Human Beings Matter More

Reading Journal: "King of the Birds"

2012-01-21T22:06:00.001-06:00

Flannery O'Connor, Mystery and Manners -- Occasional Prose, ed. Sally and Robert Fitzgerald (New York: Farrar, Straus, and Giroux, 2001), 3-21

Reading Journal: "Asbestos Removal Closes NYC Schools (Contaminated Mountains Out of Mole Spills)"

2012-01-18T12:31:00.001-06:00

John Allen Paulos, A Mathematician Reads the Newspaper (New York: Anchor Books, 1996), 140-143

Reading Journal: "Ranking Health Risks: Experts and Laymen Differ (The Dyscalculia Syndrome)"

2012-01-18T12:30:00.001-06:00

John Allen Paulos, A Mathematician Reads the Newspaper (New York: Anchor Books, 1996), 133-139

Reading Journal: "Cult Members Accuse Government of Plot"

2012-01-17T01:03:00.001-06:00

John Allen Paulos, A Mathematician Reads the Newspaper (New York: Anchor Books, 1996), 49-52

Help Us Reveal the Mystery Picture (Update #8)

2012-01-03T10:28:00.000-06:00

Note: Since beginning our drive to find new supporters, we have received $460/mo in new commitments and $9985 in special gifts. Thank you!

Help us knock out one or more of the boxes! Click this link: Give Online, Automatically, or by Mail.

For an explanation, see my Nov. 2011 Newsletter ("Reveal the Mystery Picture").

To learn more about my work training thousands to make abortion unthinkable for millions, one person at a time, click these links:

"Is Steve's Work Worth Supporting?"
About Steve
JFA's Website (Including WHO we train, WHAT we train them to do, and HOW we train them)

Trent Horn, Open Mic, and Common Ground

2011-12-30T11:39:00.000-06:00

Trent Horn, past JFA staff and now the Respect Life Coordinator for the Roman Catholic Diocese of Phoenix, creates dialogue on the open mic at CBR's GAP Exhibit at NAU in the fall of 2011. Good work, Trent!

[Note on the video: Although I appreciate the attempt by the video producer to "narrate the debate" by giving a score card at various points in the discussion, I think chalking up moments of common ground as "pro-life arguments" is misleading. Trent is using common ground here precisely as I suggested it be used in Common Ground Without Compromise: as a genuine attempt to build rapport so that we can discuss our disagreements (and so that both parties can make their arguments) more productively...namely, to an audience with hearts and minds open to rethinking. Strictly speaking, these points of common ground are not arguments. At best, their assertions or statements of what people believe.]

Messing with the Pageant (Christmas 2011 Newsletter)

2011-12-23T09:00:00.000-06:00

Should church music directors let foulmouthed, cigar-smoking teens play the lead roles in this year's Christmas pageant?

See my Christmas 2011 newsletter to see why my answer is "Yes" and to find out what important aspect of JFA's work just such a pageant mirrors.

Click here to read "Messing with the Pageant."

Merry Christmas!

Reveal (Update #7)

2011-12-22T19:57:00.002-06:00

Note: Since beginning our drive to find new supporters, we have received $350/mo in new commitments and $3925 in special gifts. Thank you!

Help us knock out one or more of the boxes! Click this link: Give Online, Automatically, or by Mail.

For an explanation, see my Nov. 2011 Newsletter ("Reveal the Mystery Picture").

To learn more about my work training thousands to make abortion unthinkable for millions, one person at a time, click these links:

"Is Steve's Work Worth Supporting?"
About Steve
JFA's Website (Including WHO we train, WHAT we train them to do, and HOW we train them)

Reveal the Mystery Picture (Update #6)

2011-12-13T21:25:00.000-06:00

Note: Since beginning our drive to find new supporters, we have received $325/mo in new commitments and $3150 in special gifts. Thank you!

Help us knock out one or more of the boxes! Click this link: Give Online, Automatically, or by Mail.

For an explanation, see my Nov. 2011 Newsletter ("Reveal the Mystery Picture").

To learn more about my work training thousands to make abortion unthinkable for millions, one person at a time, click these links:

"Is Steve's Work Worth Supporting?"
About Steve
JFA's Website (Including WHO we train, WHAT we train them to do, and HOW we train them)

Reveal (Update #5)

2011-12-06T21:14:00.001-06:00

Note: Since beginning our drive to find new supporters, we have received $275/mo in new commitments and $1350 in special gifts. Thank you!

