultimately recommended a Uniform Determination of Death Act (UDDA) which aimed to make the total brain standard into law in the states.20 This recommendation has been adopted by the American Bar Association and American Medical Association,21 and made into law in some form in all 50 states.22 The UDDA simply states: ’An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards’" Note that "circulatory death" is defined as IRREVERSIBLE cessation of circulatory and respiratory functions, so if a person can be resuscitated, by this definition they were not dead. link

Thats going to make it interesting for doctors to certify someone dead. Are they going to need to do an EEG on poor old 98 year old, cold, stiff Doris?

 

[WelshBloke]

Either separate statements, or a big non-sequitur. Not viable != fine after resuscitation.

We resus people that are not viable all the time. Most people will die shortly after being resused even if the resus goes perfectly. Its not like resusing someone fixes what made them need resusing in the first place most of the time.

 

[Jaskalas]

At what point, did most of this country turned to Gladys Kravitz from Bewitched?
View attachment 2937

That argument makes no sense.

It is the "right" to murder that is being decided, and is under contest with regards to abortion.
With babies surviving up to 4 month premature, killing them in the last trimester should be no-go except for medical necessity.

The compromise for abortion, IMO, is to get it done and over with as early as possible.

 

[DrDoug]

Conservatives have always been supporters of state paid, post-birth abortions. Instead of calling it a post-birth abortion, they call it the death penalty. Thus there is no such thing as a pro-life conservative unless that conservative is also against the death penalty. Those that want to stop abortions but are all for the death penalty are "pro-birth" and that's what I call them. If conservatives were pro-life they would give a fuck about the kid once it was born.

Nope, in their world it's "Good luck, kid, you'll get no further help from us!"

 

[shortylickens]

That argument makes no sense.

It is the "right" to murder that is being decided, and is under contest with regards to abortion.
With babies surviving up to 4 month premature, killing them in the last trimester should be no-go except for medical necessity.

The compromise for abortion, IMO, is to get it done and over with as early as possible.

The "right" to murder has already been decided. Many time by the supreme court.
Theres no reason we should be having this argument again except for the fact whiny losers want something to be angry about. Also the politicians need something irrelevant to fight over because they couldnt solve a real problem if their lives depended on it.

 

[shortylickens]

Conservatives have always been supporters of state paid, post-birth abortions. Instead of calling it a post-birth abortion, they call it the death penalty. Thus there is no such thing as a pro-life conservative unless that conservative is also against the death penalty. Those that want to stop abortions but are all for the death penalty are "pro-birth" and that's what I call them. If conservatives were pro-life they would give a fuck about the kid once it was born.

Nope, in their world it's "Good luck, kid, you'll get no further help from us!"

My dad.

 

[Viper1j]

Conservatives have always been supporters of state paid, post-birth abortions. Instead of calling it a post-birth abortion, they call it the death penalty. Thus there is no such thing as a pro-life conservative unless that conservative is also against the death penalty. Those that want to stop abortions but are all for the death penalty are "pro-birth" and that's what I call them. If conservatives were pro-life they would give a fuck about the kid once it was born.

Nope, in their world it's "Good luck, kid, you'll get no further help from us!"

EXACTLY what he said.

 

[blackangst1]

I suggest you actually read the text of the bill proposed:

https://twitter.com/x/status/1090461729518178304

[

The new bill would NOT have removed requirements 2 and 3. If there is evidence of viability, then you resuscitate the neonate. The governor's comments reflect what was already law and what was proposed to be changed.

The neonate? You mean the baby, right?

 

[Vic]

Im trying to figure out how this "the infant would be resuscitated if that’s what the mother and the family desired" is realistically any different than a child getting into an accident and the doctors asking the parents whether to use extreme measures to resuscitate the child. Baby is born with deformities and needs resuscitation vs child has accident and needs one. Both cases should be up to the parents as to whether to perform the procedure or let the child go. Am I missing something seriously terrible here?

Nope, you're not missing anything. The problem here is that some people think they should be the ones deciding for the parents.

 

[HurleyBird]

Actually, according to you, Governor Northam has nothing else better to do but listen to committee minutes...

...And despite answering the two questions posed to him about the laws and providing full answers, because he didn't answer your mythical question, its a strawman and therefore he supports "post-birth" abortions (whatever that means).

If you think that the governor isn't going to be caught up on the current hot button political events before hopping on talk radio, I have a bridge to sell you.

And no, if he is just simply answering a straw man he's only guilty of doing a monumentally bad job at it.

I'm sorry, that's not how medical law is written. If we were to follow your logic, we'd have pages and pages of medical law with line after line stating "Thou shall not prescribe 1 g of fentanyl for mental health reasons. Thou shall not perform a cardiectomy for mental health reasons."

