What Do I Want for Nurses’ Week? Reproductive Healthcare Policy Based On Evidence — An Open Letter to the MI House Judiciary Committee
May 7, 2019
Dear Members of the MI House Judiciary Committee,
As we start the celebration of Nurses’ Week here in Michigan and across the country, I would like to enter into the record a nurse’s response to the proposed House Resolution №23 regarding the assumptions regarding abortion care in the state. This proposed resolution has no basis in medical ethics or evidence based practices and reads more as a religious tome than one related to public health. Despite your claims to the contrary, none of what is described in this resolution is rooted in consensus among the medical community, and in fact, is contrary to two very main concepts of medical ethics.
When one actually studies medical ethics, two important concepts are presented as the guiding principles: informed consent and body autonomy. Informed consent applies to a patient’s right to have all sound medical options presented to them when faced with any kind intervention. They have a right to fully understand what any action, or inaction, would mean to their immediate and overall lifelong health when making any kind of medical decision, including their reproductive health. They have a right to have all of the pertinent, unbiased, and medically accurate information given to them in good faith that they are able to make the decision that will have the best outcomes for themselves, their health and their futures. Resolutions like this are put out as a stepping stone to further restricting access to information and access to abortion, which is a legal, safe and necessary medical procedure in Michigan. The arguments presented in this resolution do not represent anything but thinly veiled religious beliefs regarding when life begins. Presenting religiosity as medical expertise violates this tenet of medical ethics, and should not be endorsed by any kind of governing body.
The second principle is one that seems to be held dear in regards to all other medical interventions but abortion, and that is one of bodily autonomy, or body integrity. This principle states that you, and you alone, have the right to determine how and when your organs are used, and by whom, regardless of the impact on others. This principle is the reason why we do not mandate forced organ donation or blood donation in the state of Michigan, despite the fact that people regularly die while waiting for organ transplants and we are constantly short on life saving blood products. We value this principle so much that we even grant this right to the deceased, and do not forcibly remove organs or tissues following death, again, despite the fact that fully formed humans will die without those organs. We understand that no one else has the right to dictate how our organs are used. This concept extends to the uterus as well, and that same understanding of body autonomy should be extended by this committee. Not following this principle in all other cases of organ use or abstention except the uterus is not consistent with medical ethics, and the exclusive focus on this exception would point towards a discrimination against uterined people. Discrimination on the basis of sex, or sex organs, is illegal, and entertaining a resolution that so clearly discriminates against those with a uterus cannot, in good faith, be entertained by this body. To do so is to act in bad faith, and will not go unnoticed by those who can become pregnant.
Lastly, it is unethical to present something as a public health crisis in need of state legislature intervention when there is no such evidence to support it. The passage of this resolution that claims a need to address third trimester abortions of healthy fetuses or infanticide following a delivery is out of line with the reality of healthcare practices in Michigan. Infanticide following a delivery of a healthy newborn is clearly already illegal, and to conflate this crime with either newborn hospice care or late term abortion due to severe fetal anomalies is dishonest, vile and intentionally inflammatory. This is a move by extreme anti-choice groups meant to confuse the public, vilify healthcare professionals, as well as parents, and for anyone to push this message is completely inappropriate and beneath the dignity of your offices. If you would like to focus on actual crises related to reproductive healthcare, I would urge you to use your time more wisely, and address the real crises of increased infant and maternal mortality rates in communities of color, lack of access to care in rural communities, and the lack of affordable care to cover all these healthcare needs.
As a health professional, patient advocate, uterined person and mother of three uterined people, I strongly oppose this resolution. It flies in the face of evidenced based practice, medical ethics, and basic respect for the healthcare community. It also flies in the face of the separation of church and state championed by the same Thomas Jefferson you quoted in this resolution, who stated “Believing with you that religion is a matter which lies solely between Man & his God, that he owes account to none other for his faith or his worship, that the legitimate powers of government reach actions only, & not opinions, I contemplate with sovereign reverence that act of the whole American people which declared that their legislature should ‘make no law respecting an establishment of religion, or prohibiting the free exercise thereof,’ thus building a wall of separation between Church & State.” Using Thomas Jefferson to champion a religiously motivated bill (as it is clearly not rooted in science, medicine or common sense) in a state government resolution is, on its face, antithetical to his own beliefs on the role this body should play in our individual freedoms.
In honor of Nurses’ Week, I respectfully request that this body respect and listen medical professionals and not religiously based special interest groups regarding medical interventions, and that you vote against this insulting, dishonest and non-medically based resolution. We don’t want your empty platitudes about how much you value and respect nurses. What we want is evidenced based practice to be the guiding principles for our healthcare laws, especially as it comes to our reproductive healthcare, and not religious opinions masquerading as sound medical policy.
Sincerely,
Julia A. Pulver, RN, BSN, CCM
