Boston. -- Any medical man with even a touch of legal paranoia could tell President Bush that the rule banning abortion counseling at federally funded family clinics is a prescription for disaster. It's not just the effect of this rule on poor women and on free speech. The gag rule is a mandate for malpractice.
Consider the story of Pamela Hicks. She was a 22-year-old quality-control clerk at Fidelity Investments in Boston when she became pregnant in 1983. Early in her pregnancy, Ms. Hicks was sick enough to be hospitalized. But the doctor never told her that she tested positive for rubella. Indeed the doctor never ran tests to see if the fetus might have suffered the devastating effects of measles. She was never given the information and therefore never given the choice of abortion.
When Jovaughn was born in June of 1984, the infant boy was profoundly brain-damaged, legally blind, hearing-impaired, with severe cerebral palsy. And on the day of his birth, this young black mother also had to have a total hysterectomy.
In the six years of his life Jovaughn never could walk, crawl, sit, talk or chew. Jovaughn's father left when he was one. Ms. Hicks went on welfare when he was three. To give you an idea of a typical day in their life, it is enough to say that it took her two hours to feed the boy who died at six years, 33 inches, and 20 pounds.
A year after his death, this 30-year-old woman still wakes up at the time her son woke up. She is working again, but finds it difficult to leave her house and finds it easy to cry.
She will tell you that she was the only one who knew what her son needed, and that "it was as if we were attached by an umbilical cord." Yet when asked quietly if she wished that her son had never been born, she can also say quite directly and honestly, "Yes."
Had she known she had the measles, known the consequences and the choices, she would have had an abortion. What still angers her is that she didn't know. The doctor "made the decision for me, kept me in the dark." She adds, "You can't not tell a woman what's going on with her body. You can't dismiss a major decision like that."
A few weeks ago, a Boston jury agreed with Pamela Hicks. They found her doctor guilty of malpractice and awarded her $1.3 million.
As her lawyer Diana Lumsden says, "The law in Massachusetts says that a patient has the right to know the material risks associated with her treatment -- in this case her pregnancy. A doctor MUST tell the patient of those risks and the alternatives available."
"Must tell the patient?" Pamela Hicks was a private patient. The gag rule affects women who go to public clinics. But virtually every state in this country has some form of informed-consent law. The professional code of ethics that says doctors "must" give these patients full information is also the law.
If the gag rule stands, what will happen to the doctors who work at these clinics? What will happen when the next patient comes in who's been exposed to rubella, whose health and life will be adversely affected by pregnancy? If the doctors counsel her about abortion, the clinic will lose its funding. If the doctors don't, they may be sued.
It's always hard to read the fine print on the prescription pad. But this one says it pretty clearly. The gag rule is indeed mandated malpractice.
This time the president should do what the doctors tell him. When the congressional bill gets to the Oval Office, resist the impulse to veto it. Take two aspirin and sign it in the morning.
Ellen Goodman is a syndicated columnist.