Sunday, April 14, 2013

Kermit Gosnell, Murdered Newborns, and the Media (p. 3)

Kermit Gosnell, Murdered Newborns, and the Media
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The Media

As I mentioned earlier, this story didn’t really get all that much coverage until Kirsten Powers wrote her op-ed piece about the lack of media coverage in USA Today on 2013-04-11-TH. The trial began on March 18, after all. To quote journalist Megan McArdle on this, herself a pro-choice advocate:
This story should have been covered much more than it was—covered as a national policy issue, not a "local crime story." The press has literally been AWOL.
As I mentioned before, the press did cover it a little bit, but not nearly as much as what the story seemed to deserve. So why did this happen?

One could argue that the reason it hasn’t made the front page is that the story is ghastly and makes people uncomfortable, but I find that implausible. The school shooting of Sandy Hook Elementary didn’t exactly leave everyone cheering for joy, and I doubt it would have received any less coverage had the killer been more vicious.

Another theory is geography; Philadelphia isn’t as much of a major city as New York City or Washington D.C., and if the crime happened in one of the latter two cities (where national media outlets tend to be located in) maybe it would have gotten more attention. Maybe, but Newtown (the city in Connecticut) was less a major city than Philadelphia when the Sandy Hook Elementary school shooting became famous.

Another idea is that the trial doesn’t raise politically sexy issues. With the Sandy Hook Elementary school shooting in Connecticut, this fired up the controversy over gun control. In contrast, there really isn’t much controversy about outlawing the murdering of newborns. That said, there certainly have been front-page type criminal trials where no celebrity was involved that got more coverage than this did (e.g. Drew Peterson), cases where murder is likewise not controversial. Even more apropos is the murder of George Tiller a few years back, an abortion doctor who was murdered by (ironically) pro-life activists. This too received more news coverage than the Gosnell case. Then there’s the massive government oversight failure regarding the Gosnell incident that has very real and important policy implications here. Remember, the grand jury report accused Pennsylvania’s Department of Health of willfully disregarding patient safety.

Then we have the elephant in the room: the political controversy of abortion. One of the disturbing aspects of this case were all the red flags about the abortion-providing practice that were ignored for years. Earlier I noted that the grand jury report said one of the reasons for insufficient oversight was pro-choice politics. Upon reading what the grand jury report has to say about the Pennsylvania Department of Health, one is almost given the impression that they didn’t want to believe such horrible things were happening. When the FBI raided Gosnell’s clinic in 2010, it was looking for evidence that he was selling prescription drugs, not evidence for the gross medical malpractice that was going on. So it’s hard not to get the idea that on some level people just didn’t want to talk about this sort of thing much. And it’s hard for the rational individual to not at least suspect something similar might have been going on in the media. In her article Why I Didn't Write About Gosnell's Trial--And Why I Should Have, Megan McArdle illustrates the sort of thing I have in mind:
But I understand why my readers suspect me, and other pro-choice mainstream journalists, of being selective—of not wanting to cover the story because it showcased the ugliest possibilities of abortion rights. The truth is that most of us tend to be less interested in sick-making stories—if the sick-making was done by "our side."
McArdle is to be commended for her honesty in admitting that this was a factor for her, but I doubt this being a factor was unique to her. I think this sort of thing is simply part of human nature. When I wrote my article on Religion’s Social Influence I noted how I’ve seen Christians believe their faith to have if anything a benevolent effect on humanity and atheists believe the opposite. By my lights there seems to be a natural temptation to downplay the bad things of one’s own tribe and disproportionately emphasize the good things of one’s own tribe, as a sort of tribal selfishness.

This is what can lead to bias, both in reporting current events and on other topics. There is a temptation to obscure relevant details or omit facts that are inconvenient to one’s side. To obscure relevant details, a biased documentary, speaking of interviewing a group it disagrees with, might say something like, “We didn’t interview this group because they demanded something inconsistent with normal journalistic practices,” not mentioning that the request the documentary so vaguely refers to is the group wanting their own copy of the interview to ensure that what they said wouldn’t be taken out of context. When it comes to omitting relevant details, a person might say, “I know my scientific belief is right because Professor X says it is right,” and not mention that Professor X’s belief on the matter conflicts with what most relevant scientific experts have to say on the matter. Bias isn’t just about what you put in, it’s about what you leave out—and what you underreport.