Help us knock out one or more of the boxes! Click this link: Give Online, Automatically, or by Mail.

For an explanation, see my Nov. 2011 Newsletter ("Reveal the Mystery Picture").

To learn more about my work training thousands to make abortion unthinkable for millions, one person at a time, click these links:

"Is Steve's Work Worth Supporting?"
About Steve
JFA's Website (Including WHO we train, WHAT we train them to do, and HOW we train them)

Reveal (Funding Drive Update #4)

2011-12-01T10:40:00.001-06:00

To help us knock out one or more of the boxes, click this link: Give Online, Automatically, or by Mail.

For an explanation, see my Nov. 2011 Newsletter ("Reveal the Mystery Picture").

To learn more about my work training thousands to make abortion unthinkable for millions, one person at a time, click these links:

"Is Steve's Work Worth Supporting?"
About Steve
JFA's Website (Including WHO we train, WHAT we train them to do, and HOW we train them)

Note: Since beginning our drive to find new supporters, we have received $250/mo in new commitments and $1200 in special gifts.

Reveal (Update #3)

2011-11-14T05:30:00.000-06:00

For an explanation, see my Nov. 2011 Newsletter ("Reveal the Mystery Picture").

Reveal a Picture of Impact (Funding Drive Update #2)

2011-11-13T15:47:00.001-06:00

Note: Each new decision to partner with the Wagner family reveals more of the picture of the impact those gifts make. Pray for more people to help and check back often to see our progress!

Want to help us knock out a box or two? Click these links to give or to learn more:

Give Online, Automatically, or by Mail.
"Is Steve's Work Worth Supporting?"
Steve's Bio
JFA's Website (Including WHO we train, WHAT we train them to do, and HOW we train them)

Can You Help Us Reveal a Picture of Impact? (Funding Drive Update #1)

2011-11-03T13:31:00.000-05:00

Note: Each decision to partner with the Wagner family reveals more of the picture of the impact those gifts make. Pray for more people to help and check back often to see our progress!

Want to help us knock out a box or two? Click these links to give or to learn more:

Give Online, Automatically, or by Mail.
"Is Steve's Work Worth Supporting?"
Steve's Bio
JFA's Website (Including WHO we train, WHAT we train them to do, and HOW we train them)

Pro-Lifers Squirm at the Punishment Question...But Why? (Part V)

2011-08-27T14:30:00.003-05:00

A few years ago, I posted a series of blogs on the question, "If abortion were made illegal, how would you recommend punishing women if they get an abortion?"

Pro-Lifers Squirm at the Punishment Question...but Why? (8/7/07) (referring to this post by Anna Quindlen - my original post has an old link)
Pro-Lifers Squirm...Part II (8/9/07)
Pro-Lifers Squirm...but Why? Part III (8/11/07)
Pro-Lifers Squirm...but Why? Part IV (8/14/07)

Here are two further thoughts:

(1) As Greg Koukl points out in his post at STR (IV above), we can look to existing law as a guide. We might say, "If abortion is made illegal, women should be punished according to the same standards and guidelines that men are now punished for killing the unborn." Obviously, I'm not referring here to the way male abortion providers are now punished, since abortion providers are not now punished for killing the unborn (generally speaking). I'm referring to the current "Unborn Victims of Violence" or "fetal homicide" laws that treat the unborn child as a real human being. Indeed, as I pointed out in Question 3 of Common Ground Without Compromise, the fact that Scott Peterson was convicted of a second count of murder (second degree, against his unborn child, Conner) may have been what pushed the court to sentence him to death row. (The first count was Peterson's conviction of murder in the first degree against his late wife Laci.) So, in the context of how we currently punish the killing of the unborn (when it's against the mother's wishes), the pro-life view that the killing of the unborn should be punished similarly to the way killing already-born children is punished seems a lot less odd and a little more attainable.

I'm not saying, by the way, that everything that might be true about the Scott Peterson case (or any other fetal homicide case) is true of a woman having an abortion, whether before or after abortion is made illegal. I'm speaking strictly of a certain principled approach to law that treats the killing of the unborn just like the killing of the already-born child. If you read the posts above, you will see that I think all relevant factors should be taken into account when a court is considering how to punish (motive and intent among them). So, nothing in any of these posts should be construed as saying that I think women who have abortions, broadly speaking, are intentional murderers or share any personality traits with criminals like Peterson. Each case would have to be appraised according to its unique details, as the legal system currently does when assessing punishment for the killing of already-born humans (or wanted unborn humans, for that matter).

