美国国家公共电台 NPR--Kentucky doctors consider patient care following the Supreme Court's abortion ruling

Kentucky doctors consider patient care following the Supreme¹ Court's abortion² ruling

Transcript³

Some states have already moved to ban nearly all abortions⁴ following the Supreme Court's decision to reverse Roe⁵ v. Wade⁶. Kentucky doctors are struggling to decide how to care for their patients.

LEILA FADEL, HOST:

It was a weekend of protests for some...

(SOUNDBITE OF PROTEST)

UNIDENTIFIED PROTESTER: When abortion rights are under attack, what do we do?

UNIDENTIFIED PROTESTERS: Stand up, fight back.

FADEL: ...And celebration for others.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED SINGERS: (Singing) Reckless love of God.

FADEL: ...After the U.S. Supreme Court overturned its own precedent⁷, finding that there is no constitutional right to an abortion. Immediately, states began restricting and banning abortion in many parts of the country. And this week, a new round of legal battles will begin in state courts on behalf of abortion care providers, this time without federal protections to fall back on. Here in Kentucky, performing an abortion at any point in a pregnancy⁸ is now a crime, with a single exception in cases where the pregnant person's life is threatened. But for health care providers, even that narrow exception is confusing. Dr. Louis Monnig (ph) meets us in downtown Louisville, still in his scrubs.

LOUIS MONNIG: I just came off of a 24-hour shift on labor⁹ and delivery. And it's business as usual. People come in for pregnancy care, for deliveries.

FADEL: But the OB-GYN says it's the unknown under this new ban on abortion that's worrying him and fellow doctors.

I mean, at this point, have you thought about legally when you can and cannot perform this procedure?

MONNIG: The short answer is, I don't know, partly because some of these laws and the law in Kentucky was not written by medical experts.

FADEL: If you're making a decision, OK, this person's life is threatened, what would you be afraid of in making those decisions?

MONNIG: I think the best example is ectopic pregnancies¹⁰. They will never be a full-term fetus¹¹. They will never result in a live birth of a healthy baby. At some point, many of them will rupture¹² and can lead to sudden intense bleeding that can kill someone in, you know, minutes to hours. So many of us are put in this hard position of having to choose between doing what we think is right and necessary and having to worry about possible criminal consequences. And it may be that there is that exception for, you know, life-saving measures. But that may not stop us from getting accused, charged with something and having to go through the whole process of dealing¹³ with that.

FADEL: Are you scared?

MONNIG: I am scared. And I think a lot of us are because there's nowhere else in medicine that is policed and regulated and now criminalized to such a degree.

FADEL: University of Louisville law professor Jamie Abrams says, that fear is warranted.

JAMIE ABRAMS: That's the trouble with prosecutorial¹⁵ discretion¹⁶ is you don't know how it will be exercised in various jurisdictions¹⁷ locally. We are going to see people who, even if they know they're stretching the law, might try to do that to get themselves the claim of trying to be the most anti-abortion prosecutor¹⁴ in our state.

FADEL: We asked Kentucky's attorney general, Daniel Cameron, and Jefferson County Attorney Mike O'Connell to speak with us about how they would apply the new law. O'Connell's office did not make him available. And Attorney General Cameron's office referred us to his press conference in which he said he wants to make sure that the law is sufficiently¹⁸ followed. It's Heather Gatnarek's job to defend health care providers who perform abortions in Kentucky. She's with the ACLU. And she represents EMW Women's Surgical¹⁹ Center. It provides abortion care and birth control counseling. It's closed because of the ban. She speaks in front of the locked door.

HEATHER GATNAREK: To me, this has always been a really special place because people come here either not wanting to be pregnant or they come here because they can't be pregnant anymore. They might have stress about that and anxiety about that. But they know that they cannot remain pregnant. They come to EMW. They get compassionate²⁰ health care from dedicated²¹ providers. And then they're able to leave here and go live the rest of their lives, making decisions that are right for them and their families. And I've always thought this was a really amazing place because of that. But seeing it shut down like this is just heartbreaking because, you know, we know that normally they'd be seeing patients in that exact position today. But it's - instead, it's just quiet.

FADEL: The ACLU spent the last several years in and out of court, getting injunctions on one piece of legislation after the next, all aimed at restricting or banning abortion. But it had always been with the backing of federal law. As early as today, Gatnarek will go to the state courts with a new legal argument.

GATNAREK: We've been preparing to file a state court case in Kentucky, arguing that under the Kentucky state constitution, there should be a right to an abortion based upon many of the same ideas that used to underpin²² the federal right, including a right to privacy and bodily autonomy. And we will be asking a court for temporary injunctive relief. If we succeed in getting that, it means that EMW could again see patients and could again provide abortions. But unless or until we get that injunctive relief from the court, they're not able to provide care.

