Wednesday, December 9, 2015

Real and Hypothetical Crimes

David:
For many of our blogs, I can almost predict the positions you'll take. The only question is how far left will you take it? But sometimes you surprise me. This might be one of those times.

Recently, A pregnant woman was shot and killed during a home break-in just 2 blocks from our house. The suspect, a young, black male between 5'4" and 5'9" is still at large. In Indiana, in addition to a murder charge, the perpetrator may also be charged with additional crimes due to the fact the victim was pregnant.

http://www.nbcnews.com/news/us-news/surveillance-images-released-killing-indiana-pastors-wife-n464591

My question today: If someone injures a pregnant woman, and the attack leads to a miscarriage, is there more to the crime than just assault and battery? Does the pregnancy count for anything in your opinion?

Doug:
Interesting that you provide the race of the suspect in your description, but not the race of the victim. Also, the news link that you provided doesn't say anything about the race of the suspect.

David:
It's a local story, and they have video of the suspect. The police are searching for someone who matches the description I provided. I also didn't mention the height of the victim, but I did for the suspect. Does that make me a Heightist? The description of the suspect is a part of the investigation, and perhaps one of our readers might see or hear something.

Doug:
Be on the lookout for a 5'4" to 5'9" black male? Seriously?

David:
Someone here in Indy might hear something that could contribute to the case. I don't think that's a ridiculous hope. There is a reward for any information leading to an arrest.


Doug:
This is a terrible story. But what a strange headline: "...Killing of Indiana Pastor's Wife." The headline refers to the dead woman as the "Pastor's Wife"? How did the Pastor get into the story? I better not be referred to as "Teacher's Husband" in my obituary!

David:
More likely, you'll be "Dave Blank's amusing sidekick". You should start wearing a cape and mask...

Doug:
Even worse. But you see that my point wasn't a joke? The woman was defined by her relationship to her husband. Wait, this is a national news story? Surely (and sadly) this type of crime happens often, but let's not talk about handgun violence. Ah, I see beautiful white people, blonde woman, pregnant, and a pastor. Ok, I get it. No doubt that this is a tragic, senseless death. And also an interesting case-study into what can become a national news story and what doesn't.

David:
Since you see racism behind every comment or action, it does not surprise me your take is the reporting is racist.

Doug:
Another possibility is that racism (and sexism) really does permeate our culture.

David:
Here's another interpretation:
Whenever you wish to differentiate between two similar people, you will describe them by their differences. For example, if there is a crowd wearing red shirts, and you're wearing a blue one, and someone wanted to point you out, they would say, "He's the guy in the blue shirt". That isn't to say he's a red-shirt hater. It's what sets you apart in the crowd.

Since there was more than one murder in the past few weeks, if a reporter wanted to differentiate one from another, he would look for a unique qualifier. In this case, the fact that she was a pastor's wife was a singular qualifier. They did not say she was white, or beautiful, or anything else about her. She became "the pastor's wife" because that separated her from other homicide victims, so this case won't be confused with others. That's how it is in journalism, particularly if you cannot use the person's name as the qualifier.

To prove the point, now that the woman's name has been released, headlines are now using her name as the unique qualifier.

Doug:
A new term: "brothersplaining." In any event, your question isn't about that crime at all, but about a hypothetical heinous attack on a pregnant woman, which leads to a miscarriage. I would think that an attack that caused a miscarriage could be treated like an attack that caused the loss of an organ, such as the appendix. So, yes, it "counts." How could it not? But I don't know if it should be treated as an additional crime, just evidence to the seriousness of the battery.

David:
I believe it is the pregnancy itself, and the potential legal ramifications of that fact that make this a national story.

Doug:
I am sure you do believe that.

David:
And my question is about this case directly: should the perpetrator face additional charges for killing the unborn baby?

In your analysis, if an ex-husband kicks his 9-month-pregnant ex-wife in the abdomen, specifically with the intent to cause a subsequent miscarriage, that's the same as getting into a bar fight, and someone damages their...appendix?

Doug:
In science we usually only vary one variable at a time, not all of them. So, to make this clearer for you, the situations should be:

  Situation 1: two people get into a bar fight, and someone damages their appendix.
  Situation 2: two people get into a bar fight, and someone has a miscarriage.

or, if you prefer:

  Situation 3: an ex-husband kicks his 9-month-pregnant ex-wife in the abdomen, specifically with intent to cause a miscarriage.
  Situation 4: an ex-husband kicks his 9-month-pregnant ex-wife in the abdomen, specifically with intent to rupture her appendix.

In my analysis, 1 and 2 sound about the same, right?

David:
Not at all. Number two is manslaughter. Number one isn't. Your appendix is part of you. A baby growing inside of you is a separate person, with their own civil and guaranteed rights under the law.

