[House Hearing, 113 Congress]
[From the U.S. Government Publishing Office]
DISTRICT OF COLUMBIA PAIN-CAPABLE
UNBORN CHILD PROTECTION ACT
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON THE CONSTITUTION
AND CIVIL JUSTICE
OF THE
COMMITTEE ON THE JUDICIARY
HOUSE OF REPRESENTATIVES
ONE HUNDRED THIRTEENTH CONGRESS
FIRST SESSION
ON
H.R. 1797
__________
MAY 23, 2013
__________
Serial No. 113-19
__________
Printed for the use of the Committee on the Judiciary
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://judiciary.house.gov
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COMMITTEE ON THE JUDICIARY
BOB GOODLATTE, Virginia, Chairman
F. JAMES SENSENBRENNER, Jr., JOHN CONYERS, Jr., Michigan
Wisconsin JERROLD NADLER, New York
HOWARD COBLE, North Carolina ROBERT C. ``BOBBY'' SCOTT,
LAMAR SMITH, Texas Virginia
STEVE CHABOT, Ohio MELVIN L. WATT, North Carolina
SPENCER BACHUS, Alabama ZOE LOFGREN, California
DARRELL E. ISSA, California SHEILA JACKSON LEE, Texas
J. RANDY FORBES, Virginia STEVE COHEN, Tennessee
STEVE KING, Iowa HENRY C. ``HANK'' JOHNSON, Jr.,
TRENT FRANKS, Arizona Georgia
LOUIE GOHMERT, Texas PEDRO R. PIERLUISI, Puerto Rico
JIM JORDAN, Ohio JUDY CHU, California
TED POE, Texas TED DEUTCH, Florida
JASON CHAFFETZ, Utah LUIS V. GUTIERREZ, Illinois
TOM MARINO, Pennsylvania KAREN BASS, California
TREY GOWDY, South Carolina CEDRIC RICHMOND, Louisiana
MARK AMODEI, Nevada SUZAN DelBENE, Washington
RAUL LABRADOR, Idaho JOE GARCIA, Florida
BLAKE FARENTHOLD, Texas HAKEEM JEFFRIES, New York
GEORGE HOLDING, North Carolina
DOUG COLLINS, Georgia
RON DeSANTIS, Florida
[Vacant]
Shelley Husband, Chief of Staff & General Counsel
Perry Apelbaum, Minority Staff Director & Chief Counsel
------
Subcommittee on the Constitution and Civil Justice
TRENT FRANKS, Arizona, Chairman
JIM JORDAN, Ohio, Vice-Chairman
STEVE CHABOT, Ohio JERROLD NADLER, New York
J. RANDY FORBES, Virginia JOHN CONYERS, Jr., Michigan
STEVE KING, Iowa ROBERT C. ``BOBBY'' SCOTT,
LOUIE GOHMERT, Texas Virginia
RON DeSANTIS, Florida STEVE COHEN, Tennessee
[Vacant] TED DEUTCH, Florida
Paul B. Taylor, Chief Counsel
David Lachmann, Minority Staff Director
C O N T E N T S
----------
MAY 23, 2013
Page
THE BILL
H.R. 1797, the ``District of Columbia Pain-Capable Unborn Child
Protection Act''............................................... 4
OPENING STATEMENTS
The Honorable Trent Franks, a Representative in Congress from the
State of Arizona, and Chairman, Subcommittee on the
Constitution and Civil Justice................................. 1
The Honorable Jerrold Nadler, a Representative in Congress from
the State of New York, and Ranking Member, Subcommittee on the
Constitution and Civil Justice................................. 24
The Honorable Bob Goodlatte, a Representative in Congress from
the State of Virginia, and Chairman, Committee on the Judiciary 26
The Honorable John Conyers, Jr., a Representative in Congress
from the State of Michigan, and Ranking Member, Committee on
the Judiciary.................................................. 28
WITNESSES
Anthony Levatino, Obstetrics and Gynecology, Las Cruces, New
Mexico
Oral Testimony................................................. 30
Prepared Statement............................................. 33
Maureen L. Condic, Ph.D., Department of Neurobiology and Anatomy,
University of Utah School of Medicine
Oral Testimony................................................. 36
Prepared Statement............................................. 39
Christy Zink, Washington, DC
Oral Testimony................................................. 47
Prepared Statement............................................. 49
Jill L. Stanek, RN, Mokena, IL
Oral Testimony................................................. 50
Prepared Statement............................................. 53
LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING
Material submitted by the Honorable Jerrold Nadler, a
Representative in Congress from the State of New York, and
Ranking Member, Subcommittee on the Constitution and Civil
Justice........................................................ 61
DISTRICT OF COLUMBIA PAIN-CAPABLE UNBORN CHILD PROTECTION ACT
----------
THURSDAY, MAY 23, 2013
House of Representatives
Subcommittee on the Constitution
and Civil Justice
Committee on the Judiciary
Washington, DC.
