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Archive for Wednesday, February 22, 2012

Loss of license ordered in Kansas abortion case

February 22, 2012

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— A state administrative judge has ordered the revocation of a Kansas doctor’s license over her referrals of young patients to the late Dr. George Tiller for late-term abortions, concluding their care was “seriously jeopardized” by inadequate mental health examinations.

In an order that became public Tuesday, the judge said Dr. Ann Kristen Neuhaus failed to meet accepted standards of care in performing exams on 11 patients, ages 10 to 18, who had late-term abortions at Tiller’s clinic in Wichita from July to November 2003. The judge said Neuhaus’ records did not contain the information necessary to show she did thorough exams.

Kansas law required Tiller to get an opinion from another doctor to terminate the pregnancies. Neuhaus said each patient’s mental health issues were serious enough to allow each procedure to go forward.

Neuhaus, from Nortonville, a small town about 30 miles north of Lawrence, doesn’t have an active medical practice, but her license allows her to provide limited charity care, and she’s seeking to make it fully active again. It wasn’t clear Tuesday how quickly she’d have to stop providing charity care under Judge Ed Gaschler’s order.

The order must be reviewed by the State Board of Healing Arts, which licenses and regulates physicians, most likely at an April 13 meeting. If the board makes Gaschler’s order final, Neuhaus still could file a legal challenge.

“We are in the process of reviewing the order and whether an appeal is advisable,” said Bob Eye, an attorney for Neuhaus.

Gaschler heard evidence on a complaint filed by the Board of Healing Arts’ top litigation attorney in April 2010. The case centered on how Neuhaus reached her conclusions and whether she adequately documented the reasons behind each diagnosis. Her reports, compiled with a “PsychManager Lite” computer program, were five pages or less and don’t cite details from patients’ statements or data gleaned from her exams.

The administrative judge said that in some cases, the young patients were described as suicidal, but Neuhaus didn’t recommend further treatment. The judge said Neuhaus simply “answered yes/no questions” using the computer program and assigned whatever diagnosis “the computer gave.”

“The care and treatment of the 11 patients in question was seriously jeopardized by the Licensee’s care,” Gaschler wrote.

Julie Burkhart, a former Tiller employee and founder of the abortion-rights group Trust Women, questioned whether Neuhaus’ case was handled fairly and whether Neuhaus can receive a fair hearing from the Board of Healing Arts, with Republican Gov. Sam Brownback, a strong abortion opponent, in office. Burkhart said Neuhaus is a target for anti-abortion officials.

“There’s a political agenda here, and it seems that Dr. Neuhaus is the one who can be brought before the board and punished,” Burkhart said. “The agenda is to discredit her.”

Gaschler signed the order and mailed it to the parties Friday. The anti-abortion group Operation Rescue obtained a copy and posted it online Tuesday.

The board’s executive director, Kathleen Selzler Lippert, confirmed the authenticity of the posting but declined to comment because the board hasn’t reviewed Gaschler’s order.

The case initially stemmed from a 2006 complaint by Cheryl Sullenger, senior policy adviser for Operation Rescue. And Mary Kay Culp, executive director of the anti-abortion group Kansans for Life, which scrutinized Neuhaus for years, said the evidence against the doctor was “crushing.”

Neuhaus performed abortions herself in Wichita and Lawrence but stopped in 2002. She provided second opinions for Tiller from 1999 through 2006. Under Kansas law at the time, abortions at or after the 22nd week of pregnancy, if the fetus was viable, were allowed if the patient faced death or “substantial and irreversible” harm to “a major bodily function,” including mental health. Legislators tightened the law last year so that it no longer includes the mental health exception.

“It was just a sham,” Sullenger said, who praised Gaschler’s order and described Neuhaus’ as helping Tiller in “circumventing the law.”

Tiller was among a few U.S. physicians performing late-term abortions and was shot to death in May 2009 by a man professing strong anti-abortion beliefs.

Tiller once faced misdemeanor criminal charges that alleged, in relying on Neuhaus for referrals, he wasn’t getting the independent second medical opinion required by state law. He was acquitted two months before his murder, but at the time of his death, a separate complaint was pending before the Board of Healing Arts.

Comments

Ron Holzwarth 2 years, 6 months ago

"Neuhaus said each patient’s mental health issues were serious enough to allow each procedure to go forward."

As I understand the situation, Dr. Ann Kristen Neuhaus is not and never was a psychiatrist. So how in the world could Dr. Ann Kristen Neuhaus have any idea what she was doing? She had no training at all in the disorders she was diagnosing!

It might have been within the letter of the law in the past for a general practitioner of medicine to determine that "each patient’s mental health issues were serious enough to allow each procedure to go forward," but such a diagnosis is certainly far outside of the training that a general practitioner of medicine receives in medical school, and she should have known that.

"Legislators tightened the law last year so that it no longer includes the mental health exception."

That is a very good thing. If an abortion ever is required for mental health problems, and I certainly hope it is not, only a psychiatrist could make that determination.

