FAB Gab Episode 13: Amy Reed-Sandoval on Abortion Bans and Pandemic Ethics

6:33AM Oct 10, 2021

Speakers:

Kathryn MacKay

Amy Reed-Sandoval

Keywords:

abortion

pandemic

solidarity

people

paper

physicians

united states

case

abortion provider

albuquerque

abortion clinics

feminist

ethics

abortion bans

philosopher

third trimester abortions

abortion doctors

find

research

ways

Hello and welcome to FAB Fab. This is the podcast where the International Journal of Feminist Approaches to Bioethics brought to you by FAB Network. My name is Kathryn MacKay and today I'm joined by Amy Reed-Sandoval, from the University of Las Vegas, Nevada. And we're talking about Amy's paper, 'Revisiting Relational Pandemic Ethics in light of the COVID-19 Abortion Bans in the United States'. And that's IJFAB Volume 14, number one. Hello, Amy.

Hi, thank you for having me.

Thank you so much for joining me, this was a really, really interesting paper, obviously, very timely. And I wonder if you can just give the listeners an overview of what you discussed in this paper.

Sure. So this paper is the result of an extensive period of ethnographic research that I did at a couple of abortion clinics in Albuquerque, New Mexico. Albuquerque is a really has been a really important site for my research, which is concerned with the experiences of pregnant people who have to travel long distances and cross different types of borders, in search of abortion care. And so Albuquerque, which is home to two of only four physicians who regularly practice third trimester abortions in the United States. It's an important in fact a global destination for what I in some of my work, call abortion migration. And so, I had been researching the experiences of some pregnant women and people who had made their way to Albuquerque for abortions later in pregnancy. And then when the pandemic hits, I became concerned about how how these sorts of narratives may have been impacted by a series of closures of abortion clinics or different types of abortion bans that occurred during the early days of the pandemic, in the United States. So what had happened was a series of Republican governors had used the pandemic to further an anti choice agenda, based on the argument that abortion clinics were diverting essential medical equipment from hospitals. And they were often using kind of ostensibly moral language of solidarity to justify this references to the common good. And so who were being heard with people seeking abortion care. And so I turned to a feminist bioethics to try and make sense of this, and also did a follow up study. You know, I interviewed some of the physicians that I've been working with for I've been, whose work I've been studying for years now about the ways in which their patients have been impacted by these increased burdens in terms of accessing abortion care.

Yeah, that is so interesting. And I mean, there were many things that I learned by reading your paper that I didn't know before, for example, I didn't realise that there were only four physicians who do third trimester abortions in the United States. Yeah, yeah. I mean,

well, some physicians will occasionally take on such such a case, right at their discretion. But really, if you find yourself in a situation in which you need an abortion, that that late in pregnancy, Albuquerque is a very likely spot for you to end up in. And given that abortion access is so limited on a global scale, even in countries that kind of seem kind of progressive and feminist and whose governments seem comparatively progressive and feminist, right, that there are these limitations. And so during my my first experience doing research there, pre COVID, in the summer of 2017, I interacted with patients who had travelled from New Zealand, Canada, different countries in Eastern and Western Europe, in addition to different parts of the United States. And so it's it's kind of a local kind of Albuquerque issue in many ways. It's also kind of a global migration issue. And so and, of course, COVID politics in the United States, conservative COVID politics, I've impacted reproductive health care on a global scale as a result of this.

Yeah, absolutely. So and I really wanted to ask you about this use of the language of solidarity, to promote that, as you put it in the anti choice agenda. So why don't you take us through some of the findings in the argument that you present in the paper on that, because I find that really fascinating?

Sure, yes. Yes. Um, so solidarity and the work that I was considering that the bailiff at all his paper that I cite in the paper, was concerned with developing a relational pandemic ethics, right? And so I'm very, I find this very intriguing as Discussing the paper. So this idea that when we, when governments engage in ethical pandemic planning, they have to look beyond individualistic frameworks. Right? So there are kind of individualistic concerns, right? These concerns about right on the extent to which pan pandemic mitigation efforts involve sacrifices of personal liberty, right? different sorts of questions about vaccine dissemination, but that's also a social justice issue, of course. But But the idea here is that if we want to engage in sensible pandemic is sensible and ethical pandemic planning, we have to think about people relationally. And we have to think about existing patterns of social injustice and marginalisation and we have to turn to different values that are going to help us achieve that. And so one of and so the paper that I'm exploring identifies different types of values, but I focus in particular on the value of, of solidarity that that Bayliss at all focus on. And this this is the idea that we have to cultivate a civic spirit of solidarity and the common good to really kind of develop the the willpower and the wherewithal to get through a pandemic. And we have to kind of be attentive to our social fabrics. And we have to find a way to to be able to come together and plan together and help one another. And, and certainly, you know, those who are following the way that the pandemic is playing out in the United States, and I know elsewhere, as well, we're having lots of conversations right now about the breakdown of solidarity and notions of the common good, and showing how social division can really undermine the abilities of the state to mitigate a pandemic. And so I think this is incredibly important, and it involves relational thinking. But what I was concerned about, in engaging this work in the early days of the pandemic was, again, how this notion of solidarity was actually being abused by by politicians. And of course, the authors that I cite, are opposed to this. But but but but the idea here is that if you can make the case that, you know, certain types of medical equipment need to need to remain in hospitals, right to be treating COVID victims are kind of people who are suffering with suffering from whatever kind of disease has inspired the pandemic, saying that there's actually kind of that, that abortion care is diverting resources from from the common good. We see cases in which the language of solidarity and the common good is being used to erase the needs of a marginalised social group or social group. And in this case, it's some people who are seeking abortion care. And so that's why I really wanted to focus in on on solidarity and think, of course, we need solidarity, but what are some alternative ways of approaching solidarity in in a framework and pandemic ethics that can help us kind of counteract these forces that these forces that would have abused that notion?

