A (Very) Short History of Abortion in the United States

In light of the expected overturning of Roe v Wade, I wanted to look at the not-so-long history of abortion as a political issue in the United States today.

First, let's burst a bubble.

The Founding Fathers whom conservatives idolize so much did not outlaw abortion.

What many people might find surprising about that statement is the underlying fact that abortion even existed in the 1700s. So let's take a quick detour. Not only were abortions performed in Colonial times; we have evidence of artificially-induced abortions going back thousands of years in civilizations all over the world, using a variety of methods, from surgical to herbal. And I emphasize 'artificially-induced' because as any ob/gyn can tell you, Nature herself performs far more abortions than humans do themselves: 30-40% of all pregnancies are terminated by the human body itself in spontaneous abortion or miscarriage.

Now back to those old White guys in powdered wigs...

Before a shift in doctrine beginning in the 19th century, and accelerating in the 20th, the mainstream Protestant belief in force at the time our country was founded was that life didn’t begin until “quickening,” at a minimum 15 weeks, often about 20. Until then, abortions were allowed, and it was definitely not considered “murder.” It was procedure, albeit admittedly a risky one, given the poor hygiene and medical practices of the day. So if you pictured our Founding Fathers solemnly devoting themselves to a policy of respecting the sanctity of unborn life, think again. Their belief, shared by the Catholic Church (on which more below), was that a fetus had no soul until it quickened roughly halfway through the pregnancy.

Only much later did conservative American politicians realize that abortion was an opportunity to create a divide among people and to control women, their two favorite pastimes in my experience. Meanwhile, the Catholic Church held substantially the same belief as Protestants. Abortion was a non-issue all the way up until 1869, when Pius IX did a 180 and turned the supposedly eternal and consistent Church into enemies of something they’d previously had no problem with whatsoever. Prior to that, the doctrine was in lockstep with Protestant belief, albeit with a different lexicon: in the language of the Vatican, life began upon “ensoulment,” which corresponds to that same notion of “quickening” Protestants had always embraced, i.e. around 15-20 weeks into the pregnancy. So where do Christians in America stand today? Now, of course, it is a very political issue, and if you observe the actual numbers, it is one rife with hypocrisy. It works like this: If you’re a Christian woman (or, say, a Republican Christian politician with a pregnant mistress) and you need access to a safe abortion, you get it. Indeed, 70% of all abortions are performed on women who identify as Christians, and 23% of those are evangelicals. That means that every year, there are approximately 100,000 evangelicals terminating their pregnancies, and about another 340,000 non-evangelical Christian women terminating theirs. But if you’re a Christian and someone else needs an abortion, that is apparently very wrong and that person is going to hell, and they must be prevented from accessing safe abortion care. This has serious consequences for women's health. Completely putting aside considerations of risks tied to such issues as giving birth too young or while suffering certain medical conditions, childbirth is at the best of times a risky thing, resulting in the death of the mother 14 times more often than a safe, legal abortion performed by a doctor does.

The point of this essay is not to change anyone’s mind about abortion. I am not up to that task.

But regardless of your feelings about the issue, let’s all deal in verifiable facts.

Being “pro-life” isn’t about your Bible and it’s not about your religion’s long-standing beliefs about abortion or the nature of life's beginning, because the Bible never even mentions this medical procedure, and your religion had no problem with it until a relatively short time ago, going back less than 8% of its history. Abortion is now solely about politics, and it’s about controlling women in service to a very specific political agenda in that sphere. Religion is simply a convenient excuse, as it so often is when evil people need to justify evil actions that deprive others of their fundamental rights and human dignity.

Finally GETting it: the 2012 GET (Genomes, Environments and Traits) Conference, Boston, 25 April 2012

As I mentioned in one of my very first blog posts, I am participating in the Personal Genome Project led by Dr. George Church of Harvard. (Read that post here to get a quick overview of the project.) For the past couple of years, they have had a one-day conference (Genomes, Environments, Traits, or GET) at Harvard Medical School to discuss progress as well as host presentations on related themes and trends. Participants in the study are invited to attend free of charge, so I stopped by to enjoy some very interesting lectures on a wide range of topics, as well as to get a full update on the progress of the project.

And OK, I admit it: I also wanted to meet Dr. Church.* I have always found the idea of ‘celebrity’ rather horrifying. With the exception of a book-signing, I wouldn’t be caught dead asking someone for an autograph, and I firmly reject the idea that just because someone (e.g. actors) is in the limelight, s/he is somehow worthy of our affection and praise. And I believe that if you admire someone for his or her convictions or policies or work, then you should admire the product (i.e. ideas), not the person (who is as fallible as you). In other words, I don’t really do hero-worship, and I don’t have any ‘rock stars’. But Dr. Church is as close as I will ever come to having a hero. His audacious project to sequence 100,000 genomes has the potential to have a greater impact than any other single scientific undertaking in medical history. I realize this doesn’t make him as fame-worthy as, say, an accomplished person like Kim Kardashian or Paris Hilton, but it’s good enough for me.

