intent

A few days ago I performed my first D&C. Granted, it was an incomplete abortion (a miscarriage in which products of conception are not completely expelled and require evacuation) and was not done expressly for the purpose of aborting a fetus. Like any other surgical procedure, it felt oddly impersonal and detached. The patient, draped in sterile fashion with only the surgical site exposed, appears merely as a body part. All members of the surgical team, covered in hats, masks, long sterile gowns, gloves and shoe covers, appear mostly anonymous. The procedure itself - simple enough that I was allowed to perform much of it - is a series of well-rehearsed steps. We were in the OR probably less than 30 minutes.

I couldn't help thinking the whole time, though, that this D&C wasn't done any differently than when performed specifically to abort a pregnancy. Clearly, medical abortion is a giant ethical and moral debate with infinite arguments about what constitutes a "life"; however, from a strictly surgical perspective, it really doesn't feel any different. Like law and murder/manslaughter, it all seems to fall back on intent. Parsing out intent vaguely intellectualizes the whole situation in the first place, yet abortion draws fervently emotional responses. It's easy to debate medicolegal issues like euthanasia and abortion in the intellectual sense, but in person (in hospital?) nothing is black and white. If everyone could see things like this, I wonder if there would be more open-minded, gray people.

On that note, I leave you with this article published yesterday in the Times, written by an retired OB/Gyn discussing his experience before Roe v. Wade.