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Witnesses to Alaska lawmakers: Abortions rarely medically necessary

Laying the groundwork for an attempt to limit Medicaid-funded abortions in Alaska, legislators on Wednesday heard from expert witnesses challenging the "medical necessity" of nearly all abortions.

The Alaska Supreme Court has held that Alaska women have a constitutional right to abortions when they are medically necessary, as well as when they’re the result of rape or incest.

Abortion opponent Sen. John Coghill, R-North Pole, is seeking to have that right construed as narrowly as possible by writing into law a definition of "medically necessary" -- something the justices didn't do. Coghill said he thinks elective abortions that are not medically necessary take place and are being called "medically necessary" to qualify for Medicaid funding.

'Question is who pays'

Coghill said his legislation, Senate Bill 49, would clarify the issue.  It is not, he asserted, an attack on the right to an abortion. "We are not messing around with the constitutional issue," he said. "The question is who pays, not whether they get an abortion," he said.

Backing up Coghill's effort was testimony from doctors and researchers who said abortions were rarely or never medically necessary.

Sen. Bill Wielechowski, D-Anchorage, challenged Coghill's contention and the credibility of his witnesses, winning from some an admission that their views were outside the mainstream of their professions. "Who do you think is in a better position to decide whether a medical procedure is medically necessary -- a woman's physician or a bunch of politicians?" he asked one witness.

Leading off was professor and researcher Priscilla Coleman of Bowling Green State University, who said one claim often used to justify abortions as medically necessary was never valid.

"Abortion is never justified based on mental health grounds and abortion should not be paid for by the state of Alaska" on that basis, she said.

Wielechowski questioned Coleman about a journal article saying that one of her published papers on the topic has been "decisively debunked." She disputed that, saying it remained valid despite a fact needing correction.

Coleman said the allegations followed her assertion there was bias in the medical field. "When you are providing information that's not politically correct, you are often attacked and criticized," she said, adding that major professional organizations in the field are "biased, politically driven efforts."

What's medically necessary?

Dr. John Thorp of North Carolina said that even when the life of the mother is in danger, there is almost never a medical necessity justifying an abortion.

"Termination of a pregnancy, short of the pregnancy itself having massive hemorrhaging or bleeding, is always an elective procedure," he said.

Wielechowski challenged what Thorp considered medically necessary, while Coghill and committee members Sens. Fred Dyson, R-Anchorage, and Donny Olson, D-Golovin, joining in to support Thorp and the other invited witnesses. The committee's final member, Sen. Lesil McGuire, R-Anchorage, did not weigh in during the debate.

Wielechowski struggled to get Thorp to describe controversial positions he'd taken in the past. Finally, Thorp asked Wielechowski if he was “a plaintiff's attorney in another life?"

When not in the Legislature, Wielechowski is, in fact, an attorney, working for the International Brotherhood of Electrical Workers.

Coghill's third witness was Dr. Susan Rutherford, who specializes in maternal-fetal medicine at the Evergreen Health Center in Kirkland, Wash. She said that even though doctors in Alaska have said the Medicaid-funded abortions in Alaska were medically necessary, she doubted they actually were.

"If you were to go back and investigate cases, you would wind up with people losing their licenses and no abortion providers in the state of Alaska," she said.

Rutherford also acknowledged that her views weren't always in line with medical literature or organizations, but she, too, blamed others’ bias.

Rutherford said that even though the American College of Ob-Gyns said there isn't a link between abortion and breast cancer, she thinks there may well be.

"I have to say I just think they're being politically correct on that," she said.

Coghill said he expects to hear from others, including Planned Parenthood and the American Civil Liberties Union-Alaska, on the issue next week.

Contact Pat Forgey at pat(at)alaskadispatch.com