With the tragic and heartbreaking news of Robin Williams’ death by suicide, many people have been contemplating the reality of severe clinical depression and asking how it could have crept into the life of someone as talented, fulfilled and beloved as Robin Williams. I myself derived hours of enjoyment, solace, and even edification from his movies, some of which dealt sensitively with the topic of suicide. Perhaps his death illustrates that depression is not a character flaw; nor is it a respecter of persons.

I am more than disheartened to witness the inevitable comments that have appeared on the internet in response to the news that he was battling early onset Parkinsons’ disease. Underneath an internet story on this news, one commenter wrote:
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It gives some basic level of comfort in that Robin was successfully fighting his depression but got sidetracked by a disease with a lousy prognosis. I feel that his actions now weren’t of depression but of self determination. I truly feel, that when faced with imminent deterioration of function, the decision is that of the individual. I’ll miss you Robin, I grew up with you from age 10 on Happy Days and Mork and through your career, but I’ll always respect your decision.

As mentioned in the related news story, scientists have established that Parkinsons inhibits the production of dopamine, which, like serotonin and norepinephrine, is responsible for facilitating concentration, energy and feelings of well-being. Major depression is already indicated by a lack of these chemicals; hence, I imagine that Parkinsons-induced depression could push someone with preexisting depression into a psychological meltdown. Perhaps Williams situation frayed his connection with humanity’s innate survival instinct, giving previously checked suicidal impulses uninhibited access to his mind. Whatever the case, what happened on August 11th indicates that when he killed himself, Williams was not successfully fighting his depression: he fought valiantly, but he lost that battle.

Moreover, the respect this commenter is offering to Williams only exacerbates the situations of people with unmet mobility needs. We are approaching the second decade of the twenty first century, yet people who use wheelchairs, respirators, or other mechanical devices to engage our world; as well as those with psychological and cognitive anomalies that preclude our society’s narrow concept of independence, still lack the right to receive related services in their homes.

This would likely not have been a problem for Williams, who probably would have been able to fun the receipt of such services himself, as can others with a solid middle to upper class income. Hence the error of validating actions based on the resources of a privileged few: the underprivileged are always left to experience the negative consequences of that action. Such people need support, compassion, accommodation and access to treatment; not a choice between marginalization or death.

Ultimately, the attitude expressed by the aforementioned comment reflects a meme with universal and oppressive implications: Being impaired and/or requiring the help of others is worse than anything else. Death, despite its historical role of inducing near-pathological fear, is suddenly perceived as good. No one can know what lies beyond the grave, but let us not push ourselves or our loved one toward it with empty, privileged platitudes of “self-determination.” Instead, let us do the hard work of providing whatever individuals need to regain fulfilling lives.

In Part 1, I talked about why the Hobby Lobby decision matters. In this post, I’ll address some of the arguments offered in support of the nation that making contraception part of the standard package of preventive services required in all insurance plans violates employers’ religious freedom.

Claim: There are two parties in this dispute: employers and the government.

OK, nobody really comes out and states that as a claim, but it’s the underlying assumption behind a lot of discussion of the Hobby Lobby decision. Hell, it’s right there in the name, Hobby Lobby v. Sebelius: there was nobody arguing the workers’ case. Ultimately, this isn’t just a question of religion, or contraception, or even abortion; it’s a labor issue. But the worker is the forgotten party.

It’s pernicious, this attitude. I almost did it myself, in this very post. I almost titled it “Birth control, insurance, and employers.”

With some exceptions, the relationship between employer and employee is an inherently unbalanced one. Companies can’t survive without workers — something that people who regard workers as little more than parasites on the bottom line tend to forget — but an individual employee almost always needs a job more than the employer needs that particular employee. That gives the employer power; and the worse the labor market is, the greater their power. This reality is the reason workers organized for unionization and labor laws in the first place.

What does that have to do with Hobby Lobby? Consider that only one party — the employer — is generally portrayed as having religious liberty interests. Why is it that only the beliefs of the more powerful party carry weight? What about employees’ own beliefs about whether or not it’s morally acceptable to use their insurance to access contraception?

And that leads me to…

Claim: It’s wrong to force employers to spend their money on something their religion forbids.

If there were a law or regulation requiring people who oppose contraception to go out and buy condoms or birth control pills and hand them out to anyone who works for them, I would be sympathetic to the argument that would constitute a burden on their free exercise rights. (It would also make absolutely no sense as public policy, of course, and would never pass; remember that the Supreme Court isn’t the only check on what laws exist in this country.)

