Children do react to mothers' miscarriages. How much more are they going to react to the concept of abortion? And I think the younger the child-within certain limitations-the more frightening and untrusting and the more anxious they become. I challenge anybody who want to test this to do so, to take a group of children to a health museum and show them pregnancy and the development of the unborn child. Often, that in itself creates anxiety in younger children, particularly, if they have genuine unborn children floating in formaldehyde. But then, after you have taken them to the museum and shown them the unborn child's development, tell them a little bit about abortion and see what they feel about it. Then you also may gauge the detrimental effects of not unwantedness but merely the idea of abortion-on-the-basis-of-unwantedness on the mental health of a child already born.

My point is that the entire unwantedness-wantedness status of children is in and of itself detrimental to children because it emphasizes their nonentity status, and they realize their vulnerability. It is this way that unwantedness has adverse effects because we have allowed unwantedness to determine another human being's personhood, our children's personhood, and they know it and it is damaging to their basic trust in their parents and in humanity.

Before I close I want to just go over the four points I made: First: was unwantedness in reference to the child-after-being-born. It is detrimental when adults disrespect a child's humanness and a child's personness. It is only at that times when an adult acts on the fact that a child has no rights, that unwantedness-of-a-child-already born gets out of hand. It is not the unwantedness that is really troubling, but it is the fact that the child has no rights that adults are expected to meet.

Second: I pointed out that unwantedness-of-pregnancy does not necessarily mean unwantedness-of-a-child-already born. It most often does not mean such. Studies are to the contrary and most people will spontaneously do what they think is right for a child. I think they would do it all the more so if children had rights defined by society to help adults know what is expected of them in dealing with a child. for the child's well-being.

Third: I mentioned the universal unwantedness we all have toward our children, and it is truly impossible to want anybody, including any child, all the time. Unwantedness is an attitude which changes and it is obvious that it changes and has always changed in terms of wanting pregnancies. In this sense, it is very clear that unwantedness of a child is generally irrelevant. In essence, unwantedness is abortion rhetoric taken seriously by child care specialists who ought to know better.

Fourth: I have pointed out the effects of the very concept of wantability and abortion on a child and the child's emotional well-being. It is hard to have the basic trust necessary to be a healthy, emotionally stable child if you know that you have to be wanted by somebody in order to exist: What a terribly precarious status, i.e. to have to be "wanted" in order to be.

Those are the four points I want to leave. I would make briefly the following statements. Unwantedness on behalf of children is really abortion advocacy. Unwantedness in reference to abortion is adult

advocacy in the guise of child advocacy. Neither "abortion" nor "wantability" are child advocacy.

I think if we talk about children and wanting a child-oriented society, then the judiciary and legislature have to address themselves to the personness of children. Personness means you are a legal entity in and of yourself. Certainly, a child's personness cannot involve the same rights as a grown, mature person, but they can acquire rights and responsibilities limitedly defined that they can be legal entities in and of themselves. I think this is important to realize, that if you are a person then you have some rights whether you are wanted or not, whether you were desired or not, whether you were healthy or not, whether you are black or white, Catholic, Jewish or what have you. For one's own personal well-being to be dependent upon being wanted by someone else, is to be a nonentity, as the American Indians and th American blacks were in the 19th century, and as the Jews were in the 20th century in Nazi Germany and as millions of children are in what I have come to call "Gulag America." Children need to be persons in and of themselves with their own rights.

In closing, let me make clear that if you want to be an advocate of children's well-being, then you have to address the issue of "personness of children," and I think personness of children must be defined from the moment of conception, because that moment is the universal moment of life for each human being.

All rights must be superimposed upon the right to life. It is in such personness that children's rights will accrue to the child. Once children get reasonable rights, then I think children's mental health will be more insured than by destroying the child through abortion.

To this end, I would like to make part of the presentation the declaration of children's rights and responsibilities for your perusal. By no means do I pretend to have the answer, but I think we have to think along these lines and we have to convey these attitudes to adults.

We often do what we are expected to do, and when you think in terms of women being treated equally and you pass laws to this effect, then we begin to expect ourselves to treat women equally and we do so. When you pass laws legislating the personness of children and how they are expected to be treated, we will begin to do so like

wise.

In addition to this declaration of rights and responsibilities defining the personness of children, which I tentatively proposed-I have copies of some other material which is related one way or another to the abortion issue. Finally, I have to ask the Senator to please think about the constitutional amendment. I think, too, the American people deserve the right to work on this issue, just as we are working on the Equal Rights Amendment issue. It will be years before we can really get the constitutional amendment implemented. I think the Supreme Court has taken this issue away from the American people.

I would hope the Senate and judiciary would give it back to the American people, and let us work to try to answer questions. Senator BAYH. Thank you, Doctor.

Which of the two amendments do you prefer to support, the Helms amendment or the Buckley amendment?

Dr. NIGRO. Well, I am going to have to defer to the people who know best what the proper wording is. I really am not the one to get involved in the legal, in the semantic gymnastics of that. I think our posture has to be that: Life is not when one's life begins, but life has begun and society has to respect it. We have to convey a respect for life. Our society will be better off if we do so. Whichever amendment people more versed in constitutional law would feel we would be better off with, I would certainly go along with.