I suppose I should also clarify that the sound bite above ("If abortion is made illegal, women should be punished according to the same standards and guidelines that men are now punished for killing the unborn.") is meant to intrigue. It's not meant to cover all cases. Surely, if a woman other than the mother or abortion provider kills an unborn child in states with fetal homicide laws, she can also punished under those laws.

(2) What complicates this whole discussion of punishment is an implicit equivocation on the term "should." How should they be punished in an "ideal" legal world? Or, how should they be punished in the real legal world, taking into account things like a transitional period between the current situation to the "ideal" one?

I think sometimes when the question is asked, the pro-life person doesn't want to answer the "ideal" legal world version of the question because it sounds harsh in the present real legal world ("Abortion is not much more than a surgery"). The purpose of my posts above was partly to clarify that we shouldn't shy away from what we think the "ideal" would be (killing the unborn would be treated like the killing of already-born children), but we should also recognize that putting the "ideal" in place is complicated pragmatically, socially, and politically. So, while we need to give a clear answer to the "ideal" question (if we shy away we appear to be inconsistent in our view that the unborn is a human being), we also need to clarify that actually putting that "ideal" legal world in place may be much more complicated even than making abortion illegal is. And we all know how difficult making abortion illegal is.

"Don't Make Them Feel Guilty." Good advice?

2011-08-26T09:26:00.005-05:00

Regarding women and men who have participated in abortion, I've heard some pro-life advocates say "Don't make them feel guilty." I think the sentiment that's usually behind this statement is helpful, but I think it can be easily misunderstood when it's expressed this way. There are two possible meanings of "Don't make them feel guilty."

Help them avoid feeling bad about their abortion experience. (Indeed, some have said, "You don't need to feel bad.")
Avoid making it appear that you are a better person who can look down your nose casting judgment.

Let me respond to #1.

No, actually, if the person had an abortion, feeling bad about it is essential to coming to Christ for forgiveness. That's precisely what this person needs. So, I suggest that #1 is not helpful.

I think regularly about Greg Koukl's statement about the gospel (I suggest memorizing this.):

The Gospel is offensive enough. Don't add any more offense to it. But we should not remove the offense inherent to the Gospel, either.*

I think we could say something similar regarding the person who's participated in abortion:

The truth about the wrongness of abortion (guilt) is offensive enough. Don't add any more offense to it. But we should not remove the offense inherent to the truth about the wrongness of abortion (guilt), either.

Practically speaking, this means we follow #2 above: Avoid making it appear that you are a better person who can look down your nose casting judgment. So, this means we follow my colleague Tammy Cook's advice: we don't treat abortion as the unforgiveable sin. And, we don't treat it as "so much worse than anything I have done." Instead, we turn the mirror on ourselves and reflect on our own fallenness. This will naturally produce the empathy that's going to be most helpful to the person who has participated in abortion.

Let me add two additional thoughts:

(1) I don't mean that every person who has an abortion is equally guilty or should feel equal intensity of guilt. I do mean that whatever the appropriate amount of guilt is for someone to feel, based on all of the relevant factors (which I'm not sure I can enumerate), we should not get in the way of someone feeling that by tossing off dismissive statements like, "It's not so bad."

I think many of us (if I am any indication) have an inclination to simply try to make people feel better. Sadly, this inclination is stronger in us than the inclination to be helpful to them for the purpose of their long-term, whole-person good. My argument in this post is that we should suppress our desire to simply make people feel better and focus our efforts on walking with them as they reckon with what they've done. While taking this approach, we should encourage them toward Christ rather than away from Him into the sort of self-reliance and isolation that is so enticing to all of us when we have done wrong.

(2) I am also mindful in writing this post that I have done many serious wrongs and I am guilty. What I am arguing above is that the best way for friends of mine to be helpful to me is to let me feel that guilt and point me to Christ, who brings me to God spotless, based on His free gift of forgiveness. So, if I am not connected to the wrongness of what I've done, they might ask questions to help me connect. And, if I am beating myself silly because my sense of healthy guilt has morphed into a mechanism for self-centered inaction or depression, my friends should attempt to help me correct that by reminding me that being too focused on guilt says something about my acceptance of Christ's forgiveness. (I'm not mapping out how this discussion should go, though, so don't take this as instructions for what to say when. I'm simply mapping a general approach.)