Doug:
Ah, no. I see Situation 3 is worse than Situation 4, because that pregnancy could end up becoming a child, and the intent was shown. It isn't a child yet, so it can't be murder. But it could be considered, as I said, as evidence as to the seriousness of the crime.

For me, the real loss is about potential. Here is another pair to compare:

  Situation 5: a woman is attacked, and must have a hysterectomy. She was planning on trying to have three kids.
  Situation 6: a woman is attacked, and has a miscarriage.

Both terrible. Which is worse?

David:
Um, we seem to have a situation....of too many situations!

At least you have agreed that someone injuring a mother, intending to cause a miscarriage is worse than causing injury to an organ. We're making progress.

Doug:
You tend to get lost in the details. I don't see much of a different between Situation 1 and 2.

David:
I was talking about your comments on 3 and 4.

Doug:
I see. Some would call this "cherry picking" the parts you agree with, and ignoring the rest. Sometimes the world is not so black and white. At least others may not see it that way.

David:
You have 6 different scenarios now, and you're complaining that I chose two to make a point? That's using 30% of the available information. Hardly "cherry picking".

Doug:
That is the definition of cherry picking!

David:
No, cherry-picking is selecting out a specific fact from the mass of data, and ignoring the rest to make a point. (Or, here in Indiana, hanging out under the basketball hoop to make an easy transition basket...) Using 30% of the information is using a fairly large chunk. Hardly the same.

http://www.thefreedictionary.com/cherry-pick

Situation 3 is now a homicide, as there was intent to kill the baby. Situation 4 is likely a felony, as there was intent to cause bodily harm, not just a simple assault. Situation 5 is also a felony, similar to 4, and, of course, situation 6 is manslaughter at a minimum, as the actions led to the death of the baby.

Doug:
You keep forgetting that fetuses aren't legally considered people, so it isn't "killing" or "murder". Considering that that is the law, then one has to look at other criteria. I think "potential life" is an idea that we could both agree is a valid concept, and therefore losing many potential lives is worse than losing one.

David:
Yes, which is why this case is potentially different. If you are charged differently because an unborn baby is killed (or, a potential life is lost), that could lead to new and unbroken legal ground.

I'm glad we're making some headway in this discussion.

Doug:
I think the only way you could see headway is if you pretend I'm saying something other than what I am saying. This could be an interesting discussion about the subtle consequences of harm and potentials. Or you can just say "unborn babies are people" and that is the end of the discussion.

If "potential life" is the measure, then losing a womb (Situation 5) is worse than losing a fetus (Situation 6), right?

David:
Loosing the organ that makes a baby is worse than loosing the actual baby? No.

Doug:
It is a fetus. It doesn't just make a baby---it can make a bunch of babies. Surely you would rather have a miscarriage than a hysterectomy? That is just logical.

David:
I think most women would consider all of your situations to be terrible.

Doug:
Focus, David. Yes, all of those are terrible. But some are worse than others. To the original crime, your point appears to be "there are two murders, not one." But that seems to be moot anyway. Should it really matter in this case? Shouldn't the punishment for a single death be the maximum penalty, life in prison?

David:
So killing 20 people is the same as killing one? No, we charge killers with all of their crimes, so if they beat the rap on one count, they'll still be responsible for the majority of their crimes.

Doug:
Focus, David. Those fetuses are not alive. It is not a crime to have an abortion. It cannot be murder if it is not alive.

David:
On a related note, the Supreme Court is going to review Texas laws that require a physician performing abortions to have staff privileges at the closest hospital, and clinics offering abortions to have the same certification as an outpatient surgery center. As you clearly believe a miscarriage (and abortion, since it involves a medical practitioner)  is just like loosing an organ, these requirements are certainly reasonable.

Doug:
You clearly don't understand what I clearly believe. It doesn't look like there is much of a chance that that law will be found constitutional:

http://www.vox.com/2015/11/25/9801108/anti-abortion-scott-walker-defeat

"The Wisconsin law is similar to the Texas law that's about to spark the biggest Supreme Court ruling on abortion in 25 years. And the federal judge who struck down Wisconsin's law had absolutely nothing good to say about the arguments for upholding it. Judge Richard Posner makes a persuasive case that admitting privileges have no medical benefit for women and no purpose other than to close abortion clinics."

David:
Interesting article. I'd suggest everyone read it for a moment, before we continue.

Right, then. Let's discuss the arguments from this judge.

Apparently, as long as someone else is on the hook to take care of your mistakes (ER doctors) you have no obligation to take care of the young woman to which you caused "an emergency condition". Nice. Perform a procedure, collect your fees, and tell her to call an ambulance if she has problems. Someone else will deal with the fallout.

Doug:
Those poor ER doctors! I hadn't really taken the time to consider the plight of the ER doctors. Maybe a forced ultrasound would help calm them.

