Abortion Suicide Warning Law (obvs. Abort Ment)
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    Community Host Alissa_Sal's Avatar
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    Default Abortion Suicide Warning Law (obvs. Abort Ment)

    http://slatest.slate.com/posts/2012/...letter_slatest

    A federal appeals court on Tuesday upheld a South Dakota law mandating that doctors must warn women seeking abortions that they?ll face a higher risk of suicide and suicidal thoughts if they go through with the procedure.



    The St. Louis-based 8th Circuit upheld the 2005 law, 7-4. Planned Parenthood of Minnesota, North Dakota, and South Dakota filed an appeal in September asking the court to toss the mandated warning, arguing that it infringes on both the abortion rights of the patient and on the free speech rights of the doctor.



    The court's ruling, the Associated Press explains, ultimately came down to a "battle of medical studies." The AP:

    Statistics show that women who have had abortions have higher rates of suicide compared with women who've given birth, but the sides don't agree that there's a causal link between abortion and suicide.



    The defenders of the law cited research they said asserts a statistically significant correlation between abortion and suicide. The law's opponents, meanwhile, argued such findings overlook exterior factors such as domestic abuse or mental health, which other studies say may predispose women to both unwanted pregnancy and suicide.

    What do you think of a law that mandates doctors to warn women seeking abortions that they face a higher risk of suicide and suicidal thoughts? Good warning to help women make informed decisions, or politically motivated scare tactics?
    -Alissa, mom to Tristan (5) and Reid (the baby!)

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    Posting Addict ClairesMommy's Avatar
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    I'm okay with it, only if causation can be proven. I think sometimes we have to take a look at the topic a bit more objectively and not think that every move by the courts is to infringe upon a woman's rights. There are many medications that have warnings about increased suicidal thoughts and tendencies. Yes, granted it's the medication increasing that risk, not like with an abortion where the woman actively chooses termination, so it's a bit more of a passive example, but I don't see a warning like this scaring emotionally fragile women into keeping their babies because of the possibility they may have an increase in suicidal thoughts and behaviour. It's a health warning, and I don't think it's an anti-abortion message.

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    I think I would put more faith in studies published in peer-reviewed medical journals than in a study supported by Planned Parenthood who has a stake in abortions since that is how they make their money. I don't understand how it hurts anyone to get the warning?

    The four dissenting judges said that multiple studies cited failed to take into account factors such as pre-existing mental health issues, domestic violence and a young age at the time of pregnancy.

    "The most reliable evidence in the record shows that abortion does not have a causal relationship to the risk of suicide and that South Dakota's mandated advisory is not truthful, but actually misleading," Circuit Judge Diana Murphy wrote for the dissenting side.

    The state, in supporting the law passed seven years ago, disagreed, submitting several studies published in peer-reviewed medical journals to demonstrate a "statistically significant correlation between abortion and suicide." Planned Parenthood, however, relied on another study to argue its belief that certain underlying factors, such as mental health issues, predispose women to have both unwanted pregnancies and suicidal tendencies.
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    I think it is a good thing for a doctor to talk to their patient about any potential consequences of their actions. My doctor tells me that if I do not loose weight, I could become a diabetic. Not a scare tactic. Just fact. I do not see how this is different.

    ~Bonita~

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    Community Host Alissa_Sal's Avatar
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    My problem with it is that correlation is not causation, and it makes me worry that politicians are focusing on abortion (and yes, I do think this is a political issue, since we're talking about a law here) rather than exploring the risk factors may lead to BOTH abortion AND suicide, such as domestic violence, substance abuse issues, and poverty. For example, lowered SES (socioecomic status) is a risk factor for both abortion, and suicide.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818047/

    SES—including higher levels of educational attainment, employment, and higher income—is associated with better health and lower risks of all-cause mortality (Adler et al., 1994; Feinstein, 1993; Rogers, Hummer, and Nam, 2000). These factors are associated with suicide at the aggregate (Kubrin, Wadsworth, and DiPietro, 2006; Stockard and O’Brien, 2002; Wadsworth and Kubrin, 2007) and individual (Stack, 2000a) levels. Although education, employment, and income are clearly related to each other, it is important to investigate their separate relationships with the risk of suicide. For example, Kposowa and colleagues (1995) found a bivariate relationship between income and suicide that was explained away in multivariate models.