For me, the most interesting part of the day was the update on the project itself. The whole team was there, each updating on his or her area of responsibility (bioethics, legal, operations, etc.). They then fielded questions from the group of us there. The question I wanted to ask (but didn’t have to because apparently everyone was thinking it and someone else posed it first) was, isn’t the project terribly skewed towards a certain subset of the population? First there’s education and IQ: since they aren’t aggressively advertising it yet, they are getting mostly people who have a higher educational level; and since they require everyone to pass a test on the basics of genetics, risk and privacy issues at stake, it will also skew towards the more intelligent. Also, looking around the room, I saw a majority male and majority white audience (though admittedly I don’t know for sure how representative that was of the overall participant pool). Add to that the fact that one must be an American citizen to participate and it does seem a little imbalanced. There really wasn’t much of an answer for that. For the educational/IQ and American citizen issues, those are all related to legal/informed consent/privacy requirements, so they can’t really budge there for now. As for ethnicity and sex, presumably at some point they will be making a wider push for more participants and attempt to balance things then.

And that brings me to the next thing I noticed: despite the fact it’s been up and running for a few years now, it is still very early days, so patience is the key word here. There’s so much more to it than simply soliciting, receiving and processing DNA. Remember, nothing like this has ever been attempted before, so there is a very steep learning curve here: how best to collect and process so many samples, and with the best maintenance of the samples; even deciding WHAT to sample, since this is also about environment and about getting as wide a spectrum of data as possible; how to handle the interface with participants; all the legal and privacy issues; how best to process all the data to ensure it’s actually turned into something meaningful. The list goes on and on.

As for the numbers, here’s where it stands right now: there are about 2,000 of us in the project. In the first five years of the project, they sequenced 10 genomes (starting with Church’s, who led by example and released all his data); now they are up to about that many per month. The market cost for the process is down to around USD 4-5k, which is already half as much as last time I checked a year or two ago; and the price will continue to plummet as the process is improved and streamlined (which is an important secondary goal of the project).

Besides the project update, there were many fascinating presentations on other subjects, from a CEO who has the goal of achieving the 100-dollar genome, to an incredible project that is achieving the ultimate biomimickry: creating actual miniature bio-synthetic organs on which to do drug trials to ensure greater accuracy and reliability of results (not to mention saving a lot of rats!). That latter one was amazing and the implications for drug research are profound. Take for example asthma drug research. Progress in this area has been (literally painfully) slow. One of the main reasons? Animals simply don’t mimic the human version of asthma very well, so researchers often go down dead-end paths, wasting a lot of time and research money along the way. But imagine growing a biosynthetic lung and testing drugs on them directly. The researcher, Dr. Geraldine Hamilton, showed some pictures of some of the actual organs they had created. Astounding accomplishment both from a technical point of view and in light of its staggering implications.

So what does the future of genetics hold for us? The possibilities are practically endless. As Dr. Church said, we all have some ‘superpower’ in our genes (large or small, whether we are aware of it or not). This can be anything from harder-than-average bones to HIV-resistance. Now imagine identifying thousands of such ‘superpowers’ through large-scale genomic research. Then imagine leveraging that knowledge of individual genes to create therapies for others who lack that particular ‘superpower’. You don’t need much of an imagination to realize that the implications for the future and well-being of humanity are profound.

The future is a wild place, folks. Hold on.

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*For the record, I did get to meet him and speak with him for a few minutes, and was quite proud of myself for not gushing overly much. I think I might even have been relatively coherent.

Bad Science and/or Bad Science Writing

This humorous article posted by a friend on Facebook got me to thinking about science writing. Poor science reporting is a pet peeve of mine. Sometimes it's difficult to suss out which is really bad: the science writing or the science itself....or both. Many writers reporting on science lack a scientific background themselves*, which makes it challenging enough; add in a reporter's need to sensationalize, and you often get some really horrendous science writing.

This disturbing tendency is particularly damaging when it comes to health-related science. "Research Suggests Consuming X Leads to Cancer" for example. How often do we see headlines like that? I can never tell what to take seriously, because it's difficult to tell who is doing a bad job: writer or researcher....or both...or neither (if in fact the conclusions are sound)? But taking the information at face value, I can't know how seriously to take it. People who eat X get cancer at a rate 1.5x higher than others. OK, but is that cause and effect? Correlation? Coincidence? Is it environmental? Genetic? For example, maybe the problem is that people who eat X have a taste for X because they possess a gene that makes them crave it, and that gene has a dual role, one that leads to a higher tendency towards cancer. Or maybe people who eat X like the taste and the substance has a taste similar to something else that is in fact causing the cancer. Or maybe it is coincidence. (Don't start with the 'no coincidences' thing!) If you take enough data about enough things and draw enough conclusions, you will sooner or later run into coincidences like this. It's not just possible: it's quite probable. Anyway, the point is that the permutations and possibilities are practically endless: genetics, environment, both, neither, coincidence, epigenetics or just plain flight of fancy....or some unimaginable combination of all.