...

I suggest you read what you wrote. In the span of two paragraphs, you argued that in one case, one doesn't need to codify "an obviously negligent treatment." Then suddenly in other case, despite you admitting that you won't find a physician to meet your bad example and would therefore fit "an obviously negligent treatment"

No I didn't say anything close to that. I'm going to be gracious here and assume that you're simply misinterpreting me or skimming rather than blatantly straw manning my position. I said that you would have a hard time finding a physician who would carry out an abortion for a minor mental health reason, which isn't to say that a few surely do exist. I didn't say that if you did find such a doctor there would be obvious negligent treatment and therefore liability for malpractice. That's your own unsubstantiated logical leap. A physician being unlikely to perform an procedure under certain conditions because it's likely to be uncomfortable for the majority of physician does not defacto make another physician's performance of that procedure negligent, especially when the procedure under those conditions is literally enshrined in state law. And of course, the fetus isn't going to be suing for malpractice in the first place.

since you think you are such an expert on Virginia medical practice, what is the incidence of abortions beyond the third trimester that result in delivery of a non-intact fetus that 3 physicians signed off on meeting the state's "mental health" phrase?

I'm not your researcher, but I imagine pretty close to none. That said, this line of attack of yours is absolutely illogical. Your argument in favour of the current restrictions needing to be loosened is that... the current restrictions seemingly work well? What?

 

[abj13]

If you think that the governor isn't going to be caught up on the current hot button political events before hopping on talk radio, I have a bridge to sell you.

And no, if he is just simply answering a straw man he's only guilty of doing a monumentally bad job at it.

We get it. You are committed to your false thread title and despite it being pointed out to you multiple times by multiple people, you are too intellectually dishonest to admit you have woefully mischaracterized the Governor. The very first thing he said was that he wasn't there and couldn't answer on behalf of Delegate Tran. You accuse him of lying despite having no evidence and its clear your only motivation of your accusation is to justify your thread title.

In no part during the question offered to the Governor was anything about mental health, and yet you want him to answer a question not posed to him. He was asked about abortions at "a stage of labor," and he answered. He was asked about whether one or three physicians should sign off, he answered.

Perhaps you should have listened to the interview before posting your false thread title.

No I didn't say anything close to that. I'm going to be gracious here and assume that you're simply misinterpreting me or skimming rather than blatantly straw manning my position. I said that you would have a hard time finding a physician who would carry out an abortion for a minor mental health reason, which isn't to say that a few surely do exist. I didn't say that if you did find such a doctor there would be obvious negligent treatment and therefore liability for malpractice. That's your own unsubstantiated logical leap. A physician being unlikely to perform an procedure under certain conditions because it's likely to be uncomfortable for the majority of physician does not defacto make another physician's performance of that procedure negligent, especially when the procedure under those conditions is literally enshrined in state law.

And just like that, the goal posts move another 50 miles. Just like your shifting inability to properly understand what was meant by resuscitation, you can't even keep your own points consistent. I asked you, what physician would support offering an abortion for anxiety. You answered NONE. That's your own words, not mine. Now its "a few surely exist." Do you even read what you write?

As I have explained to you multiple times, medical law is not the same as criminal law. Medical law and malpractice utilizes expert opinion to define what is acceptable medical practice. This is why state and federal laws do not have books upon books of banned medical decisions or treatments. Yet somehow you think there's no need to codify "an obviously negligent treatment," but then two paragraphs later write that you have to make something explicitly illegal despite your admission that you know of NONE that would allow anxiety as an indication for a third trimester abortion.

I'll write this again, since the point is so important and you keep avoiding it: This is why examining the thoughts of the Virginia physician is so important as detailed over and over in my previous posts. This is also why the law uses common medical law phrases like medical opinion and best clinical judgement, and why you purposely ignored my statements regarding that phrasing. Performing something that is not the standard of care of the state medical board is how malpractice is established. That fact you write something so contrary to that concept indicates your ignorance of medical law.

And of course, the fetus isn't going to be suing for malpractice in the first place.

Further proof of your inability to understand health law. Just like your inability to explain phrases like medical opinion and best clinical judgement, you continually write laughable statements.

I'm not your researcher, but I imagine pretty close to none. That said, this line of attack of yours is absolutely illogical. Your argument in favour of the current restrictions needing to be loosened is that... the current restrictions seemingly work well? What?

Where did I say I agreed with the changes to the law? Did you find it? Please read your own thread. Once you do, my point will make better sense.

 

[abj13]

The neonate? You mean the baby, right?

You realize that neonate has a specific medical meaning, right?

 

[blackangst1]

You realize that neonate has a specific medical meaning, right?

Yes. A newborn child.

