Commentary/commentary:
"She mounts her challenge by problematising the binary opposition that Western medicine invokes—not unreasonably, one might think—between disease and health, death and life, and she contrasts it unfavourably with the traditional Indian worship of Sitala, the goddess of smallpox...
There is something rather stunning about a level of science-phobia that sees “negativising” disease, suffering and death, as harmful and repressive. It is extraordinary that Marglin, even for a moment, countenances the possibility that human suffering might be a source of joy and pleasure if only it weren't for the intervention of an oppressive system of Western medicine."
***
I have just learnt that despite the progress of modern medicine, there is a "deeply restrictive, extraordinarily painful and sometimes fatal condition" that afflicts almost half of humans at some point of time.
It results in "serious physical suffering and medical risks, including incontinence, hypertension, weakened bones through calcium depletion, preeclempsia, the danger of deep vein thrombosis".
Furthermore, half of those who allow this condition to develop fully suffer prolapsed pelvises within 30 years.
Surely if we could stop this condition we would. What's more, the tools for doing so are safe and proven, and have been tested in the field for decades.
So what are we waiting for?
(The condition in question is pregnancy, and the cures for it range from abortion to sterilisation to mandatory IUD insertion)
Original letter (rejected by the ST forum - I can see why)
"Subject: Abortion debate must be concrete, not abstract
Dear Editor
I refer to Ms. Tan Seow Hon's proposal to revisit Singapore's abortion laws.
Two months ago, the UK Parliament considered this issue and decided to retain 24 weeks as the point during the pregnancy up to which abortions should be available. Opponents of abortion rights made claims, similar to Ms. Tan's, regarding changes to medical technology shifting the date of viability (i.e. when a foetus could survive outside the mother's womb). Their views were rejected by the British Medical Association and the Royal Society of Obstetricians and Gynaecologists, both of whom supported the 24-week limit.
Ms. Tan suggests that in the face of uncertainty as to the "metaphysical" status of a foetus, we "err on the side" of disallowing abortion. Her statement suggests there are no other competing considerations, and thus sweeps aside the life-changing effects of pregnancy and childbirth on women. For instance, an employer may pre-emptively dimiss a female employee simply for being pregnant. Moreover, pregnancy and childbirth entail serious physical suffering and medical risks, including incontinence, hypertension, weakened bones through calcium depletion, preeclempsia, the danger of deep vein thrombosis, and a 30-year risk of pelvic organ prolapse, which affects about half of women who have given birth.
Ms. Tan portrays the proper policy approach as an abstract exercise involving figuring out the grand question of "when life begins". But the consequence of disallowing abortion is not abstract. It forces a deeply restrictive, extraordinarily painful and sometimes fatal condition, with long-term medical consequences, upon full grown women - women whose human status, unlike that of a foetus, is neither a metaphysical dilemma nor subject to any uncertainty.
A woman who is prevented from economically supporting herself and her family because of pregnancy, or who risks physical harm from pregnancy and/or childbirth, will not have her problems solved by putting the baby up for adoption. Moreover, adoption does not address the position of a woman who believes a foetus is not yet sentient and can be ethically aborted, but has qualms about giving away a baby she has birthed. By promoting adoption as a substitute for abortion, Ms. Tan is refusing to take seriously the effects on women of pregnancy and childbirth.
I agree we should consider whether first- and second-trimester foetuses constitute persons who should have legal protection. But even if a foetus is a person, another question is whether forcibly requisitioning one person's body to maintain another is justified. (Could we compulsorily require someone to donate their spare kidney, blood, bone marrow or liver tissue to save lives? Is forcing a woman to bring an unwanted pregnancy to term really any different?) The answers to these questions should not be based on shaky claims about medical technology, nor should they use a frame of analysis which treats harms done to women as inconsequential or costless.
Yours etc."
[Addendum: shlim205's reply:
"Much as this Tan Seow Hon's letter is nothing more than a ridiculous and one-sided view of abortion, I don't think your reply serves to level the discussion.
Ms. Tan suggests that in the face of uncertainty as to the "metaphysical" status of a foetus, we "err on the side" of disallowing abortion. Her statement suggests there are no other competing considerations, and thus sweeps aside the life-changing effects of pregnancy and childbirth on women
I might be very dense, but this seems like a huge leap of logic. How did you jump from an ethical debate to one about health risks and social ramifications?
pregnancy and childbirth entail serious physical suffering and medical risks
All this is true, but you have casually tossed aside the actual risk value in favour of the shock factor. Any number of pharmaceuticals carry the exact same medical risks. Health risks are also associated with exercise, driving a car, skydiving, etc. The state of modern obstetrics is not as bleak as you might think. Even if you were (as I presume) to argue that disallowing abortion is "forcing" women to take on these risks, there are 2 ways to look at this: 1) No one "forced" the woman to engage in behavior leading to her becoming pregnant (except in cases of rape, but we aren't arguing that now); 2) simply living in a civilized society "forces" us to engage in many activities that have costs as well -- when I cross the road, I have an increased risk of being run over by an SBS bus. It doesn't mean I'm not ever going to cross roads, just that I will take the sufficient safety precautions to avoid being run over."
