The American Feminist

The American Feminist, Fall 1997

Fighting for Pro-Life Medical Students: Dr. Pamela E. Smith

Like the feminist physicians of the last century, Pam Smith, M.D., champions the rights of all her patients - women and their unborn children. Smith, president of the American Association of Pro-Life Obstetricians and Gynecologists, received her undergraduate degree from Cornell University and her medical degree from Yale Medical School. She is former director of medical education in obstetrics and gynecology at Chicago's Mount Sinai Hospital on that city's west side and is currently practicing at Lawndale Christian Medical Center. Smith is a founding member of Physicians Ad Hoc Committee for Truth (PHACT) and is FFL's advisor on abortion policy.

Smith describes the Accreditation Council for Graduate Medical Education (ACGME) mandate to make abortion training mandatory for medical residency programs as "out of touch with human reality." Abortion advocates want to mandate abortion training at medical schools at any cost, despite the objections of institutions that have a conscientious objection to abortion. Under the ACGME legislation, medical schools would be denied accreditation if they did not provide abortion training. Without accreditation medical schools would not be assured of receiving federal funding, and their ability to operate would be jeopardized.

Fortunately, the ACGME legislation was defeated with help from organizations including the American Association of Pro-Life Obstetricians and Gynecologists, the National Conference of Catholic Bishops, and the National Right to Life Committee. In a victory for pro-lifers, the Coats-Snowe amendment, which prohibits the government from discriminating against physicians, hospitals, or residency programs that refuse to promote abortion, was passed by Congress on April 25, 1996, and later signed into law by President Clinton.

Although Smith does not support mandatory abortion training she believes that the subject of abortion should be covered in medical schools. "Abortion is something that one and a half million women electively participate in annually. Abortion should be discussed at the medical school and residency level," said Smith.

Smith explained that many women have problems during pregnancy that require doctors to use the same procedures that would be used in an abortion. For example, miscarriages may require the dilation and curettage (D & C) technique. Also, some illnesses require separating the mother from her child late in pregnancy by removing the baby from the womb. Smith stated that medical students "have to learn these techniques in order to take care of women in situations where the intent is not to kill the child." Abortion, however, is purely elective and requires dismemberment of the fetus, which may be technically difficult. Smith said partial-birth abortion solved a technical problem for abortionists because it was easier for the doctor to deliver the child in breech position and kill her just before she was born then it was to dismember her inside the womb.

Patients naturally assume that their abortion providers are trained ob-gyns or surgeons. However, Smith estimates that 90 percent of ob-gyns do not provide abortions as a routine part of their practice. Only rarely are surgeons trained as abortion providers.

Abortion advocates hope that if more doctors are required to perform abortions during their residencies they will choose to continue performing abortions after residency, thus replacing retiring abortionists. "So many women submit themselves to abortion that there is a market for people to provide this almost as an exclusive service," said Smith.

Of course, some doctors do not need to be coerced into performing abortions. In fact, there are doctors who are willing and eager to provide abortions. Smith says that many abortion providers sincerely believe they are providing a service for women. Some students, including the members of organizations such as Medical Students for Choice (MSFC) and the American Medical Women's Association (AMWA), really want to learn about abortion.

MSFC was founded by Judy Steinaur with the support of Dr. David Grimes, vice chairman of the Department of Obstetrics and Gynecology at the University of California in San Francisco. Grimes contends that the legalization of abortion is insufficient if there are too few physicians willing to provide abortions. In his 1992 article, "Clinicians Who Provide Abortions: The Thinning Ranks" (Obstetrics and Gynecology v. 80, n.4, pp.719-723), Grimes acknowledges that "exemptions from training should be allowed for those opposed to abortion on religious or ethical grounds," but he also advocates that residency programs "pressure residents to participate in this 'elective' activity by requiring them to arrange their own coverage if they choose not to perform abortions." In some cases, this translates into extra nights of duty.

Grimes believes higher pay would also act as an incentive to encourage more clinicians to provide abortions. Evidently unable to distinguish between life-saving and life-terminating procedures, Grimes attempts to trivialize the brutality of abortion by asserting: "Many aspects of medicine are both distasteful and a chore." Smith points to this article as documentation of Grimes's real goal coercing residents into performing abortions.

Abortion advocates are mobilizing to reverse the shrinking number of abortion providers. The pressure is mounting on medical students who wish to preserve the lives of all their patients.

Recently, Planned Parenthood and other abortion clinics started to offer their own training. And the AMWA is now offering its Reproductive Health Care elective course curriculum to medical schools that sponsor fourth year electives. The goals of the course are to ensure that medical students are well-training in "reproductive health" services and to increase the number of abortion providers.

JIn addition, MSFC founderudy Steinaur stated in a June 8 "CBS Evening News" interview that MSFC will increase demands that medical schools "teach all the aspects of abortion." Smith also encourages teaching ALL the aspects of abortion including the physical and psychological risks that women experience.

"That would be true education to see both sides of a problem," responded Smith in the CBS interview.

With the increasing pressure on students to learn abortion procedures, what can pro-life medical students do? It is difficult for medical students to organize because of the intense time commitment required to survive medical school. Hence, pro-life medical students are limited in their response to the pro-choice mentality that is rampant in their schools. In order to assist pro- life medical students, a new organization, Medical Students Supporting Life (MSSL), is emerging in medical schools across the country. Founded by Marcus Shaker of Arlington, Va., MSSL is the first national organization of pro-life medical students. MSSL will provide a support structure and networking base for pro-life medical students, and much of its efforts will be channeled toward abortion education and the finer points of doctor-patient counseling.

In addition, Smith's organization, the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), and Feminists for Life are teaming up to tackle the pro-choice rhetoric in medical schools. Combining AAPLOG's medical insights with FFL's college presence will provide practical support for pro-life medical students.

Smith sympathizes with medical students who want to observe the Hippocratic oath, which states that no physician should give a woman an abortion or kill a patient. "The Hippocratic oath was never a law, but a guiding principle for conduct. It was held to for centuries, but now that we have lawyers deciding what the ethical standards of our nation should be, the AMA has decided that whatever is legal is moral," said Smith. "The Hippocratic oath is no longer considered relevant to our society because the law allows us to do things the oath does not."

"We are sure that most women physicians would lend their influence and their aid to shield their sex from the foulest wrong committed against it..."

As quoted from The Springfield Republican in The Revolution 4 (22):346 Dec.2, 1869