What Counts as ‘Essential Medical Services’?

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The coronavirus crisis has certainly put a lot of things into perspective —and not just the value of relationships with our family or how much money we really need to get by. What counts as essential medical service has also become a topic of national conversation. This is most salient in regard to abortion, though transgender-related surgeries and medical treatments have also been in the mix. God willing, one positive benefit that may come from this epidemic is persuading Americans that our current medical ethics system is in serious need of reappraisal.

In my home state, the Commonwealth of Virginia, Governor Ralph Northam on March 25 exempted “family planning services” from his directive to all hospitals and health care providers to stop performing elective surgeries or procedures. The broader measure, a quite responsible one, was done in order to conserve the Commonwealth’s supply of personal protective equipment, and to prepare for a potential surge in coronavirus patients. Yet his exemption of “family planning services” means abortion provider Planned Parenthood can continue to operate. Indeed, the Planned Parenthood office in Roanoke, Virginia, declared their intention to continue to perform abortion services during the COVID-19 pandemic because they are “essential.”

One might note, as an aside, that this is the same Democrat Northam who achieved national notoriety for his comments regarding House Bill 2491. That bill, submitted to the Virginia Assembly by Democrat representative Kathy Tran, aimed to lessen legal restrictions on second- and third-trimester abortions. In an interview with WTOP radio, Northam stated:

You know when we talk about third-trimester abortions, these are done with the consent of, obviously, the mother, with the consent of the physicians… And it’s done in cases where there may be severe deformities, there may be a fetus that’s non-viable. So in this particular example, if a mother is in labor, I can tell you exactly what would happen. The infant would be delivered, the infant would be kept comfortable, the infant would be resuscitated if that’s what the mother and the family desired, and then a discussion would ensue between the physicians and the mother.

That galling statement came after similar horrifying comments by Tran in a subcommittee hearing that her bill would allow a doctor to perform an abortion even at the point of childbirth.

Craziness in my beloved Commonwealth aside, other states have taken a different tack in regards to abortion in the time of COVID-19. Alabama, Alaska, Ohio, Texas, Iowa, Indiana, Oklahoma, Mississippi, and Kentucky have all sought to include abortion in their definition of nonessential medical procedures. This would effectively limit if not ban abortion access during the coronavirus outbreak. Federal judges in Alabama, Arkansas, Ohio, Oklahoma and Texas subsequently blocked those state-level orders because, so they argue, abortion is a “right” which the state cannot infringe upon.

In truth, this crisis has already led the state to “infringe upon” a number of other rights—and, I’d argue, with good reason. The First Amendment includes “the right of the people peaceably to assemble,” yet many states have formally restricted citizens’ right to do exactly this, under penalty of law. The Sixth Amendment, meanwhile, enumerates the rights of accused persons to a speedy and public trial. Courts at all levels of our nation will be having a hard time honoring this, given current movement restrictions. Again, I’m not arguing that in an unprecedented health crisis the state shouldn’t take necessary steps to ensure the health and well-being of its citizens. But it’s a bit rich for politicians and judges to assert that abortion access is more important than freedom of assembly because medical and health experts claim it to be so.

This becomes even more ridiculous when one considers those who criticize the suspension of “gender-affirming surgeries” because of the prioritization of fighting COVID-19. A March 19 piece at Vice.com bemoaned the delay of “life-saving” surgeries for transgender and gender non-conforming people. This is because, so claims the author, such surgeries “can greatly reduce gender dysphoria and improve their quality of life.” Not undergoing such surgeries, in turn, causes “enormous stress and disappointment.” Transgender person Jaceon Coronado, meanwhile, told NBC News that the delay of removing his breast tissue made him “really mad.”

According to current projections, millions of people across the world will suffer debilitating ailments from the coronavirus. It’s possible that hundreds of thousands, if not millions, of Americans will die from it. Even more terrifying, many of these people will die quarantined in hospitals, unable to communicate with family and friends, nor even to receive Viaticum from a priest. Yet we are expected to accommodate people who struggle with gender dysphoria and “need” to have elective surgeries to alleviate their “stress and disappointment”? Just as ridiculous is a March open letter signed by 100 LGBTQ or LGBTQ-supportive organizations claiming that LGBTQ people are at greater risk from COVID-19 than the general public. But the coronavirus is a virus. It does not care if you are gay, straight, transgender, or anything else.

Part of what has led us here is what Fordham University philosophy professor Nathan Ballantyne calls “epistemic trespassing.” One form of this is when members of the empirical sciences step into other domains. For example, the politicians and judges declaring abortion an “essential” medical procedure rely on expert opinions such as the March 18 joint statement by The American College of Obstetricians and Gynecologists (ACOG) and a number of other medical and health organizations. These professionals are indeed experts… in their field. Yet their statement is entirely reliant on a non-neutral philosophical claim regarding what kinds of events (e.g., childbirth) negatively “impact a person’s life, health, and well-being.” The problem isn’t with the tremendous expertise found among those in the obstetrics and gynecology fields but with their epistemic trespassing into philosophical claims about what constitutes the good life, and then trying to act like such claims are medical or scientific or both.

I am not a medical or health expert. I trust those who are and who have done the relevant modeling demonstrating how deadly COVID-19 could be if America doesn’t maintain the necessary precautions. But I know enough to perceive when experts exploit their authority to defend claims based on faulty assumptions outside their area of expertise. Catholic philosopher Alisdair MacIntyre’s 1980s lecture “The Idea of an Educated Public” exhorts us all to be savvy enough to identify such epistemic trespassing. Perhaps if we are, there will be a lot fewer abortions and transgender surgeries, both during the COVID-19 crisis and long after.

Photo credit: AFP via Getty Images

Casey Chalk

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Casey Chalk is a senior contributor at Crisis. He holds a Masters in Theology from Christendom College.

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