It's been a long week ...

In some respects, I don't feel right posting pictures and stories when 240 miles away from where I sit 33 students and professors will no longer have that same opportunity ... the chance to share memories with loved ones, get an education, travel, or fulfill dreams. The horror of Virginia Tech has stopped many people in their tracks the world round these past few days. Here in Washington, many folks are talking of the DC-area sniper shootings of a few years ago where men and women were shot as randomly as they were last Monday walking in to stores or pumping gas. And even closer to home, George Washington President Stephen Trachtenberg wrote an opinion piece in the Washington Post describing the challenge universities have in supporting students with mental illness. Just last year, GW dismissed a student who sought proactive counseling following the suicide of one of his friends. The student was not allowed to attend classes or set foot on campus. As a future health care provider, those actions struck a raw nerve. Last week, however, makes me pause --- what is the role of a university in caring for students who really need help? Do you expel a student at the first sign of any mental distress or offer them multiple sessions of therapy? Are we as a society ready to make decisions about when individuals are a threat to themselves and others and need to be committed, either voluntarily or involuntarily? I'm not sure what the balance is. If anything positive is to come out of last week's senselessness, let it be the recognition of mental health parity on par with physical illness. Mental health disorders are real, are crippling, and affect not only the patient but the lives of many others ... events of last week reveal that one just never knows ... best to end each day with no stone left unturned.

Last Wednesday was also a particularly tough day, although it wasn't as readily visible to the world as the Virginia Tech tragedies. The United States Supreme Court ruled 5 - 4 to uphold the federal Partial Birth Abortion Ban Act. I have been following this case and its predecessor versions (Just seven years ago, the Supreme Court struck down a Nebraska statute as unconstitutional on nearly the very same grounds.) this semester in class and knew the decision was going to be handed down this term. Originally signed into law in 2003, this act is the FIRST federal law that mandates the necessity (or not) of a medical procedure. Pro-life or pro-choice debates aside, think of the ramifications of this --- Congress as a legislative body gathered 'evidence' that 'proved' that a particular type of procedure is NEVER medically necessary, never necessary to save the health of a pregnant woman, and has proscribed it in ALL situations. You have members of Congress without medical training determining necessity of interventions from Capitol Hill. Is it disturbing to anyone that a medical procedure can be declared as never being necessary by lawmakers? Think of all the situations where it may be needed; it's hard to declare these types of things preemptively.

The term 'partial birth' itself is not a medical term but in general refers to later term abortions and specifically the intact D&E procedure; this particular procedure has often been declared the safest among several other options a woman later in pregnancy would face when needing to or choosing to undergo an abortion at this stage. Later term abortions comprise less than 1% of all abortions performed annually and are often done because the mother's health and/or life is at grave risk, or it is discovered that the fetus has severe developmental challenges. In any case, choosing to abort is a very deeply personal decision of the parent(s) based on several factors. In ruling as it did last week, the Supreme Court, however, claimed that the fact that the act did not include an exception for the health of the mother, as well as the life of the mother, was not unconstitutional because it was determined never necessary by Congress for the mother's health (The Congressional hearings carefully chose their witnesses to present views they wanted to hear while they were drafting this bill --- of the six physicians testifying, none had ever performed the procedure they proscribed (the intact D&E), several did not perform abortion services at all, and one was not even an obstetrician.). The act was also allowed to stand because it only proscribed one specific type of procedure; other, riskier later term abortions are still permissible but may more adversely affect the woman, her health, and her future reproductive capabilities and choices. This act is also the first that relates specifically to a type of abortion procedure, rather the right to abortion itself. Justice Ruth Bader Ginsberg in her dissent wrote, "In candor, the Act, and the Court's defense of it, cannot be understood as anything other than an effort to chip away at a right declared again and again by this Court -- and with increasing comprehension of its centrality to women's lives." Last Wednesday particularly concerns me on grounds that it narrows a woman's access, options, and ability to exercise control over her own body. As long as pregnancy remains a risky experience for a subset of women, I believe that abortion - particularly the best situated procedure considering the woman's health and unique situation - should remain safe, legal, and available.