Category: Scholarly works

AMA Journal of Ethics | Katie Watson | December 2018

This article is a short, well-argued piece explaining all the different connotations of the word ‘elective’ when it comes to abortion, and why, at best, it is not accurate, and at worst, is insulting, stigmatizing, and harmful. For a brief overview, though:

First, hospital surgeries are scheduled according to a three tier system: elective, urgent, or emergent. ‘Emergent’ means that it’s a true emergency, and the patient needs surgery within the next hour (think about a gunshot wound). ‘Urgent’ usually means that the surgery must be performed in the next 24 hours or else the patient is at risk of suffering serious harm (think appendicitis or a broken bone). A surgery is scheduled as ‘elective‘ if it is to be scheduled at the convenience of the patient and surgeon. Abortion is in a special category called “time-sensitive”–it need not be performed today or tomorrow, but even modest delays can cause risk of harm. Another example of time-sensitive surgery is oncologic procedures: if the surgery to remove your tumor or your chemotherapy were delayed even a few weeks or a month, that might seriously jeopardize your health. Abortion is time-sensitive, too: with each increasing week of gestation, the risk of mortality rises 38%. (That absolute risk is very low, but that doesn’t mean we can ignore the increased risk from delaying. This is not even to mention the risk that delay might make the abortion inaccessible entirely, which causes other harms–see the link in the next paragraph!)

Second, abortions are often categorized as ‘elective’ to distinguish them from more necessary procedures that are ‘therapeutic’ or ‘medically indicated.’ The consequences for a woman who is denied an abortion are real, and have been studied. But let Katie Watson tell you why ethically they are just as necessary as other kinds of care.