The moment of conception just strikes me as being the proper description of this, but then again, I do not know. I think the American people would like to iron this out as we are the ERA. Give us the constitutional amendment. It will be years. Now, no one is going to stop abortions tomorrow. There will be time for the other side to work on alternatives, to work on doing something for the circumstances that surrond them, the circumstances that are so bad that a child cannot be allowed to exist.

We have to address ourselves to improving society, to improving our society. There will be time to work on the alternatives. We know where they stand. They are doing abortions right and left and they will continue to do them even if you give us that amendment. We have a lot of work to do, just like the ERA.

Senator BAYH. I understand you have to catch a plane, so I will let you go. I am sorry for the interruption. It may be a bad confession but I am not running the show here, and even if I were, I am not sure that I could have done better.

We appreciate your patience as well as the contribution you have made for the record.

I must say I share your deep concern for the individual, to try to protect the rights of children. Some of the horror stories and not-so-horrible stories of abuse to children is inexcusable, and I want to read your proposal there, as far as a bill of rights of children. Dr. NIGRO. I hope you will also take a look at this scientific critique of abortion's medical procedure.

Senator BAYH. Yes; we will.

Dr. NIGRO. Thank you, sir.

Senator BAYH. Thank you, Doctor.

a scientific critique of abortion

as a medical procedure

By SAMUEL A. NIGRO, M.D.

Everyone is entitled to the philosophical orientation of his choice, but those

who advocate a technique as a medical procedure should provide a rationale documented by scientific evidence that goes beyond clinical impressions or philosophical preferences. In the absence of such scientific evidence, the technique as a medical procedure must be regarded as unethical, in accordance with Sections 2 and 3 of the Principles of Medical Ethics of the American Medical Association. That is, all methods of healing should be founded on a scientific basis with clinical investigation limited to a systematic, competently designed research program producing valid and significant data.

To argue that abortion, or any technique for that matter, is a person's right begs the scientific question since this is really no more than an assertion of one's philosophy or emotional bent. Any medical technique is a right if it is indicated in accordance with scientifically sound medicine. If abortion is to be defended as a medical procedure, its value must be scientifically demonstrated. Most articles opposing abortion as a medical procedure are in fact philosophical discussions of the nature of the fetus and the time when life begins. Most articles supporting abortion as a medical procedure are pseudoscientific disquisitions about indications, benefits and absence of complications, pseudoscientific chiefly because scientific criticism is not applied. This present article opposes abortion by applying scientific criticism to many studies on which the abortion movement relies. This will not be a complete review of the abortion literature, but the criticisms offered may be universally applicable. Philosophical issues will be avoided, but they cannot be ignored completely because they are the reason for the emotional skew of abortion studies.

THE EMOTIONAL SKEW

This is evident in two ways: the need to call abortion "therapeutic" and the need to deny complications.

Bartemeier has been very direct about the word therapeutic:

"... the term 'therapeutic abortion' is a misnomer; it appears to have been

PSYCHIATRIC ANNALS/2:9 SEPTEMBER 1972

ABORTION CRITIQUE

devised to circumvent the laws of the states. No carefully conducted clinical investigations have demonstrated the therapeutic value of these surgically induced procedures."

Even abortion proponents will occasionally confirm this:11

"This phrase [therapeutic abortion] compounds the ethical confusion and intellectual dishonesty which are characteristic of popular and professional attitudes and notions about abortion. Obviously abortion is not a treatment for anything unless pregnancy is considered a disease, and if it were that, it is the only disease which is 100 per cent curable by abortion or delivery at term."

Therapeutic efficacy for abortion was claimed by Ford et al.12 in a study with such elementary deficiencies that the competence of the editorial board of JAMA, ultimately responsible for its publication, was in question before the judicial council of the American Medical Association.

THE LIST OF COMPLICATIONS

This tendency to claim therapeutic value may indicate that unconscious mental processes or conscious philosophical issues are influencing those studying abortion to justify it by abusing the scientific method. In addition, these same mental processes that find therapeutic value may also be influencing abortion proponents to underestimate the complications. Nevertheless, the list of known complications has grown quite long. The socialist countries of Central and Eastern Europe, which permit abortion, stress the necessity of warning the Proponents may pregnant woman about the grave risks of abortion, and in some instances underestimate anti-abortion efforts have even required government sponsorship.7

Even in Western countries, the evidence is growing concerning the adverse medical and surgical consequences of induced abortions. Stallworthy, Moolgaoker and Walsh detail the complications of over 1,000 abortions in a teaching hospital in England. They state clearly that abortion as a surgical procedure is neither simple nor safe even when performed in the early weeks.

In summary, it is important to remember that an underlying emotional skew exists among those studying abortion. Because most studies are done by abortion proponents, this emotional skew causes the studies on the therapeutic value to be highly suspect. Thus, good scientific methodology is needed to offset the emotional skew that makes claims of therapeutic value where none exists and understates morbidity, conclusions which are contradicted by counter-abortion efforts and trends in the more experienced countries.

ABORTION STUDIES AND

SCIENTIFIC METHODOLOGY

As of this writing, two generalizations are justified: first, abortion studies are generally deficient in research design, sampling techniques and methods of evaluation. Second, abortion data is inadequate for meaningful statistical analysis both in terms of efficacy and adverse consequences. Simon and Senturia23 described these deficiencies in the 28 major abortion studies conducted prior to 1965, all of which were found repeatedly to suffer from situational research problems that rendered inconclusive the data about the effects of induced abortions.

Little has changed. One recent example is a study by Meyerowitz, Satloff

continued

complications