LETTERS: ABORTION AND ETHICS

To the editor:

I would like to share with you some concerns I have as a medical ethicist on a bill vetoed by the governor but subject to an override vote in Jefferson City on Sept. 13.

I am concerned about Senate Bill 279, which assures that women faced with unwanted pregnancy are enabled to make informed decisions as to their legal options. The right or principle of informed decision-making in health-care matters is accepted in both ethics and law. This isn't a right mere to make a decision or choice. Persons seeking health care could be (and have been) easily victimized if it is viewed in this light. Rather, it is the right to make a reasoned decision based on relevant facts in light of one's beliefs, values and personal goals. This right is often referred to as informed consent. I prefer the term "informed decision-making" since it is agreed in law and in ethics that the right to consent implies a right to refuse.

Persons seeking medical care have a right to be given the information and consideration necessary to make an informed decision about their care. The information to be given includes, but is not limited to, an explanation of reasonable, legal options available with a consideration of their benefits and drawbacks. Consideration for the person's right to make an informed decision also demands that she/he is given reasonable time and opportunity, free of coercion or deceit, to reflect on these facts in light of personal values, beliefs, wishes and goals.

I believe it is especially important that women considering abortion be given this consideration. Life and death are at issue here, not the removal of an appendix or repair of a torn tendon.

I believe the bill attempts to do this by assuring that a woman receives information on options other than abortion from persons outside the clinic. She will receive information on abortion at the clinic. I think this is best. I do not believe, in our current polarized society on abortion, that it would be realistic to expect one person to impartially present all the options.

I understand that there has been a move to allow persons in abortion clinics to be certified to give this information. I am uncomfortable with that. In our country an abortion clinic is a very profitable business that makes money selling its service. There appears to be a great conflict of interest to have persons on site at clinics providing information about alternatives to abortion.

TOBIAS MEEKER, Medical Ethicist

St. John's Health System

Springfield, Mo.