Being Pro-Choice

I’m pro-choice. If a woman wants to have an abortion, I believe it is her choice to do so and no one ought to stand in her way. I oppose abortion laws. Similarly, I believe that if I want to take an antibiotic, it is my choice to do so and no one ought to stand in my way. I oppose prescription laws. And also similarly, if someone wants to inject themselves (or swallow) Ivermectin, it is their choice and no one ought to stand in their way. In each of these cases—and all others—I believe information should be provided so that the individual in question can make an educated decision about the action in question, but I believe that they should be allowed to act on their own decision.

I said that in the cases described *and all others* they should be allowed to act on their decision. That also applies, then, to doctors who do not wish to perform abortions and doctors who do not wish to *administer a patient ivermectin (or any other medicine). They ought to be able to act on their choices just as the patients in question ought to be able to. Yet, at least one judge in Ohio has thought it appropriate to require hospitals (admittedly, not specific doctors) to administer a medication they oppose using for a patient (see this). And, as I assume most readers, know, Texas now has a law in place that makes it much harder for doctors to perform abortions on patients who want it. To be clear: even if both patient and doctor agree that the abortion is the best course of action and are willing participants, the doctor is likely to face legal repercussions if the woman is more than 6 weeks pregnant and any private citizen decides to sue. (See this and this.)

What we have in both these cases is a situation where the freedom of some to live in a world where the actions of others are limited—e.g., to not give a patient a drug they oppose using or to help a woman have an abortion—is thought to outweigh the freedom of those others to live their lives as they see fit. The freedom—really, its just the preferences—legally outweigh those of others. To think this is a deep moral debate strikes me as misguided. Abortion is a rightly contentious issue and, in my view, its moral permissibility can only really be resolved by determining whether or not the fetus has a moral status on par with the mother’s. The people behind the Texas law—and those that would sue medical professionals because of it—do not seem interested in trying to discuss that question at all. They seem simply to want to impose their views on others. Those wanting people to be able to use Ivermectin in Butler County, Ohio, similarly seem simply to want to impose their view—or that of the patient—on medical professionals. In both sorts of cases, we have a pernicious form of moralism at play. (See this and this.)

I assume there will always be doctors unwilling to perform abortions. They should be free to act on their preferences. I assume—and hope—there will also always be doctors willing to perform abortions. They, too, should be able to act on their choices (when they have a patient that so chooses). A patient and a doctor coming to an informed agreement should not be interfered with. The same holds for a doctor willing to *administer a patient Ivermectin when the patient wants such. And a doctor unwilling to administer it. For that matter, the same is true (or so I believe) for a doctor and patient wishing to use a Mercitron on a patient that wants it. (See this). Unfortunately, this is not well accepted.

* 9/5, replaced “inject” or “injection,” fixing as needed to accommodate.

Regressive Regulations and structural racism

The CDC released data last month showing how women fled NYC at the height of the pandemic to give birth, largely as a reaction to fear of overwhelmed hospitals as well as restrictive birthing policies.

What’s interesting about the data, from my perspective, is how clearly it demonstrates that it’s those with wealth who can avoid the limitations regulations create. New York State has regulated birth centers out of existence, largely through the burdensome and outdated Certificate of Need (CON) process, resulting in fewer options for precisely those people who can’t buy themselves out of these limitations.

Predictably, from the CDC data, white women were most likely to successfully escape the city. Black and Hispanic women were left behind, likely as a result of less flexible employment and fewer financial resources overall. Meanwhile, at the same time women downstate were desperate to find safe places to give birth during a pandemic, New York was prosecuting midwives who served an upstate maternity desert of low-income Mennonite women. The absurdity of the entire situation should be obvious, but in reality it demonstrates one of the primary ways in which regulations have regressive effects.

Certified professional midwives, licensed in 35 other states, are illegal in New York. As a group they tend to serve underserved communities, including low-income rural communities and communities of color. So when low-income New Yorkers looked around for out-of-hospital birthing options during a global pandemic it turns out they couldn’t find any, not because of a market failure, but because of simple and obvious government failure.

There’s a broader lesson here for classical liberals. Most people acknowledge that classical liberalism has a diversity problem, but it’s been hard to know what to do about it. I think one clear way libertarians and classical liberals can appeal more strongly to diverse populations, including women and people of color, is by emphasizing the way government regulations overwhelmingly harm the most vulnerable among us. While there’s been a lot of work done in this area in terms of criminal justice reform, the drug war, and immigration, women’s issues haven’t yet really gotten as much attention. And regulation in particular is still often discussed as an efficiency issue rather than a justice issue. Yet government-imposed barriers place real and disparate burdens on women and communities of color, creating serious impediments to accessing diverse providers on the one hand and wealth building among would-be entrepreneurs on the other.