Commentary

When an Ultrasound Becomes Political

By Sigrid Fry-Revere
This article appeared in the Chicago Tribune on May 17, 2007.

One of the thorniest questions Republican presidential candidates face in preparation for primary season is whether a woman should have to view an ultrasound of her fetus before consenting to an abortion. The question is more complicated than it seems — it’s not simply a pro- or anti-abortion test — but the proposal is an extraordinary abuse of medical freedom.

Arizona Sen. John McCain, former Massachusetts Gov. Mitt Romney and former Arkansas Gov. Mike Huckabee have all shown support for state-mandated ultrasound requirements. Whatever their stances on abortion, they should recognize that every American has a right to make his or her own medical decisions without political interference.

In Texas the legislature is about to take its intervention in the physician-patient relationship to a lamentable extreme. By a vote of 22-8 earlier this month, the state Senate passed a bill that requires the physician performing an abortion to “review the image of the unborn child with the woman.”

At least six other states — Connecticut, Missouri, South Carolina, North Carolina, Virginia and West Virginia — are considering similar laws. The sponsor of the South Carolina bill, Rep. Greg Delleney, said, “I’m just trying to save lives and protect people from regret and inform women with the most accurate nonjudgmental information that can be provided.”

The practice of informed consent is crucial to modern medicine. It enables patients to make their own decisions, including those regarding what tests and procedures to undergo. No one in the context of any other voluntary medical procedure is legally required to have or to view X-rays, ultrasounds, PET scans, MRIs, CT scans or any other diagnostic imaging results before an operation.

Forcing a woman to have and watch a medically unnecessary ultrasound is an unsettling distortion of the informed consent process, eerily reminiscent of that haunting scene in A Clockwork Orange, in which the protagonist’s eyes are forcibly propped open as he is shown images intended to recondition his behavior.

Whatever their specific intentions in doing so — and they invariably seek to scare women into changing their minds about having abortions — the candidates must recognize that it is a perversion of the concept of informed consent, let alone an unconscionable intrusion into the doctor-patient relationship, to impose medically unnecessary procedures.

In its ruling on Gonzales vs. Carhart last month, the U.S. Supreme Court provided new ammunition for those in favor of mandatory ultrasound viewings prior to abortion. The court held that the government could prohibit medical procedures, in this particular case partial-birth abortion procedures, “in furtherance of its legitimate interests in regulating the medical profession in order to promote respect for life, including life of the unborn.”

In fact, the court maintained, the government could undertake such action even if it might not, from the patient’s own perspective or that of her physician, be in her best interest. What medical expertise do the justices have on which to render such a judgment?

The court also wrote that “the State has an interest in ensuring so grave a choice is well informed.” There is no question that decisions about abortion are difficult, but that doesn’t mean women aren’t fit to make them, or that women should be forced — “for their own good” — to undergo procedures and view images they don’t wish to see.

Sigrid Fry-Revere is director of bioethics studies at the Cato Institute.