But that’s not what’s happening with employer-sponsored insurance. When a company hires an employee, they offer a compensation package. Part of that package goes directly to the employee in the form of wages or salary. Part of it goes to pay premiums for an insurance policy that allows the employee to access a wide variety of health care services, including contraception if they so choose. For companies that pay wages with debit cards, should they be allowed to put restrictions on those cards so that they can’t be used to buy anything that the employer’s religion forbids? After all, it’s certainly possible to construct an argument that not doing so would be facilitating the employees’ access to something (that the employer considers to be) evil. If you’d object to not being allowed to buy alcohol or pork with your payroll card, then you can understand why some people object to the contraception exemption.

I really can’t stress enough that health insurance is an earned benefit. It’s not a gift. People say that the owners of Hobby Lobby shouldn’t have to spend their money on something they don’t believe in, but it’s not their money once the employee has earned it by exchanging her labor for it.

Claim: Every plan excludes some things, so excluding contraception is no different.

Just as an employer can’t pay you unlimited salary, they can’t provide unlimited health insurance. Limitations based on price will have to be made. Now, where you would draw the line on those limitations may not be the same place where your employer draws the line, but at least everyone agrees that it’s reasonable for insurance plans not to cover absolutely everything.

Additionally, there will be limitations on what’s covered due to judgments about what is or is not effective. You can’t get homeopathic remedies with health insurance, thank goodness, because they’re useless. But those limits should be based on medical and scientific evidence.

What’s being proposed in Hobby Lobby and similar cases is that the decision about what medical services you can access with your health insurance should be made not based on cost — which is regrettable but unavoidable — or medical judgment, but on your employers’ religious beliefs.

Claim: This isn’t about making sure people have access to contraception; it’s about punishing employers for having the “wrong” religious views.

Despite what folks like Rod Dreher might have you believe, advocates for insurance coverage of contraception are not driven by a compulsion that “The Religious Right Must Always Lose.” We do have an interest in making sure that safe, effective contraception is available to everyone, and in making sure that employees’ rights are protected. We do often express anger and frustration about beliefs we consider harmful. But if the U.S. moved to a single payer system or a system where everyone got vouchers to buy their own insurance or whatever, we’d be fine with that. We wouldn’t be upset because we’d no longer have the opportunity to show those Christians who’s boss. It’s not about them.

There has been something I’ve been meaning to write for a while now: I think that it’s important to note that while All Our Lives supports the practice of safe sex, there is no need for people to engage in sex for sex’s sake. I often worry that some individuals, particularly people in their twenties and thirties, may feel obligated to have sex because that is what society expects them to do. Of course, the same problem applies to teenagers, who are impacted by the same message: there is a timetable on when someone should lose his or her virginity, and they had better do it before they grow up to be a 40-year-old virgin. Anyone who ends up in that situation has something wrong with him or her, either sexually, socially or psychologically. The latter mentality is oppressive to those who, for whatever reason, choose not to have sex.

While it is certainly possible for trauma or illness to affect someone’s libido, there are many healthy, legitimate reasons for avoiding sexual activity, either in the long-term or in one’s choice of partners. Some of them may include:

-Putting off the responsibility of sexual activity until one is more established in terms of a career or education
-Not having found the right person to have sex with
-Being temporarily uninterested in sex
-Having an asexual orientation
-Avoiding intercourse that does not match one’s orientation, such as when a lesbian who has not “come out” resists pressure to have sex with men.
-Spiritual decisions regarding the relationship between the individual’s body and his or her relationship with the Divine.

Personally, I’d say that being abstinent has been one of the healthiest decisions I’ve made in my life. I am waiting to have sex with someone with whom I am deeply in love, preferably within a marital covenant. That is what “works” for me, both spiritually and emotionally.

It is true that my initial choice to abstain was rooted in a concept of self-respect that was tied to my religious beliefs. However, as time went on, I also felt that sex would be source of stress and conflict in my life. During high school, college and graduate school, I struggled to take care of my basic needs and complete my schoolwork with the excellence that I wanted to achieve. I sense that attempting to manage birth control pills, ovulation calendars, condoms, etc would have been very burdensome, not to mention anxiety-producing. When I had irregular periods in 2006, I knew that it wasn’t because I was pregnant. (I was severely stressed.) I can’t imagine how awful I would have felt if I had had to worry about pregnancy every month. Because I was abstinent, STIs or pregnancy weren’t even possibilities, so I was free to focus on other things.
I still associate my abstinence with spiritual commitment and see it as a way of honoring my identity as one of God’s creatures. However, I am also proud of continuing to make the sexual choices that are right for me. When I have sex, it will be with the right person, at the right time, or not at all.