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Kermit Gosnell, Murdered Newborns, and the Media (p. 2)

Kermit Gosnell, Murdered Newborns, and the Media
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Failure of Government Oversight

The the grand jury report is long, but I recommend reading at least the first thirteen pages to get a sense of how horrible this was. Here’s an excerpt:
This case is about a doctor who killed babies and endangered women. What we mean is that he regularly and illegally delivered live, viable, babies in the third trimester of pregnancy – and then murdered these newborns by severing their spinal cords with scissors. The medical practice by which he carried out this business was a filthy fraud in which he overdosed his patients with dangerous drugs, spread venereal disease among them with infected instruments, perforated their wombs and bowels – and, on at least two occasions, caused their deaths. Over the years, many people came to know that something was going on here. But no one put a stop to it….Over the years, there were hundreds of “snippings.” Sometimes, if Gosnell was unavailable, the “snipping” was done by one of his fake doctors, or even by one of the administrative staff. But all the employees of the Women’s Medical Society knew. Everyone there acted as if it wasn’t murder at all.
The murdered babies, racist medical practice, and the endangered women are enough to make this newsworthy, but one of the disturbing facets of this case was how government oversight agencies had a “see no evil” approach to this extraordinarily shoddy abortion clinic. From the report:
Pennsylvania is not a third-world country. There were several oversight agencies that stumbled upon and should have shut down Kermit Gosnell long ago. But none of them did, not even after Karnamaya Mongar’s death. In the end, Gosnell was only caught by accident, when police raided his offices to seize evidence of his illegal prescription selling. Once law enforcement agents went in, they couldn’t help noticing the disgusting conditions, the dazed patients, the discarded fetuses. That is why the complete regulatory collapse that occurred here is so inexcusable. It should have taken only one look.
One line of defense is the Pennsylvania Department of Health, which is supposed to audit medical facilities like Gosnell’s to ensure they provide safe health care and follow the rules. The department gave the OK to open the clinic in 1979, but didn’t conduct another site review until ten years later, where Gosnell got a pass when he promised to correct the violations the department found. There were site views in 1992 and 1993 reporting violations but the department didn’t ensure the violations were corrected. Quoting from the report:
But at least the department had been doing something up to that point, however ineffectual. After 1993, even that pro forma effort came to an end. Not because of administrative ennui, although there had been plenty. Instead, the Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all. The politics in question were not anti-abortion, but pro. With the change of administration from Governor Casey to Governor Ridge, officials concluded that inspections would be “putting a barrier up to women” seeking abortions. Better to leave clinics to do as they pleased, even though, as Gosnell proved, that meant both women and babies would pay.
So pro-choice politics played an unfortunate role in stopping the inspection of abortion clinics, which I frankly find astounding. The pro-choice ideal of legal and safe abortions would be meaningless without the government making an effort to keep women safe; and in that regard inspecting clinics and ensuring violations are corrected are commonsense safeguards. The idea that such protections would put up a barrier to women is tragically misguided; removing these protections put up a barrier to these women getting safe abortions. I thus find it disastrously ironic that pro-choice politics played a role in government agencies turning a blind eye the problems of the clinic.

But the failure of the department gets worse:
The only exception to this live-and-let-die policy was supposed to be for complaints dumped directly on the department’s doorstep. Those, at least, would be investigated. Except that there were complaints about Gosnell, repeatedly. Several different attorneys, representing women injured by Gosnell, contacted the department. A doctor from Children’s Hospital of Philadelphia hand-delivered a complaint, advising the department that numerous patients he had referred for abortions came back from Gosnell with the same venereal disease. The medical examiner of Delaware County informed the department that Gosnell had performed an illegal abortion on a 14-year-old girl carrying a 30-week-old baby. And the department received official notice that a woman named Karnamaya Mongar had died at Gosnell’s hands.

