one to support her. She is alone. She has been socially aborted by those close to her before she sees me. She is afraid and bitter. She sees herself going through this pregnancy by herself-and she shouldn't-no woman should have to go through a pregnancy alone. So I reach out to her I tell her that she need not be alone and I see to it that, to the best of my ability, she isn't.

But, I am horrified to think of how many young women are irreparably hurt by this procedure in this country each year. It blows my mind to think of all the healthy young children-with their lives ahead of them-that we are destroying each year in the United States. I grow frightened by the utilitarian motives which underlie the new and a violently destructive medical ethic which is sweeping our nation. Now, we have euthanasia to look forward to. At least nine states have entered legislation to legalize some form of euthanasia for the socially undesirable.

This Subcommittee has a powerful responsibility before it. You must sift through all the testimony, all the rhetoric, all the emotion and all the lies before you can reach some kind of decision. But in your deliberations, remember this one thing-you cannot have creative social change without a fundamental respect for human life. If we are to improve the quality of life, then let's improve it for everyone. Let us not make arbitrary deletions from our human ranks to make a quality life for only some.

We are in the midst of a value-crisis, more sever than any other crisis our nation has known. Much of this crisis revolves around our growing lack of respect for each other. Our nation will not last if we persist in these attitudes. You, in your deliberations, must come to the realization that the right to live, the right to one's own existence is the substance upon which all other human rights are based. How can black people use public toilets if there are no black people? How can migrant workers hve the right to a decent wage if there are no migrant workers? How can an erson pursue liberty and happiness if he has no life with which to pursue it?

I pray that you will see the denigration of life which exists today in our nation. I pray that you will have the courage to stand up to the destruction which engulfs us. And I pray that you will have the courage to be unpopular and both the courage and the wisdom to produce a total Human Life Amendment to the U.S. Constitution with recommendation for passage. While it is not the final answer and more beyond that would have to be done, it would indeed be, a giant step for mankind.

Thank you very much.

STATEMENT OF DR. THOMAS W. HILGERS, F.A.C.O.C., CHIEF RESIDENT IN OB/GYN, MEDICAL COLLEGE OF OHIO AT TOLEDO, OHIO

Dr. HILGERS. Mr. Chairman, my name is Dr. Thomas W. Hilgers, M.D., and I am deeply privileged to have the opportunity to come before you today to testify in support of the passage by Congress of a total human life amendment to the United States Constitution. The need for such an amendment has been provoked by the United States Supreme Court decision of January 22, 1973, when all legal protection of our unborn brothers and sisters was removed. I would like to impress upon you the gravity of this decision and the need for it. to be rectified.

Let me begin by stating categorically as others on the panel before me, that each individual human life begins at fertilization and is a progressive continuum from that point on, whether intra- or extrauterine until natural death. The scientific basis for this statement has been laid down by countless numbers of medical researchers who have dedicated their lives to the investigation and study of early human life. Its documentation can be found in any number of textbooks on this subject written by these experts, and you might look at the book which I submitted to the subcommittee, Induced Abortion: A Docu

mented Report, in which a number of these textbooks and the phrases that they are using in this description are quoted.

Consensus for this viewpoint can be found in the Declaration of Geneva which was adopted by the World Medical Association, to which the United States is a founding member, and this occurred in September 1948. This declaration, which states the world medical profession's respect for human life from the moment of conception came after a lengthy discussion of war crimes based on information from the United Nations War Crimes Commission. It was followed in 1949 by the International Code of Medical Ethics which re-iterated the importance of this respect. It, too, was drawn up by the World Medical Association. This was all re-affirmed by the World Medical Association in 1970 by what has been known as the Declaration of Oslo. In addition, such pro-abortion leaders as the California Medical Association and the late Dr. Alan Guttmacher, former president of Planned Parenthood-World Population, have clearly written that life begins at fertilization.

Let there be no mistake about this, the evidence is as clear as anything in modern medicine. In fact, for any physician to imply to a State or Federal legislative body, to any of our courts of law, or to a woman pregnant and distressed that there is anything but a human life present within the womb of a pregnant woman is nothing but blatant and calculated medical malpractice.