There is a very serious problem that many women face, and that is classic Freudian denial of pregnancy. Meaning that many woman mentally suppress the reality of a pregnancy far too long. That is very common, and extremely unfortunate. I have no idea what a possible solution to that problem might be.

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jafs 2 years, 6 months ago

Except that the law doesn't include a mental health exception, it doesn't simply require that a trained psychiatrist perform the evaluations.

Also, why couldn't a psychologist or social worker do those as well?

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Ron Holzwarth 2 years, 6 months ago

Correct, there is no mental health exception anymore. I mentioned that.

About a psychologist or social worker diagnosing mental disorders, they are simply not trained or qualified to do that. A psychologist works with psychological problems, and a social worker works with social problems.

Only a psychiatrist works with mental disorders.

And I do know about that, all too well.

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jafs 2 years, 6 months ago

Yes, and you said "that is a very good thing" that the law no longer includes that.

Seems to me your general reasoning was that only trained professionals should do them, not that mental health problems shouldn't be a grounds for an abortion.

If so, then this law over-reaches quite a bit, and requires that even women/children whose mental health will be compromised to bear the children.

And, your distinction is an odd one, between psychological/mental health issues - they are just different ways of talking about the same thing, as far as I can tell.

The only difference between a psychiatrist and a psychologist is that the psychiatrist can prescribe medicine.

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Ron Holzwarth 2 years, 6 months ago

"The only difference between a psychiatrist and a psychologist"

There's about 8 years of schooling difference after graduation from college. That's pretty major.

"different ways of talking about the same thing, as far as I can tell."

It doesn't sound as though you have studied the issues very well. For starters, do you really think that schizophrenia is only a psychological problem?

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bethann 2 years, 6 months ago

There is not an 8 year difference in schooling between an MD and a psychologist with a PhD.

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Ron Holzwarth 2 years, 6 months ago

bethann, that is true, but a psychologist with a PhD is almost always going to be teaching other people to be a psychologist, and won't be working as one himself.

But, he would certainly be qualified to do so.

Very, very few practicing psychologists have a PhD. It is not required in order to be a practicing psychologist.

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jafs 2 years, 6 months ago

No, I think there's probably a biological/genetic component as well.

But, we're not talking about that - we're talking about whether or not a trained psychologist can make a determination about the mental health ramifications of giving birth.

I see no reason to believe they can't.

You may be using "mental health" in a more specific diagnostic manner than I was, in which case you're right, of course. There's a difference between conditions like schizophrenia and conditions without biological/genetic factors involved.

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jafs 2 years, 6 months ago

Also, our mind/body connection is remarkable, and many activities can affect brain chemistry, exercise being just one of them.

I seem to recall that MPD folks can exhibit measurable physical conditions in one personality that are absent in others.

The mere discovery that there are some physical correlations with psychological conditions isn't enough to conclude that the conditions are caused by the physical manifestations, or that the best way to treat them is medically.

We're much more complicated, and interesting than that.

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Ron Holzwarth 2 years, 6 months ago

Oh, yes. You know what I think is really interesting? Is that Chang and Eng Bunker, the original Siamese twins, were never able to play chess with each other, because they always knew what move the other was going to make!

That let me to believe years ago that many of our thoughts are based partly in our bodies, and not only in our brains.

And there's something that has stunning implications. Not so much in only heart transplants, or in only lung transplants, but in many cases when a combination heart and lung transplant from a single patient to another single patient is done, some personality transfer has been documented to occur!

Here's a link to the wiki article about Chang and Eng Bunker: http://en.wikipedia.org/wiki/Chang_an...

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Ron Holzwarth 2 years, 6 months ago

If you had spent a cumulative total of three weeks in psychiatric wards and met a lot of other patients in there, didn't know how many different psychiatrists you have seen because there were too many of them, didn't know how many different psychiatric medications your psychiatrists have tried on you because there were too many of them, and spent a lot of time reading scholarly articles on psychiatric issues, you would have a much greater insight into these issues.

That is what I was talking about when I said: "And I do know about that, all too well."

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Ron Holzwarth 2 years, 6 months ago

The horrific thing about it all is that there was a triggering event a bit over 26 years ago. I did rather well until that happened. When I think about what my earning power was back then I am stunned, good grief, I was loaded.

I am sure my life would be very different today if that had not happened, or if I had made a better decision at the time. And I would do ever so much better today if only,,, but that is something I have no control over.

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jafs 2 years, 6 months ago

All of that seems to argue against putting one's faith in psychiatrists, don't you think?

At least psychologists can't prescribe medicine that is ill suited for the treatment, and has terrible side effects and interactions with other medications.

To my knowledge, psychiatrists, while more trained in medicine, are actually less well trained in psychology, and "talk therapy:, and tend to put their stock in medication instead.

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Ron Holzwarth 2 years, 6 months ago

You're correct. A psychiatrist thinks of the brain as a body organ that does not always function correctly, or the patient is not able to properly control it.

So, only a psychiatrist can prescribe the available medications that can help. There has been a lot learned in the last two decades or so about brain functioning and some insight into why some individuals go into high functioning hyperactivity and then back into depression when they are unable to do any more than the basics of living.

