I Know This Much Is True: Abortion Is A Medical Intervention to Which Women Need Access

@RHRealityCheck

Savita Halappanavar’s death is personal to me.

No one knows for sure yet what happened to Savita Halappanavar. We know that she wanted to be pregnant, that she miscarried, and that the care she received did not save her life. It is important to push for medical accountability in such cases, and to demand a full investigation into whether protocols existed and were followed, and if the patient was subject to discriminatory harassment and remarks, as has been alleged. It is positive that an expert has been appointed to carry out such an investigation.

But we do not have to wait for the investigation to highlight what we already know about abortion in Ireland. For me, this knowledge is weighty and painful.

In 2009, I went to Ireland with a colleague to talk with women, medical providers, and government officials about the impact of Ireland’s restrictive abortion laws on women’s health and lives. No government official agreed to receive us despite multiple requests for meetings. This refusal was the backdrop of the desperation and sadness that was palpable in the voices and testimonies of all the women, doctors, social workers, and community educators we spoke to.

And here is what I learned.

I learned that the Irish government has yet to regulate access to life-saving abortions in Ireland, despite the fact that such medical interventions have been legal in that country for two decades. I learned that the legality of abortion where the pregnant women’s life is in danger was upheld by the Irish Supreme Court in 1992 and supported by a referendum that same year. So while abortion, generally, is criminalized in Ireland, women whose lives are threatened by their pregnancy are constitutionally entitled to have an abortion in Ireland.

And in 2010, I saw that the European Court on Human Rights berated the Irish government for not regulating access to life-saving abortion clearly, creating insecurity for medical providers and patients alike. In 2011 the United Nations Human Rights Council issued various recommendations to the same effect.

My research taught me that many medical providers in Ireland want clarity on when they can intervene and when they cannot. Some asked me how the government proposes they treat a woman who may or may not die as a result of her pregnancy. Should they tell her to come back when she was sure she was going to die? How would she know? And what if it was too late? Who would be responsible for such preventable deaths? In fact, during our research in 2009, and despite the fact that abortion in life-threatening cases had been legal for almost two decades, we were not able to find one single medical provider who had ever heard of a life-saving abortion taking place in Ireland.  

But more than anything, I learned about the pain and fear pregnant women face when something is clearly wrong with their pregnancy and they know they can’t get care near home. I know this because they told me. Some told me with their heads bowed, others sitting straight up. Some told me calmly, others cried. They all spoke with quiet, sad voices about a society that does not see their suffering and a government that does not seem to care.

Savita Halappanavar’s death, however it happened and whomever (if anyone) is responsible for delivering substandard care, should serve as an opportunity for a deeper and more respectful conversation on this topic in Ireland.

Abortion is a medical intervention to which women need access, some to save their lives. This is not an opinion; it is a fact, evidenced by the thousands of women who travel from Ireland to the United Kingdom or mainland Europe to terminate pregnancies every year.

And knowing this, how can we not act?

In America, Our Inalienable Right to Vote is in Jeopardy

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The right to vote is an illusion for me: I have been allowed to vote only once in my more than two decades as an emancipated adult. But while I have never been completely at peace with this disenfranchisement, it is the consequence of my personal choice to migrate early and often: my home country, Denmark, extends only limited democratic rights for citizens living abroad.

It is, however, not a choice for the millions of U.S. citizens who will not be allowed to vote in the upcoming presidential election, either because they have been convicted of a felony, or because they are excluded from voting through voting roll purges, strict voter ID laws, or existing or new restrictions on when and how eligible citizens are allowed to vote.

These restrictions on who is allowed to vote and how are based on two erroneous assumptions.

The first and most easily dismissed assumption is that voter fraud is rampant in the United States, requiring stricter regulations on new voter registration, voter ID requirements, and limits on voting hours. This notion is so obviously false that it has been debunked numerous times by independent watchdog organizations and in the mainstream media. Latest figures show that about one in 16,000 registered voters might have a problem, though some issues are neither intentional nor malicious but rather the result of people moving, changing their signature, or misspelling the name of the city in which they live.

Unfortunately, widespread voter fraud is a notion that has traction with those who already believe the United States consists of the deserving and the undeserving. In this way, some commentators conflate welfare recipients, urban residents, and individuals likely to engage in voter fraud. More damningly, non-governmental groups ostensibly working to verify voter registers across the country have seemingly been targeting counties with predominantly minority populations, or low-income communities, using methods that have been discredited by government agencies, such as the Wisconsin Government Accountability Board.  Just this weekend, the New York Times reported that some are so focused on proving fraud that they fabricate the proof. As a result, hundreds of legitimate voters have been purged from registers.

