Article shows despair some residents experience
by Catherine Elvy, Staff Writer
For medical residents in obstetrics-gynecology, abortion training can prompt deep soul searching.That scenario was well illustrated when a Brown University clinical instructor and pro-choice advocate recently penned a disturbing article for a leading medical journal reflecting the divergent experiences of young doctors as they confronted the realities of abortion training.
In response, however, a leading Christian medical organization cautioned residents to be alert to the agendas of some universities, and he urged pro-life proponents within the medical community to share readily their perspectives with their junior colleagues.
Janet Singer, an Ivy League alumna, midwife, and clinical teaching associate at Brown's Warren Alpert Medical School, decided the public would benefit from hearing directly from physicians describing their experiences in the six-week rotation covering contraception, abortion, and miscarriage management.
In July, Obstetrics & Gynecology published Singer's results in an article entitled "Four Residents' Narratives on Abortion Training: A Residency Climate of Reflection, Support, and Mutual Respect."
The account generated a splash of mostly supportive publicity in media outlets, as well as a horrified response from National Right to Life.
Likewise, to the director of the Christian Medical and Dental Associations, the report signaled the robust need for residents to seek out pro-life colleagues and hear biblical viewpoints during their training.
"Church leaders should come alongside medical students and help them deal with the issues they face from a biblical perspective and, if large enough, organize support groups or [Sunday school] classes for health professional students addressing these issues," said Dr. David Stearns, chief executive officer of the organization.
In Rhode Island, Singer readily described how she decided to form a support group for Brown residents on the heels of encountering a new doctor distraught after performing a late-term abortion immediately followed by an emergency C-section for a baby just a week further along.
"She needed to talk about how overwhelming it felt to try to decide where the cusp of life was, why it was okay to take one fetus/baby out of the womb so it wouldn't live and one out so it might," Singer told WBUR FM 90.9.
Singer, president of the board of the Abortion Access Project, earned a master of science in nursing from Yale University in 1991 and holds undergraduate degrees from Columbia and Harvard universities.
Singer's article grew out of the deep conversations residents had with their mentors.
Brown's program expects residents to counsel patients about pregnancy options and to provide pre-abortion and port-abortion care. Likewise, most residents who opt out of abortion training participate in observational experience at a clinic.
In response to Singer's literature, Stearns warned that Brown appears to be practicing so-called desensitization therapy on residents.
"By exposing them to every aspect of the abortion, except doing it, and requiring their participation in pre-abortion counseling and post-abortion counseling, they essentially take residents opposed to abortion down the classical slope from opposition, to toleration, to participation, and then to doing the abortion themselves, while telling them that it is the professional, compassionate, and expected thing to do," Stearns said.
Stearns also noted that federal law forbids a resident from being compelled to perform an abortion.
As for Singer's article, two of the featured residents opted to undergo full abortion training and two declined. Here are some of the more thought-provoking excerpts from the residents' narratives:
Resident No. 1 (opted out): "If my first task as a physician is to do no harm, how can I justify harming a fetus?"
"Since opting out, I have realized that my line of thinking has been feto-centric at best and over-intellectualized at worst. Nonetheless, in the absence of a clear moral understanding of abortion, I can only do no harm..."
"I realize through conversations with co-residents that providing abortions does not come easily or naturally to most providers... As someone who entered obstetrics and gynecology because of the opportunities to empower women, I find myself feeling guilty that I cannot get over what increasingly seems to be a theoretical suspicion that life as seen on a two-dimensional ultrasound scan represents actual life."
Resident No. 2: "After my first morning of early abortions, we performed an 18-week termination. Seeing the fetus on the ultrasound scan and then watching it while we did the procedure really shook me to the core. I thought maybe I had made the wrong choice, and I could not stop thinking about what my family would think if they knew what I had done..."
Resident No. 3: "I would love to live in a world where no abortions were needed... Although I might not always understand an individual woman's choices, if she feels that she cannot be a parent for whatever reason, I will support her in that decision. I see little role for my personal values in the shared decision-making process."
Resident No. 4 (opted out). "I am a born-again Christian, and I believe life begins at conception..."
"I realize that not providing terminations does not make me a 'bad' ob-gyn... It makes me, well, me: a unique human who has her own passions, beliefs, struggles, and decisions. I also feel that being true to myself and unwavering in my beliefs makes me a better, more honest, and relatable physician."
In a commentary for National Right to Life News Today, editor Dave Andrusko was struck by how loudly some of the residents' consciences roared during their abortion training.
"We glean fascinating insights from young doctors, and especially how they wrestled their consciences into submission," Andrusko wrote.