Yet not one of these alarm bells – not even Mrs. Mongar’s death – prompted the department to look at Gosnell or the Women’s Medical Society. Only after the raid occurred, and the story hit the press, did the department choose to act. Suddenly there were no administrative, legal, or policy barriers; within weeks an order was issued to close the clinic. And as this grand jury investigation widened, department officials “lawyered up,” hiring a high-priced law firm to represent them at taxpayer expense. Had they spent as much effort on inspection as they did on attorneys, none of this would have happened to begin with.
From Section VI of the report:
We discovered that Pennsylvania’s Department of Health has deliberately chosen not to enforce laws that should afford patients at abortion clinics the same safeguards and assurances of quality health care as patients of other medical service providers. Even nail salons in Pennsylvania are monitored more closely for client safety.
Indeed, the department has shown an utter disregard both for the safety of women who seek treatment at abortion clinics and for the health of fetuses after they have become viable. State health officials have also shown a disregard for the laws the department is supposed to enforce. Most appalling of all, the Department of Health’s neglect of abortion patients’ safety and of Pennsylvania laws is clearly not inadvertent: It is by design. [emphasis theirs]
You read that right, by design. The report gives evidence for this and goes on about the details in how the Pennsylvania’s Department of Health failed to do its job, but for space I won’t mention all the details here. While Pennsylvania’s Department of Health’s willful neglect of patient safety is awful enough, it gets even worse. Gosnell still might have been caught sooner had other government agencies not also dropped the ball. The report talks about how the Pennsylvania Department of State in many ways had “more damning information than anyone else” and likewise failed. From section VI of the report:
Yet even a 22-year-old woman’s death did not warrant an investigation, according to the Board of Medicine. It is curious, therefore, that the only complaint against Gosnell that did lead to any kind of disciplinary action by the Board involved a non-certified physician’s assistant who treated a child for pink eye in 1990. As it happens, the child’s grandmother, the complainant, worked for the Bureau of Professional and Occupational Affairs....We are concerned, however, about the patients whose doctors do not end up in the news – doctors who may be unethical, reckless, or unprofessional every day with impunity. We want to know that the Department of State is protecting the public from dangerous doctors even if they do not happen to treat someone with a connection to the department, and even if they do not end up in the news. We do not have that confidence after this investigation.
There are other troubling details about the Department of State’s failure that justify the grand jury’s aforementioned lack of confidence, but for space I’ll omit them. Another failure is the Philadelphia Department of Public Health. From section VI:
An employee of the Philadelphia Department of Public Health alerted her bosses – twice – that things were seriously wrong at Gosnell’s clinic. The last time she did so was one month before Karnamaya Mongar died. Records produced by the city department reveal that employees in at least two different divisions within the department missed red flags that should have led to investigation and action.
Again, for space I’ll skip the details. Another organization should have done better is the National Abortion Federation (NAF) which “upholds the strictest health and legal standards for its members.” The NAF inspected the clinic after Gosnell applied for membership.
Gosnell, bizarrely, applied for admission [to the federation] shortly after Karnamaya Mongar’s death. Despite his various efforts to fool her, the evaluator from NAF readily noted that records were not properly kept, that risks were not explained, that patients were not monitored, that equipment was not available, that anesthesia was misused. It was the worst abortion clinic she had ever inspected. Of course, she rejected Gosnell’s application. She just never told anyone in authority about all the horrible, dangerous things she had seen.

Bureaucratic inertia is not exactly news. We understand that. But we think this was something more. We think the reason no one acted is because the women in question were poor and of color, because the victims were infants without identities, and because the subject was the political football of abortion.
And in section VI:
Had state and local officials performed their duties properly, Gosnell’s clinic would have been shut down decades ago. Gosnell would have lost the medical license that he used to inflict irreparable harm on women; to illegally abort viable, late-term fetuses; and to kill innumerable babies outside the womb.
The horribleness of the crimes and the massive government oversight failure seems to make this story quite newsworthy indeed. So why the failure of the press here?

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Kermit Gosnell, Murdered Newborns, and the Media

Kermit Gosnell, Murdered Newborns, and the Media
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Imagine a clinic in the United States that murdered hundreds of newborns by severing their spinal cords with scissors, had jars of severed baby feet, and engaged in racist medical malpractice—with massive government oversight failures allowing this to continue for well over a decade. Sound like front-page material for the United States? It wasn’t.

Isn’t the Kermit Gosnell Case Newsworthy?