These efforts are usually partisan. The ongoing case in Ohio, in which the state government is seeking to strike down early voting in selected districts and for selected populations, has the possibility of preventing more registered Democrats than Republicans from accessing polls on non-work days.

The second assumption behind the exclusion of voters in the United States is that voting is a privilege and not a human right. International human rights treaties define the equal right and opportunity to vote and to be elected in genuine periodic elections as key to democracy, peace, and human dignity. And while the United States is historically reluctant to sign on to international human rights obligations, the U.S. Senate accepted the ongoing obligation to implement the right to vote as defined in international law in 1992.

To be sure, some will say that the millions of convicted felons who are excluded from voting for life have brought it upon themselves and do not deserve to participate in democracy. No amount of data showing the disproportionate (and perhaps intentional) impact of this policy on communities of color will convince this group that those convicted of crimes should not be excluded from voting. The notion that voting as a human right means there can be no distinction between the deserving and the undeserving will also not have any impact: people who believe that those convicted of felonies should lose all rights for life do not believe in human rights at all.

So far, politicians have assumed they have support for voter ID laws because some three-quarters of the U.S. population poll in favor of these laws. However, the same polls show an almost equal concern among the population that legitimate voters will be excluded from the polls in November. The difference between these two concerns is that the latter is real and the former is largely fabricated, as is the worry that those convicted of felonies are undeserving of the right to vote.

More to the point, ensuring the right to vote should not be based on polling data. The U.S. government—including both the executive and the legislative branches—has the obligation to ensure that the right to vote is more than an illusion for all U.S. citizens, regardless of their ethnicity, home, or history of conflict with the law.

Who is a "Criminal?" Exclusion of Vulnerable Groups from International AIDS Conference Nothing to Celebrate

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As the International AIDS Conference ended in Washington D.C. last week, rumor has it that the lead organizer invited participants to celebrate the fact that “criminals” had been kept out of the conference. This with reference to the fact that sex workers and those convicted for drug crimes were prevented by current law from obtaining visas for the gathering.

Setting aside for a moment the insanity of excluding the voices of two groups very much affected by the HIV epidemic in general and by misdirected prevention policies in particular, and regardless of whether the rumors are true, we can use this opportunity to reflect on the definition, use, and potentially manipulative power of criminal laws and policies.

For starters, our concept of what is criminal is relative and fluid at best. When I did research on access to abortion for rape victims in Mexico in 2006 and 2007, I was shocked to learn that child victims of incest were considered criminals in many jurisdictions. Meanwhile, rapists could escape the label by marrying their victim, a relatively common provision in several other countries too, including Cameroon and Brazil. This notion of incest victims as criminals and rapists as... not criminals, illustrates the fluidity of the concept.

Sex workers too are not always breaking the law. In some jurisdictions, such as Canada until very recently, sex workers can avoid criminal sanctions by doing only out-calls or by working alone—conditions that tend to render their work more dangerous. In other jurisdictions, such as for example Nevada and New Zealand, sex work is generally legal, subject to regulation.

Punitive measures attached to drug use also depend on the jurisdiction, down to quite substantial differences on what constitutes an illegal substance in the first place. Considering the uncontested and severe health consequences of tobacco and alcohol overuse, it is amazing that these drugs are in legal circulation in the United States while other drugs with equal or lesser negative health implications are not. Moreover, there is now an overwhelming consensus that drug addiction is an illness rather than a malicious choice, and that treating it as an illness renders better (and cheaper) results than treating it as a crime.

But even if we believe existing criminal provisions in whichever jurisdiction we live in are just, the use of the criminal law to target specific populations for punishment should cause pause.

In the United States, Michelle Alexander has documented the highly selective application of the criminal law, in particular as it relates to drug-related infractions. For example, while whites and blacks use drugs at similar rates (and whites are slightly more likely to deal illegal drugs), blacks are overwhelmingly more likely to be targeted for arrest, prosecution, and punishment. Likewise, ambiguous criminal law provisions on sex work in Louisiana up until very recently allowed the police to apply the provisions with the most severe punishments to trans sex workers of color.

Such police discretion in the use of criminal law—even if one agrees with the provisions as they stand—converts the penal code into a very effective tool for repression and discrimination.

In fact, those who believe in the fairness of existing criminal laws should be particularly worried about the selective application of them. If you think that everyone who smokes pot belongs in jail (and that the threat of jail sentences is a good way to bring down pot use), shouldn't you be worried that individuals who are neither resource-poor nor of color hardly ever are punished (and therefore will not benefit from the dissuasive powers of the law)?

