There's a reason why there are so few abortion providers in America today: Doctors are aware of the facts. At day 21 after conception, the heart of the fetus is beating, it has its own blood supply that is not shared with the mother, and all its internal organs are rapidly developing. Early in development the fetus responds to pain and has cortical brain activity. If any doctor had a patient with brain activity who responded to pain but wasn't able to sustain life on their own, the physician's question would be, "What's the prognosis for improvement?" For fetuses, the prognosis is overwhelmingly good. Why are we treating the lives of unborn children so much more recklessly than the lives of the elderly in intensive care units?

I sympathize with women who have crisis pregnancies. I've delivered food, diapers, and money to women with new babies on many occasions. As a psychiatrist and father, I'm aware of the turmoil and soul-wrenching difficulty that a baby can bring to life, especially in situations where there are limited resources.

Choice and privacy over one's own body are of penultimate importance and are foundational to the practice of medicine and the Constitution. They are surpassed only by the right we all have to live, in my view and in the view of many physicians and citizens, both in the uterus and outside it.

David Estep
Morgantown, West Virginia

Sharon Lerner replies: As I write in the story, the mayor's plan allows those who "object on moral grounds" to opt out of training.

I applaud Mayor Bloomberg for addressing the need to continue to train gynecologists in pregnancy termination. A woman's right to choose to become a mother is totally dependent upon having the skilled physicians able to safely and effectively perform the procedure (or to supervise medical terminations, which are now so efficacious). The physicians of my generation embraced the opportunity to help women avoid the fatal complications of improperly done abortions. By his actions, Mayor Bloomberg clearly demonstrates his concern for the health and well-being of the women of New York City.

Irene N. Sills, M.D.
Associate Professor of Pediatrics
Albany Medical Center
Albany, New York

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