The Subcommittee met, pursuant to call, at 10:04 a.m., in
room 2141, Rayburn House Office Building, the Honorable Trent
Franks (Chairman of the Subcommittee) presiding.
Present: Representatives Franks, Jordan, Goodlatte, Chabot,
King, Gohmert, DeSantis, Nadler, and Conyers.
Staff Present: (Majority) Paul Taylor, Majority Counsel;
Sarah Vance, Clerk; (Minority) David Lachmann, Subcommittee
Staff Director; and Veronica Eligan, Professional Staff Member.
Mr. Franks. The Subcommittee on the Constitution and Civil
Justice will come to order.
Without objection, the Chair is authorized to declare
recesses of the Committee at any time.
Thank you all for being here.
I will now recognize myself for an opening statement.
When innocent children are buried under the rubble caused
by tornadoes or are shot by crazed monsters, evil monsters in
schools or theaters, none of us consider that to be a partisan
issue. Likewise, protecting pain-capable unborn babies is not a
Republican issue or a Democrat issue. It is, rather, a test of
our basic humanity and who we are as a human family.
For the sake of all the Founding Fathers of this Nation
once dreamed America could someday be and for the sake of all
those since then who have died in darkness that we might all
walk in the light of liberty, it is important for those of us
who are privileged to be Members of Congress to pause from time
to time and remind ourselves why we are really all here.
Thomas Jefferson said the care of human life and its
happiness, and not its destruction, is the chief and only
object of good government. The phrase in the 14th Amendment and
the Fifth Amendment capsulize our entire Constitution. No
person shall be deprived of life, liberty, or property without
due process of law.
Ladies and gentlemen, protecting the lives of all Americans
and their constitutional rights is why we are all here. The
bedrock foundation of this republic is that clarion declaration
of the self-evident truth that all human beings are created
equal and endowed by their creator with uncertain unalienable
rights, the rights of life and liberty and the pursuit of
happiness.
Every conflict and every battle our Nation has ever faced
can be traced to our commitment to this core self-evident
truth. It has made us the beacon of hope for the entire world.
It is who we are.
Yet today, a great conundrum looms before America. When
authorities entered the clinic of Dr. Kermit Gosnell, they
found a torture chamber for little babies that I do not have
the words or the stomach to adequately describe. According to
the grand jury report, Dr. Kermit Gosnell had a simple solution
for unwanted babies. He simply killed them.
He didn't call it that. He called it ``ensuring fetal
demise.'' The way he ensured fetal demise was by sticking
scissors in the back of the baby's neck and cutting the spinal
cord. He called it snipping. Over the years, there were
hundreds of snippings.
Ashley Baldwin, one of Dr. Gosnell's employees, said she
saw babies breathing. She described one as 2 feet long that no
longer had eyes or a mouth, but in her words was like ``making
this screeching noise, and it sounded like a little alien.''
And I just wonder, for God's sake, sometimes is this really who
we are?