More to the point, the selective implementation of criminal sanctions creates the illusion that white, upper-middle class people can't be violent repeat offenders, something the exposure of Dominique Strauss-Kahn’s sexually aggressive nature—whether considered criminal or not—should by now have been dis-proven.

In other words, the definition of criminal offenses, the selective implementation of the law, and the resulting stereotypes generate a self-enforcing loop of discrimination and exclusion to the detriment of all. The exclusion of so many legitimate voices from this year’s AIDS conference is just one example. The incarceration of 10 percent of the adult black population in the United States is another.

“Criminal” is not an objective term, and the application of criminal sanctions has consequences that go way beyond jail sentences or fines. Policy makers would do well to remember that when they seek to devise solutions to the many human rights violations suffered by sex workers, injection drug users, and others vilified by the law.

A Human Rights Perspective on Headscarf and Veil Bans

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On July 5th, the international soccer association, FIFA, overturned its 2007 ban on players wearing headscarves. The association announced it will allow headscarves on a trial basis only. Soccer rules forbid equipment that makes a religious statement or is dangerous. 

On the latter issue, new headscarf designs held together by Velcro and other non-pin options have eliminated the potential health concern, and in any case there is no evidence that headscarves have ever caused injuries in the first place. On the former, one can only assume the association ultimately saw the absurdity in banning headscarves when crucifixes are often worn and kissed by players during games.

The news comes in the middle of celebration that several gulf countries for the first time are sending female athletes (wearing headscarves) to the Olympics. However, it also comes as more and more European countries are restricting the wearing of headscarves or face-veils in public.

In some cases, these restrictive laws are written so as to apply to the conspicuous wearing of all religious symbols and dress in specific public spaces—such as public schools—or by specific persons—for example, teachers. Regardless of the general way these laws are written, often they are almost exclusively applied to Muslim women who wish to cover their hair or face or both.

France is the first European country to have passed a blanket ban on covering up one’s face in public, effective April 2011. While the law is written in a neutral manner—it prohibits all persons from covering up their faces in public unless for purposes of safety, such as wearing a helmet—the debate and stated motivation for the law was, at least in part, to “liberate” women from the “imposition of the veil.”

Headscarf and veil bans—however they are expressed in law—raise numerous red flags for those who care about human rights.

First of all, clothing is a matter of freedom of expression. For a state to impose its view of how everyone must dress arbitrarily interferes with our ability to express ourselves freely, whether expressed as a clothing ban (“you can’t wear a headscarf”) or a requirement (“you must”). 

Secondly, when the imposed or banned piece of clothing is predominantly linked to a particular religion, it also affects our human right to express our faith freely. United Nations experts on freedom of religion repeatedly tell states that, while state religions are permissible, majority religions or the religion of government officials cannot be imposed on those who do not share that faith. To ban clothing that has particular meaning in one particular religion, while seemingly neutral, is a poor veil—excuse the pun—on blatant discriminatory intent. It may be that everyone in France is prohibited from covering their face in public, but only those for whom covering their face is an expression of their faith suffer as a result.

The purported “liberation” intention behind the French law is particularly problematic from the perspective of overcoming harmful stereotypes and discrimination. When the French government says or implies through its policies and actions that all or most Muslim women who wear facial veils do so because they are “oppressed,” each and every Muslim woman in France, far from being liberated, is deprived of any autonomy with regard to her freedom of expression and religion. Moreover, for the government to perpetuate the stereotype that all Muslim women are submissive and oppressed does little to further integration and understanding in society generally.

This is not to say that the French government should take a laissez-faire attitude towards discriminatory social norms—in fact, quite the contrary. France has a duty to combat inequality between men and women across the board. Where gender inequality is reinforced by the imposition of social norms and religious arguments—whether based on Islam, Christianity, Judaism, or any other religion—the state must ensure access to information and resources so as to prevent discrimination and provide recourse in cases of abuse.

In fact, the most disturbing aspect of the French ban on face-veils is that misplaced “liberation” policies can render very real problems invisible. It is noticeable that recent French police figures show that every two and a half days a woman is beaten to death by her partner, and that an estimated 75,000 women are subject to sexual violence every year in France. These women are not all Muslim and certainly do not all cover their faces. Yet they are in need of urgent government protection that so far has been demonstrably inadequate.

It is tremendously positive that FIFA has recognized the rights of women and girls to play sports and to express their religious beliefs at the same time. It is also positive that Saudi Arabia,Qatar, and Brunei are opening the doors for women’s self-expression through physical activity and sportive achievement. It is less positive that so many countries in Europe are choosing to perpetuate discriminatory stereotypes against Muslim women while ignoring many of the very real gender issues at their door.