The point here is that I don't point the finger at women and men who have made decisions to participate in abortion, as if I have done no wrong. I have done many serious wrongs. So, the following is a message not just to others, but to me:

The truth about my guilt is offensive enough. Don't add any more offense to it. But please don't remove the offense inherent to my guilt, either.

*Note: I've altered the wording in the article slightly, based on personal conversations with Greg.

35% of "Pro-Lifers" Say Abortion Should Be Legal?

2011-08-19T09:05:00.002-05:00

I've posted twice already on the new Gallup abortion poll numbers:

Here's another thought. Look at Gallup's summary of the data (see the second table here):

David Lee brought one of the numbers to my attention: 35% of self-proclaimed pro-lifers believe abortion should be legal in the first trimester. Note that 26-27% of the "pro-life" group also believe aborting a "mentally impaired" or "physically impaired" child should be legal.

It's because of this phenomenon ("pro-life" people taking "pro-choice" positions when it comes to law) that I made the comment in my book (and we make the same comment during JFA's ADD Seminar), that the terms "pro-life" and "pro-choice" can't tell you much in themselves. You need to ask more questions of people to know what they themselves mean by it. In my experience, the term "pro-life" sometimes means,

"I'm personally pro-life, but I can't tell others what to do with their bodies."

It's difficult, though, to distinguish that position from the classic pro-choice position that says,

"Regardless of how I feel about abortion personally, I believe we shouldn't make laws against it. Women should be able to choose it."

71% Say Abortion Should NOT Be Legal...

2011-08-15T09:29:00.007-05:00

...in the second trimester, according to Gallup's 2011 poll. (See Page 11, Question 21.) (68% said abortion should be illegal in the second trimester in Gallup's 2003 poll).

86% say abortion should not be legal in the third trimester (compared to 84% in Gallup's 2003 poll).

Gallup also found some interesting common ground on certain reasons for abortion (see Q. 20 in the data):

There's still very little support for abortion when the reason is "I can't afford a child." (61% think it should be illegal.) There's less support than in 2003 for keeping it legal to kill an unborn child with a physical disability (45% in 2011 think it should be illegal vs. 37% in 2003) or mental disability (46% in 2011 think it should be illegal vs. 39% in 2003).

And, there's still widespread support for keeping abortion legal in the case of rape (75%) and when the mother's life is in danger (83%).

Sadly, Gallup didn't combine specificity on the timing of abortion with specificity on the reasons for abortion, as it did in 2003. (See the data here.) For more on this, see Question 11 in Common Ground Without Compromise (available for free at www.commongroundbook.com for a limited time).

Gallup Focuses on Common Ground

2011-08-15T09:19:00.004-05:00

Last week, Gallup released the data from a new poll on abortion. Here's their summary. Thankfully, they focused on specific reasons for abortion and/or specific times when abortions are performed. And, predictably, this polling approach revealed a great deal of common ground.

I say, predictably, because this is what Gallup has found in the past when it has asked specific questions. See Questions 1 and 11 in Common Ground Without Compromise (Chapters 4 and 6). If you don't have the book yet, you can still get it for purchase or for free using the links found here: www.commongroundbook.com.

(HT: Trent Horn)

"By the Reasons Which They Have Themselves Discovered"

2011-08-10T20:24:00.000-05:00

"People are generally better persuaded by the reasons which they have themselves discovered than by those which have come into the mind of others." - Blaise Pascal, Pensees, #10

Early Embryonic Humans Can Correct Their Own Genetic Anomalies?

2011-07-11T09:27:00.002-05:00

Although it appears these researchers from the European Society of Human Reproduction and Embryology are attempting to refine pre-implantation genetic diagnosis (a practice that is little more than a way to separate out a class of disabled humans so they can be killed before implantation into their mothers' wombs), the finding that the embryo has the ability to correct certain of its chromosomal anomalies not only supports the idea that the embryo is an organism, but that it is a human organism with some abilities we already-born folks don't have.

Sometimes pro-choice advocates will offer the supposed limited functionality of the embryo to me as support for the idea that the unborn isn't a person. They will say, "The embryo doesn't even have a brain! It's not doing anything!" I'll seek genuine common ground by agreeing that the embryo in the first two weeks doesn't have a brain, but I'll point out that it doesn't need one to organize its body systems. We need a brain for that purpose at our stage of development, but the embryo doesn't. So, I sometimes ask, "Can you organize your body systems without a brain?" Or, I'll ask, "Can you double your size every few hours or days?" The embryo, of course, can do these things very well. And, now it appears they can correct certain anomalies to some degree, even though those anomalies are genetic.