"Risks Associated With Exercise
Vigorous physical exertion also acutely and transiently increases the risk of sudden cardiac death and actue myocardial infarction... The risk of exercise for any population depends on its prevalence of cardiac disease...
Individuals with sickle cell trait have a remarkably higher incidence of exertion-related death."
--- ACSM's Guidelines for Exercise Testing and Prescription, American College of Sports Medicine, American College of Sports
Exercise Risks - Health encyclopaedia - NHS Direct
"There is always a risk of injury from exercise, particularly from strenuous activity that puts excessive pressure on the joints and muscles. If you want to start exercising, but you either have not done it before, or you have not exercised for a long time, you should talk to your GP about your fitness before starting any kind of exercise programme. This is particularly important if:
*risk factors*
*List of things to take note of:*
Preventing injuries
Always warm up and warm down
Try not to overdo it
Make sure your technique is correct
Use the right equipment
Injuries"
Abortion Risks - Risks of Abortion Procedures
"Serious complications occur in
- Heavy Bleeding - Some bleeding after abortion is normal. However, if the cervix is torn or the uterus is punctured, there is a risk of severe bleeding known as hemorrhaging. When this happens, a blood transfusion may be required. Severe bleeding is also a risk with the use of RU486.
One in 100 women who use RU486 require surgery to stop the bleeding. - Infection – Infection can develop from the insertion of medical instruments into the uterus, or from fetal parts that are mistakenly left inside (known as an incomplete abortion). A pelvic infection may lead to persistent fever over several days and extended hospitalization. It can also cause scarring of the pelvic organs.
- Incomplete Abortion - Some fetal parts may be mistakenly left inside after the abortion. Bleeding and infection may result.
- Sepsis – A number of RU486 or mifepristone users have died as a result of sepsis (total body infection).
- Anesthesia – Complications from general anesthesia used during abortion surgery may result in convulsions, heart attack, and in extreme cases, death. It also increases the risk of other serious complications
by two and a half times. - Damage to the Cervix - The cervix may be cut, torn, or damaged by abortion instruments. This can cause excessive bleeding that requires surgical repair.
- Scarring of the Uterine Lining – Suction tubing, curettes, and other abortion instruments may cause permanent scarring of the uterine lining.
- Perforation of the Uterus - The uterus may be punctured or torn by abortion instruments. The risk of this complication increases with the length of the pregnancy. If this occurs, major surgery may be required, including removal of the uterus (known as a hysterectomy).
- Damage to Internal Organs - When the uterus is punctured or torn, there is also a risk that damage will occur to nearby organs such as the bowel and bladder.
- Death - In extreme cases, other physical complications from abortion including excessive bleeding, infection, organ damage from a perforated uterus, and adverse reactions to anesthesia may lead to death. This complication is rare, but is real.
Uterine position and infertility
"If every woman with some displacement of her uterus had trouble getting pregnant, there would be a significant drop in the number of babies being born. Almost 20-40% of women who have never had a baby have some displacement. And over 50-60% of women who have had a baby have some, too. In other words, the position of the uterus, when different from what is considered normal, is not pathology but a variation of the normal...
Displacement of the uterus is usually an incidental finding on physical exam. Sometimes it can be in association with weakening of other pelvic supports, leading to rectal pain or urinary incontinence, but in most women is without any symptoms and requires no intervention."
Finally:
Preventing pelvic organ prolapse
"There are a number of things you can do to reduce your risk of prolapse or help prevent a mild prolapse form getting worse:
* One of the most effective things you can do to reduce your risk of prolapse is to exercise your pelvic floor muscles. Doing regular pelvic floor exercises (also called Kegel exercises) throughout your adult life helps keep the muscles toned and strong. Most women do Kegel exercises when they are pregnant and for a few months after birth, but by making pelvic exercises part of your daily routine you can further reduce your risk of both prolapse and incontinence in later life.
* If you are significantly overweight, try to lose weight. This will remove some of the pressure from your pelvic area.
* If you smoke, try to cut down or stop, as this will help reduce strain from coughing.
* Don't lift heavy objects. This can damage your pelvic muscles.
* Eat a high fibre diet (fresh fruits, vegetables, bran) to help prevent constipation and reduce straining.
* If you are menopausal or post-menopausal, some doctors may suggest you use hormone replacement therapy to protect against prolapse or prevent an existing prolapse from getting worse, but there is little scientific evidence to support the claim that HRT prevents prolapse. Before you make a decision about whether or not to use HRT, discuss the risks and benefits with your doctor."
