Something rotten in the state of Pennsylvania

For those of you who have missed the gruesome case of Kermit Gosnell and his victims, Slate has a grim article. It reads like something from an Eli Roth movie. [For the second time in a week, I feel moved to offer a disclaimer that the article details some horrifying crimes. It (and the remainder of this post) should be avoided if you're squeamish.] Gosnell, a Philadelphia doctor (I can barely bring myself to type that word, in this case), is accused of numerous things, the most grievous being the murder of newborns by severing their spinal cords.

The case throws into stark relief some of the more pressing ethical questions about abortion and murder, certainly late-term abortions. I intend to side-step that thorny issue, and to focus merely on the same question William Saletan appears to be asking in his series of articles on the subject -- how could this have been allowed to happen, and how did the politics of abortion contribute?

There are these disturbing images:

The grand jury's report, citing forensic evidence and testimony from clinic employees, accuses Gosnell of routinely delivering viable babies and severing their spinal cords. But it also details ill treatment of women. According to the report, Gosnell used unlicensed workers to administer anesthesia, failed to obtain patients' informed consent, gave them expired drugs; endangered their health with poor sanitation and broken equipment, and caused the deaths of at least two women.

Unless I am gravely mistaken, one of the central tenets of the pro-choice movement is that restrictions on abortion will lead to unsafe conditions just like this, except performed in back alleys. Apparently this clinic exists as some kind of horrible converse.

From 1993 on, Gosnell went completely uninspected. The grand jury says the health department "decided, for political reasons, to stop inspecting abortion clinics at all. … 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." Casey was pro-life; Ridge was pro-choice.

I cannot understand this at all. In a world where our restaurants are inspected to confirm a basic level of sanitation, how can a "clinic" where invasive medical procedures are performed escape even the barest scrutiny? This seems like the worst effect of the worst kind of political cowardice.

This just sent me over the edge:

The other agency that could have stopped Gosnell was Pennsylvania's Department of State, which included the state Board of Medicine. According to the grand jury, the department ignored complaints about Gosnell for years. The complaints involved unlicensed administration of anesthesia; sexually transmitted infections (apparently spread by the clinic itself); perforated uteruses, cervixes, and bowels; hospitalizations of infected patients; and family members prevented from summoning emergency aid. The consequences allegedly included a hysterectomy and a patient's death.

This truly enrages me. A few years ago, a completely frivolous complaint was filed against me; it was absurd on its face. Despite its obvious lack of merit, I had to go through a lengthy response process, during which time the complaint and the records were reviewed by the Board (in a different state). The complaint was dismissed as soon as it could be, but even for a gripe as patently ridiculous as the one I faced, a very formal protocol was followed.

Seeing how grossly patient welfare can be affected by a break-down in the system meant to protect it, I am almost grateful for the seeming other extreme of my own experience. (I still think there should be a speedier process for dispensing with complaints that are clearly frivolous or abusive.) Given the gravity of the multiple complaints lodged against Gosnell, every single person involved in handling them is guilty of negligence, at the very least.

I understand that the abortion issue is immensely fraught. I can see how onerous regulations could be used to stymie access to legal, safe abortions. But using those issues as an excuse to abdicate regulatory responsibilities is partially to blame for the death of at least two women and many infants. Everyone involved deserves our collective anger, not merely the monster who perpetrated the acts themselves.