FADEL: Are you hopeful that any of that will change anything?

GATNAREK: I have to maintain some hope that we might be able to get relief in the state courts. Without it, we know that many, many folks will have an incredibly hard time getting out of state to access abortions or may not be able to altogether. There is, of course, a constitutional amendment²⁴ on the ballot²⁵ for Kentucky voters in November. So the voters will be deciding whether to amend²³ Kentucky's state constitution to explicitly²⁶ prohibit a right to an abortion.

FADEL: The clinic has consistently provided abortion care in Kentucky for decades. For many years, it was the only clinic in the commonwealth²⁷ that did.

(SOUNDBITE OF DEVICE CHIMING)

FADEL: Good morning.

MARJORIE FITZGERALD: Hi. Come on in.

FADEL: Thank you.

FITZGERALD: Good morning.

FADEL: Good morning. I'm Leila.

FITZGERALD: Marj (ph).

FADEL: The next morning, we meet Ona Marshall, the co-owner of the clinic, and Dr. Marjorie Fitzgerald (ph). She goes by Marj. She's an anesthesiologist at EMW. They show us around the now closed clinic.

FITZGERALD: So we're going to go on in here.

FADEL: OK.

FITZGERALD: So this has been set up to be so comfortable, this donated by a former patient.

FADEL: That's Dr. Fitzgerald showing us a room of recliners where patients wait. On average, they performed 20 to 25 procedures a day. People would come from across Kentucky and the country. But today, she says, the clinic feels hollow. And Marshall says, there have been brief interruptions in care before, when the Kentucky legislature enacted²⁸ laws restricting abortions or forcing doctors who perform them to jump through new hoops²⁹.

ONA MARSHALL: But usually, we had an injunction in less than 24 hours.

FADEL: This time, it's unclear if the clinic will ever resume care. That depends partially³⁰ on what Gatnarek does in court this week. Marshall and Dr. Fitzgerald say it's always been hard for patients to get in the door because of anti-abortion rights protesters outside. It was so difficult for the patients that when Dr. Fitzgerald would check their vitals...

FITZGERALD: I would invariably see patients' heart rates when they've just come in - like, they would lose their shoe because someone stepped on their shoe, knocking it off. I mean, they were physically³¹ assaulted sometimes. And their heart rate would be 120, you know? They'd be hypertensive. They were - I mean, it was like a stress response.

FADEL: Ona Marshall jumps in here.

MARSHALL: Last Saturday before Father's Day, we had 160 protesters.

FADEL: One hundred and sixty. So if you're coming in for care, you have to get through 160 people?

MARSHALL: Yes.

FITZGERALD: They have bullhorns.

MARSHALL: So they're blocking the sidewalk.

FADEL: Bullhorns?

FITZGERALD: Oh, yeah.

MARSHALL: Yeah. Loudspeakers, sometimes loudspeakers in the front and the back.

FADEL: Saying?

MARSHALL: Oh, saying...

FITZGERALD: It's murder, just insulting them.

MARSHALL: Yeah, insulting them about the clothes they wear. If they have shorts on, that's why they got pregnant.

FADEL: The protesters aren't outside on the day we visit. The few signs of the patients that typically come through here are the pile of thank you cards on a bird feeder in the corner and the six empty stretchers prepared for patients who would be waiting for procedures. Dr. Fitzgerald doesn't know if she'll ever help prepare another patient here for surgery.

What happens now for you?

FITZGERALD: I will do what I can to help women get service elsewhere.

FADEL: She's 74, a self-described morning person. Her white hair is partially pulled back. A red pen graces her white blouse. Keep our clinics, it reads, a little heart next to the words. Dr. Fitzgerald says she was drawn³² to this work because she started in health care before Roe v. Wade was law in the United States.

FITZGERALD: I went to medical school to be an obstetrician and then decided³³ to be an anesthesiologist. But I was a nurse before I went to medical school. I worked at what was the city hospital here called Louisville General Hospital. And I saw patients who had sepsis from having had illegal abortions. I think having seen those women that did not have the option for safe care has never gone away. I still remember those women. Now we go back to the days of illegal abortions, and women's lives will be lost because of this.

FADEL: She recounts some of the stories of her patients at this clinic.

FITZGERALD: I've taken care of patients who had gone through IVF only to find out that they have a congenital anomaly that is not compatible with life. They are grieving. I've taken care of, a couple of weeks ago, a 13-year-old and a 14-year-old next to a patient who's 44 years old. It's the gamut³⁴ of women that are desperate. And it's the hardest day in their life to a person. As they're going to sleep, they look up and thank me and thank the staff for being here and providing care for them.