So, it appears the embryo, while she can't do everything we can do at our stage of development, can do a host of things at her stage of development that we can't do at ours.

(HT: LifeNews)

"Lovingly, Carefully, Thoughtfully"

2011-07-01T13:44:00.003-05:00

One of my supporters wrote me the following note recently:

"I continue to support Steve Wagner through JFA because you continue to teach and reach out to the next generation lovingly, carefully, and thoughtfully. Meeting them where they live in heart and mind. With the truth of the sanctity of life, good, bad, happy, or sad. Dialoguing with them, engaging them in the debate. Accepting their feelings about how they think." (Handwritten note, June 2011)

I think that last phrase, "accepting their feelings about how they think..." captures our goal with one-to-one conversations in an interesting way. We're not accepting bad ideas (we want them to be discarded), but we can accept a person's feelings about their ideas, and we can understand how difficult it is for any of us to be confronted with new/unexpected information. Cognitive dissonance is not just dissonant cognitively. It's going to have an impact on our emotions.

What Percentage of Spina Bifida Kids Are Aborted?

2011-06-23T08:50:00.087-05:00

Because of the sophistication of ultrasound and other prenatal diagnostic techniques, doctors can diagnose certain disabling conditions prior to birth with a fair amount of accuracy. Spina bifida is one of those conditions. In a recent newsletter, I relayed the testimony of one young man with spina bifida at the University of Texas at San Antonio. I made the claim in that newsletter that more than half of children diagnosed in the womb with spina bifida are killed through legal abortion. (I meant, in the U.S.)

Is this claim accurate?

After looking at a number of studies, I've concluded we don't really know. (So, you'll notice I changed the figure in my newsletter.) I had based my "more than 50%" claim on the Mansfield study listed below, and I felt my estimate was safe. From that study, we can know that during the period from 1980-1991, two U.S. studies counted 15 fetuses prenatally diagnosed with spina bifida and 15 of those were killed by abortion (100%). But the sample size here is too small to help us make conclusions about the general population then, and much less today. From the other studies that I cite below, we can know that in the late 80's, there was a 30% termination rate in California, and that in the late 80's to mid 90's a 48% termination rate was recorded in Hawaii. By my reading of the data, we can also know that in 1995 in Houston, there was at least a 37% termination rate of spina bifida children after prenatal diagnosis. And we have some data for six states for the period from 1985-1994 (see below). We have a few studies from Europe that show 66%, 72%, and 78% termination rates (see below), but we can't say much confidently about U.S. practice from European studies.

There also seems to be some evidence that the termination rates in the U.S. vary by geographic location, timing of diagnosis, and other factors. Another concern is the age of the data in these studies. Only one United States study has any data from the 2000's (Cragen, et.al 2009), but the termination rate from that study is unclear (it may be 34% and it may be higher, but we can't know from the published data). Only two from Europe have any data from the 2000's (Aguilera, et.al. and Amari, et.al).

In many scientific studies (of risk factors for breast cancer, for example), the age of the study doesn't affect it's relevance to the discussion, precisely because the question being considered isn't time-dependent. But studies of how many spina bifida children are aborted after prenatal diagnosis is really a sociological question rather than a biological or epidemiological question. In other words, if we're asking "How many parents abort a child that is diagnosed in utero with spina bifida?" we are asking a question about current behaviors of a certain community of human beings, and older studies are only helpful if we can also demonstrate that relevant social and medical factors haven't changed. Examples of social and medical factors that should be factored in when attempting to extrapolate from older studies on this question include...

"Have attitudes towards certain kinds of abortion changed?" This sociological question is important because people are less in favor of late-term abortion now than in the past, and many times a spina bifida diagnosis comes later in the pregnancy. If people are against late-term abortion and late-term abortion is the only option other than giving birth to their spina bifida child, then they may very well choose to give birth.
"Are we more able now to diagnose spina bifida earlier in pregnancy?" This medical question is important to the question at hand because people are generally more in favor of abortion if it's done earlier. In other words, if a spina bifida diagnosis can be reliable early in pregnancy when people feel more comfortable with abortion, they are probably more likely now to abort spina bifida children.
"Are there now more successful treatments for spina bifida than there were even ten years ago?" This medical question is important to the question at hand because people are sometimes influenced by quality-of-life considerations when deciding about abortion. So, if they perceive the quality of life of their spina bifida child can be relatively good, it may decrease the willingness to abort in spina bifida cases. In other words, if there are more successful treatments now than there were, it's reasonable to assume more people would opt for giving medical treatments to their unborn child rather than killing her.

