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MICHELE NORRIS, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Michele Norris.

ROBERT SIEGEL, host:

And I'm Robert Siegel. Among those affected by yesterday's Supreme Court abortion decision are doctors who perform the procedure. Some of them say they still don't know exactly what the Partial Birth Abortion Ban Act does and does not allow. Others say the Supreme Court has set a dangerous precedent that permits legislators to intrude into the practice of medicine. NPR's Julie Rovner has more on how physicians are responding to the ruling.

ROVNER: Deborah Oyer runs a clinic that provides family planning, gynecology and abortion services in Seattle, Washington. She says she doesn't purposely do the specific procedure she thinks is now illegal under the Supreme Court's ruling yesterday, but she's not entirely sure.

Dr. DEBORAH OYER (Family Doctor, Seattle, Washington): The wording of what procedure is illegal was not as clear as we would like it to be. The term partial birth abortion is not a medical term. And so how to define exactly where the line is between legal and illegal in the procedures we do isn't clear to me. Then if I interpret it as drawn in one place, but the courts interpret it as drawn somewhere else, I may have crossed that line.

Rovner: And while Oyer says she doesn't expect to have the abortion police standing over her while she operates, she's still worried that someone in the room might view the procedure differently than she does.

Dr. OYER: You know, we have residents we train, we have people who work for us who can interpret things differently. Or, you know, a patient's partner - someone else who is in the room. And, while I try to be very cognitive into the beliefs of the person in the room, people beliefs change over time. Now people get in under false pretenses.

Rovner: But supporters of the law say doctors like Oyer are overreacting. Douglas Johnson is legislative director of the National Right to Life Committee. He helped shepherd the law through Congress. He says after the Supreme Court struck down as similar Nebraska law seven years ago, the federal version was rewritten. The goal was to better differentiate the term partial birth abortion from the more common abortion method know as dilation and evacuation, or DNE. There are several distinctions, including the fact that in a DNE, the fetus is usually removed in parts, while in the banned procedure it must be intact. At the same time, Johnson says…

Mr. DOUGLAS JOHNSON (Legislative Director, National Right to Life Committee): These all has to be done intentionally and deliberately for the purpose of committing this overt act. So it's impossible to violate this law by accident.

ROVNER: Still, Johnson says he won't be sorry if doctors like Oyer stop doing second trimester abortions for fear of violating the ban.

Mr. JOHNSON: If you want to be absolutely sure that you will never commit a traffic offense, then don't get in a car. These so-called classical DNEs are terrible things. They involve dismembering a living member of the human family - usually in the fifth and sixth month. We think they ought to find something else to do.

Rovner: But that attitude infuriates doctors like Nancy Stanwood. She's an assistant professor of Obstetrics and Gynecology at the University of Rochester in New York. She does perform the disputed procedure, which is known medically as intact dilation and extraction, or DNX - or at least she did.

Dr. NANCY STANWOOD (Professor, University of Rochester, New York): The great concern is that, essentially, they've taken out of our armamentarium a procedure that for some women are the safest and best course. And that's really profoundly disturbing and really unprecedented that they don't have a health exception.

ROVNER: In fact, it's the first time the Supreme Court has allowed an abortion restriction that lacks an exception for the pregnant woman's health. Stanwood says that's the result of Congress and the Supreme Court, in effect, practicing medicine without a license.

Dr. STANWOOD: And usually people go to jail for that. So you can think of where does this go next? Are they going to tell the surgeon how to amputate a leg next? Are they going to tell somebody how to write prescriptions for anti-depressants next? I mean, we, within our medical practice - base practice - both on scientific evidence, on-going research, and on clinical experience. And that's what medical practice needs to be based on. Not on what legislators think needs to happen.

ROVNER: It may be that one of the most far-reaching impacts of the decision may not be on the abortion debate at all but on lawmakers' ability to decide on what doctors may or may not do. Julie Rovner, NPR news, Washington.

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