Hence, I want to assure readers who choose not to have sex that that choice is perfectly healthy and normal. No one should ever feel pressured to have sex because they have reached a certain age, or because our society maintains an ableist association between a lack of sexual activity and psychological infirmity.

So, if you have sex, make sure it’s in a situation where you feel safe, respected, and ready. If that means not having sex, that’s ok, too.

A lot of advocates for women’s health and for workers were pretty upset after Monday’s Burwell v. Hobby Lobby decision. The Lannisters even sent their regards. So of course, the Very Serious People arrived on the scene to tell us that it’s really no big deal and we shouldn’t get so worked up over it.

I don’t think so. Let’s look at some of the reasons people are saying that the holding was narrow and there probably won’t be any serious practical effects.

Claim: The ruling only applies to closely-held corporations.

True, but that doesn’t make it narrow. Over 90% of American companies are “closely-held corporations.” Those companies employ over 50% of American private sector workers. It’s true that most of them are unlikely to refuse to offer insurance that covers contraception (known hereafter as “standard insurance,” because by law that’s what it is), but that doesn’t mean the scope of the decision itself isn’t broad.

Claim: The ruling won’t have much effect because the affected employees will still get contraception coverage.

Well, they might. The HHS has created a system to accommodate religious non-profits who don’t want to offer standard insurance, and the Court said that for-profit corporations could be offered the same accommodation. It hasn’t yet been established that HHS has the legal authority to extend the compromise to for-profit corporations, though that does seem likely to happen. But there’s another problem. In Little Sisters of the Poor v. Burwell (formerly Sebelius), which is currently making its way through the Federal court system, a religious order is claiming the accommodation itself violates their rights because signing a form certifying that they won’t provide standard insurance means they’re directing the government to provide contraception coverage in their stead, and therefore cooperating with “evil.” It’s not impossible that the Court might say now that the government can provide contraception for Hobby Lobby employees, only to strike down the system they’re using to provide it later.

Claim: Hobby Lobby offers insurance that covers contraception; they were only asking not to cover “abortifacients.”

This is true in the case of Hobby Lobby itself. However, the decision applies to insurance coverage of all contraception. Basically, the Court used the concern over so-called “abortifacients” as cover to issue a broader ruling that will allow for-profit companies to deny all contraception coverage to their employees and their dependents.

In any event, the claim that the four methods in question are in fact abortifacient is highly contestable. I find it incredibly troubling that the Court felt no need to address the factual content of that claim.

Claim: The ruling only applies to contraception.

The majority said that people with religious opposition to vaccines, mental health screenings, or other services often covered under standard insurance might still have to cover them. At first, this seems to make the ruling more palatable; at least it affects fewer people and services than it otherwise might. But in fact, this is a problem precisely because the Court is singling out contraception as somehow unlike other medical services.

In any event, our decision in these cases is concerned solely with the contraceptive mandate. Our decision should not be understood to hold that an insurance coverage mandate must necessarily fall if it conflicts with an employer’s religious beliefs. Other coverage requirements, such as immunizations, may be supported by different interests (for example, the need to combat the spread of infectious diseases) and may involve different arguments about the least restrictive means of providing them. [page 46 of the majority opinion]

I’m not sure how the least restrictive means test would ever have a different result; after all, the government theoretically could step in and set up a program to cover any specific type of medical care. I think this comes down to “supported by different interests.”

Contraception is covered as part of standard insurance because the ability to plan and space pregnancies is good for women’s and children’s health. If the majority genuinely found that interest compelling, it would make no sense to argue that other coverage requirements might pass muster due to serving different (super-duper compelling?) interests. I don’t think they did, lip service to the contrary notwithstanding; there was not one mention in the opinion of the health benefits of family planning. It’s hard not to wonder whether the majority simply don’t think of contraception as “real medicine” like vaccines.

If HHS extends the religious nonprofit accommodation to cover closely-held corporations and if the court doesn’t strike down the accommodation, it may be that the practical effect of the decision is small. That’s the best-case scenario, and it’s certainly possible. No, SCOTUS didn’t ban birth control, and it’s not The Handmaid’s Tale. But it’s still a big deal.

Like Secular Pro-Life, I’m not keen on this new “People of Choice” site. For starters, I don’t like modeling anything after the nasty, classist People of Wal-Mart. It’s unbecoming anyone who claims to respect all human beings equally.