So, it's difficult to conclude much about what percentage of unborn children diagnosed in utero with spina bifida are killed by abortion (in the U.S.). Sure, we can guess at how many parents elect to have their spina bifida kids killed, but at this point, my view is that we don't have much more than guessing.

Following are some of the studies I reviewed, along with my comments.

Studies Referring to Data from the United States and Europe (1):

Mansfield C, et. al., Termination rates after prenatal diagnosis of Down syndrome, spina bifida, anencephaly, and Turner and Klinefelter syndromes: a systematic literature review. Prenatal Diagnosis, Sept. 1999; 19(9):808-12. This oft-quoted 1999 study by Mansfield, et. al. reviewed four European studies and two United States studies. Four of the studies, on my reading, have sample sizes too small to make very strong generalizations about the question at hand (Belgium, Italy, and two from the U.S.). The two studies with more significant sample sizes, UK and France, reported termination rates of 61% and 63% respectively. Note the years of the spina bifida studies, though: 1987, 1991, and 1995 (Note: this is the year of the study; both the 1991 and 1987 studies refer to data from the 80's; the 1995 study refers to data from 1990-1991). I'm not sure much we can accurately conclude about current practice from these studies. See an excerpt from Table 1 below.

Mansfield C, et. al., Termination rates after prenatal diagnosis of Down syndrome, spina bifida, anencephaly, and Turner and Klinefelter syndromes: a systematic literature review. Prenatal Diagnosis, Sept. 1999; 19(9):808-12; Table 1 (excerpt).

Studies Referring to Data from the United States (5):

Ellen M. Velie and Gary M. Shaw, Impact of Prenatal Diagnosis and Elective Termination on Prevalence and Risk Estimates of Neural Tube Defects in California, 1989–1991, Am J Epidemiol 1996;144:473-9. This study from California shows about 30% termination rate for unborn children diagnosed with spina bifida. The data is about 20 years old, though.

Mathias B. Forrester, Ruth D. Merz, and Paula W. Yoon. Impact of Prenatal Diagnosis and Elective Termination on the Prevalence of Selected Birth Defects in Hawaii. Am. J. Epidemiol. (1998) 148(12): 1206-1211. This study from Hawaii shows a 48% termination rate for spina bifida diagnosed unborn children. All of the data used in the study, though, is at least 15 years old; some of it is 24 years old (1987-1996).

Cragan, et. al. Surveillance for anencephaly and spina bifida and the impact of prenatal diagnosis--United States, 1985-1994. MMWR CDC Surveill Summ. 1995 Aug 25;44(4):1-13. See Table 2. This study summarizes data on termination rates for spina bifida from 6 states or areas in the United States: California (29%); Iowa (19%); Arkansas (3%); Atlanta, Georgia (26%); South Carolina (25%); and Hawaii (23%) This data is also at least fifteen years old. View the abstract for a summary of the study here.

Cragen, et.al. Including Prenatal Diagnosis in Birth Defects Monitoring: Experience of the Metropolitan Atlanta Congenital Defects Program. Birth Defects Research (Part A) 85:20-29 (2009) It's unclear from the published data in this study what the termination rate of spina bifida kids after prenatal diagnosis is, but it's likely that is was at least 34% and was probably higher. [Notes on how I arrived at the 34% figure: Although Fletcher, et.al. concluded that this study showed a 35% termination rate, the table from which they appear to have drawn that conclusion is misleading. See Table 2 on Page 25. It includes live births and still births that are not necessarily following a prenatal diagnosis. The study is attempting to show how including termination numbers (not rates) increases the overall prevalence numbers of various deformities. So, without more interaction with the authors about unpublished data they may or may not have, we can't conclude for certain what the termination-after-spina-bifida-prenatal-diagnosis rate is from this study either. The dates of the data of this study (1995-2004) gave me the most promise of any study I looked at that we might get some help with the question at hand, but all we can really conclude regarding spina bifida children from this study is that during the 9 years of the study, 64 spina bifida children were killed by elective abortion, 102 were born, 14 were stillborn, and 7 had unknown outcomes (although the authors guess that termination in an outpatient facility was the likely outcome). It's likely that many of the abortions followed a prenatal diagnosis, but we can't know for sure. If that's the case, the number might be 34% (64/187). If we use that as a baseline and include the "unknown outcomes," and if we also consider the fact that the number of live-born and stillborn kids prenatally diagnosed is likely lower than the total number of those kids, then the percentage of terminations after prenatal diagnosis would be higher (64 aborted / 187-n prenatally diagnosed).]