Yeah, absolutely. And this is sort of, not on your last point. But what you were saying just prior to that, about the way that solidarity is being employed, for these kind of alternate purposes. It strikes me that that's something that's happening to attack abortion rights in the United States, in a lot of different ways, kind of noticing over the years that different sorts of arguments that originate in one place, particularly in feminist work, or in critical race work, perhaps or disability rights work is being imported and used to undermine Roe v. Wade. And it's, you know, the various state laws that instantiate Roe v. Wade at the state level?

Absolutely, yes. And that that's been it's been very chilling to see that play out here in the United States and elsewhere with regard to abortion rights with regard to efforts to teach critical race theory and in schools, right, or even kind of talk about the real history of the United States. And so I certainly found that very chilling. And it raises the question, well, how you know, as feminists, how do we mitigate against this? And so I argue in the paper and I, I turned to Sally Schultz's work on solidarity, which is very much a project based solidarity, right, she talks about the solidarity that can that can come about as a result of a shared commitment to a certain political goal. And and I argue that in light of what we've seen play out, in the case of the COVID-19, abortion bans, we should build into our pandemic ethics, some discussion of the ways in which these values can be abused, right, and can be used for nefarious ends. And so I think that on solidarity should that we should also support solidarity when it comes to the efforts of marginalised groups and their allies to stand up against our ways in which the pandemic is being abused. For an anti anti egalitarian social goals, and so and so that's that that's the direction which I argue that we should take the discussion in light of the way in which we've sadly, recently seen this play out on the ground.

Yeah, absolutely. Now if I could just sort of change pace for a second, I would really love to ask you about the process of doing the research. I think at a point in the paper, you actually note that you're a philosopher, but you did this field work. And because part of the reason behind the podcast and the journal, of course, is to help facilitate Junior academics growing in their field. I wanted to ask you what it was like as a philosopher doing field work. And whether or not you had any challenges and getting that going conducting it? Yeah, thank

