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Texas Supreme Court justices at an abortion case hearing in November. (Photo by SUZANNE CORDEIRO/AFP via Getty Images)

Weekend Listening: Honest Conversations About Abortion

The case of Kate Cox and the importance of difficult discussions.

Free Press readers are the rarest of communities in 2023 America: we don’t all agree.

We are a group of more than half a million readers who disagree passionately—but who, for the most part (ahem; I won’t name commenters but we know who you are)—respect one another’s views.

The same goes for those of us who are building The Free Press. Editors and writers here disagree about Ukraine and the limits of cancel culture and immigration and presidential politics. 

We also disagree about abortion.

And this past week, thanks to the case of Kate Cox in Texas—the first time a woman has sought a court pre-authorization for an abortion since Dobbs—that’s the topic we’ve been debating in our Slack.

In case you missed it, here are the details of the case.

Kate Cox is a 31-year-old mother of two from Dallas. She was pregnant with a much-wanted baby who had been diagnosed with trisomy 18, a genetic condition that causes major birth defects and severe developmental and intellectual delays. The condition kills 90 percent of the babies born with it before their first birthday. 

Cox was 20 weeks pregnant when she first filed her lawsuit and argued that carrying her pregnancy to term would risk her health and her ability to have more children in the future. A Texas court granted Cox a medical exception to the state’s ban on abortion after six weeks. 

But Texas Attorney General Ken Paxton warned that Cox’s physician could still face penalties for performing the procedure—including first-degree felony prosecutions. He appealed that decision to the state’s supreme court, which overturned the lower court’s decision, denying Cox an abortion. 

In an unsigned opinion, the judges found unanimously that Cox’s doctor “could not, or at least did not, attest to the court that Ms. Cox’s condition poses the risks the exception requires” and that the doctor’s “good faith belief” that Cox’s life was at risk was not enough for an exception. 

On the day of the ruling, Cox said that she had traveled to another state for an abortion. 

“I am a Texan. Why should I or any other woman have to drive or fly hundreds of miles to do what we feel is best for ourselves and our families, to determine our own futures?” asked Cox. (Read her whole op-ed.)

Our brilliant researcher here at The Free Press, Neeraja Deshpande, disagrees with me on this case, and so I asked her to give her argument first: 

While Cox’s legal argument focuses on the health of the mother, the emotional force of her request for an abortion comes from a desire to spare her daughter suffering. Even if her daughter is part of the tiny minority of people with trisomy 18 who live to adolescence or adulthood, she will be severely disabled and require constant medical care. 

“I do not want my baby to arrive in this world only to watch her suffer,” Cox wrote.

No one can blame Cox, already a mother twice over, someone who knows what it is to birth and raise a child, for preferring the known of abortion to the unknown of what is likely to be a short and agonizing life for her baby. But trisomy 18 or not, her daughter was destined to suffer—everyone in this world suffers.

Euthanasia, by abortion or other means, seeks to address the problem of suffering. And in doing so, it puts us in the dangerous position of determining how much suffering we will allow another person to endure before we end their life. It forces us to decide who is better off dead and who is better off alive. 

This week, former Pennsylvania senator Rick Santorum shared a photo of his 15-year-old daughter Bella, who has trisomy 18. On Bella’s twelfth birthday, Santorum said of her: “Her joy and radiance is a gift to all those around her. Bella is so happy and proud of herself when she rides her tricycle, swims in the pool, rides her pony, jumps on her trampoline, and walks down the hallway in her walker.” 

Bella Santorum has gone through more hardship than most of us ever will, but her life, from all indications, is nevertheless full of real meaning and happiness amid the suffering. 

It is hard to say that Kate Cox’s child should be born just to die, but in my opinion we cannot declare ourselves the arbiters of human dignity and expect good results. 

Insofar as our views on this complicated issue can be labeled, Neeraja is pro-life. I am pro-choice.

As I wrote in these pages after the passage of Dobbs:

“I’m pro-choice. My own stance is that abortion is not trivial. It is tragic. And yet the life of the mother always takes precedence.

I am horrified by the law in a state like Arkansas, in which a teenager could be raped by a relative and forced to carry a pregnancy to term. It is hard for me to see how such a policy could possibly be cheered by those who regard themselves as pro-life.

But I also shudder at the comparisons some in the pro-choice movement have made between abortions and procedures like a tonsillectomy. These are lies and crude propaganda—as anyone who has ever seen an ultrasound of their baby will tell you.

I also do not think a nine-week-old fetus is the same thing as a baby. Or as the woman carrying it. Which is why I do not think abortion in the first trimester is the same as murder. I look at laws in places like Denmark and Ireland, which bar abortion after 12 weeks, or Germany and France, which bar it at 14 weeks, and those seem to me like sensible compromises.”

To me, the case of Kate Cox is another appalling example of the cruelty of near-total abortion bans. 

It’s also a tragic rebuttal to the pro-life claim that exceptions to those bans allow for a doctor and patient to make decisions in the woman’s best medical interests. That wasn’t the case for Kate Cox—who was prohibited from following the good-faith opinion of her doctor. And it won’t be true for other women like her—in Texas and in other states with similar bans—as they grapple with the painful question of whether to end a pregnancy. 

Illuminating debates, including on abortion, are what we work hard to bring you on Honestly. So for today, as you think about Kate Cox’s case and what it portends, and perhaps debate it with people in your own life, we offer you three episodes of the podcast that have helped clarify our own thinking—wherever we fall on the issue.

In December 2019, Caitlin Flanagan wrote the single most honest essay I’ve ever read about abortion. Two years ago, she came on Honestly to discuss the issue in light of new abortion restrictions in Texas—the same restrictions that denied Cox an abortion.  

Yale Law professor Akhil Reed Amar is anti-Roe, but pro-choice. He came on the podcast after a draft of the Dobbs decision was published last year to explain his dissent from liberal orthodoxy on America’s abortion laws.

And in the immediate aftermath of the Dobbs decision, we hosted a roundtable featuring Bethany Mandel, who is pro-life; Katherine Mangu-Ward, who is pro-choice; and Jeffrey Rosen, the head of the National Constitution Center and one of the country’s foremost legal commentators. It was the kind of conversation we need more of: deep, honest, and thought-provoking. 

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