A bipolar individual can cycle several times a day, and sometimes the cycles last for months. But, some medications actually do help a great deal, and with sedatives for manic cycles and antidepressants for depressive modes, such individuals can function quite well, except that erratic schedules seem to be the norm, and quite often preclude work that needs to be done on any kind of schedule. Most employers do not like that.

And, there's the ADHD syndrome, that also presents a problem for many individuals.

Plus, instances of paranoia come into play at some times, and that is actually a psychological problem in many cases, I think.

But in cases of schizophrenia, a psychiatrist is definitely required. Medication is the only thing that is going to help an individual with that problem, and a psychologist can't really do much except keep them company and discuss some of their delusional thoughts, while taking notes to pass on to a psychiatrist later.

And now, I'm at the limits of my knowledge base about psychiatric issues.

If a person is having only a stressful life event and does not fit the description of a disorder that is described in the 'Diagnostic and Statistical Manual of Mental Disorders', which is now it its fourth Edition (DSM-IV), then a psychologist is what is needed.

But, the very best care is when a psychologist and a psychiatrist work together. In a psychiatric hospital, many of the nurses have some training but have not specialized in psychology, and they can help a great deal. Plus, a psychiatric hospital will almost always have psychologists available, but their services seem to be rarely used. That is what is done in psychiatric hospitals everywhere, as far as I know anyway, and in some outpatient clinics.

Some patients really do not need the services of a psychiatrist, and others do not need the services of a psychologist.

It's a very complex subject, with many gray areas. That's just an overview, of course.

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bethann 2 years, 6 months ago

Psychologists work with mental disorders and also can & frequently do diagnose them. Many social workers have specific training and do that as well. Most psychiatrists in this day & age prescribe medications and do little if any talk therapy. They often work in tandem with psychologists and social workers and prescribe medications based on their evaluations for mental disorders.

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Ron Holzwarth 2 years, 6 months ago

Yes, a typical appointment with a psychiatrist is only 15 minutes.

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Alice Lieberman 2 years, 6 months ago

Both psychologists and social workers are trained to diagnose mental disorders. In fact, social workers are the largest provider class of mental health services in the country. A Licensed Specialist Clinical Social Worker can not only diagnose independently, but can also collect third party reimbursement, and can assess clients for involuntary commitment. So can Psychologists, similarly licensed.

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Ron Holzwarth 2 years, 6 months ago

I suppose that could be done, but a problem is that after they've made a diagnosis they need to be sent to a psychiatrist later, because only a physician can write a prescription for treatment.

But it is certainly true that they could refer a patient to a psychiatrist or send a patient to a psychiatric hospital where they would later see a psychiatrist.

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Mike1949 2 years, 6 months ago

You people don't get it. If you all ever succeed in stopping abortions, then we will go back to the 20's where it was done in dirty back rooms, and I wasn't old enough to know how many women died, but I've been told it was quite a few. Ya know, they tried prohibition and that didn't work too well did it? If you try prohibition with abortions, it will just go underground but instead of people getting drunk and creating a atmosphere that helped create mobsters and the like, in this case, women will die. Haven't you all learned that you can not legislate moral attitude. Just how many times do you have to fail to get that through your thick skulls? And remember, there is a very large portion of the population (would not be surprised if it was by far a large majority) that does not agree with you all. You can pass all the laws on morality you want, at least employment will go up because you're going to need to build more jails!

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Amy Heeter 2 years, 6 months ago

A good call. Stop the slaughter!

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Cait McKnelly 2 years, 6 months ago

Spoken by the woman who would be happy to force a 12 year old to give birth.

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Amy Heeter 2 years, 6 months ago

If Flee had lived he would be suspended too. Enough with the martyr stuff. The chickens have come home to roost. Get over it.

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Cait McKnelly 2 years, 6 months ago

"Flee"? "Enough with the martyr stuff"? Are you referring to George Tiller? (What an interesting thing to call him. I wonder where that nickname came from?) Because if you are, there are a lot of people who would far far rather he be just suspended (including his wife and children) by the state rather than dead at the hands of a so called "pro lifer". So tell me, are you part of the Scott Roeder "fan club" that writes to him in prison? Because you obviously think that Tiller doesn't deserve the status of "martyr", do you?

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just_another_bozo_on_this_bus 2 years, 6 months ago

So in the judge's opinion, forcing 11-year-olds to carry a pregnancy to term would have been the preferred recommendation?

That's just sick. You have to wonder if this judge would order the doctor's execution if he could.

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xclusive85 2 years, 6 months ago

Bozo, this is a little overboard. Nowhere in the story did the judge say that all of the recommendations were invalid. I believe that the case you mention would be one that most reasonable people, the judge included, would have no problem with. However, you fail to take into account any of the other cases. It is the extreme views like this (and no abortions in any case whatsover from the other side) that make it nearly impossible to have a reasonable conversation about the issue at hand.

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just_another_bozo_on_this_bus 2 years, 6 months ago

The elephant in the room in your appeal to "reason" is that forcing anyone, regardless of their age, to carry a pregnancy to term against their will is unreasonable.