David:
That's because you don't pay malpractice insurance. 

Doug:
I am sure we all pay for it in the cost of our healthcare.

David:
Yes, you do. And then complain about the high cost of healthcare.

And you don't understand the medical necessity of performing an ultrasound before a procedure like this. If a woman came to the hospital, she would get an ultrasound as the standard of care. But in an abortion clinic, it's somehow a forced and unnecessary insult to a woman.

Doug:
It may be necessary, or maybe not. How about we let the doctor and patient decide, like we do all other medical procedures! I just don't understand why in this one case you want the government in your pants.

David:
I saw multiple patients on a routine basis (which means we saw 6-8 patients per month) when I worked in Bloomington, Indiana, from the local abortion clinic. The patient had no idea which procedure the doctor used for her abortion, nor if there were any potential complications. When I'd call the clinic, they would not put me in touch with the provider, or even tell me who did the procedure. No one carried pagers, and they were always "unavailable", even if it was 11AM.
Our OB/GYNs got hooked into multiple malpractice cases because they were the doctor on-call, but had nothing to do with the problems created by someone else. They got stuck because the abortion doctor was nowhere to be found. It did put the patients at greater risk, because we had to sort things out from scratch. No where else in medicine does such an exclusion exist.
When the patient is admitted under the on-call OB/GYN, the original doctor who performed the abortion does not have his name attached to the case at the hospital. So, who knows how many complications he actually has? There is usually no mechanism to assign blame to that provider. These laws fill that hole.

Doug:
Oh, I thought that they were there to protect the women having the procedure? They are really there to assign blame in case of complications. Ok, just making sure we have our priorities straight.

David:
If malpractice is involved, blame belongs with the physician who committed the malpractice, not with the doctor who repairs the damage. I guess your priority is to make sure abortion providers have no responsibility to their patients? Because in my experience, there were many women who suffered from poor abortion clinic care.

It's like that time when I got blamed for you spilling the green paint. Or did I spill the paint, and you got blamed? Whatever. I'm sure you were responsible for something ...

The fact that women still do well, is a testament to the hard working hospital staff that pick up the pieces from a botched abortion. But, that doesn't mean that all is well, or that things shouldn't be done differently. The doctor who did the procedure should continue to care for his patient.
To argue that keeping a clinic open is more important than making it safe, is a travesty of judicial over reach. The judge decided that if these laws are maintained, some clinics would close, because their doctors can't get on staff at a real hospital. The judge decided that is less acceptable than increasing safety. So much for making women safe.

Now, here's an article about the same court decision from a slightly less biased source:

http://abcnews.go.com/US/wireStory/federal-court-rules-wisconsin-abortion-law-unconstitutional-35379491


"Judge David Manion was the lone dissenter, saying the law protects women's health and doesn't amount to an undue constitutional burden. "The solution to the plaintiffs' problems is that they find more qualified doctors, not that the state relax — or that we strike down as unconstitutional — precautions taken by the state to protect the health and safety of pregnant women who have chosen to end their pregnancies," Manion wrote.
Doug:
So, you would happy with the hospitals doing the abortions? And no need to make the process any more expensive than it needs to be, right?

David:
Why would those things suddenly change? 

Doug:
I thought your point was that hospitals were safer than clinics? We can just do the abortions in hospitals. Good idea!

David:
Abortions would still be done in the very clinics they are performed in now, and at the same cost. But, the equipment would be the same equipment that is standard in any outpatient surgery center, and the doctor would be available to handle his own complications. For practitioners that are currently getting a free ride from their mistakes, they might brush up on their skills a bit if they were now to be accountable when things go wrong.

So far, everything the government has done with healthcare has made it more expensive. It hasn't stopped them in any aspect of Obamacare. 

Doug:
If you say it enough times, it will make it true, right?

David:
But, suddenly, now you care about costs over safety.

Doug:
No. But you didn't deny that it will indeed cost more, for no additional benefit. If it doesn't cost more, and it provided additional safety, count me in! I'm merely pointing out your hypocrisy. You clearly believe in keeping the government out of things that they have no business in. Letting the government be involved where they should not: that would be a Real Crime. 

1 comment:

  1. Oh, it likely will add to costs, for the patient or their insurance carrier. It should not cost tax payers more, because the government is forbidden from using tax dollars to fund abortions. For all of the other extremely generous care that Planned Parenthood provides, this would have no impact. Need antibiotics for an STD? Need a health screening? Check!
    As I outlined extensively, it would make abortions safer. But you say you are against that unless it doesn't add to any cost. How convenient. Especially when you so succinctly declared that ultrasounds might or might not be a standard of care. Your medical knowledge is breathtaking.
    Perhaps I can talk you into covering my next shift, Dr. Blank.

    ReplyDelete

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