I have stated that the prevalence of criminal abortion is in great
measure owing to a seeming neglect of fœtal life on the part of medical
practitioners, and that in other degree it is attributable to ignorance
by the community of the actual character of the offence, an ignorance of
physiological facts and laws; and on both these points abundant proof has
been afforded of the truth of my assertions.
I have also stated that medical men, in all obstetric matters, are the
physical guardians of women and their offspring; a proposition that none
can deny.
We have seen that unjustifiable abortion, alike as concerns the infant
and society, is a crime second to none; that it abounds, and is
frightfully on the increase; and that on medical grounds alone, mistaken
and exploded, a misconception of the time at which man becomes a living
being, the law fails to afford to infants and to society that protection
which they have an absolute right to receive at its hands, and for the
absence of which every individual who has, or can exert, any influence in
the matter, is rendered so far responsible.
Under these circumstances, therefore, it becomes the medical profession
to look to it, lest the _whole_ guilt of this crime rest upon themselves.
And, in the first place, it might be asserted with some truth, that such
is indeed the case. For, on the one hand, it was from physicians, as
is proved by early medical literature, that the mistaken notions, both
of the law and of the people, regarding intra-uterine vitality, were
derived; and on the other, the apathy and silence still existing on this
subject among medical men, though thousands and hundreds of thousands of
human lives are thus directly at stake, and are annually sacrificed, can
only be explained on one of two suppositions,—either that we do not yet
really believe in the existence of fœtal life, though professing to do
so, or that we are too timid or slothful to affirm and defend it. By the
one alternative a gross lie seems proved; by the other a degrading and
strange inconsistency.
But, I believe, this apparent negligence proceeds only from ignorance
of the real duty of the profession. It is my aim, while setting forth a
deliberate and carefully prepared opinion upon this point, to inspire, if
possible, in my fellow-practitioners throughout the land, somewhat of the
holy enthusiasm sure in a good cause to succeed despite every obstacle,
and an earnest, uncompromising hostility to this result of combined error
and injustice, the permitted increase of criminal abortion.
Enough has already been said to show that there is need of increased
vigilance on the part of medical men, lest they themselves become
innocent and unintentional abettors of the crime.[256] If, on the other
hand, the community were made to understand and to feel that marriage,
where the parties shrink from its highest responsibilities, is nothing
less than legalized prostitution, many would shrink from their present
public confession of cowardly, selfish and sinful lust. If they were
taught by the speech and daily practice of their medical attendants, that
a value attaches to the unborn child, hardly increased by the accident of
its birth, they also would be persuaded or compelled to a similar belief
in its sanctity, and to a commensurate respect.
But it is asked, is our silence wrong? Is there not danger otherwise of
increasing the crime? These are the questions not of wisdom, or prudence,
or philanthropy, but of an arrant pusillanimity. Vice and crime, if kept
concealed, but grow apace. They should be stripped of such protection,
and their apologists, thereby their accomplices, condemned. Answers,
however, are ready at hand to the questions proposed.
“It is one of the great desiderata of registration, that more
particularity should be observed in collecting facts relating
to the subject of the still-born.”[257]
“Has it been sought,” society demands of the profession, “to
account for the peculiarities relating to the still-born, and
to combat the causes which in certain circumstances swell their
number in so deplorable a manner?”[258]
“An honest and fearless expression of these causes and
circumstances, on the part of medical men, would bring to light
an amount of knowledge that might be useful in checking this
horrible and increasing waste of life.”[259]
“Such an exercise of his knowledge, experience, and true moral
courage, is not only the province, but the conscientious duty
of the physician.”[260]
“It should be constantly borne in mind, that there is here a
high and stern morality, that should stimulate the medical
profession in the exercise of their utmost effort and
ingenuity, with the view to master and disclose the secrets of
these villainous practices; the more villainous, because they
are very generally conceived in fraud, practiced in deception,
upon innocent and unsuspecting victims, and result the most
commonly in the destruction of two lives at once.”[261]
“For ourselves, we have no fear that the truth in reference to
the crime of procuring abortion, would do aught but good. It
would appear that sheer ignorance in many honest people, is the
spring of the horrible intra-uterine murder which exists among
us; why not then enlighten this ignorance? It would be far more
effectually done by some bold and manly appeal, than by the
scattered influence of honorable practitioners alone. Will not
the mischief, by-and-by, be all the more deadly, for delaying
exposure and attempting relief?