Waller DK, et. al. Frequency of prenatal diagnosis of birth defects in Houston, Galveston and the Lower Rio Grande Valley, Texas 1995. Fetal Diagn Ther. 2000 Nov-Dec;15(6):348-54. This study shows at least a 37% termination rate for spina bifida after prenatal diagnosis. Keep in mind, though, that the data for this study is now more than 15 years old, so we should be cautious of conclusions we draw from the study about current practice today. Also, keep in mind that in 8 of the 10 cases of abortion for spina bifida in this study, the child also had other serious abnormalities, so we can't really conclude that the spina bifida part of the diagnosis was the decisive factor for the couples who elected for abortion. [Notes on how I arrived at 37%: Although Fletcher, et.al. (page 2) cited this study as reporting a low 7-10% termination rate for spina bifida, that's a misread of the abstract, in which the authors say that between 7 and 10% of the cases of elective termination were not included. Since this study is not really attempting to determine termination rates after prenatal diagnosis, Table 2, which lists a 16% number, along with an 8% number, is confusing for our purposes. Unfortunately, my attempts to get clarification from the author of the study were unsuccessful. So, I went back to the study and read it more carefully. As I said, Table 2 appeared to report a 16% termination rate. Upon a more careful reading of that Table 2 and the study, I realized that the percentage in the table refers to fetuses terminated out of the entire number of fetuses in the study. The study explicitly says that only a third of the fetuses included in the study were prenatally diagnosed. (In fact, that's the purpose of this study, to determine how many babies with deformities were prenatally diagnosed. It's not intending to tell us what people did with their children after prenatal diagnosis. So, our work here is an extrapolation from the data.) In other words, 10 of the 64 children (16%) with spina bifida in this study were killed by abortion. But 64 is the total number of spina bifida children in this study. If you look in Table 1 to find how many of those children were prenatally diagnosed, the number is 27 (22 with only spina bifida + 5 with spina bifida and other deformities). While we can't be positive from this data that all of the children listed as being killed by abortion in Table 2 (10) were killed following a prenatal diagnosis, it's likely. If that's the case, the percentage of parents who decided to kill their spina bifida child after prenatal diagnosis is at least 37% (10/27). Remember that some of the terminations were excluded, so even this termination rate is probably low.]

Studies Referring to Data from Europe (3):

Aguilera, et. al. Prognosis of spina bifida in the era of prenatal diagnosis and termination of pregnancy. Fetal Diagn Ther. 2009;26(2):68-74. Epub 2009 Sep 11. This Bristol, UK study had a sample size of 74. 72% of the unborn children diagnosed with spina bifida were killed by abortion. The study refers to data from 1999-2007.

Amari, et. al. Prenatal course and outcome in 103 cases of fetal spina bifida: a single center experience. October 2010, Vol. 89, No. 10 , Pages 1276-1283. This study, which refers to data from Germany (1993-2008), reports a 66% termination rate. A total of 103 children were prenatally diagnosed with spina bifida, and 68 were killed by abortion.

E. Garne et. al. Prenatal diagnosis of severe structural congenital malformations in Europe. Ultrasound Obstet Gynecol 2005; 25: 6–11. This study, which refers to data from 1995-1999 from 17 European-based registries of congenital malformations, reports a termination rate of 78%. 405 children were prenatally diagnosed with spina bifida. 314 were killed by abortion.

Two Documents from the 1980's
As I was about to publish this piece, David Lee pointed me to two other notable documents from the 1980's.

Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. 2nd edition. US Preventive Services Task Force. Washington (DC): US Department of Health and Human Services; 1996. Section 1, Chapter 42: "Effectiveness of Early Detection". This report claims that a number of studies confirm that "Induced abortion is sought by the majority of women who choose to be screened and whose screening tests reveal neural tube defects, thus leading to a decreased birth prevalence of affected infants among screened women." It lists numerous studies. One of them, from South Wales, follows. I may take all of these up in a subsequent post, but the dates of the studies are 1984, 1982, 1983, 1985, 1983, 1979, and 1991, so even if the studies do show that a majority seek abortion in the case of spina bifida, the data would be almost 30 years old, and some of them are from Europe, so then we would have to speculate on the relevance of that data to the situation in the United States today.

Roberts CJ, et.al. The efficacy of a serum screening service for neural-tube defects: the South Wales experience. Lancet. 1983 Jun 11;1(8337):1315-8. A quick look at the abstract of this study reveals a 40.7% termination rate for spina bifida. Note: If one isn't careful, he's apt to read the 56.1% termination rate for "open neural tube defects" as the termination rate for spina bifida. But 56.1% is the termination rate in this study for both spina bifida (40.7%) and anencephaly (66.6%) combined. As far as I can tell, it is uniformly true in studies like this that anencephalic kids are more likely to be aborted than spina bifida kids. So, we must take that into account when we're attempting to understand spina bifida in isolation.

Faden, R.R., et.alPrenatal Screening and Pregnant Women's Attitudes toward the Abortion of Defective Fetuses. Am J Public Health, 1987; 77:288-290. This study analyzed the attitudes of 490 Maryland women in a prenatal screening program in 1980-82. Figure 1 seems to indicate that as the certainty about the diagnosis increases, more people are willing to abort. If I'm reading that Figure correctly, each of the women in the study only got to pick one of the options of the certainty level of the diagnosis at which they would choose abortion (25%, 50%, 75%, 95%, 100%). Keep in mind that the data in the this study is almost 30 years old.

"Where Is God If We Can't See Him?"

2011-06-15T14:46:00.001-05:00

Last night I asked my three-year-old who would keep her safe. She said Daddy, Mama...and for good measure she added herself and her little sister to the list. I asked, "Who else?" She said, "God!" I said something like, "Even though you can't see Him, He loves you. He'll keep you safe."

With just a moment's pause, she said, "Where is God if we can't see him?"

Perhaps I was tired or was just touched that my three-year-old has gotten to the stage of asking these sorts of questions (I've been waiting over three years for this, actually!), but I didn't know what to say. I started a sentence and then stumbled and started again and stumbled again. I ended up with something like "You know how sometimes if I'm out in the hall or something, you can know I'm here even though you can't see me? It's a little bit like that with God." But I felt this response left a bit to be desired. I didn't really answer her question, for example.

So, I'm still looking for a good way to discuss "where God is" even though we can't see him.

Surprise, Surprise. Another Vague Poll.

2011-06-13T10:01:00.001-05:00

NPR and Thomson Reuters took a poll recently that "showed" that a majority believes abortion is morally wrong (59%), and that a majority (54%) believes abortion restrictions should either stay the same as they are or be eased. Keep in mind that the questions asked didn't specify the type of abortion, timing of the abortion, or the reason for the abortion. All three of these are factors that I've found in my conversations with people radically alter how they respond to whether they think abortion should be legal/illegal or whether they think it's right/wrong. A more helpful poll would only ask about morality and legality with reference to these specifics.

The question about restrictions was similarly murky. It only asked people if they believe the law should stay the same or be changed, but it didn't ask people to explain anything about what their understanding of current abortion law is. I've found in my conversations that most people (at least on college campuses) are ignorant of the fact that abortion is legal through all nine months. (This has been recently challenged with fetal pain statutes in some states, so the status of abortion after 20 weeks is in flux.)

A more helpful poll would ask people when they think abortion is legal. Then, and only then, should we ask them if they think that state of affairs should continue, be stricter, or be more relaxed.

You can see for yourself the survey's questions and responses here.

I continue to be skeptical about whether we can gain much useful data about what people actually believe about abortion from such broad questions. Sure, you can get a sense of how widespread general attitudes of positive or negative are, but you can't conclude much more.

Here's another NPR story about the poll.

Note: Keep in mind also that the majority referred to on both questions may not be the same people. It's like a venn diagram. Some believe abortion is immoral and that it should be illegal. Some believe abortion is morally okay and should be legal, and some think abortion is immoral, but it should be legal. I think it's safe to say that very few, if any, believe abortion is morally okay, but that it should be illegal.

(HT: Lifenews.com)