A man named Kermit Gosnell ran the clinic accused of the horrible crimes I mentioned, and is now on trial for those crimes. The case didn’t get that much media attention until Kirsten Powers wrote her op-ed piece about the lack of media coverage in USA Today on 2013-04-11-TH. The op-ed article noted that since the trial began March 18, there has been very little coverage of the case, and that a Lexis-Nexis search confirms that none of the news shows on the three major television networks mentioned the trial, with the only exception being where Wall Street Journal columnist Peggy Noonan hijacked a segment in Meet The Press to briefly mention it. Quoting from the op-ed:
The Washington Post has not published original reporting on this during the trial and The New York Times saw fit to run one original story on A-17 on the trial's first day. They've been silent ever since, despite headline-worthy testimony.

Let me state the obvious. This should be front page news. When Rush Limbaugh attacked Sandra Fluke, there was non-stop media hysteria. The venerable NBC Nightly News' Brian Williams intoned, "A firestorm of outrage from women after a crude tirade from Rush Limbaugh," as he teased a segment on the brouhaha. Yet, accusations of babies having their heads severed — a major human rights story if there ever was one — doesn't make the cut.
Another thing about the clinic was the gross medical malpractice, e.g. it had only one bona fide doctor (Kermit Gosnell himself) and not even one nurse. From the grand jury report on the case:
There was blood on the floor. A stench of urine filled the air. A flea-infested cat was wandering through the facility, and there were cat feces on the stairs....Investigators found the clinic grossly unsuitable as a surgical facility. The two surgical procedure rooms were filthy and unsanitary – Agent Dougherty described them as resembling “a bad gas station restroom.” Instruments were not sterile. Equipment was rusty and outdated. Oxygen equipment was covered with dust, and had not been inspected…. Employing unlicensed, untrained workers in a facility that was grossly inadequate and unsanitary, his operation made a pretext of providing health care.
If nothing else, government oversight agencies that are supposed to monitor such health care situations should have caught on to this years ago. There were women “moaning in the waiting room or the recovery room, where they sat on dirty recliners covered with blood-stained blankets.” The unqualified staff, dirty and unsanitary conditions, shoddy medical equipment, and other factors made the clinic a deadly threat to women, in some cases resulting in death, including a woman named Karnamaya Mongar. The medical malpractice was also tinged with racism. The report:
Only in one class of cases did Gosnell exercise any real care with these dangerous sedatives. On those rare occasions when the patient was a white woman from the suburbs, Gosnell insisted that he be consulted at every step. When an employee asked him why, he said it was “the way of the world.”…. Tina Baldwin told the Grand Jury that the untrained medical assistants, without supervision by Gosnell, routinely administered even the final dose of sedation just before the procedure – unless the patient was white…. Tina Baldwin also testified that white patients often did not have to wait in the same dirty rooms as black and Asian clients. Instead, Gosnell would escort them up the back steps to the only clean office – Dr. O’Neill’s – and he would turn on the TV for them.
The grand jury report says that among the reasons nobody acted to investigate the clinic was “because the women in question were poor and of color, [and] because the victims were infants without identities.” All this strikes me as pretty newsworthy (not to mention that one of the ironies behind Gosnell’s racist medical malpractice is that the man himself is African-American).

One More Thing...

One more thing I’ve left out of this case: the accused man, Kermit Gosnell, was running an abortion clinic called the “Women’s Medical Society.” I’ve already mentioned my views on abortion when I wrote about Judith Jarvis Thomson’s famous violinist thought experiment, but really one’s views on abortion shouldn’t matter here. Even if you are pro-choice, to keep abortions legal and safe we should be concerned that some abortion clinic got away for so long endangering so many women, and we should be concerned about the failure of government oversight agencies to protect these women.

It shouldn’t matter whether this man was running an abortion clinic; the murdered babies, racist medical practices, endangered and exploited women, and many government failures not only make the case extremely newsworthy but also constitute something we shouldn’t turn a blind eye to. Americans should be concerned (among other things) about the failure of oversight that didn’t catch this horrible thing sooner. This is also the sort of newsworthy case that Americans should have known about sooner when the trial first started. So why didn’t this happen? Before answering that question, I’ll go into a bit more detail about the case so we can see how bad the problem is. I’ve already mentioned the crimes, but I’ve so far been vague about how exactly the government dropped the ball here. I’ll briefly sketch that next.

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