To be sure, women enjoy more autonomy in France than in Saudi Arabia—no one is disputing that. What is at stake when it comes to dress-codes, however, is the very same principle of self-expression and individual right to dress according to our faith and beliefs: it is equally oppressive for the latter government to require all women to cover their faces in public as it is for the former to require that we don’t.

How Governments and Individuals - Meaning Each of Us - Deny the Persistence of Racism and Abuse

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When you work on human rights issues, you notice a certain pattern in government denial of abuse. First line of defense: it didn’t happen. Or if it happened, they did it to themselves. Or if they didn’t, we certainly had nothing to do with it. Or if we did, we didn’t mean to. It doesn’t matter if the issue is torture, forced evictions, or garden-variety employment discrimination. The response from those in charge is often, if not always, the same.

Though this pattern is annoying, to say the least, I have lately become acutely aware of a much more depressing trend: the denial of abuse among those of us who should know better. Of course, we don’t call it denial. We call it "realism." But the mechanism is the same.

1. “It didn’t happen.”

For decades, commentators and a large proportion of the US public have posited that racism no longer exists. Despite the fact that skin color and ethnicity matters with regard to just about any social indicator you care to look at — health, education, employment, housing, law enforcement — most white people believe the system we live in is racially just.

The writer Touré has described this situation as a “fog of racism:” a situation so subtle, it is blurred. “With this form of racism,” he says, “there is no smoking gun. There is no one calling you a nigger to your face. There's no sign saying you can't enter this building. ... But … it’s there.”  

This is not much different from the many people who are genuinely puzzled at the need for continued attention to women’s issues in the United States now that “the genders are equal.” I hear this argument almost daily, despite ample evidence to the contrary, including the continued pay gap and the vicious attack on reproductive rights for women and not men.   

2. “They did it to themselves.”

Blaming the victim is par for the course in rape cases, a context in which it (rightfully) is denounced by women’s groups as sexist, discriminatory, and just plain wrong. But it is also common for individuals who identify sexual or racial discrimination to be called silly, overly sensitive, or even vindictive. 

When I firmly told off a male colleague at a former employer for caressing my waist, a female colleague immediately and loudly concluded that I “must have gotten up on the wrong side of the bed.” 

And I can’t count the times I have been told that “black people are racist too,” as a manner to excuse racial discrimination. In sociology and social psychology, this phenomenon is called internalized oppression, that is the manner in which an oppressed group comes to use against itself the methods of the oppressor. More commonly, it is expressed as a desire to maintain the dignity of the group: we may suffer, but we don’t complain or sulk. 

3. “We had nothing to do with it.”

Most people don’t like to think of themselves or the people they know as bigots. This is natural and reasonable. It is hard to remain sane if you believe your actions are consistently insensitive or morally wrong. This, however, is not the same as noticing and addressing injustice — especially injustice that we, ourselves, are benefitting from. 

For example, I cannot in good conscience say that I have nothing to do with racism (or sexism, or hetero-centrism, or…) when I know that I benefit daily from a system that overwhelmingly recognizes my humanity and rights because of my Northern passport, fair skin, perceived heterosexuality, motherhood, and Judeo-Christian background (I could go on). Unlike my Peruvian ex-husband, I don’t have to think about what I wear when I travel in order to avoid additional hassles at airport security. And unlike those of my female friends who are non-gender-conforming and childless, I don’t have to defend my worth as a woman.  

4. “We didn’t mean to.”

When all other justifications have failed, the usual fall-back for governments who violate human rights is lack of intent: we may indeed have tortured a couple of prisoners, but it was unknowingly done and therefore, it is implied, of limited importance. 

This excuse is hardly ever used as a denial strategy for continued and entrenched racial, sexual, and other discrimination in the United States. And not because we recognize our responsibility in the stereotypes we perpetuate. But rather because we don’t. In fact, as shown above, we routinely deny the very existence of discrimination.

I am not advocating a collective guilt complex, or, worse, some sort of warped paternalistic pity-fest in which those of privileged background pound our chests in earnest distress and bemoan the supposedly pathetic lives of those considered beneath us. I am, however, advocating a reckoning that allows us to confront those stereotypes that result in the abuse of human rights. Even, and especially, when this means that some of us must give up our special privileges.

And here’s why: I know I am benefiting from many of the stereotypes that prevail in the country I have chosen to live in. I also know I am complicit in the resulting discrimination to the extent that I don’t challenge it.