Why South Dakota’s "Informed Consent" Law Doesn’t Go Far Enough

When I first read the story about South Dakota’s “informed consent” law backed by anti-choice zealots, I was appalled. Imagine requiring doctors, prior to performing an abortion, to “read to each patient, pausing to make sure she understands and signs each page” of a consent form that reviews the potential side effects and risks of having an abortion: it could make her suicidal, cause her psychological distress, and/or cause infection, infertility and even death.

To make sure she understands the magnitude of her decision, the doctor must give the woman “at least two hours to ponder the information” before she can have the abortion she seeks.

This questionable law is being reviewed right now by the 8th Circuit Court of Appeals in St. Louis. Meanwhile, let’s give it the benefit of the doubt. Let’s overlook for the moment the law’s most egregious flaws: Its violation of patient privacy and doctor-patient privilege and its potential chilling effect on a patient.

Instead, for purposes of this discussion, let’s accept that the points covered by South Dakota’s form are not altogether misleading. In fact, they should have already been reviewed as possibilities by a woman considering an abortion-confiding, one hopes, in a spouse, parent, friend, counselor, or clergyperson. Would there really be all that much harm done by laying out the potential consequences to the woman one more time? Let’s say the answer is “no.”

The real problem with this South Dakota law is that its pre-abortion informed consent requirements are incomplete. Those doctors should be required to provide more warnings during this last-minute disclosure session.

Let’s have every South Dakota woman seeking an abortion acknowledge that she knows, if she bears a normal child, that the cost of raising that child to the age of 18, in today’s dollars, will average $190,528-not counting the costs of her prenatal medical care and delivery, and postnatal follow-up care.

She should be informed, if she is to continue the pregnancy, of exactly how much financial support she can realistically expect from anti-abortion advocates and their organizations, and from government sources like Medicaid and social services (and be told how long she can expect those sources of aid will continue).

She will be asked to provide information about her sources of family support, if any. She will be required to affirm that she knows she may be an outcast of her family if her pregnancy goes forward.

Let’s also make sure that the woman is informed of the potentially horrible effects on the fetus if she has been taking mood-altering drugs or medications while pregnant, and describe to her in detail the medical and behavioral problems that could afflict a newborn whose mother is a drug addict or alcoholic.

By leaving out these other important factors a woman needs to consider in deciding to have an abortion, South Dakota’s legislators have tipped their hand, revealing that this law is based on a particular religious viewpoint.

South Dakota’s Failure to Protect Its Young

It’s rather charming, though, for South Dakota’s legislators to seek to protect mothers-to-be and their fetuses. It shows that life is valued. Somebody cares.

But again, that laudable sentiment is incomplete. Shouldn’t informed consent be required of anyone who will be making decisions in matters of life or death? Where’s South Dakota’s law mandating full disclosure to its young people who are considering signing up to go to war? South Dakota’s one of 10 states providing the largest proportion of “high-quality” recruits for the conflicts in Iraq and Afghanistan. Wouldn’t you think those legislators would want to similarly protect “the best and the brightest” of their young men and women?

Such an informed consent form would include, in addition to making sure the would-be recruit is aware of the value and noble tradition of serving his or her country, requirements to hear about, and initial each in turn, points such as the following:

Are you aware that Iraq did not have Weapons of Mass Destruction, as was claimed in order to launch this war?

Do you understand why so many Iraqis are angry that the U.S. launched an unprovoked attack against them?

Are you prepared to kill other human beings?

Given that killing violates one of the Ten Commandments, are you able to justify killing in a war because your state tells you to do it?

Can you accept knowing that your actions may kill or maim innocent people, including little children?

Do you know the symptoms of post-traumatic stress syndrome?

Do you realize you may not be provided with the body armor, weapons, and military backup you need in order to have a chance to survive?

Do you know that the Sunnis, Shiites, and Kurds are fighting each other, and that you will be in the crossfire?

Do you know how many U.S. military personnel have lost arms and legs during the Iraq War? How many have had serious head injuries? How many have died?

Do you know what support the U.S. will provide for your immediate family while you are abroad fighting in this war? Do you know whether your family will qualify to receive food stamps?

Are you aware of the scandals involving poor standards of care at our under-funded veterans’ hospitals-up to and including the Walter Reed Medical Center?

Do you know about how ‘privatization’ is impacting the military at all levels, with private companies seeking to maximize profits when your life or health might be at risk?

These are just a few points to get those life-sanctifying South Dakota legislators started. They’ll find there are many more they should include in their assumed in loco parentis role.

Advance this Informed Consent Idea to the U.S. Congress

Why stop with the young and the vulnerable? Let’s take this informed consent idea to the very top.

Imagine if, prior to voting to approve the Iraq debacle, members of Congress had been required to listen to the potential risks and side effects down the road. The narrator (the Vice President? nice touch!) would have had to pause to let each point sink in: So many military and civilian deaths expected. So many grievous woundings. So many lives lost or irretrievably broken. The financial, social, military, diplomatic, moral costs of the war. The conflicts of interest among those in the Bush administration pushing for the war.

And they’d have had no “I didn’t know, things happened so fast” excuse; there would have been a two-hour waiting period before the floor vote.

Now there would have been a fitting use for a informed consent requirement.

ALICE CHERBONNIER is the Managing Editor of the Baltimore Chronicle. She can be reached at: editor@baltimorechronicle.com