If Dr. Gosnell had killed the children he now stands
convicted of murdering only 5 minutes earlier and before they
had passed through the birth canal, it would have all been
perfectly legal in many of the United States of America. More
than 325 late-term unborn babies are torturously killed without
anesthesia every day in the land of the free and the home of
the brave.
If there is one thing that we must not miss about this
unspeakably evil episode, it is that Kermit Gosnell is not an
anomaly in this gruesome Fortune 500 enterprise of killing
unborn children. Rather, Kermit Gosnell is actually the true
face of abortion on demand in America, and every American with
the slightest shred of compassion for the innocent should go to
paincapable.com and learn the truth of this case and others
like it for themselves.
Not long ago, I heard Barack Obama speak very noble and
poignant words that whether he knows it or not apply so
profoundly to the real subject of this hearing. Let me quote
excerpted portions of his comments.
He said, ``This is our first task, caring for our children.
It is our first job. If we don't get that right, we don't get
anything right. That is how as a society we will be judged.''
The President asked the question that so many of us have
asked for such a long time on this issue. He asked it on
another issue. He said, ``Are we really prepared to say that we
are powerless in the face of such carnage, that the politics
are too hard? Are we prepared to say that such violence visited
on our children year after year after year is somehow the price
of our freedom?''
Again, that sounds exactly what many of us have said for so
many years regarding the children we are discussing here today.
The President also said, ``Our journey is not complete
until all our children are cared for and cherished and always
safe from harm. This is our generation's task,'' he said, ``to
make these words, these rights, these values of life, liberty,
and the pursuit of happiness real for every American.''
Never have I so deeply agreed with any words ever spoken by
President Obama as those I have just quoted. And yet in the
most merciless distortion of logic and reason and humanity
itself, this President refuses to apply these incontrovertible
words to helpless victims like those of Dr. Kermit Gosnell.
How I wish somehow that Mr. Obama would open his heart and
his ears to his own words and ask himself in the core of his
soul why his words that should apply to all children cannot
include the most helpless and vulnerable of all children. He is
their President, and they need him so desperately.
And my friends on this Committee, those helpless children
that we speak of today need all of us as well. Indeed, they are
why we are all here.
And with that in mind, I would like to end my opening
statement with two short video clips taken from today's
headlines. The first part is of the Live Action organization's
undercover expose of the late-term abortion industry. It shows
a late-term abortion counselor in my own State of Arizona
advising a pregnant woman on the need to address the unborn
child's pain.
The second is part of a testimony delivered by the
Philadelphia district attorney's office describing the horrors
uncovered in Dr. Kermit Gosnell's late-term abortion clinic.
So please go ahead.
[Video shown.]
[The bill, H.R. 1797, follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
__________
Mr. Franks. I would now yield to the Ranking Member, Mr.
Nadler from New York, for his opening statement.
Mr. Nadler. Thank you, Mr. Chairman.
We are back once again considering legislation that would
curtail women's reproductive rights. I understand how
personally important this is to some of my colleagues, and they
are certainly entitled to their beliefs. But the many Americans
who see the world very differently, including millions of women
who value their personal autonomy, can be forgiven if this
looks like just another battle in the Republican war on women.
I accept that on this one we are going to have to agree to
disagree. In this case, my colleagues appear, through the
operation of the criminal code, to be trying to settle a
scientific question on which there is no consensus within the
field. That is an exercise of raw political power, not of
dispassionate fact-finding.
Some of the views we are going to hear today are, in fact,
viewed by many scientists in the field as outliers, not as
mainstream scientific thought. The fact that the majority has
allowed two individuals to purport to present--to purport to
present as clearly established science views that are clearly
marginal in their fields will create a false and misleading
record.
The fact that the minority has been limited to only one
witness demonstrates just what a farce these hearings are. Yes,
I know we could have invited our own medical expert, but at the
expense of hearing from an actual woman who can provide a real-
world look at the impact this legislation will have on real
families. We could not do both.