I have been asked by your staff to address the question How have liberalized abortion laws affected my practice of medicine? I will, in fact, address myself to this question. But first, I would like to point out that there is nothing liberal about legal abortion. It is not a new idea, but an old mistake. It is a violent, destructive, and dehumanizing medical procedure. It is, in fact, one of the most nonprogressive and unconstructive acts a society can impose upon itself. I am presently the chief resident in obstetrics and gynecology at the Medical College of Ohio at Toledo. I came to this position only after having been forced to resign from my previous residency program in obstetrics and gynecology at the Mayo Clinic. I had satisfactorily completed 3 years of a 31⁄2 year residency program when I was asked to finish my last 6 months of training in a hospital that did abortions. The denial of my conscentious objection to this course of action left me with no other recourse but to resign my position and leave one of the most prestigious medical institutions in the United States and the world. Because of my belief in the value of life, I had to delay my subsequent residency program by 8 months.

This kind of subtle prejudice is being equally applied to other young physicians around the country who share similar deeply held beliefs, although many of them have been too intimidated by their institutions to face up to their own respective institutions. However, I know personally of physicians who have lost their positions because of their unwillingness to condone the destruction of unborn human life. What greater denial of civil rights can there be?

Senator BAYH. Doctor, you say you left Mayo because you were asked to finish a last 6 months of training in a hospital that did abortions.

Were they going to ask you to participate in performing these abortions?

Dr. HILGERS. No, sir, I was assured I would not have to either participate or assist in the performance of an abortion.

Senator BAYH. Or treat patients that had been subject to that kind of operation.

Dr. HILGERS. That is right.

However, it was my feeling, having been an obstetrician for some time in residency, that it was totally in antithesis to what I firmly believe as a physician and that I could not perform or work in an institution one of whose primary goals was the direct destruction of human life.

Senator BAYH. I may be jumping ahead in your testimony, but to maintain a continuity, that also would apply after you had finished your residency, to your practice in the hospital that performed abortions?

Dr. HILGERS. Yes, sir.

Senator BAYH. Then what you are saying is that if some doctors in the hospital want to perform an abortion, that you would refuse to practice in that hospital?

Dr. HILGERS. I will set up my practice only in a hospital that has a policy against the performance of abortion.

Senator BAYH. Even if you are not asked to perform an abortion? Dr. HILGERS. That is right.

Senator BAYH. Have you ever had an experience where a hospital has required a doctor to perform an abortion?

Dr. HILGERS. Not overtly I have not.

Senator BAYH. Please go ahead.

Dr. HILGERS. Perhaps to clarify this somewhat for you, Senator, I hold similar views in regards to the military and my conscientious objection to being a part of an institution one of whose primary functions or methods is the violent destruction of human life.

Senator BAYH. Would you expand on that for me, please?

Dr. HILGERS. I am a conscientious objector to being a participant in a military institution who is involved in the destruction of human life.

Senator BAYH. So you would not serve as an Army doctor?

Dr. HILGERS. No, sir.

And I might say that in terms of the Mayo Clinic situation, there were really two alternatives open to me. There are two hospitals in Rochester, one a Catholic hospital that has a policy against performing abortions, one a Methodist hospital which does abortions. I could have theoretically finished my residency in either institution, but the chairman of my department and the powers or the authority of the academic community there refused my opportunity to finish in a hospital that did not do abortions.

Senator BAYH. Does Mayo refer commonly to both hospitals?
Dr. HILGERS. Yes, sir.

I will continue.

Throughout the years of my postgraduate medical education, I have personally witnessed the impact of legal abortion in a number of different ways. During my internship in Rochester, N.Y., I saw the implementation of New York State's abortion-on-demand, upto-24-weeks law. During my tenure at the Mayo Clinic, I witnessed both pre- and post-Supreme Court legal abortion. While I was at

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Mayo, I spent 6 months at Cook County Hospital in Chicago, which had its own unique situations. And, since moving to Toledo, I have had yet another exposure to legal abortion, this the result of the Supreme Court decision.

I would like to relate to you a number of personal experiences I have had in all these four locations. I will do this without specific reference to the actual institutions where I had these experiences, unless specifically and otherwise indicated, so that my patients may be protected.

Senator BAYH. May I ask you, just to help us have a better understanding of your attitude, to explain the difference between the Mayo situation and the Cook County situation, where you said for 6 months you were associated with a hospital that did have abortion experience. What was the difference as far as your own philosophical and

moral outlooks?