 

[MarkLuvsCS]

misclick

 

[HurleyBird]

And just like that, the goal posts move another 50 miles. Just like your shifting inability to properly understand what was meant by resuscitation, you can't even keep your own points consistent. I asked you, what physician would support offering an abortion for anxiety. You answered NONE. That's your own words, not mine. Now its "a few surely exist." Do you even read what you write?

Yes, do you even when you go back and link to it? OK man, the straw manning here has to stop. I know it's no innocent mistake at this point when you actually link my previous statement. You asked what group of VA physicians was advocating for performing abortions on the basis of anxiety, and I said "none that I'm aware of." Where to begin with the false equivalences? Not knowing of something isn't the same as declaring non-existence. A group isn't the same as individuals. Advocating isn't the same as silently hoping, etc. And again, this is just a completely illogical detour. Whether or not there are people out there who will abuse bad laws doesn't mean you make bad laws.

As I have explained to you multiple times, medical law is not the same as criminal law.

Tort law isn't the same as criminal law. Medical law can fall under either depending on the circumstances. There is such a thing as criminal malpractice.

Medical law and malpractice utilizes expert opinion to define what is acceptable medical practice. This is why state and federal laws do not have books upon books of banned medical decisions or treatments.

No shit. But my doctor trying to treat my foot rash with a mercury pill is not the same situation as state law enshrining that I enjoy more substantial rights than another individual when they come into conflict. I'll just quote my entire point from before that you failed to respond to instead of continuing to bash my head against the wall.

You're the one conflating malpractice and standard of care with state law. You don't need to codify not treating autistic patients with autism with mercury because it's an obviously negligent treatment, and demonstrably so. On the other hand, drawing the line between the rights of the fetus and the rights of the mother is an entirely ethical question. There is no obviously negligent action unless you botch the procedure. Lowering the legal constraints under which a physician can perform an abortion (eg. removing the substantial and irremediably clause) is tangibly unique from your misfitting autism example. As vile as it may be, it isn't malpractice to abort a late term, viable fetus for mental health reasons if it's allowed by state law. You aren't harming the mother with a hypothetical mental health inspired abortion. It's merely following the guidelines of a statute that is lopsided in favour of one side's rights over another.

But I've explained a dozen times what the distinction is here and you've ignored it several times. After your demonstration above I have little hope of getting through to you, so all I can say is that you should go back and re-read my points that you haven't responded

Funny, that's my exact advice for you. Since you can't even get things right when you link to my posts though I'm thinking you might be a lost cause here.

Yet somehow you think there's no need to codify "an obviously negligent treatment," but then two paragraphs later write that you have to make something explicitly illegal despite your admission that you know of NONE that would allow anxiety as an indication for a third trimester abortion.

Skipping over the same straw man as before, no, I don't think you need to make anxiety specifically illegal. It's rather the corollary that I'm against. I don't think it should be enshrined. That's what the law literally says when the fetus can be aborted at any time on the basis of mental health alone, without any qualifiers or thresholds.

I'll write this again, since the point is so important and you keep avoiding it: This is why examining the thoughts of the Virginia physician is so important as detailed over and over in my previous posts. This is also why the law uses common medical law phrases like medical opinion and best clinical judgement, and why you purposely ignored my statements regarding that phrasing. Performing something that is not the standard of care of the state medical board is how malpractice is established. That fact you write something so contrary to that concept indicates your ignorance of medical law.

Ugh. Look, the phrasing of the law is that if "the physician's best clinical judgement, the continuation of pregnancy is likely to result in the death of the woman or impair the mental or physical health of the woman." The physician isn't making a clinical judgement on whether an abortion is ethical for a certain situation, he's making a clinical judgement on whether the mental health of the patient is likely to be impaired. If the physician performs an abortion where there's no good risk of mental health impairment, then the state medical board can go after him if they can (good luck) prove that. But the physician is explicitly allowed by state law to perform an abortion for any likely mental health concern though. There are (no longer) any constraints or limits such as "substantially and irremediably." The state medical board can't say "We disagree with state law so we're going to suspend your license." They don't have that power. The worst they can do is to call the physician's clinical judgement into question as it relates to diagnosing a likely mental health impairment, not as it relates to using that diagnosis as a reason to perform an abortion.

Further proof of your inability to understand health law. Just like your inability to explain phrases like medical opinion and best clinical judgement, you continually write laughable statements.

There doesn't need to be a victim for malpractice to occur, but it sure helps.

Where did I say I agreed with the changes to the law? Did you find it? Please read your own thread. Once you do, my point will make better sense.

Well, you're arguing against me arguing against the proposed changes to the law, so....