“Whatever estimate may attach to our opinion, we believe that
not only ought these things not so to be, but that the public
should know it from good authority.”[262]
“This is a topic which ought to be regarded of the highest
interest to the profession and the public.”[263]
“It is by far the most important subject before the profession,
and in its medical as well as moral bearings, appeals alike to
our patriotism and humanity.”[264]
“We think the public have very erroneous ideas of the turpitude
of this crime, and we deem it our duty, as conservators both
of the public health and morals, to set it in a correct light
before them.”[265]
“The question of criminal abortion is doubtless one of extreme
difficulty; it is not, however, beyond the reach of the
enlightened prudence and the firm will of the authorities. It
is a subject of such vital import to society in general, that
we feel convinced it cannot but awaken the anxious thought of
the persons who, from their position, are entrusted with the
application of the laws and the control of public morals.”[266]
Whoever shall succeed in fixing upon it the attention it
deserves, “has taken a stand in this matter alike creditable to
his head and his heart, and we feel that he will receive the
hearty thanks of every true physician.”[267]
“The increasing prevalence of infanticide,” which is but
rare compared with criminal abortion, “its dangerous moral
influence, the apathy with which so many regard its spread,
and the very considerable difficulty in obtaining conviction,
call loudly for reform. The question is one of national
importance.”[268]
“With this view of the case before us, I suggest it as our
imperative duty to direct the attention of legislators to the
importance of enacting a statute in conformity thereto.”[269]
Such are the confessions, independently given, of high-minded and
honorable medical men. No more can be added, no less would have been
true.
It must be granted, then, that a bold and manly utterance of the truth,
combining as this must, contradiction of the error and denouncement of
the crime, should be made by the members of the profession on every
occasion. By this course it is plain that a healthier moral tone would
be made to prevail in the community, the crime would become of rarer
occurrence, and the laws, such as they are, would be more faithfully
attempted to be enforced.
But it has been shown that the laws on the subject of criminal abortion
are radically imperfect and defective, and that this is attributable,
wholly, to a medical cause. We assert, therefore, that not only is it
the duty of the profession as individual components of society, but more
especially as medical men, to see them amended, and to leave no means
untried, no effort unmade, for the attainment of this end.
“Physicians alone,” says Hodge in his Introductory Address, “can rectify
public opinion, they alone can present the subject in such a manner
that legislators can exercise their powers aright in the preparation
of suitable laws; that moralists and theologians can be furnished with
facts to enforce the truth upon the moral sense of the community, so
that not only may the crime of infanticide be abolished, but criminal
abortion properly reprehended, and that women in every rank and condition
of life may be made sensible of the value of the fœtus, and of the high
responsibility which rests upon its parents.”[270]
It has been stated, indeed publicly avowed by a medical body,[271] that
when a physician “shall become cognizant of any attempt unlawfully to
procure abortion, either by persons in the profession or out of it, it
shall be his duty immediately to lodge information with some proper legal
officer, to the end that such information may lead to the exposure and
conviction of the offender.”
This doctrine is doubtless true to a great extent, but it cannot be
applied to the confidential disclosures of patients themselves, which no
man has a right to reveal, unless constrained by the direct command of
the court, at which, it has been ruled, even professional secrets must be
divulged.[272]
* * * * *
It follows, from the evidence we have now adduced, that if it be the
duty of the profession to urge upon individuals the truth regarding
this crime, it is equally their duty to urge it upon the law, by whose
doctrines the people are bound; and upon that people, the community, by
whose action the laws are made.
And this should be done by us, if we would succeed in suppressing the
crime, not by separate action alone, but conjointly, as the profession,
grandly representing its highest claim,—the saving of human life.
Every step toward this end should be hailed with enthusiasm. The late
action of the State Society of Massachusetts, directly resulting from
professional agitation of the subject, deserves praise and imitation; the
body referred to having passed a series of resolutions to the following
effect: “That the Fellows of the Massachusetts Medical Society regard
with disapprobation and abhorrence all attempts to procure or promote
abortion, except in cases where it may be necessary for the preservation
of the mother’s life; and that no person convicted of such attempt,
can, consistently with its by-laws, any longer remain a fellow of the
society.”[273]
But the mere passage of resolutions in disapproval of this horrible and
so rapidly increasing crime is not sufficient to effect its abatement.