The bill, as introduced, would prohibit nearly all
abortions beginning at 20 weeks. That, as every first-year law
student knows, is facially unconstitutional.
Just this week, the U.S. Court of Appeals for the Ninth
Circuit struck down a similar Arizona statute, saying, ``Since
Roe v. Wade, the Supreme Court case law concerning the
constitutional protection accorded women with the respect to
the decision whether to undergo an abortion has been
unalterably clear regarding one basic point. A woman has a
constitutional right to choose to terminate her pregnancy
before the fetus is viable. A prohibition on the exercise of
that right is, per se, unconstitutional.''
That, of course, is what this bill would do, and voting for
it would violate our oaths to uphold the Constitution.
Nonetheless, despite that, this bill would prohibit nearly all
abortions, including those involving threats to a woman's
health and in cases of rape or incest and where the woman may
have become suicidal.
Exceptions to protect the woman where her life and health
are at risk, as is not included in this bill, are required
throughout pregnancy, even post viability, if the bill is to be
constitutional. But such exceptions are not in this bill.
I hope that in addition to the many statements of concern
we will hear today for fetuses, we can also hear a few words of
concern for women and their families. The bill, as introduced,
would, as in the case in the last Congress, apply only to the
residents of the District of Columbia. I understand from the
Chairman's public statements that he intends to expand the
bill, to amend it to apply to the entire country.
While I had previously objected to the singling out of the
people of the District of Columbia, who are, after all,
taxpaying Americans who serve in our military, respond when one
of us has an emergency requiring police, fire, or EMT services,
and serve as congressional staff, I must now extend my
objections on behalf of my constituents and on behalf of the
women in the entire country.
This legislation represents an extreme view of the abortion
question and is at odds with the science. That is why people in
many States have firmly rejected it, including the people I
represent. Just as it is an outrage for Congress to impose its
will on the people of the District of Columbia, in this case,
so, too, I will fight any such usurpation of the rights of my
constituents.
I am not going to sit here and debate the question of fetal
pain, except to note that even Dr. Anand, who was cited in the
majority's witness testimony and hearing memo and who was
called by the majority to testify before this Subcommittee in
2005, told us, ``I think the evidence for and against fetal
pain is very uncertain at the present time. There is consensus
in the medical and scientific research community that there is
no possibility of pain perception in the first trimester. There
is uncertainty in the second trimester.''
The Journal of the American Medical Association concluded
that, ``Evidence regarding the capacity for fetal pain is
limited but indicates that fetal perception of pain is unlikely
before the third trimester.''
The Royal Academy of Obstetricians and Gynecologists
concluded, ``It can be concluded that the fetus cannot
experience pain in any sense prior to 24 weeks gestation.''
Are we really going to take sides in this scientific debate
by jailing and bankrupting people who don't agree because we,
as an all-knowing Committee of Congress, are going to decide
what the science is? That is what this bill would do.
Similarly, the claim that an abortion is never necessary to
protect a woman's health is simply not one that is widely held
in the medical profession, and the idea that we should be
enshrining this marginal view into the criminal code defies
reason. I hope that our medical witnesses will at least agree
that a woman can become pregnant as a result of rape, something
that some Members of this body seem to question.
I find it deeply disturbing that when it comes to issues
like this, some people think there is nothing wrong with making
families in crisis have the courage of legislators'
convictions. That is also wrong.
I know that we will hear a lot about the Gosnell case
today, and I would like to address it at the outset. Dr.
Gosnell has been proven a criminal. He is going to jail, and
deservedly so.
Colleagues who were here at the time may recall that I
actively supported passage of the Born-Alive Infants Protection
Act--I think this was about 12 years ago--which made it a crime
to kill an infant once it is born alive. As I said at the time,
that was already illegal everywhere, and even if it was
duplicated, we should support it now. I am confident that it
was the right thing to do.