    Higher SES may reduce suicide risk in several ways. Higher incomes may reduce suicide risk by allowing individuals to access help from mental health professionals or paying for goods or services that ease their lives. Employment provides income, but may also foster social integration by providing meaning and organization to the routines of daily life, offering opportunities to make friends, and encouraging responsibility to co-workers by fulfilling job requirements (Kasl and Jones, 2000; Theorell, 2000). Work is associated with lower risks of overall mortality (Rogers, Hummer, and Nam, 2000), and employed persons have lower risk of suicide mortality (Stack, 2000a), although there are some exceptions among specific occupational groups (Stack, 2001).

    High levels of education may reduce the risk of suicide by providing individuals with a greater sense of self-control and access to tightly knit pro-social groups that promote marriage, employment, and improved social capital (Kawachi and Berkman, 2000; Mirowsky and Ross, 2003; Waite, 2006). Education may also facilitate strategies for managing stressful social environments (Krueger and Chang, 2008; Lantz et al., 2005).
    A lot of what they wrote about the relationship between SES and suicide could easily apply to abortion as well as suicide, for example, access to health care services, social support, et cetera.

    Point being, I don't believe that it's as simple as "Abortion causes suicide." I think a lot of factors interplay in suicide, abortion, and the places where the two meet, and I would prefer to see public policy that explores this rather than slapping a warning label on abortion and calling it a day.
    -Alissa, mom to Tristan (5) and Reid (the baby!)

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    People experience depression after giving birth. Granted, I am not a doctor, but it would stand to reason if you A. give birth, B. have a miscarriage, or C. have an abortion there will be a substantial change in hormones. It would be irresponsible for a doctor to not tell their patients that it is normal to have emotional trauma after such an experience. Social pressures aside, abortion is a big deal. It is bound to affect people in different ways. Telling someone, if you have thoughts of suicide call your doctor is not against abortion. It is just common sense. I can think of several TV commercials advertising medicines that say the exact same thing. It also does not hurt to tell a young woman in a difficult situation to make sure they are thinking things through. It is not like you can go back and change their mind after the fact.

    ~Bonita~

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    Well as Alissa said, correlation is not causation and until they prove that suicide after abortion is linked to the abortion and not other factors then I would be okay with them presenting this information.

    Now, if they wanted to present that you can experience the same hormonal changes and possibly a depression then I am on board with that. Just like the tell you after a baby you can experience PPD. Not everyone does and those that do don't always commit suicide or hurt their babies. The PPD can cause this but having a baby doesn't cause this.

    I'm tired and hope that makes sense.

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    Do they disclose the risk of suicide for women who have a baby they can't afford? Do they disclose the risk of suicide for women locked into an abusive relationship with someone they don't like but are tied to for life through a child? Do they disclose the risk of suicide for women who feel forced into giving their child up for adoption because they see no other alternative? There are risks to everything. Ending a pregnancy causes a major hormone shift no matter how it happens, and women do need to be aware of that, but just to say, there's an increased risk of suicide if you have an abortion, with nothing else, is just wrong.
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    Women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be attributable to abortion. The strongest subgroup estimates of increased risk occurred when abortion was compared with term pregnancy and when the outcomes pertained to substance use and suicidal behaviour.