FADEL: As we prepare to leave, Dr. Fitzgerald shares another reason she does this work, why she says she knows what a country without Roe v. Wade means.

FITZGERALD: My story is not unique. Many grandmothers, faced with a birth control failure in their young adult years pre-Roe v. Wade, had to resort to an illegal abortion.

FADEL: Wow.

FITZGERALD: And that was my story. And that's been my - one of my motivating factors in providing care for other women.

FADEL: Wow. What was that like? Can you describe it?

FITZGERALD: It was through the assistance of women who got me to a facility in Chicago. And I had what was an illegal abortion.

FADEL: And the facility you went to - we're sitting in a facility that is bright. I mean, we were describing the colors downstairs, purple and pink and green. And there are recliners. Was the facility like that?

FITZGERALD: No, it was dangerous.

FADEL: What did it look like?

FITZGERALD: It was dangerous. And it was none of this.

FADEL: She said nothing more about that day.

(SOUNDBITE OF DUSTIN O'HALLORAN AND HAUSCHKA'S "ORPHANS")

1 supreme   

adj.极度的，最重要的；至高的，最高的

参考例句：

• It was the supreme moment in his life.那是他一生中最重要的时刻。
• He handed up the indictment to the supreme court.他把起诉书送交最高法院。

2 abortion   

n.流产，堕胎

参考例句：

• She had an abortion at the women's health clinic.她在妇女保健医院做了流产手术。
• A number of considerations have led her to have a wilful abortion.多种考虑使她执意堕胎。

3 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

4 abortions   

n.小产( abortion的名词复数 )；小产胎儿；（计划）等中止或夭折；败育

参考例句：

• The Venerable Master: By not having abortions, by not killing living beings. 上人：不堕胎、不杀生。 来自互联网
• Conclusion Chromosome abnormality is one of the causes of spontaneous abortions. 结论：染色体异常是导致反复自然流产的原因之一。 来自互联网

5 roe   

n.鱼卵；獐鹿

参考例句：

• We will serve smoked cod's roe at the dinner.宴会上我们将上一道熏鳕鱼子。
• I'll scramble some eggs with roe?我用鱼籽炒几个鸡蛋好吗？

6 wade   

v.跋涉，涉水；n.跋涉

参考例句：

• We had to wade through the river to the opposite bank.我们只好涉水过河到对岸。
• We cannot but wade across the river.我们只好趟水过去。

7 precedent   

n.先例，前例；惯例；adj.在前的，在先的

参考例句：

• Is there a precedent for what you want me to do?你要我做的事有前例可援吗？
• This is a wonderful achievement without precedent in Chinese history.这是中国历史上亘古未有的奇绩。

8 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

9 labor   

n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦

参考例句：

• We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
• He was completely spent after two weeks of hard labor.艰苦劳动两周后，他已经疲惫不堪了。

10 pregnancies   

怀孕，妊娠( pregnancy的名词复数 )

参考例句：

• Since the wartime population needed replenishment, pregnancies were a good sign. 最后一桩倒不失为好现象，战时人口正该补充。
• She's had three pregnancies in four years. 她在四年中怀孕叁次。

11 fetus   

n.胎，胎儿

参考例句：

• In the fetus,blood cells are formed in different sites at different ages.胎儿的血细胞在不同时期生成在不同的部位。
• No one knows why a fetus is not automatically rejected by the mother's immune system. 没有人知道为什么母亲的免疫系统不会自动排斥胎儿。

12 rupture   

n.破裂；(关系的)决裂；v.(使)破裂

参考例句：

• I can rupture a rule for a friend.我可以为朋友破一次例。
• The rupture of a blood vessel usually cause the mark of a bruise.血管的突然破裂往往会造成外伤的痕迹。

13 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

14 prosecutor   

n.起诉人；检察官，公诉人

参考例句：

• The defender argued down the prosecutor at the court.辩护人在法庭上驳倒了起诉人。
• The prosecutor would tear your testimony to pieces.检查官会把你的证言驳得体无完肤。

15 prosecutorial   

公诉人的，原告的； 起诉的

参考例句：

• If prosecutorial misconduct results in a mistrial, a later prosecution may be barred. 如果检察官的不轨行为导致审判无效，再行起诉可能会被除数禁止。 来自口语例句
• Prosecutorial supervision is required according to public power attribution of civil litigation. 民事诉讼的个性和检察监督是对立统一的关系，并不排斥检察监督。

16 discretion   

n.谨慎；随意处理

参考例句：

• You must show discretion in choosing your friend.你择友时必须慎重。
• Please use your best discretion to handle the matter.请慎重处理此事。