thank you for that, that question. And I and I hope that I can say things that will inspire Junior academics who might be interested in doing that philosophical field work to do so I'm certainly very passionate about it, and I found it extraordinarily worthwhile. For this project, I received a grant to support interdisciplinary collaboration, and NIH grant. And so I my first step was to convince a physician. So I worked with a physician in the family planning division of the Obstetrics and Gynaecology department at the University of New Mexico School of Medicine, I had to convince her to kind of take me on as a partner to do to do some of this research. And of course, this this was someone remade, seeing a wonderful physician, who not only is a practising physician at that time, she's a practising abortion provider, but also a professor ready to train and train people to do this work moving into the future. And so I had, the first challenge was to share some of the benefits of doing philosophy or kind of make a case for getting philosophical work happening in this space. And so fortunately, I was able to find a mentor and a collaborator who was willing to take me on that journey. So So, to me, as a philosopher, I'll talk about why he was beneficial to me, and then also why I hope it was beneficial to non philosophers doing some of his work. as a as a philosopher, particularly someone who's interested in issues of abortion ethics, I found it to be extraordinarily helpful to actually be in a space where I was able to see abortions happening. So I was I was brought into a couple of abortion clinics. And that was the expectation for being in that kind of learning environment. I was shocked at first as a philosopher to be invited into that space. But I was able to kind of see how abortions work, including abortions later in pregnancy in the second and third trimesters. With their permission, I was able to interview some of the patients and the physicians, and it really drove home for me, the fact that we just cannot have sensible and fair conversations about abortion, if they're not linked to the stories of the people who are having them. And I know that this gets said, time and time again, by feminists in abortion and abortion research, right. But there was something about being in that space and hearing those stories that really, that really made this come alive for me, because I confess that I was interested in the experiences of pregnant people who have to cross borders for abortion care. But I was at the very beginning of the research, I was still a little bit uncomfortable with third trimester abortion, I'll be really honest about it. I knew as a feminist that I needed to support it. But I had I had maybe just some personal misgivings that I didn't want to give voice to. But once I was in this space, I saw the procedures I talked to the people who were having the procedure of I heard their stories, the issue kind of, ethically speaking, the issue became clarified for me in ways that I wouldn't have achieved if I just had kind of abstract debates about this. And of course, I learned so much about border crossing for abortion care, which hadn't hadn't been written on to a great extent by social scientists. So I had to do the research myself. So it was incredibly informative and come transformed in many respects my vision of political philosophy and immigration ethics, that's how huge it was for me. Um, I hope that for the physicians that I worked with the two different abortion clinics, I hope that the experience was also beneficial to them. I know that they, you know, abortion providers are vulnerable in many ways, particularly though the few who are doing this work are providing abortion care later in pregnancy. And so of course, they have an interest in having this information, get out into the public domain, right and really kind of humanising this process. But I also found that often when I was in these medical spaces, I often found that abortion doctors wanted to open up about different ethical challenges. That they were encountering in their work that perhaps philosophers haven't yet anticipated. And they're things that I'm the kind of team. For example, I had a very philosophically kind of challenging and rich conversation with an abortion doctor who had just finished an abortion and was going through the process of making sure that she had found all of the foetal remains right, kind of. And so this right, this is a very vivid process. And she was going through it and sort of kind of opening up about, again, different challenges that she had faced and philosophical questions that she had. And so I think that being a philosopher, in this space alongside the people who are doing this work at these incredibly important moments, I think that that can be I think that that can be beneficial both ways. And it can show medical providers as well, that there is a space to ask these kinds of questions and have these kinds of conversations. And so it can be challenging to make the original case to do this work. But once you're able to get your foot in that door, and kind of find a community of people who are willing to work with you. I think it can be really transformative, I would encourage you in your academics to give it a try if they're interested in it.

And yeah, Wow, that's so interesting. And that really does. That experience sounds so important, and really rich.

Thank you, thank you for and I think often people don't appreciate that the extent to which abortion providers themselves are, again, grappling with ethical challenges. I know that some abortion doctors really struggle when it comes to providing abortions in cases of disability, right? This is something that feminists have written about, right, but we don't think about what it's like to be the abortion provider who has to defend abortion rights on the one hand, but has these personal misgivings. On the other hand, right. I interviewed a physician who was actually trying to incur with letting a patient know that she didn't have to get an abortion because of an anticipated facial deformity on the on the part of the foetus, right, or the eventual baby, she was talking about different cosmetic surgery options that were available, right. And, and the fact that, um, that abortion providers are having these struggles and want to be able to talk to them, and talk about them. I think it's something that I hadn't appreciated before, right. But there's just so much nuance to be discussed and explored. And once you do, kind of the ethnographic research and kind of get into those spaces, so many issues come to light that maybe as philosophers, we don't automatically anticipate.

Yeah, definitely, definitely. So I guess just to bring it back to this paper for a moment, in order to kind of wrap up, I think we're getting quite close to our time, there's so much to talk about. It's really interesting. Yeah, regarding COVID-19, ongoing effects and access to abortions going forward. Is there anything in particular that you hope that people will take away from this paper having, having learned and, and now thinking?

Yes, well, in this paper, in a couple of recent articles, as well, I really want to draw attention to the fact that abortion is a migration challenge in so many ways. And so accessing abortion care protect, particularly if one finds oneself in a so called abortion desert, right, a lot of the US South is an abortion desert, right? This is an issue that we that we have to also evaluate via the lens of migration, justice, in many ways. And COVID just exacerbated that, in so many ways. So so. So on the one hand, I hope that this paper is just more evidence of the vulnerability of rights to abortion care on a global scale, I think to kind of harken back to the issue that we were just talking about, it's, we can in the case of a pandemic, moral language, feminist moral language can easily be abused, and in ways that that harm harm women that harm people with reproductive with gestational capacity. And so I hope that people will take that home as well. And finally, just just the fact that that, again, kind of abortion rights touches upon so many different kind of ethical challenges that we've been addressing as bioethicists and feminist scholars, I think we need to broaden the lens by which we approach this problem and use as many tools as we have at our disposal at our disposal to try and really make the case for increased abortion rights in the in the United States involved and beyond. Yeah,

I completely agree with that. Thank you so much for talking with me, Amy.

Yes, thank you for your time. I really appreciate it.

Well, thank you for your time. Thank you for joining me. And thank you so much for listening to this episode of fat gab. You can find Amy's paper linked in, this episode's notes along with a transcript of our discussion. FAB Gab is hosted by me, Kathryn MacKay and produced by Madeline Goldberger. You can find our other episodes on Spotify, Radio Public, Anchor, or wherever you get your podcasts of quality. Thanks again for listening. Bye.