Something more is wanted than the testimony of record books, the
pointless vote of a board of councillors. There must come a hearty,
earnest, and unanimous voice from the mass of the profession; an
assertion that criminal abortion, or at least its permitted commission,
shall no longer exist.
Too much zeal cannot be shown by physicians in relieving themselves
from the weight of responsibility they may have incurred by innocently
causing the increased destruction of human life. Let it not be supposed
by the public that there is among us, either in theory or practice, any
disregard of the unborn child. If such impression have already obtained,
from our own negligence, the falsehoods of irregular practitioners, or
otherwise, it should at once be removed. Fœtal life ever is, and ever has
been, held sacred by all respectable physicians, and whenever criminal
abortion has been known to have been advised, perpetrated or abetted by
one claiming our honorable name, he has invariably and at once lost all
professional standing.
We have seen that it is no trifling matter, this awful waste of human
life. It is a subject that demands the best efforts of the whole
profession as a body and as men. The crime, no longer practiced in
secret, must be met boldly; and met with unanimity, it will be met
successfully.
But whether these efforts are to be at once decisive or not, whether
they are to be received with the gratitude of the community or its
disfavor, is no concern of ours. Our duty is very plain; it is to stand,
irrespective of personal consequences, in the breach fast making in
the public morality, decency, and conscience, and, to the best of our
strength, to defend them.
It might be, it very likely would be, for our immediate pecuniary
interest, as a profession, to preserve silence; for we have shown that
abortions, of all causes, tend to break down and ruin the health of the
community at large. But to harbor this thought, even for a moment, were
dishonorable. “I will never set politics against ethics,” said Bacon,
“for true ethics are but as a handmaid to divinity and religion.”
We must take this decided stand, there is no choice; else we are
recreant to the high trust we have assumed, and to ourselves. Whether
the suppression of abortion be effected or no, one thing is certain, our
own hands will have been cleansed of this sea of blood. We shall have
declared our abhorrence and our innocence of the crime.
Longer silence and waiting by the profession would be criminal. If these
wretched women, these married, lawful mothers, aye, and these Christian
husbands, are thus murdering their children by thousands, through
ignorance, they must be taught the truth; but if, as there is reason to
believe is too often the case, they have been influenced to do so by
fashion, extravagance of living, or lust, no language of condemnation can
be too strong.
Let us, then, meet the issue earnestly and boldly. Silence and patient
expectance have been fairly tried; the disease is not self-limited; the
evil, instead of working its own cure, has assumed a gigantic, an awful
growth.
Abstract discussions of this matter, by ourselves, and within the closed
doors of our several societies, no longer avail. We are all agreed upon
the guilt of abortion; we ever have been. Our prayers for its suppression
have not been answered, for they have hitherto been offered with inactive
hand.
We should, as a profession, openly and with one accord appeal to the
community in words of earnest warning; setting forth the deplorable
consequences of criminal abortion, the actual and independent existence,
from the moment of conception, of fœtal life. And that the effort should
not be one of words merely, we should, as a profession, recommend to the
legislative bodies of the land, the revision and subsequent enforcement
of all laws, statutory or otherwise, pertaining to this crime,—that the
present slaughter of the innocents may to some extent, at least, be
made to cease. For it is “a thing deserving all hate and detestation,
that a man in his very originall, whiles he is framed, whiles he is
enlived, should be put to death under the very hands and in the shop of
nature.”[274]
In conclusion; a committee, consisting of Drs. Blatchford, of New York,
Hodge, of Pennsylvania, Pope, of Missouri, Barton, of South Carolina,
Lopez, of Alabama, Semmes, of the District of Columbia, Brisbane,
of Wisconsin, and the writer, was appointed by the National Medical
Association, at its meeting at Nashville, in 1857, to report upon
criminal abortion, with a view to its general suppression. The report of
this committee, brief, but in strict accordance with the series of papers
now ended, has lately been made to the Association, at its session held
at Louisville, in May of the present year. The report was accepted, and
the resolutions appended to it[275] were _unanimously_ adopted.
In behalf of the committee, of whom he had the honor to be chairman,
the writer cannot close this portion of his labors without thanking the
physicians of the land, represented as they are by the Association, for
their hearty and noble response to the appeal that has been made them.
He would express, were it possible, the gratitude not of individuals,
but society; for by this act the profession has again been true to “its
mighty and responsible office of shutting the great gates of human death.”