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Cait McKnelly 2 years, 6 months ago

Every case cited in the proceedings against Dr. Neuhaus was of a girl under the age of majority. So, what "other cases" would you have allowed? The one that was 15? The one that was 16?

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xclusive85 2 years, 6 months ago

Sorry, you are right that all of these particular recommendations were for minors. They are not the only times that she performed second opinions for Dr. Tiller. As for the rest of these cases that were part of this decision, I don't have the authority or knowledge of each situation to pass judgement on which should have been allowed or not.

My post was directed at Bozo for going to the extreme side of an argument directly. Bozo rarely, if ever tries to find validity in what others say if they don't agree 100% with them. That kind of behavior does not further discussion one bit.

I don't see why if someone thinks that abortion should not be allowed in every case, that makes them in favor of raping 11 year olds.

Now to be fair, I find that math uses the same tactic. But in this case, bozo used it first, so that is where the comment came from and why it was directed the way it was.

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xclusive85 2 years, 6 months ago

Sorry, you are right that all of these particular recommendations were for minors. They are not the only times that she performed second opinions for Dr. Tiller. As for the rest of these cases that were part of this decision, I don't have the authority or knowledge of each situation to pass judgement on which should have been allowed or not.

My post was directed at Bozo for going to the extreme side of an argument directly. Bozo rarely, if ever tries to find validity in what others say if they don't agree 100% with them. That kind of behavior does not further discussion one bit.

I don't see why if someone thinks that abortion should not be allowed in every case, that makes them in favor of raping 11 year olds.

Now to be fair, I find that math uses the same tactic. But in this case, bozo used it first, so that is where the comment came from and why it was directed the way it was.

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just_another_bozo_on_this_bus 2 years, 6 months ago

So you support forcing 11-year-olds to carry pregnancies to term, right?

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just_another_bozo_on_this_bus 2 years, 6 months ago

The issue isn't Neuhaus. The issue is self-important busybodies like yourself injecting yourself into that which is none of your business.

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jhawkinsf 2 years, 6 months ago

The issue of abortion aside, Bozo, you seem to be defending medical care that borders on malpractice. I wouldn't go to a psychiatrist for a root canal. Nor would I go to a dentist to have a pacemaker installed. These women should have been referred to medical practitioners trained in the specific field for which they would then be rendering an opinion.

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Cait McKnelly 2 years, 6 months ago

They weren't "women". They were children.

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jhawkinsf 2 years, 6 months ago

If I had said children, you would have corrected me and said they were women. But if they are children, then their parents should be making these decisions, right? And up to what age?

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Richard Payton 2 years, 6 months ago

Parents that rape a child is now making decisions? Children forced to make a decision for something they shouldn't have to deal with? Legal guardians can make the best decision for the parents and child? I have no best answer. The parents that force a child to have sex aren't a parent but a menace to society.

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just_another_bozo_on_this_bus 2 years, 6 months ago

The was one intent and one only of this law-- to create hoops to be jumped through before women (or in this case girls) seeking to terminate a pregnancy.

It doesn't take an expert to know that forcing a girl to carry a pregnancy to term would be psychologically damaging to them.

But I'm curious-- would you consult a "trained professional" before smashing your forehead with a hammer to tell you whether it's potentially harmful?

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jhawkinsf 2 years, 6 months ago

If I were in the habit of smashing my forehead with a hammer and then found myself in the company of a general practitioner, I would expect that general practitioner to refer me to the appropriate mental health professional, not a dentist, not a oncologist, not a proctologist. A referral to any of those is not an appropriate referral and borders on malpractice. And should that dentist, oncologist or proctologist treat me for my apparent mental health problem, they would certainly be guilty of malpractice.

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just_another_bozo_on_this_bus 2 years, 6 months ago

You could have just said you didn't want to answer my question rather than just posing a wholly different scenario.

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jhawkinsf 2 years, 6 months ago

I thought I did answer it. But if you state it more clearly, I try again. But you keep avoiding the central issue here. And I asked that the very emotional issue of abortion be put to the side, just for a moment. Read the article and you will see that the judge said that these young women received substandard care that seriously jeopardized their health. Having been victimized once by being impregnated at such an early age, then were then victimized again by having received substandard care. Where is the outrage that victims are being victimized?

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Liberty275 2 years, 6 months ago

Is it any of your business who can and can't have abortions?

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jhawkinsf 2 years, 6 months ago

In general, I'd say no. But if you want an absolute answer, then it's neither yes or no.

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Cait McKnelly 2 years, 6 months ago

"Bravo! bozo avoids the Nuehaus issue and tosses in kids..." And you are completely ignoring that every case brought against Neuhaus in the "investigation" (yeah, right), was a minor. Common sense would have said that, psychiatrist or not, children are in danger when they have children. I honestly have to believe that you don't have kids. Or at least you have no daughter(s).

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jhawkinsf 2 years, 6 months ago

I am a parent and in every single instance where my child was referred, I expected that referral to be made to a medical practitioner trained and qualified in that specialty. If it's common sense you desire, why go to a doctor of any specialty? My grandma has an awful lot of common sense considering she finished the eight grade back in the old country.