What Dr. Gosnell did had nothing to do with abortion. It
was murder and infanticide, pure and simple. That Born-Alive
Infants Protection Act was not about abortion because it
involved live births and affirmatively killing a newborn. It
was about classic murder.
Similarly, Dr. Gosnell's practice of snipping a newborn's
spine following a live birth is indefensible, clearly murder,
and obviously illegal. That is why he was convicted.
What the Gosnell case does not illustrate, no matter how
many times activists insist it should, is anything regarding
the practice of abortion generally. The fact is that 40 years
after Roe, it is hard to find another practitioner like Gosnell
really--the fact that 40 years after Roe it is hard to find
another practitioner like Gosnell really speaks to the actual
state of that practice.
I am sorry that some on the other side of this debate seem
so gleeful that this has happened. It is a tragedy for these
women, and it is a disgrace that any medical practitioner
should have acted in such a manner.
I would urge my colleagues to think about the extent to
which he, Dr. Gosnell, represented the poor quality of
healthcare services available in poorer communities. We should
be working to make sure that high-quality healthcare is
provided to the uninsured, to make sure that the full range of
healthcare services, including family planning services, that
are available to people with money are available to the poor
and uninsured as well.
If that means funding a Planned Parenthood clinic in every
neighborhood to put guys like Gosnell out of business, so be
it. If it means closer regulation of the medical profession, so
be it. If it means an end to the constant efforts by my
Republican colleagues to limit the rights of injured patients
to sue, so be it.
But let us not pretend that this is about the practice of
abortion in America today. If it were, our prisons would be
filled with Gosnells. I don't think the Chairman has stopped
going to the dentist because one dentist in Oklahoma was found
to have infected thousands of patients, and I don't think we
should outlaw abortions because a bad actor committed crimes
against his patients.
Mr. Chairman, I yield back the balance of my time.
Mr. Franks. I thank the gentleman and would just suggest to
him that there is no one on either side of this aisle that is
gleeful about the actions of Dr. Kermit Gosnell.
And I would yield now to the distinguished Chairman of the
full Committee, Mr. Goodlatte from Virginia.
Mr. Goodlatte. Thank you, Mr. Chairman. I very much
appreciate your holding this hearing and for your leadership on
this issue.
Since the Supreme Court's controversial decision in Roe v.
Wade in 1973, medical knowledge regarding the development of
unborn babies and their capacities at various stages of growth
has advanced dramatically. Even the New York Times has reported
on the latest research on unborn pain, focusing in particular
on the research of Dr. Sunny Anand, an Oxford-trained neonatal
pediatrician who has held appointments at Harvard Medical
School and other distinguished institutions.
According to the New York Times, 25 years ago, doctors were
convinced that newborns' nervous systems were too immature to
sense pain. Anand resolved to find out if this was true.
In a series of clinical trials, he demonstrated that
operations performed under minimal or no anesthesia produced a
massive stress response in newborn babies, releasing a flood of
fight or flight hormones like adrenaline and cortisol. Potent
anesthesia, he found, could significantly reduce this reaction.
But Anand was not through with making observations. He noticed
that even the most premature babies grimaced when pricked by a
needle.
New evidence, however, has persuaded him that fetuses can
feel pain by 20 weeks gestation and possibly earlier. As Dr.
Anand would later testify, ``If the fetus is beyond 20 weeks of
gestation, I would assume that there will be pain caused to the
fetus, and I believe it will be severe and excruciating pain.''
Congress has the power to acknowledge these developments by
enacting H.R. 1797 and prohibiting abortions after the point at
which scientific evidence shows the unborn can feel pain with
limited exceptions. The terrifying facts uncovered during the
course of the trial of late-term abortionist Kermit Gosnell and
successive reports of similar atrocities committed across the
country remind us how an atmosphere of insensitivity can lead
to horrific brutality.
The grand jury report in the Gosnell case itself contains
references to a neonatal expert who reported that the cutting
of the spinal cords of babies intended to be late-term aborted
would cause them, and I quote, ``a tremendous amount of pain.''