For another — does anyone think that it would be hard to put together a “People of Pro-Life” site that had tons of sexist, hateful, and ignorant commentary? I could make a good start in about five minutes using only comments from elected officials, never mind random internet commenters. Would we like it if that was passed off as “exposing the words and behaviors of the ‘pro-life’ community”?

Some of the material on the “People of Choice” site absolutely deserves to be exposed and called out. There are pro-choice people out there who hate women and support abortion so they don’t have to be responsible “if that dumb bitch gets herself pregnant.” There are pro-choice people who support abortion because they want poor women and women of color to have fewer kids. There are pro-choice people who revel in how dehumanizing and hateful they can be toward unborn human beings. There are pro-choice people whose arguments are based on ignorance of how sexual reproduction works. But there’s a way to criticize fact-free arguments and racist/misogynist/*ist ideas without trying to make a community’s worst members into the face of the whole community. That’s dishonest and lazy. Most pro-choice people are really just trying to do what they think is best, the same way we are. I disagree with them about what’s best, but that doesn’t make them the enemy.

The Christian Science Monitor ran a great article last week about the challenges faced by women who choose to give birth to and raise children conceived in rape. Unfortunately, laws are often slanted toward abortion or adoption, even if those aren’t what the mother wants:

It’s more common for states to provide rape survivors with emergency contraception, easier access to abortion, or quick termination of parental rights of the father when the child is being given up for adoption.

While some women choose those paths, sometimes because the thought of the child triggers a replay of the trauma, the Hope group says it’s important that society not stereotype rape survivors and end up ostracizing women who choose to keep their children.

“People ridicule you and distrust you because you chose to have your child – ‘Oh, you must not have been raped,’ ” Megison says. “It’s such a strange world we live in where you have to be questioned as a mother why you love the child that … you nurse and play with and pray with and read stories with.”

Hope After Rape Conception is an organization that was formed by women who had to fight rapists for custody of their children or grandchildren. They’ve written model legislation to terminate rapists’ parental rights, and are trying to get it passed in the 26 states that still have no such provision.

Beyond the law, it’s important to change societal beliefs about rape, women who have been raped, and women who bear children conceived in rape. That means calling out toxic attitudes about “legitimate rape” and assumptions that women frequently lie about rape. It also means that we have to stop looking at the child conceived in rape as an extension of the rapist. Every child is a human being in his or her own right.

Under a law recently passed by the Tennessee legislature, women may face prosecution for assault or criminal homicide if their drug use during pregnancy is believed to have harmed or killed their children. All Our Lives is calling on the governor of Tennessee to veto the bill. Although we share Tennessee lawmakers’ concern for the lives and health of children, we disagree that these laws are the best way — or even an effective way — to protect fetal and newborn life.

Determining the effects of maternal drug use on the developing child is not simple or straightforward. Mothers who struggle with drug addiction often face many other challenges. Their children may suffer adverse health effects of maternal poverty and stress, unhealthy environments, unplanned or poorly timed pregnancy, and lack of prenatal care. It can be difficult to separate these effects from any harms directly resulting from drug use. But even in those cases in which the link between a mother’s drug use and harm to her child is clear, the question remains: How does sending her to prison help her child, or any other child?

Punishment doesn’t heal. And as we’ve seen through decades of the drug war, the possibility of punishment isn’t much of a deterrent to drug use.

In 2011, the American College of Obstetricians and Gynecologists issued a statement titled “Substance abuse reporting and pregnancy: the role of the obstetrician–gynecologist.” They reported the following:

  • Incarceration and the threat of incarceration have not reduced the incidence of alcohol or drug abuse.
  • The fear of being reported to the police causes patients to avoid or distrust doctors. This can mean they don’t get adequate prenatal care, which leads to worse health outcomes for both mother and child.
  • It is often the case that pregnant women struggling with addiction have sought care. Unfortunately, many couldn’t get into a treatment program that serves pregnant women, couldn’t afford treatment, or found that available programs failed to accommodate their family and work lives.

All of this is the exact opposite of what people who are concerned about the lives and health of children should want. We’re also concerned that a pregnant woman struggling with addiction might see abortion as her only realistic way of avoiding criminal prosecution.

In our view, the most pro-life thing a society can do is to ensure that pregnant women have all the resources they need to care for themselves and their children. In the case of women who are addicted to drugs, that would include immediate access to affordable, high quality drug treatment programs.