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JayhawkFan1985 2 years, 6 months ago

Do you have adequate medical training to know what type of practioner is qualified? All doctors complete a rotation through all specialty areas, including psychiatry. I'd say even a GP is more qualified than you to have an opinion. Plus, the law doesn't make the distinction you are making with your claims of substandard care.

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jhawkinsf 2 years, 6 months ago

Apparently the judge in this case disagreed with you. It is not my statement that the patients received care that seriously jeopardized the mental health of these young women. That was the opinion of the judge. And I presume that the judge had before him expert testimony as to what care should have been provided and by whom that care should have been provided. With all the evidence and all the testimony, the judge made a ruling and took away the GP's license. While you claim the law does not make the distinctions I am making, be clear, I am not now making those distinctions. It's a judge. Apparently, the law does make those distinctions, at least in the opinion of this judge. Most everyone here is trying to engage in the very hot topic of abortion. I've tried to narrow the discussion to what care these young women received. That it happened in a case of abortion is beside the point I'm making.

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JayhawkFan1985 2 years, 6 months ago

This administrative law judge is part of the Brownback administration, not part of the judiciary. This case will be overturned upon appeal to a real court.

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jhawkinsf 2 years, 6 months ago

So you believe that an 11 year old possesses the wisdom to bypass qualified medical practitioners and seek the advise of those not qualified even though it "seriously jeopardizes" their health through "inadequate mental health examinations"?

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just_another_bozo_on_this_bus 2 years, 6 months ago

This issue has absolutely nothing to do with the mental health of the women involved. See my post above.

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jhawkinsf 2 years, 6 months ago

If my general practitioner referred me to a dentist for a heart problem, there would be some level of malpractice going on. That these young women were referred to a doctor not qualified to assess these conditions means that there was a certain level of malpractice going on.
That there are people defending this malpractice simply because the procedure is abortion are missing the point. These young women were the victims of malpractice. And for that malpractice, the doctor is losing their license. A wholly appropriate response to malpractice.

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just_another_bozo_on_this_bus 2 years, 6 months ago

"If my general practitioner referred me to a dentist for a heart problem,"

This is a false analogy. What the legislature did in creating this law was the equivalent of requiring your heart surgeon to require you to undergo a psychological evaluation before he could treat you for your cardiological problems.

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jafs 2 years, 6 months ago

Not really, I think.

If the law states that a mental health exception is a valid reason to terminate a pregnancy, then the mental health of the patient must be determined, and whether or not it will be harmed by carrying the pregnancy to term.

It stands to reason that a professional who is trained in that sort of evaluation will do a better job of that than somebody who isn't trained.

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jhawkinsf 2 years, 6 months ago

There must be a certain assumption that should a patient come to a professional who is not qualified to treat the patient, it is incumbent upon the professional to recuse themselves from treatment, referring to an appropriate professional. A simple referral to a qualified professional was the thing to do. Not treat someone, or give an opinion, to which the general practitioner is not qualified. The question that should be asked is why was the referral to a general practitioner made in the first place when a referral to a mental health professional was clearly indicated by the law?

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jafs 2 years, 6 months ago

I'll be interested to see what happens with an appeal, if there is one.

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Ron Holzwarth 2 years, 6 months ago

I tend to think there won't be one because she will have a very difficult time presenting reasonable grounds for appeal, and she won't have the money to hire a lawyer.

There is no possibility that an attorney would take this case on a contingency fee basis, because there will be no payout awarded if he wins. The only thing she could fight for would be to get her medical license back.

But it really is a terrible shame all the way around. I personally knew a physician that lost his medical license, and there was quite some discussion about how terrible it was that all those years of schooling to become a medical doctor were now wasted.

And, I heard quite a lot about another physician that lost his medical license on unreasonable grounds. I believe he got his back later.

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Cait McKnelly 2 years, 6 months ago

So what kind of answer would you have accepted from a 15 year old, math? Hmm..let's see. "I am under the age of consent and this pregnancy is the result of a rape, whether I consented or not. I want this abortion because my reproductive system hasn't stopped growing. My hormones haven't adjusted to adult levels and I face a far higher incidence of eclampsia and gestational diabetes, setting me up for high blood pressure and type 2 diabetes later in life. My uterus hasn't stopped growing yet and as a consequence I am in danger of internal trauma that will cause me problems with bearing children as an adult, including fibroids and polycystic ovary disease. I also face social stressors as my age continues to subject me to compulsory education laws and I will have to attend school pregnant, facing social stigma from my peers and the inability to engage in a normal social life. I certainly have neither the physical, social nor financial resources to bear a child." So would that kind of answer have satisfied you math? Because you won't get that kind of answer from a 15 year old. You'll get, "I can't ride the rodeo circuit."or "I can't play basketball." I don't even know if you would get that kind of answer from a parent. But every bit of it is the truth. The very fact that you would be comfortable with the idea of forcing a child to bear a child is a real indication of the length of cruelty to which you would go to enforce your morals on others. And I will point out again; every case cited in the action against Dr. Neuhaus was of an underage girl. Not woman, girl.

