  Yesterday, as part of my OB/GYN rotation, I went to a hospital clinic that performs VTOPs, voluntary terminations of pregnancy. A young girl, who had used the morning-after pill, but unfortunately a month too late, came in at about 9 weeks. What does that mean? It means that there was a visible heart beating on transvaginal ultrasound, and that in the suction basin there was an intact little ribcage the size of a pea, a perfect hand the size of a snowflake. I nodded, staring at it. Acknowledge, move on. The whole procedure was quick, as the attending said, "ten minutes, but five minutes of it is opening packages and getting ready. " The only thing that hurt was the injection of a little local anesthetic. It was the least impressive and least invasive gynecologic procedure I had seen. The staff was kind, professional, and despite the emotionally traumatic nature of what was being done, the whole episode was more to me like a trip to the salon.
I don't think the patient will remember the experience with any pain or dissatisfaction. I don't think the experience will plague her as something she regrets. I have seen, in the past month, a hundred patients with obstetrical records that include abortions, and they seem to me to be almost par for the course, and more representative of a failure of birth control than a life mistake. Today, we evacuated the uterus of a woman who'd tried to have babies by IVF - in vitro fertilization - only to have her fetus spontaneously die in utero. She had come in for a routine checkup, and the doctor just told her that he couldn't pick up a heartbeat. Given the option of letting the uterus clear itself naturally or having a D&C, she opted to have it taken out.
I understand her feelings. When you are attached to what's in there, and what's in there dies, wouldn't you want out of you as soon as possible? This is what differentiates it from a VTOP in my mind, what places the experiences on completely different planes. There was a great little piece in the New England Journal of Medicine about the history of the Hippocratic Oath, showing how it's changed over history. At my school, it's not worded in any way that could be construed as anti-abortion. This is true at many, if not most, american medical schools.
The same little part of it, about hastening death, etc, would have applied also to euthanasia, which, during the time of Hippocrates, was a very popular practice. incidentally. Oh, it's all just a reflection of current mores, which people shout about as if those mores were unadulterable and unchanging, which is a load of crap. I'm not a political creature, but somewhat of a moral relativist stuck in a profession that professes to a moral high ground. There is so much inconsistency. What do you really believe in? What would you have your doctor believe about the sanctity of life? 
