This business of "medical necessity"

Senate Bill 49 and its sponsor substitute is before the legislature and each of us again. This “Act defining ‘medically necessary abortion’ for purposes of making payments under the state Medicaid program” continues to be yet another attempt to do an “end-run” around the Alaska Constitution and to implement discrimination of health care for segments of our population. This proposed legislation must not be implemented for the following reasons:


• Certified, trained and reasoned health care professionals will affirm that “body and soul” cannot be separated. It is not possible to disconnect and separate stress, violence, fear, war, poverty, post traumatic stress disorder and personal life issues from health, well-being, and disease One has only to observe warriors coming home from battle, children who have been neglected or physically abused, life trauma, harassment, minority repulsion from society, and domestic violence to clearly understand the effects on health and well-being of individuals.

• This proposed list of “medically necessary abortions” that are proposed to be approved for to do abortions was created by what group we do not know. This list is incomplete, punitive, and academically inconsistent with the current understanding of recognized medical and psychological experts in their fields on the impact of many different physical illnesses, mental illnesses, emotional states, and psychological disorders on the outcome of a pregnancy – intended or unintended. It is not the purview of this legislative group to make that determination of health, illness, or management.

• At the very least, it is reprehensible that this proposed legislation was and is not referred to the Department of Health and Social Services for review, study and participation. To do otherwise represents deplorable political and uncivil actions for a fair and transparent hearing of the issues.

• The education, social supports, financial resources, and encouragement for contraception and reproductive accountability on the part of men and women in our society is far superior to these regressive and pejorative attempts to control one segment of the society. To enact such measures against one segment of society is not politically or socially ethical and it is certainly not constitutional.

• Let us be clear. Men absolutely and decidedly must bear and assume joint responsibility in the personal and social outcomes of unintended and unwanted pregnancies with the subsequent emotional, physical, mental, social, and economic adversities for those involved.

We can do far, far better than enact this legislation. All stakeholders must be at the table. Correct and informed discussions must take place in a civil manner. Alaska can do better than enact this proposed legislation.

carolyn V Brown MD MPH



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