These facts justify expanding the application of this bill
Nationwide, and I fully support Constitution Subcommittee
Chairman Franks' intention to do so.
Indeed, the Polling Company recently found that 64 percent
of Americans would support a law such as the Pain-Capable
Unborn Child Protection Act. Only 30 percent would oppose it.
And supporters include 47 percent of those who identify
themselves as pro choice in the poll.
In the 2007 case of Gonzalez v. Carhart, the Supreme Court
made clear that, and I quote, ``The Government may use its
voice and its regulatory authority to show its profound respect
for the life within the woman and that Congress may show such
respect for the unborn through 'specific regulation' because it
implicates additional ethical and moral concerns that justify a
special prohibition.''
Justice Kennedy, who wrote the majority opinion in the
Carhart case, also wrote that the Government has ``an interest
in forbidding medical procedures, which, in the Government's
reasonable determination, might cause the medical profession or
society as a whole to become insensitive, even disdainful to
life, including life in the human fetus, even life which cannot
survive without the assistance of others.''
As the New York Times story concluded, throughout history,
a presumed insensitivity to pain has been used to exclude some
of humanity's privileges and protections. Over time, the
charmed circle of those considered alive to pain and,
therefore, fully human has widened to include members of other
religions and races, the poor, the criminal, the mentally ill,
and thanks to the work of Sunny Anand and others, the very
young.
The Gosnell trial reminds us that when newborn babies are
cut with scissors, they whimper and cry and flinch from pain.
But it takes only a moment's thought to realize that wherever
babies are cut, they whimper and cry and flinch from pain.
Delivered or not, babies are babies, and they can feel pain at
20 weeks.
It is time to welcome young children who can feel pain into
the human family, and this bill at least will do just that. I
congratulate Chairman Franks and yield back.
Mr. Franks. And I thank the gentleman.
And I will now yield to the Ranking Member of the
Committee, Mr. Conyers from Michigan.
Mr. Conyers. Thank you, sir.
Ladies and gentlemen, it has been said by one of our
esteemed Members of this Judiciary Committee that when Members
of Congress attempt to play doctor, it is bad medicine for
women, and that is what brings us here today.
Could I just ask the ladies from Planned Parenthood that
are in the audience, and we welcome everyone that is in this
room, but could those women just stand up for a moment?
Thank you. Thank you very much for coming.
What I see us doing here this morning is undermining the
basic reproductive rights of women by prohibiting any abortion
after 20 weeks, with only limited exception and imposing
criminal penalties, among other sanctions. This subject is an
extremely difficult one because every pregnancy is unique and
different.
Some women, unfortunately, must face the emotionally
devastating decisions in the course of their pregnancies that
require them to consider abortion as a health option. But if
this bill became law, Congress would be able to impose its will
with respect to one of the greatest tragedies that these women
and their families may ever endure by using the threat of
prison and lawsuits to coerce them into making decisions that
may be bad for their health, their families, and deny them
essential medical care.
Now the problem, of course, is this. Is that any attempt,
as in 1793, to ban pre-viability abortions is patently
unconstitutional under Roe v. Wade. It has been the law for
more than 40 years, and even after viability, the court has
required any abortion prohibition to include an exception to
protect the woman's life and health, which this bill fails to
do.
It has already been mentioned that the Court of Appeals has
struck down a similar attempt that is embodied in H.R. 1793 by
saying since Roe v. Wade, the Supreme Court case law concerning
the constitutional protection accorded women with respect to
the decision whether to undergo an abortion has been
unalterably clear regarding one basic point. A woman has a
constitutional right to choose to terminate her pregnancy
before the fetus is viable. A prohibition on the exercise of
that right is, per se, unconstitutional.
That very clearly identify the problem with this attempt in
1793 before us today. And then, to add insult to injury, 1793
explicitly states that a risk of suicide is insufficient cause
to allow a woman to end a pregnancy.