SB1391 has a good intent behind it, but good intent does not guarantee good effect. And we fear that the effect of this law will be to discourage vulnerable women from seeking care that would benefit themselves and their babies, and even to provide an incentive for abortion. That doesn’t foster life.

RHRealityCheck has put up a petition to Governor Haslam. We know that there are a lot of pro-lifers who wouldn’t be comfortable signing a petition run by RHRealityCheck, so if you’d prefer to call the governor’s office directly, the number is (615) 741-2001.

I’m a night owl by nature. Left to my own devices, I’d go to bed at 4am and wake up at noon. Sadly, employment and parenthood mean that’s not an option. (Not that employment and parenthood are sad. You know what I mean.) So to get my nocturnal brain kicked into gear in the morning, I check Twitter. I usually find something that’ll wake me right up.

“Pro-lifers should support sex ed… but pro-lifers aren’t welcome in our sex ed club!” http://t.co/ULFEvDTOPN #prolife #prochoice #catch22

— secularprolife (@secularprolife) March 11, 2014

Like this.

Better than coffee! (Full disclosure: I hate coffee.)

From a philosophical point of view, I get why this happens. I understand why pro-choicers see both birth control and abortion as questions of being able to control one’s own body, even though I think they’re wrong to dismiss the obvious difference between the two. And I understand why people who oppose birth control think that acceptance of contraception inevitably leads to acceptance of abortion, even though I think they’re wildly mistaken. In both cases, though, I just want to ask why they’re so sure that theirs is the only viewpoint that reasonable [birth control|pro-life] advocates could hold.

I also understand it from a practical point of view. Birth control is far more widely accepted than abortion. So if you want people to reject birth control or accept abortion, it’s in your interest to link the two. You might even get really protective of the idea that they have to be linked. But most people don’t see them as the same. So groups like All Our Lives and Secular Pro-Life will just keep on reaching out to those people, and advocating for family planning freedom as one component of our work against abortion.

A new meta-analysis published in PLOS Medicine provides more information on the link between intimate partner violence and abortion. You can read the entire analysis online, but this post at WECARE summarizes some of the main points, from the point of view of people working to reduce abortions.

1) Intimate partner violence, including history of rape, sexual assault, contraception sabotage, and coerced decision-making, was associated with abortion.   Unfortunately with the limited data available to the authors, it was not possible to ascertain the typical timing of exposure to violence relative to abortion. However, it is likely that various patterns exist, with violence both preceding and following abortion in many victims’ lives. Escalation of violence after the procedure is a strong possibility, particularly when partners are against the abortion.In a high quality study by Fisher and colleagues (2005) published in the Canadian Medical Association Journal, the authors reported that women presenting for a third abortion were over 2.5 times more likely to have a history of physical or sexual violence than women presenting for their first.

2) Women in violent relationships were more likely to have concealed their abortion from partners compared to women who were not victims of violence. Women likely believed they could not continue the pregnancy and were afraid of the abusive partner’s behavior if the abortion had been revealed. Many women in abusive relationships may feel they have to abort, because they are trying to free themselves from the relationship, they do not want to bring a child into a home with violence, and/or they do not believe they have the emotional energy to go through a pregnancy and raise a child, among other reasons. With sensitive, appropriate pre-abortion counseling, women in abusive relationships can be identified and safely assisted out of the violent, dangerous situation and helped to continue their pregnancies if desired. Without sensitive, substantive care, abortion is often perceived as the only option available.

3) Women welcomed the opportunity to disclose IPV and to be offered help. Women who present at abortion clinics are often at a point where they are quite receptive to help, and if screening and intervention do not occur, countless women will continue their lives feeling trapped and afraid in a violent relationship. If the abortion take place, then there is a high probability that they will suffer psychological consequences as a result that further compound a life marked by significant suffering. Numerous studies from the peer-reviewed literature have documented the fact that women, who feel pressured by partners, abortion counselors, other people in their lives, and/or by life circumstances, are more likely to experience post-abortion mental health problems.

The study focused on women having abortions, but the findings also have obvious implications for crisis pregnancy centers.

(Thanks to Consistent Life for the tip.)

Personally, not speaking for All Our Lives as a whole, I feel a deep ambivalence about the focus on the Roe v. Wade anniversary in general and the March for Life in particular. That said, All Our Lives believes that being pro-life means being pro-everybody’s-life. That’s why we support the For Peace & ALL Life Meetup and March group at today’s event. Thanks for representing, folks, and keep warm!