Occasionally there are more mundane reasons for bad science reporting. I recently read an interesting piece in Discover magazine about taste. The writer said that everything Americans think they know about the 'map of the tongue' is in fact based on a very bad translation of a German study. So forget that bit about sour being on the sides, sweet on the tip or whatever.

And sometimes it is a question of science writers bowing to and passing on received 'wisdom', information that is passed along so many times that we all - including science writers who should know better - just believe it. Take that utter and complete nonsense about needing eight cups (64 oz, roughly 2 liters) of water a day. This ridiculous 'fact' is based on a bad journalist's laziness. In the 1990s, a New York Times reporter mentioned it in a piece. He had gotten it from a study done two generations earlier. Problem is, he didn't bother to read more than the 'eight cups' part: the study's author went on to say that 30-40% of that amount is gotten from our food anyway. Now we have an entire bottled-water industry built on the premise that if your urine isn't 100% clear, you're dying of kidney failure within the hour.

Bottom line: next time you read a science headline, take it with a grain of salt...but no more than a grain, as otherwise you'll die of heart failure immediately, according to a recent study.


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Footnotes:

*Not that there's anything wrong with that, says the science buff who has a degree in languages and who barely passed high school biology thanks to a distinct squeamishness about frog dissection.

It ain't the stupid people's fault; it's the smart ones who oughta know better, but don't

I can't remember where I read it, who said it (I seem to recall it was a 19th century American) or exactly how the quote goes, but it amounts to "The bad state of the world ain't the stupid people's fault; it's the fault of the smart ones who oughta know better, but don't."

When I was growing up, I labored under a blissful illusion: somewhere, somehow, a bunch of really smart people were out there making the world a better place, and doing so at a steady, methodical pace using rigorous scientific means. To take one example: I always thought medicine was the paragon of such scientific (and beneficent) efficiency. In my imaginary world, when you went to the doctor, the doctor examined each symptom, checked the results against some impressive (but, as it turns out, entirely imaginary) database, went through checklists and arrived at both a diagnosis and a treatment based on the best available data from the world of medicine. In turn, s/he logged the results of this diagnosis, treatment and outcome into this fictional database, strengthening the field of medicine with ever more data. As I reached adulthood, this illusion was slowly destroyed, replaced with the reality that (again, to pick on medicine) doctors basically just muddle through as best they can, relying on their training and whatever attempts they care to make at staying abreast of current trends in their field.

So as an adult, I have slowly come to learn what a rather inefficient, unproductive world it is that we occupy. Even in areas where one expects competence and intelligence, too much digging results in disappointment. Picking on medicine here again, take the example of back pain. For decades (if not centuries), the standard treatment for 'throwing out one's back' has been bed rest. In fact, it has been conventional wisdom for so long, few bother to question it. Doctors to this day routinely tell their prostrated patients to take it easy, stay in bed. There's only one problem. Scientific evidence suggests that not only is bed rest not a good idea, it can actually prolong the problem. Moderate exercise, though initially uncomfortable, is considerably more effective a treatment. I can attest to this through personal experience: after reading this rather astonishing screw-you to conventional wisdom, I acted on it. I throw my back out a couple of times a year. I used to just lie in bed waiting for the pain to pass. Now, I drag myself out the door and, painful as it is at first, I walk. It's a little embarrassing since I am bent over a good 45 degrees or so, and I creep along at around one mile per hour. But sure enough, after 10-20 minutes, I am walking upright and the pain is all but gone. The old 'cure' of lying in bed left me prostrate for at least the whole day.

This is not meant to suggest that doctors are incompetent or even, for that matter, that they universally prescribe bed rest for back pain! The point is, why aren't we as a society doing a better job of simply documenting, compiling and cross-referencing our experiential data and then rationally acting on the results? In medicine, science, public policy and, yes, religion and ethics, we consistently fail to act on the evidence we accumulate so easily. I can forgive religion: it's entirely premised on accepting things blindly on faith. But what's science's excuse? And medicine's? Healthcare workers aren't even utilizing the humble checklist routinely, a simple 'no-brainer' that could save countless lives.* And what is the excuse of public policy 'experts' when they continue to prescribe courses of action that have failed repeatedly, ignoring policies that have proven to be successful? The easy answer is that people are just foolish. The harder but more worthwhile answer is that we have a lot of work to do in educating even the 'smart' people to follow a more rigorous approach to their respective endeavors.

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Footnotes

*Yes, checklists. That most basic of things. You'd be surprised how rarely it is used. Imagine if every significant procedure at a hospital required a checklist. 'Did you check for contraindications? y/n; if y then proceed; else, check' 'Did you cross-reference the bed chart with the computer records before performing the procedure? y/n; if y then proceed; else, cross-reference'