Book Review of Choice: a Doctors Experience with the Abortion Dilemma by Don Sloan

Dr. Don Sloan wrote Choice: A Doctor’s Experience with the Abortion Dilemma in 1992, when it was titled Abortion: A Doctor’s Perspective, a Woman’s Dilemma. The book was re-released in 2002 with the new title. By 2002, Dr. Don Sloan had been a doctor for forty years. For most of that time, he had been performing abortions.

Dr. Sloan first tells of how he became involved with abortion. He discusses his experiences as a resident in Philadelphia in the 1960s, when abortion was illegal in all but the most extreme cases. He tells stories of women who came into the emergency room injured from attempted self-abortions as well as poorly done illegal ones (the back-alley’ abortions) Sloan’s stories are very hard to take; he uses graphic descriptions of medical procedures and pulls no punches in describing the terrible condition of many of his patients. His depictions are extremely graphic and upsetting. Sloan describes how he was disturbed by the condition of many of the women he treated and how he came to believe that abortion should be available to all women. Women are still injured form abortion, even when it is legal. However, pro-lifers should remember that when abortion is illegal, it is still important to help women carry their pregnancies to term and have their babies. Pro-life crisis pregnancy centers will be needed more than ever.

Sloan met a doctor named Dr. Douglas Spencer. Dr. Spencer was a small town doctor who was an illegal abortionist of some skill. Unlike the back-alley practitioners that Sloan often ran into in Philadelphia, Dr. Spencer had few complications. Sloan depicts Dr. Spencer as a selfless saint, a kindly mentor and a champion of women. No doubt, his portrait is an exaggeration- no human being can really be as kind and selfless as Dr. Spencer is described to be.

He also discusses how Dr. Spencer had few complications. However, there is no way to really know this. Since women traveled from all over to have their abortions and then went home almost immediately afterward, Spencer would most likely not see any complications that were not readily apparent on the abortion table. For example, there is no way to know how many of those women ended up with life threatening infections. Only their local doctors would know.

Dr. Sloan goes on to discuss how he became an illegal abortionist. Then he describes how he and other doctors worked to make abortion legal in the United States. He talks about how Roe Vs. Wade, the Supreme Court case which struck down all anti-abortion laws and created abortion as a legal right for women, was in his opinion a great victory. After Roe Vs. Wade, Dr. Sloan worked with other pro-choice professionals to set up one of the country’s first abortion clinics. His clinic was a high volume clinic, seeing many clients every day. Sloan describes how patients and their partners lounged on the floor of the waiting room and lined up outside. He discribes making a great deal of money. Despite the obvious lucrative nature of his work, he continues to depict his motives as being purely altruistic.

Sloan also discusses some of the other people he met while in the abortion business, including future pro-life activist Dr. Nathanson, who, at the time, was the co-founder of NARAL, a group dedicated to keeping abortion legal. Sloan also describes some of the women in his clinic, touching on their situations.

Dr. Sloan paints things as being entirely black or white. Abortion is good. Laws against it are bad. Pro-Choice doctors are good; Anti-Choice’ activists are bad. To him, abortion is a morally benign procedure, a gift to women in crisis. Nowhere in the book does he show the slightest ambivalence about providing abortions. Abortion, in Sloan’s world, is unquestionably good. And the doctors who provide abortions, or at least the doctors he depicts, are heroes who do abortions out of compassion and respect for women.

Sloan never deals with the moral complexities of abortion, or delves into the reasons behind women’s abortions. He never discusses the fetus/unborn baby. In his rhetoric, the potential baby is completely omitted, and he never seems to address the central question in the abortion debate- is abortion killing a person? Sloan acts as though this question does not exist; in his world there are only pregnancies to be ended and women to set on a path to freedom and health. When discussing women’s reasons for having abortions, he only skims the surface. For example, he talks about how many inner city women came in to have abortions, but never discusses greater issues that may be driving them, such as poverty, lack of birth control, lack of role models or self-esteem issues that might make them more vulnerable to having unplanned pregnancies. Abortion, in his mind, seems to be a cure-all; deeper issues never really enter into the picture.

He also puts abortion providers on a pedestal. His depiction of Dr. Spencer is romanticized. He even makes excuses for an abortionist he worked with who turned out not to be a doctor at all. This man was non-medical professional illegally performing abortions on unsuspecting women, yet Dr. Sloan makes excuses for him.

Overall, Choice was very much worth reading. It gave me insight into the mind of someone who spent over thirty years doing abortions, and added to my understanding of the issue. I did not agree with most of the points Dr. Sloan made or accept all of his conclusions as being correct, but I still feel that I learned a lot from reading the book.

Anyone interested in the abortion issue should read Choice, because it helps the reader understand the view of a provider. However, it is hardly a balanced or definitive work, in that it never addresses many of the deeper issues surrounding abortion or its moral ambiguity. Despite Dr. Sloan’s rose-tinted perspective on the issue, I appreciated learning about his motivations and opinions. I feel that I can better understand what drives a person to dedicate his or her life to something that so many people find offensive and wrong; why someone would open him/herself up to so much criticism and risk the disapproval of so many people.

Quotes from the book

With the D&E, as with any suction procedure, the materials passing through the suction tip are easy to see, and at that stage, the clear polyethylene tubing and the translucent plastic cannula are of a large enough bore to allow you to identify what you are seeing. In fact, it’s medically required that you do so, to confirm that the abortion is total and the uterus empty. Out pass the limbs, the intestines and the various internal organs. Most important, it is imperative for the operator to be convinced that the skull tissue has passed, this being the largest part of the fetus formed at that stage of pregnancy.”(p 187)

…..

“So we have these centers where patients are counseled, but don’t make the mistake of thinking it’s a thorough job. The counseling is less than might be desirable at times…For someone performing abortions, the volume can be so great it’s overwhelming. I’ve sent out tens and tens of thousands of women, and I know so little about so many of them- most of them. How could I? In a sense, the doctor is only a tradesperson, a technician performing a task, like any other…There are many times- frequently, in fact, and I do to this very day- when I will get a referral to do an abortion on a woman I’ve never seen, will see only for those fleeting minutes of the termination, and then never seen again. That scenario isn’t peculiar to me- it goes with the territory.”(p 103)

…..

“If a woman with a serious illness- heart disease, say, or diabetes- gets pregnant, the abortion procedure may be as dangerous for her as going through pregnancy … with diseases like lupus, multiple sclerosis, even breast cancer, the chance that pregnancy will make the disease worse is no greater that the chance that the disease will either stay the same or improve. And medical technology has advanced to a point where even women with diabetes and kidney disease can be seen through a pregnancy safely by a doctor who knows what he’s doing. We’ve come a long way since my mother’s time….The idea of abortion to save the mothers’ life is something that people cling to because it sounds noble and pure- but medically speaking, it probably doesn’t exist. It’s a real stretch of our thinking.”(P 45-46)]

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About Sarah

Sarah is a member of the board of The Pro-life Alliance of Gays and Lesbians.
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