    Conclusions This review offers the largest quantitative estimate of mental health risks associated with abortion available in the world literature. Calling into question the conclusions from traditional reviews, the results revealed a moderate to highly increased risk of mental health problems after abortion. Consistent with the tenets of evidence-based medicine, this information should inform the delivery of abortion services.
    http://bjp.rcpsych.org/content/199/3/180
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    Coleman Article Should be Retracted, Not Debated in a Subsequent Issue of BJP
    University Of Pennsylvania School of Medicine
    Serious flaws in the reporting and conduct of the Coleman review should have been identified in pre-publication review and not left for readers of BJP to sort through subsequently. The article should be retracted and should not given the dignity of post-publication debate in a subsequent issue of the journal.
    The review lacks the fundamental transparency that is expected of systematic reviews and meta-analyses and needed to allow readers to independently evaluate its conduct and
    More... Serious flaws in the reporting and conduct of the Coleman review should have been identified in pre-publication review and not left for readers of BJP to sort through subsequently. The article should be retracted and should not given the dignity of post-publication debate in a subsequent issue of the journal.
    The review lacks the fundamental transparency that is expected of systematic reviews and meta-analyses and needed to allow readers to independently evaluate its conduct and interpretation of results without having first to go back to the original studies. Search strategies are not even provided in sufficient detail for readers to ascertain the adequacy and completeness of the retrieval of relevant studies.
    Results for 36 effects obtained from 22 studies that are integrated into a single effect size represent highly diverse outcomes ranging from smoking of marijuana to suicide. The overall effect size that is calculated does not generalize back to the individual outcomes in any meaningful way. This aspect of the meta-analysis recalls a photo often incorporated into workshops on meta-analysis. The photo depicts the famous road sign for New Cuyama, California in which a total of 4663 is indicated for a population of 562, an elevation of 2150 feet, and a date of establishment of 1951. The calculation of an estimate of the heterogeneity of the effect size reported by Coleman is missing, in violation of standards for reporting a meta-analysis.
    Multiple effects sizes are obtained from individual studies are integrated in a way that violates basic assumptions of independence of individual effect sizes that are required for a meaningful meta analysis. The 22 studies include 13 from Coleman's author group, and so the meta analysis violates usual expectations that a meta analysis be independent of the author group who generated the original studies. David Reardon who is a co-author of Coleman on a number of these studies has declared his strategy [1]:
    "For the purpose of passing restrictive laws to protect women from unwanted and/or dangerous abortions, it does not matter if people have a pro-life view...In some cases, it is not even necessary to convince people of abortion's dangers. It is sufficient to simply raise enough doubts about abortion that they will refuse to actively oppose the proposed anti- abortion initiative. In other words, if we can convince many of those who do not see abortion to be a "serious moral evil" that they should support anti-abortion policies that protect women and reduce abortion rates, that is a sufficiently good end to justify NRS efforts. Converting these people to a pro-life view, where they respect life rather than simply fear abortion, is a second step. The latter is another good goal, but it is not necessary to the accomplishment of other good goals, such as the passage of laws that protect women from dangerous abortions and thereby dramatically reduce abortion rates."
    Many of the studies included in the Coleman meta-analysis, including most of the studies conducted by her group, are strongly criticized by other researchers and excluded from consideration in other systematic reviews, including a forthcoming report by the National Collaborating Centre for Mental Health (NCCMH) at the Royal College of Psychiatrists (RCPsych). One can only speculate on the timing of the BJP's publishing of Coleman's review relative to the impending release of the RCPsych report. Results of some of the original Coleman studies are not replicated in subsequent re-analyses of the same data sets by others. Coleman integrates results from studies without controlling for measures of mental health outcomes obtained prior to an abortion and in a number of instances, the mental health outcomes entered into her meta analysis were obtained before the abortion. In other instances, the effects reflect differences between women who obtained an abortion for an unwanted pregnancy versus women who delivered a wanted baby, a grossly inappropriate comparison if the intention is to obtain a valid estimate of the effects of abortion on mental health.
    It is a mater of technical details, but important to evaluating Coleman's meta analysis that she used the wrong formula to calculate population-attributable risk and violated basic assumptions for such a calculation.
    These serious flaws were apparent in a cursory reading of Coleman's article. I am confident that a closer read and a retrieval of the original studies and others that were ignored by Coleman would have yielded still more problems. But I think this analysis reaches the threshold for demonstrating the necessity of retracting the Coleman article and it begs an explanation for the nature of the peer review that led to the article being accepted.
    The Coleman article is not a contribution to scientific literature but rather represents the revenge of Coleman and her offer group on the scientific community which has held their work to basic objective scientific standards, criticized its poor quality, and excluded from integration into systematic reviews on the basis of objective criteria.
    1. Reardon DC (2002). A defense of the neglected rhetorical strategy (NRS). Ethics Med 18 (2): 23-32.

    http://bjp.rcpsych.org/content/199/3...psych_el_33923



    Emphases are mine. The bolded areas point out flaws with this study itself. The red highlights the fact that the co-author of many of the studies in this analysis is a pro-life activist whose primary goal is to restrict access to abortions. Nice source, yes, let's base our decision-making on this flawed piece of **** article.
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