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Ron Holzwarth 2 years, 6 months ago

This whole article is about late term abortions, that is, abortions performed somewhere near the third trimester when the fetus could possibly survive outside of the uterus.

Instead of inducing labor and then having a premature infant, it's easier to just have an abortion. That point seems to have been totally missed by just about all of the above posters.

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Cait McKnelly 2 years, 6 months ago

Yes and no, Ron. By law in this state, anything after the 21st week is considered "late term", despite the fact that the medical definition of viability is 24 weeks. Even at 24 weeks such infants face a lifetime of potential problems and require weeks in NICU if they survive. Are there cases where babies born that early have survived? Certainly. But they are very rare and have without fail faced lifelong severe disabilities. And those were pre-term babies from adult women who didn't have the added physical stresses of being the fetus of a child, which has it's own special negative effects. Many of these girls, our of fear of their parents/society, hid the fact that they were pregnant. Given some of their ages they may not even have known they were pregnant. It's difficult at best for a parent to help their child when they don't even know what's going on.

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Ron Holzwarth 2 years, 6 months ago

There's a very big story in my life about a woman hiding her pregnancy. I wish she would have told me about it.

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Cait McKnelly 2 years, 6 months ago

I know :( And your story breaks my heart for you.

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Ron Holzwarth 2 years, 6 months ago

Yes, you did comment on that when it hit the news. Thanks. I sure do hope to meet him someday.

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voevoda 2 years, 6 months ago

And the anti-abortion zealots focus on the very rare late-term abortions of healthy, viable fetuses in order to "try and justify" "quackery at in it's worst form"--that is, claiming that the sloughing of a fertilized egg is akin to murdering a human being.

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bad_dog 2 years, 6 months ago

"It's predictable that the forum pro-abortion zealots are harping on the very, very small fraction of abortions that are performed on pre-pubescent girls..."

Pre-pubescent girls are capable of becoming pregnant?

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jjt 2 years, 6 months ago

All abortion is wrong?

Would it be possible please for those who take the view that all abortion is wrong to answer the practical challenges to their views. For example children who are pregnant or the woman carrying a dead fetus, or a clearly unviable fetus, rape victims. Would some one who is happy to post anti abortion views (and that is their right) simply give a view / answer for each of those four examples. Thanks.

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Ron Holzwarth 2 years, 6 months ago

For a child that is pregnant, an abortion is probably going to be necessary if she might not survive a pregnancy. But it should be performed early in the pregnancy, and not be done late term when the fetus might be able to survive outside of the uterus. I obliquely referred to that at the end of the first posting on this thread.

Read this article from ABC News if you can handle it: http://abclocal.go.com/wpvi/story?section=news/local&id=7906881

A dead fetus is just about always spontaneously aborted without assistance. If the fetus is dead, it's a surgery, not an abortion.

A clearly unviable fetus also is often spontaneously aborted. But "clearly unviable" might be quite a gray area. Is a Down's syndrome infant an unviable child? And for some people, "clearly unviable" might be stretched to mean that the child was not going to be the sex that the parents wanted.

I don't know about a rape victim, except for this: For the rest of her life, every normal woman is going to wonder what her child would have been like. The memories and repercussions of an abortion are lifelong, and should never be casually dismissed.

The Jewish position on the matter is that life begins with the first breath, so abortion is acceptable for good reasons, but is certainly never encouraged.

That position was derived by the rabbis in antiquity from Genesis Chapter 2, verse 7: "then the LORD God formed man of dust from the ground, and breathed into his nostrils the breath of life; and man became a living being."

Whatever a Christian position on the matter is, it was dreamed up, because abortion was never mentioned in the New Testament.

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ebyrdstarr 2 years, 6 months ago

Regarding children who are pregnant, sure it sold be ideal to terminate those pregnancies are early as possible, but the problem is that when the girl is 10 or 11 (as sadly they were in some of these cases), no one knows the girl is pregnant until well into the pregnancy. It probably wouldn't occur to most 11 year-olds to think to take a pregnancy test after missing a period. And how many parents would ever think it possible to check such young daughters for signs of pregnancy?

But just because the pregnancy isn't discovered until the 20th or 24th week doesn't make it any less dangerous for a young girl to continue to carry that pregnancy to term. An 11 year-old (generally) simply isn't physically equipped to give birth regardless of how far along she is into a pregnancy.

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Ron Holzwarth 2 years, 6 months ago

A woman is still going to be in the first trimester until a bit after a second cycle has been missed.

And, did you notice my statements about the Jewish and Christian positions in my posting?

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ebyrdstarr 2 years, 6 months ago

But the fact is that in these cases of 10 and 11 year-old girls, it's quite common for no adults to know there is a pregnancy until well after the first trimester is over. An 11 year-old girl isn't likely to be thinking, "Gee, I have now missed two menstrual cycles. I should probably take a pregnancy test." That won't be on her radar. Plus the fact that reporting a missed menstrual cycle or two might necessitate mentioning the sexual abuse she has endured which she is probably pretty darn scared to do. So the point remains that a lot of these pregnancies are not discover until the first trimester is over. Should the ignorant child who didn't put it together that she was dealing with the very adult situation of being pregnant still be forced to carry that pregnancy to term and give birth? Her body still isn't properly equipped to handle it so the health concerns remain regardless of when the pregnancy is uncovered.