Dr. HILGERS. When I was at Cook County Hospital, Mr. Chairman, the Supreme Court decision had not taken effect. The Cook County Hospital, which is in Chicago, was under the jurisdiction of the Illinois State statute. However, there was a period of time

Senator BAYH. Were abortions performed under the Supreme Court decision any different than those performed under the Illinois State statute?

Dr. HILGERS. Sir, I have always been in favor of State statutes which allow abortions to save the life of the mother. I feel that in a pluralistic society that this is the best solution legally. It is not the only solution, but from a legal standpoint, it is the best solution to the problem.

Senator BAYH. Well, did the Illinois statute at that time permit other kinds of abortion?

Dr. HILGERS. No, sir.

Senator BAYH. Well, it seems to me that the experience you had in Cook County, as far as the abortion was concerned, was different than that at Mayo's.

Dr. HILGERS. Sir, this is a time-yes; it is somewhat different in the sense that the clientele is different. The Mayo Clinic is by and large a white, upper-middle-class institution, whereas Cook County Hospital is a primarily indigent hospital located in one of the largest urban ghettos in the United States. So in that sense

Senator BAYH. Were there different kinds of abortion based on different premises, different medical conditions at Mayo Clinic and at Cook County Hospital?

Dr. HILGERS. What I am trying to relate to you is that my experiences in abortion, both pre- and post-Supreme Court decision, and when I was at Mayo and when I was at Cook County, we witnessed women who were leaving those institutions, going to New York or other places to have abortions, and then coming back, either with complications and problems or, perhaps, my seeing them even before they went. All of these factors have influenced or have had an impact on my practice of medicine, and that is why I would like to relate to you these personal experiences of mine, because, as it was my understanding, this is what we were supposed to or at least I was supposed to address this morning.

Senator BAYH. Yes; I am just trying to nail down the very personal reasons for your views. I appreciate your sharing them with us as none of us on this Subcommittee have experienced similar ones. I find your experience invaluable, and I certainly do not want to ask you to say something that you are not prepared to say.

But was your experience at Mayo Clinic where you were asked to serve in a hospital and perform abortions, after the Supreme Court decision?

Dr. HILGERS. Yes, sir.

Senator BAYH. So abortions were being performed there that were not based on saving the life of the mother, which was the experience that you had in Cook County?

Dr. HILGERS. Yes, sir.

Senator BAYH. All right.

Thank you.

Dr. HILGERS. Part of my testimony, Mr. Chairman, in regard to Cook County Hospital-because I do not make a specific reference to it later-regards a 22-week period of time where a Federal district court ruled the Illinois State law unconstitutional. This was then stayed by Supreme Court Justice Thurgood Marshall, and it reverted back to the original Illinois statute. I have a personal experience with what happened during that 2-week period of time at Cook County, which I would like to relate to you at a later point.

In any regard, all the situations I would like to present to you, I think you will find have influenced my practice of medicine in one way or another.

First of all, I have had one experience with dealing with a nurse who was in the midst of a severe anxiety reaction because she had just scrubbed on a hysterotomy-which is a small Caesarean section, if you will-abortion where the baby had been "aborted" fully alive. She had expressed to her supervisor prior to this time that she would assist at early abortions but would not wish to assist at late abortions. However, one day there was no other nurse around to assist the physician except her, and she was asked to assist at a late abortion. The physician was to perform a hysterotomy abortion on a woman he thought was 16 weeks pregnant. However, he had miscalculated, and he first detected that she was 20 weeks pregnant when the baby was removed from the uterus. When asked by this nurse if he would send the child to the nursery for care-and in this hospital there was a regional intensive care nursery for premature infants-the physician stated to her that, since this baby was only a pathology specimen, it would be sent to the pathology laboratories. This caused the assisting nurse a great deal of despair which took her several days to come out of. I had a relationship with her in discussing many of these problems and conflicts which she had in her mind.

Similar reports of these kinds of staff reactions are now being reported in a number of articles in the medical literature. In 1 year alone in New York State, over 1,800 of these so-called living abortions were born and left to die.

A number of my patients have indicated to me that abortion is now OK because it is now legal. These same patients are very ignorant on the facts of biological development and behavior of the unborn