ABORTION AND THE PRIVATE PRACTICE OF MEDICINE by Jonathan B. Imber

ABORTION AND THE PRIVATE PRACTICE OF MEDICINE

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KIRKUS REVIEW

A study of OB/GYN specialists in a medium-sized city that sheds light on why relatively few abortions in the US are performed by doctors in private practice, but are relegated to free-standing clinics that usually offer only abortion services. In his investigation of the 26 ob/gyn specialists in the city he calls Daleton, Imber learned that only 10 were willing to perform an abortion on request, and most of these restricted the procedure to patients already on their rosters. They also tended to refuse the request if they felt it was for ""frivolous"" reasons (a child of the ""wrong"" sex) or if a woman already had had one abortion (on the grounds that she should have been more careful about birth control). Only two were willing to perform second-trimester abortions--a more complicated operation during which the fetus frequently must be ""hacked apart"" (to quote one doctor). Ten others, who had previously performed abortions, no longer did so, some because of concern about their reputations in the community, some because they said they had become revolted by the second-trimester abortions they had performed during their residencies. The remaining six were Catholic, and had never performed abortions. Since Daleton has no abortion clinic, the doctors who deny the procedure (for whateverreason) must refer the patients to out-of-town clinics, the nearest of which is 30 miles away. The haphazard and often inconsistent responses to requests for an abortion, says Imber, mean that ""a woman's right to choose the procedure is always circumscribed by the physician's right not to perform it."" He points to a 1977 study that found that eight out of 10 US counties--containing one-quarter of the female population of childbearing years--had no physicians, clinics or hospitals providing abortion services. He believes that the attitudes of many Daleton doctors are conditioned by their training, which called for avoidance of any operation unless there were patent medical reasons for it. Abortion on demand, he says, has created a ""doctor's dilemma."" Physicians in private practice now solve it by referring patients to clinics, even though this might not be in the patients' best interests. Imber began this book as a doctoral thesis, and it frequently reads like one, with considerable minutiae that might turn off the casual reader. It should be of interest, however, to physicians and other medical professionals, sociologists and anyone concerned with the abortion dispute.

Pub Date: Aug. 1st, 1986
Publisher: Yale Univ. Press