 

[abj13]

Yes, do you even when you go back and link to it? OK man, the straw manning here has to stop. I know it's no innocent mistake at this point when you actually link my previous statement. You asked what group of VA physicians was advocating for performing abortions on the basis of anxiety, and I said "none that I'm aware of." Where to begin with the false equivalences? Not knowing of something isn't the same as declaring non-existence. A group isn't the same as individuals. Advocating isn't the same as silently hoping, etc. And again, this is just a completely illogical detour. Whether or not there are people out there who will abuse bad laws doesn't mean you make bad laws.

Tort law isn't the same as criminal law. Medical law can fall under either depending on the circumstances. There is such a thing as criminal malpractice.

No shit. But my doctor trying to treat my foot rash with a mercury pill is not the same situation as state law enshrining that I enjoy more substantial rights than another individual when they come into conflict. I'll just quote my entire point from before that you failed to respond to instead of continuing to bash my head against the wall.

Funny, that's my exact advice for you. Since you can't even get things right when you link to my posts though I'm thinking you might be a lost cause here.

Skipping over the same straw man as before, no, I don't think you need to make anxiety specifically illegal. It's rather the corollary that I'm against. I don't think it should be enshrined. That's what the law literally says when the fetus can be aborted at any time on the basis of mental health alone, without any qualifiers or thresholds.

Ugh. Look, the phrasing of the law is that if "the physician's best clinical judgement, the continuation of pregnancy is likely to result in the death of the woman or impair the mental or physical health of the woman." The physician isn't making a clinical judgement on whether an abortion is ethical for a certain situation, he's making a clinical judgement on whether the mental health of the patient is likely to be impaired. If the physician performs an abortion where there's no good risk of mental health impairment, then the state medical board can go after him if they can (good luck) prove that. But the physician is explicitly allowed by state law to perform an abortion for any likely mental health concern though. There are (no longer) any constraints or limits such as "substantially and irremediably." The state medical board can't say "We disagree with state law so we're going to suspend your license." They don't have that power. The worst they can do is to call the physician's clinical judgement into question as it relates to diagnosing a likely mental health impairment, not as it relates to using that diagnosis as a reason to perform an abortion.

There doesn't need to be a victim for malpractice to occur, but it sure helps.

Well, you're arguing against me arguing against the proposed changes to the law, so....

It is incredible how the original post of this thread can reflect one's inability to follow what is spoken or written. This thread was posted under the idea that Governor Northam supports "post-birth" abortions. Yet, after watching the posted part of his radio interview, the Governor admits to not being present for a committee meeting and responds to the very question posed to him. Somehow in your mind, he's supposed to not be governing but listen to every moment of every committee meeting, ignore the questions posed to him to answer some question you want him to answer. After he responds to both questions, you accuse him of supporting "post-birth" abortions despite nothing in his response to the questions indicate that it is his position. As multiple people have pointed out, it is remarkable the amount of inane logic that has to be used to twist an interview into saying something he never did.

And look what happens again? Now I'm accused of supporting the law changes, not because I said I support it, but because I chose to respond to the illogical fallicies and ignorance of medical laws posted in this thread. Huh? Please, for all of us, where have I endorsed the proposed law changes? Just like Governor Northam, what is said and is written is somehow twisted to support your fantasy world.

And to top it all off, you flip-flop and can't keep a consistent train of thought together, completely and utterly contradict yourself multiple times, and then try to twist your own words to again support your fantasy world. There is no way that legislation can be kept up to date on what is acceptable medical care, this is why we don't have laws prohibiting the usage of mercury for treatment of children with autism. With how medical laws are written, it is up to the Virginia physicians to determine what is acceptable, and for this law, what is "impairment of mental or physical" health. You proposed "anxiety" as a possible criterion that would fit, despite admitting that NONE would support it. Now you realized your mistake and start backtracking and moving the goal posts, well its now its a "hard time finding" one. This is exactly why I have written multiple times about the importance of the Virginia physician in what is determining standards of care and this is how malpractice is determined. Even though, as you admit, no Virginia physician would advocate for "anxiety" to be a sufficient indication for a third trimester abortion, you still want to codify it as illegal. That means that you think we should go back and codify everything that isn't the standard of care as illegal, ala with your comparison to "duelling lawyers."

Remember, you are the one who claimed "Whether or not a physician would abort a late term viable fetus for something as inconsequential as anxiety has no bearing on whether or not we should give one the legal cover to do so" despite the fact it is Virginia physicians who determines what qualifies as the standard of care that meets "impairment of mental or physical" health. And almost unsurprisingly, in your last response, you suddenly reverse course and admit the thoughts of the state medical board do matter. So which is it? They don't matter, or do they suddenly appear important through the thoughts of VA physicians and the state medical board?

It is an interesting discourse on warping one's reality. The Governor supports "post-birth" abortions despite discussing items that do not indicate that position. I support the law changes, because... well, where did I say that???