Curious Bioethics: July 10-16, 2023
Body reattachment, Nebraska abortion case, Measles warning, an 1800s abortionist, The Comstock Act
In today’s curated collection, you’ll find:
🗞️Bioethics News: Body reattachment, Nebraska abortion case, Measles warning
📚Recommended Reading: Famous Abortionist from Old New York: Madame Restell
🦉Educational Opportunities: The Comstock Act Explained
Hey there, Curious Human!
I had a bit of a rough week clinically, so please forgive my day late delivery of Curious Bioethics. This week's professional highlight included telling a story live at Stanford’s Story Rounds. I told a story of sexual harassment and the magic that can follow when individuals band together to demand organizational courage.
I’m thrilled to be heading out on a week of much-needed vacation. I turned off my pager and the hospital’s HIPAA texting app. As with many American’s, I have hard time separating myself from work, so I’m looking forward to being in the mountains and a little more off the grid.
🗞️ Bioethics in the News
Body reattachment surgery in Israel
“The fact that such a child has no neurological deficits or sensory or motor dysfunction and that he is functioning normally and walking without an aid after such a long process is no small thing,” Einav said.
Suleiman Hassan, a 12-year-old Palestinian from the West Bank, suffered what is known as an internal decapitation, with his skull detached from the top vertebrae of his spine – officially known as a bilateral atlanto occipital joint dislocation.
Surgeons at the Hadassah Medical Center were able to repair his orthopedic injuries in June and announced the surgery last week. I have to assume there were no severe injuries to any major blood vessels or nerves. This is a very rare situation, and this boy is incredibly lucky.
This case highlights the serious impact of access to high-quality hospital services. Patients seriously injured in rural areas, far from hospital services, are less likely to have a good outcome.
Nebraska Mom Pleads Guilty to Giving Abortion Pills to Her Teen Daughter
Jessica Burgess faced eight years in prison for helping her then 17-year-old get abortion pills. A plea deal brought it down to two.
When Celeste Burgess was 17, someone told the police she had a stillbirth and buried the remains. The police obtained a warrant for her Facebook messages between her and her mother. These messages revealed Celeste’s mother, Jessica Burgess, had discussed ending the pregnancy with pills.
Celeste was charged as an adult and plead guilty in May, facing a two-year prison sentence. Her mom, Jessica, also faces two years in prison.
To learn more about how tech companies may expose patient data, check out “How US police use digital data to prosecute abortions” by Runa Sandvik.
In this case, it was Facebook that revealed Celeste’s abortion, but it’s usually healthcare workers and friends who turn in people for having abortions. You can read more about that data below:
London Measles Outbreak Prediction
London could see tens of thousands of measles cases due to low levels of vaccination, the UK Health Security Agency (UKHSA) has warned.
Mathematical calculations suggest an outbreak could affect between 40,000 and 160,000 people.
Levels of measles, mumps and rubella (MMR) vaccinations in the UK are at their lowest level in a decade, with around one in ten children not protected by the time they start primary school.
Data below show UK and Wales with three years with significant measles outbreaks (2012: 4,211, 2013: 6,193, 2018: 2,557). While the 2012-2013 outbreak was not limited to London, the recent outbreaks show that many cases occur in London. 67 million people live in the UK and nearly 9 million in London.
For comparison, the US had its worst measles outbreak in 2019, with 1274 cases in the country.
Measles vaccination in the US remains high-ish (90.8%), similar to the UK. Small communities that avoid vaccination can fuel larger outbreaks. In 2019, Ultra-Orthodox Jewish communities were linked to an outbreak in Rockland County, NY. Travel may expose folks to measles in unexpected places, such as at Disneyland in 2015, which spread to other US states and Mexico. Last March, the CDC warned that nearly 20,000 may have been exposed to measles at a religious event in Kentucky.
📚 Recommended Reading
Madame Restell
The Life, Death, and Resurrection of Old New York’s Most Fabulous, Fearless, and Infamous Abortionist
Acting as a businesswoman, an abortion doctor, and reproductive justice advocate, Madame Restell provided contraceptive pills, abortion pills, and surgical abortions in New York in the 1800s. Born Ann Trow Lohman in England, she was married with a child when she and her husband moved to New York, hoping to build a better life. Her husband died in New York, and Ann needed to find a way to make a living and support her daughter. She worked as a seamstress for low pay and poor working conditions. After meeting her second husband, Ann met Dr. William Evans. He was not a formally trained physician, but in the years before medical regulation, he fashioned himself into a doctor to sell herbal pills and powders.
Ann decided to sell her own pills and, ultimately pills to end pregnancies. She fashioned herself Madame Restell, claiming to have been trained as a physician in France (where sexual mores were more liberal). She ran effective advertisements in local newspapers that drove business.
In addition to cataloging an enterprising woman making her way in a difficult city, Wright shows how difficult it was to be a woman in the 1800s. Women working in service as maids could easily be coerced into sex or simply raped and quickly abandoned by their employers. Work for women was extremely limited and competitive. Women with children faced the outsized task of working and figuring out how to keep them safe while unsupervised. Toddlers were often left to care for babies, or children were drugged with laudanum or other sedatives so parents could work to afford the family’s food.
I was struck by how few reports of Restell’s patients being harmed could be found. She had many repeat customers for her pills and surgical abortions. As opposed to many other abortions reported at the time (with high incidence mortality), Restell kept surgical patients in her care for days after the procedure to ensure they were fed and resting. Her services were incredibly popular, and the fees catapulted her out of poverty to become a wealthy (if not respected) woman of the time.
Restell’s ultimate downfall came from notorious anti-vice crusader Anthony Comstock. He saw contraception and abortion as equally reprehensible and made it his mission to go after people like Restell. In a post-Dobbs American, the Comstock Act first passed in 1873, has resurged in importance.
For shorter summaries of Restell’s life, check out these resources from the New York Historical Society and Smithsonian Magazine:
Life Story: Ann Trow Lohman, a.k.a. Madame Restell (1812 - 1878), Notorious Abortionist: The story of the most famous abortionist in New York history.
Madame Restell: The Abortionist of Fifth Avenue - Without benefit of medical training, Madame Restell spent 40 years as a “female physician”
🦉Educational Opportunities
No registration is required! Just go straight to YouTube for this on-demand bioethics education.
The Comstock Act with Boom! Lawyered
Conservative anti-abortion activists attempt to resurrect the Comstock Act to ban mailing abortion pills. In this video, Imani Gandy is joined by special guest and colleague Garnet Henderson, reporter and Comstock Act expert, to explain how we got here and where we're going.
That’s it!
As always, thanks for being curious!
Hit reply and let me know what ethics issues you are most curious about this week—I’d love to hear from you!
See you next week!
Be Well & Be Curious,
Alyssa
