Safe, legal and rare: 0-for-3 in West Philly

Abortion should not only be safe and legal, it should be rare.

-- President Bill Clinton, Democratic National Convention speech, Aug. 29, 1996.

The procedures that took place in Dr. Kermit Gosnell's office were not safe -- his carelessness and amorality in the way he attemped to perform them caused him to murder, according to prosecutors, a female patient and seven babies, and those were just the cases in which they were able to bring charges.

Many of them were not legal -- including a number performed after the 20th week of pregnancy, which is unlawful.

They certainly were not rare.

And so the fact that it went down this way was a disgrace. The person who is ultimately responsible for all this -- personal responsibility and all that good stuff, right? -- is Gosnell himself, a monster whose behavior is inexplicable. But he did get an assist from all the regulators, most notably from the state of Pennsylvania, who somehow thought they were supporting woman's reproductive rights by allowing this unsafe and lethal practice to operate without any inspections after 1993, when the term of anti-abortion Gov. Bob Casey began winding down. Pretty stupid, since Gosnell's butcher shop could now bolster those who want to place more legal restrictions on abortion, which could then have the counter-productive effect of more unsafe and unlawful clinics down the road.

Here's more on Pennsylvania's shocking derreliction of duty:

But perhaps most frightening of all? The atrocities were discovered by accident , as the Philadelphia Inquirer points out. Warnings—from patients and their attorneys, a doctor at a Philadelphia hospital, women’s health groups, pro-choice groups, and even an employee of the Philadelphia Department of Public Health—failed to prompt state and local authorities to investigate or take action against the clinic.

The grand jury report said that one look at the place would have detected the problems, but the Pennsylvania Department of Health hadn’t inspected the place since 1993. Here’s the grand jury report, in surprisingly strong language:

The Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all. The politics in question were not anti-abortion, but pro. With the change of administration from Governor Casey to Governor Ridge, officials concluded that inspections would be “putting a barrier up to women” seeking abortions.

“Even nail salons in Pennsylvania are monitored more closely for client safety,” the report states.

The whole thing is appalling, and there's something here to offend everyone, whether the lack of inspections was due to ideology or because, as some have argued, the victims of Gosnell's crimes were predominantly poor and black. At the very minimum, from this tragedy should come a new commitment by state as well as local officials to make sure this kind of clinic operates safely and legally.

But is there a grand lesson here about the question that looms over every mention of abortion -- is it right? I think people who expect any tipping point to come from this case will be disappointed. Clearly, advocates and opponents of abortion rights share only one thing on the Gosnell butchery -- outrage -- but they still couldn't differ more in their conclusions. Check out two prominent opinion writers both based here in Philadelphia, the liberal blogger Susie Madrak and conservative op-ed writer Christine Flowers.


This is what happens when you don't have strong regulation (the emphasis on real regulation, not harassment, as is all too often the case with abortion providers), and not enough people to enforce it. (And the lack of political will to do so.) This is what happens when a commodity becomes so inaccessible, and expensive (because if your insurance won't cover it, you have to pay cash), a greed-driven monster can make a fortune doing it.

It happens when competent, caring, ethical doctors are too afraid for their lives to work as abortion providers, This is what the anti-abortion forces have wanted all along -- to drive doctors away from the field.

Everyone should denounce this horror. But let's not ignore the reality that if abortion was as accessible and affordable as it should be, these women could have had abortions in the first trimester and none of this would have happened.


Roe talks about the legality of abortion, but in ignoring the human and social meaning of the procedure (despite former Supreme Court Justice Harry Blackmun's sanctimonious preaching) it's clearly created a lobby for whom the "needs" (and sometimes even the convenience) of a woman takes precedence over everything else.

Perhaps the indictment of Gosnell will force us to now consider that full meaning of legal abortion...

Sometimes, it now seems, it's hard to tell the difference between abortion and a capital crime.

For me, the Gosnell case, horrific as it is, hasn't changed my belief that Clinton nailed the issue with the safe, legal and rare standard. I know it's often asked -- why "rare" if you believe that abortion should be legal? For one thing, like any kind other kind of preventive medicine, early measures like birth control (including abstinence) are vastly preferable to an expensive and more elaborate medical proceedure that carries some risks. Second, let's be honest -- abortion is a moral quandry for many people, and anyone on either side of the debate who tells you that he or she knows all the answers is lying, and so the less often it happens, the better. However, the one indisputable tragedy of the Gosnell case is not that abortions were performed -- but that they were performed and regulated so callously.