The Jewish and Christian positions you cited were irrelevant to my challenge of your naive assertion that pregnancies of young girls should only be terminated early in the pregnancy.

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Ron Holzwarth 2 years, 6 months ago

"after the first trimester is over" makes no statement as to whether she is in the second or third trimester. Third trimester abortions or nearly that are the subject of the article we are commenting on.

You asked: "Should the ignorant child who didn't put it together that she was dealing with the very adult situation of being pregnant still be forced to carry that pregnancy to term and give birth?"

I think I answered that already with: "For a child that is pregnant, an abortion is probably going to be necessary if she might not survive a pregnancy."

And in your last paragraph, I said "should" and you apparently misread that to mean "only".

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ebyrdstarr 2 years, 6 months ago

You said they should not be performed after viability. So, yes, I took that to mean they should only be performed early. I don't think that's a misinterpretation of what you wrote. Since that came immediately after your sentence you cited above, yes, I took that to mean you would not support abortions post-viability for young girls. Otherwise, why add the restriction that it should "not be done late term when the fetus might be able to survive?"

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Ron Holzwarth 2 years, 6 months ago

I think I addressed that issue in the very first comment that follows the article:

"There is a very serious problem that many women face, and that is classic Freudian denial of pregnancy. Meaning that many woman mentally suppress the reality of a pregnancy far too long. That is very common, and extremely unfortunate. I have no idea what a possible solution to that problem might be."

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ebyrdstarr 2 years, 6 months ago

How on earth does that address the question of young girls receiving post-viability abortions? And in a young girl, it's hardly some Freudian denial thing.

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Ron Holzwarth 2 years, 6 months ago

We're not talking on the same level at all. There are plenty of books that you can refer to, I can't write one for you here.

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ebyrdstarr 2 years, 6 months ago

I'm just trying to figure out what you're talking about. I was purely talking about late-term abortions for young girls. You said such abortions should occur early in pregnancy, not after a fetus becomes viable. I responded that with young girls, it's not always possible to know that early that she is pregnant, but the danger of pregnancy and childbirth is still there. Where you went from there, I'm not sure. I was just trying to pin down your position and challenge your implied assertion that late-term abortions for young girls shouldn't happen.

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Cait McKnelly 2 years, 6 months ago

"I don't know about a rape victim, except for this: For the rest of her life, every normal woman is going to wonder what her child would have been like. The memories and repercussions of an abortion are lifelong, and should never be casually dismissed." Just as you have a story in your background, I have one in mine. Over 40 years ago I was raped and and became pregnant from that rape. I was 17 years old. I had one of the first legal abortions in the state of Kansas pre Roe V.Wade. The law went into effect on July 1, 1970 and my procedure was done July 7th. Did I regret it? No. There are times that it has come to the forefront of my mind. The man that raped me was executed in Missouri in 1989 for murdering another woman he had raped eight years after he raped me. I thought about it then. Still didn't regret it. Do I regret it now? Let me check.. Nope, still don't regret it. I don't meditate on what the child would have been like because for me, there was no "child". A fetus is not a human being, it's a potential human being and this was one potentiality I wanted no part of. I have been reviled, spit on, screamed at and called "baby killer" because I'm perfectly open about my abortion. I guess I'm just comfortable enough with myself, the decision I made and strong enough in my "self" to tell those people, inwardly and outwardly, to go die in a tire fire. Who I truly pity are those women who aren't strong enough to take that kind of abuse and "moral" judgmentalism. I frequently wish I could help them. Oh and by the way, I do consider myself "normal" (whatever that is).

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Ron Holzwarth 2 years, 6 months ago

I did not use the word "regret" in my posting.

I think I was correct when I said "The memories and repercussions of an abortion are lifelong, and should never be casually dismissed."

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ebyrdstarr 2 years, 6 months ago

The memories and repercussions of carrying a pregnancy to term and giving birth are lifelong and should never be casually dismissed. Especially when the pregnancy occurs as the result of a rape. Given that either way, there will be lifelong memories and repercussions, it would be lovely if we could let each and every woman decide which memories she would rather live with.

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Ron Holzwarth 2 years, 6 months ago

Yes, I certainly agree with that. But, she should talk to a professional about what exactly is happening before it's done, so that she really understands the possible results of either decision.

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ebyrdstarr 2 years, 6 months ago

I find it condescending and obnoxious to be told that women need to talk to some "professional" before deciding what to do with her own body and life. Why can't we trust women to know themselves, make their own decisions, seek out information they think is relevant to those decisions, and then live with the consequences after?

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Ron Holzwarth 2 years, 6 months ago

We are or at least were talking about children, remember?

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ebyrdstarr 2 years, 6 months ago

No, this line of the thread was about women who were raped.