17 jurisdictions   

司法权( jurisdiction的名词复数 )； 裁判权； 管辖区域； 管辖范围

参考例句：

• Butler entreated him to remember the act abolishing the heritable jurisdictions. 巴特勒提醒他注意废除世袭审判权的国会法令。
• James I personally adjudicated between the two jurisdictions. 詹姆士一世亲自裁定双方纠纷。

18 sufficiently   

adv.足够地，充分地

参考例句：

• It turned out he had not insured the house sufficiently.原来他没有给房屋投足保险。
• The new policy was sufficiently elastic to accommodate both views.新政策充分灵活地适用两种观点。

19 surgical   

adj.外科的，外科医生的，手术上的

参考例句：

• He performs the surgical operations at the Red Cross Hospital.他在红十字会医院做外科手术。
• All surgical instruments must be sterilised before use.所有的外科手术器械在使用之前，必须消毒。

20 compassionate   

adj.有同情心的，表示同情的

参考例句：

• She is a compassionate person.她是一个有同情心的人。
• The compassionate judge gave the young offender a light sentence.慈悲的法官从轻判处了那个年轻罪犯。

21 dedicated   

adj.一心一意的；献身的；热诚的

参考例句：

• He dedicated his life to the cause of education.他献身于教育事业。
• His whole energies are dedicated to improve the design.他的全部精力都放在改进这项设计上了。

22 underpin   

v.加固，支撑

参考例句：

• China needs regional stability to underpin its continued economic growth.中国需要地区稳定来巩固其持续的经济增长。
• These developments are underpinned by solid progress in heavy industry.重工业的稳固发展为这些进展打下了基础。

23 amend   

vt.修改，修订，改进；n.[pl.]赔罪，赔偿

参考例句：

• The teacher advised him to amend his way of living.老师劝他改变生活方式。
• You must amend your pronunciation.你必须改正你的发音。

24 amendment   

n.改正，修正，改善，修正案

参考例句：

• The amendment was rejected by 207 voters to 143.这项修正案以207票对143票被否决。
• The Opposition has tabled an amendment to the bill.反对党已经就该议案提交了一项修正条款。

25 ballot   

n.（不记名）投票，投票总数，投票权；vi.投票

参考例句：

• The members have demanded a ballot.会员们要求投票表决。
• The union said they will ballot members on whether to strike.工会称他们将要求会员投票表决是否罢工。

26 explicitly   

ad.明确地，显然地

参考例句：

• The plan does not explicitly endorse the private ownership of land. 该计划没有明确地支持土地私有制。
• SARA amended section 113 to provide explicitly for a right to contribution. 《最高基金修正与再授权法案》修正了第123条，清楚地规定了分配权。 来自英汉非文学 - 环境法 - 环境法

27 commonwealth   

n.共和国，联邦，共同体

参考例句：

• He is the chairman of the commonwealth of artists.他是艺术家协会的主席。
• Most of the members of the Commonwealth are nonwhite.英联邦的许多成员国不是白人国家。

28 enacted   

制定（法律），通过（法案）( enact的过去式和过去分词 )

参考例句：

• legislation enacted by parliament 由议会通过的法律
• Outside in the little lobby another scene was begin enacted. 外面的小休息室里又是另一番景象。 来自英汉文学 - 嘉莉妹妹

29 hoops   

n.箍( hoop的名词复数 )；（篮球）篮圈；（旧时儿童玩的）大环子；（两端埋在地里的）小铁弓

参考例句：

• a barrel bound with iron hoops 用铁箍箍紧的桶
• Hoops in Paris were wider this season and skirts were shorter. 在巴黎，这个季节的裙圈比较宽大，裙裾却短一些。 来自飘（部分）

30 partially   

adv.部分地，从某些方面讲

参考例句：

• The door was partially concealed by the drapes.门有一部分被门帘遮住了。
• The police managed to restore calm and the curfew was partially lifted.警方设法恢复了平静，宵禁部分解除。

31 physically   

adj.物质上，体格上，身体上，按自然规律

参考例句：

• He was out of sorts physically,as well as disordered mentally.他浑身不舒服，心绪也很乱。
• Every time I think about it I feel physically sick.一想起那件事我就感到极恶心。

32 drawn   

v.拖，拉，拔出；adj.憔悴的，紧张的

参考例句：

• All the characters in the story are drawn from life.故事中的所有人物都取材于生活。
• Her gaze was drawn irresistibly to the scene outside.她的目光禁不住被外面的风景所吸引。

33 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

34 gamut   

n.全音阶，(一领域的)全部知识

参考例句：

• The exhibition runs the whole gamut of artistic styles.这次展览包括了所有艺术风格的作品。
• This poem runs the gamut of emotions from despair to joy.这首诗展现了从绝望到喜悦的感情历程。