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jhawkinsf 2 years, 6 months ago

If anyone believes that the law that requires a second opinion, an opinion as to the mental health of a woman seeking a late term abortion, is just a cynical attempt to hinder a woman's right to an abortion, I would have to agree. That said, in these cases, there is equal cynicism in trying to avoid complying with the law by making inappropriate referrals to unqualified professionals that resulted in harm being done to the very people they were seeking to help. As doctors, they were expected to know better.

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jhawkinsf 2 years, 6 months ago

That's why you're not a qualified professional. You have a pre-conceived notion as to whether or not the patient has the requisite symptoms that would indicate a diagnosis that would then permit or not permit certain treatment. Unfortunately, the doctor in question also had a pre-conceived notion, though the opposite of your pre-conceived notion. It was that pre-conceived notion that equally disqualified her from being a "qualified professional". Neither of you should be rendering professional opinions.

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bgreve 2 years, 6 months ago

This comment was removed by the site staff for violation of the usage agreement.

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jafs 2 years, 6 months ago

And now we see the truly "pro-life" viewpoint, strange as it is.

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jhawkinsf 2 years, 6 months ago

Jafs, I didn't see the comment before it was removed but I doubt very much it was a true pro-life viewpoint precisely because it was removed. Whether one is pro-life or pro-choice, they can have well thought out arguments to justify their respective positions. Apparently the removed comment did not fit that criteria.

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jafs 2 years, 6 months ago

Yep.

I was being sarcastic, of course.

Many "pro-life" proponents seem to also be in favor of the death penalty and pro-war, which is clearly contradictory to me.

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Pragmatron 2 years, 6 months ago

Don't these old white MEN have anything better to do? I get it. All government is evil except when I say so.

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Ron Holzwarth 2 years, 6 months ago

Allahu Akbar!

This is a reposting of a comment I made on February 10, 2012:

I was personally shocked when the exhilaration and thrill of being one of a crowd that was stoning a woman to death was relayed second hand to me.

I knew, although not closely, the man who had participated in that stoning in Saudi Arabia, and I was told he was smiling with happiness and joy as he described his participation in the event. I do not understand that at all.

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jafs 2 years, 6 months ago

Many people seem to get a visceral thrill from violence - that's hardly limited to the Muslim community.

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Ron Holzwarth 2 years, 6 months ago

That's true, and very regrettable. My younger brother and some of his friends used to take great delight in torturing toads and frogs. I thought it was terrible.

Maybe I ought to go be a Buddhist.

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voevoda 2 years, 6 months ago

Under Islamic law, early abortion is permitted, because a soul enters the fetus only on the 40th day after conception. Contraception is always permitted.

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Kirk Larson 2 years, 6 months ago

Freedom of Choice, it's the American Way!

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bad_dog 2 years, 6 months ago

Who pays for your healthcare and food?

Taxpayers already pay for the healthcare of others via payroll withholding for Medicare & Medicaid. Those with coverage pay higher health insurance premiums due to hospital /physician write-offs for those who can't/don't pay for their healthcare.

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lunacydetector 2 years, 6 months ago

how many rapes were reported from these pregnancies?

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Ron Holzwarth 2 years, 6 months ago

That is a very, very good point. If a young girl gets pregnant, something very wrong has happened and it certainly should be investigated. For a very young girl, it can be a terrifying situation to be in when she is afraid to tell anyone who got her pregnant.

In at least some cases, she would need to be assured and actually get removal from her present living situation and into one that is safe.

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Cait McKnelly 2 years, 6 months ago

That is something that you don't know, I don't know and we will never know. Those records are sealed to the public as they involved juveniles. But I would bet my biscuits there were more reported than not. Do not make a blanket assumption that just because these girls ended up aborting that their pregnancies weren't reported to legal authorities. The fact that they aborted is the ONLY reason you even know their pregnancies existed. And that, in and of itself, is a shame.

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jjt 2 years, 6 months ago

Same as usual.

I posted my question at 09.00 this morning and at 8pm still no one who says all abortion is wrong has addressed my four questions with a reason as to why there should not be an abortion in each case.

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Katara 2 years, 6 months ago

You won't get an answer just as I never got an answer to my question that I asked 7 times.

My question was for those who claim women who seek abortions are irresponsible and did not take precautions to avoid pregnancy.

I asked how they feel when birth control fails through no fault of the women. I cited the recent birth control pill recall (1 million packets of pills were affected by this).

I, to this date, have not received an answer.

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JayhawkFan1985 2 years, 6 months ago

I'm tired of the right wing hypocrisy. They hate Obama are because it forces them to buy insurance against their will, but they have no problem demanding women have ultrasounds prior to getting an abortion even against their will. They try to gut health insurance policies. They also create a climate of fear and intimidation that resulted in Dr. Tiller's murder. Now they are going after Dr. Neuhaus questioning the standard of care she offered. All the while the GOP guts the social services support system including public education, higher education, emergency services for families in crisis, WIC, food stamps, etc. Hypocrites will spend an eternity in hellfire without repenting...

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