So, ladies and gentlemen, this is a sad day, and I know
that there are other views. But when we have a measure this
draconian that fails to include any exceptions for cases
involving rape and incest, this, of course, would force a
person to bear her abuser's child. So keep in mind that 25,000
women in the United States become pregnant as a result of rape,
and 30 percent of these rapes tragically involve women under
the age of 18.
And so, I thank the Chairman for allowing me to express my
opinion on this measure.
Mr. Franks. And I thank the gentleman, and I would just
suggest for the record that, indeed, there is an exception to
save the life of the mother in this. And any issues regarding
rape or incest are usually dealt with before the beginning of
the sixth month of pregnancy.
And I would now----
Mr. Nadler. Mr. Chairman, maybe I could speak out of order
for a moment for 30 seconds?
Mr. Franks. Sure.
Mr. Nadler. Thank you, Mr. Chairman.
I just wanted to clarify that in my opening remarks, I had
no intention of suggesting that the Chairman or any Member of
this panel was gleeful about the Gosnell case in any way.
Mr. Franks. I sincerely appreciate that, Mr. Nadler.
And I would now introduce our witnesses, would now welcome
you here. I know that there is never anything easy about what
you are doing today, but I am grateful to all of you here, and
we are grateful to every last person in the audience as well
for being here.
And I will now introduce our witnesses. Now I will suggest
to you that the Speaker failed to check with us when he
scheduled votes. And so, I will introduce--I will be giving the
introduction here, and then we will have to adjourn for a few
moments, and we will go vote. And we will come back, and then
we will hear your testimony.
But thank you for your patience.
Dr. Anthony Levatino is a board-certified obstetrician/
gynecologist. Over the course of his career, Dr. Levatino has
practiced obstetrics and gynecology in both private and
university settings, including as an associate professor of OB/
GYN at the Albany Medical College. And I thank you for being
here, sir.
Dr. Maureen Condic is an associate professor of
neurobiology and an adjunct professor of pediatrics at the
University of Utah School of Medicine. Dr. Condic is the
director of human embryology for that medical school, and I
thank you for being here.
Ms. Christy Zink is a resident of Washington, D.C., and I
thank you, Ms. Zink, for being here as well.
Our final witness is Jill Stanek, a nurse turned speaker,
columnist, and blogger, and a National figure in the effort to
protect both preborn and post born innocent human life. And Ms.
Stanek, I thank you for being here as well.
And with that, we will recess and we will return,
hopefully, in 25 to 30 minutes. And again, I apologize for the
interruption.
[Recess.]
Mr. Franks. The Constitution Committee will come to order.
I start out by telling you that it seems that we are going
to have another vote in approximately an hour. So we are going
to go ahead and get started as soon as possible, and I want to
thank everyone again for their attendance.
And I especially want to thank the witnesses for their
presence here. I know each of you took great pains to be here.
So each of your statements will be entered into the record
in its entirety, and I will ask that each of you summarize your
testimony in 5 minutes or less. To help you stay within that
time, there is a timing light in front of you. The light will
switch from green to yellow, indicating that you have 1 minute
to conclude your testimony. When the light turns red, it
indicates that the witness' 5 minutes have expired.
And before I recognize the witnesses, it is the tradition
of the Subcommittee that they be sworn. So if you would please
stand to be sworn.
[Witnesses sworn.]
Mr. Franks. Please be seated. Let the record reflect that
the witnesses answered in the affirmative.
I now recognize our first witness, and please turn on your
microphone, Dr. Levatino, and please proceed, sir.
TESTIMONY OF ANTHONY LEVATINO, OBSTETRICS AND GYNECOLOGY, LAS
CRUCES, NM
Dr. Levatino. Good morning. Chairman Franks and
distinguished Members of the Subcommittee, thank you for
inviting me.
My name is Anthony Levatino. I'm a board-certified
obstetrician/gynecologist. I have served in both academic and
clinical settings. Currently, I practice in Las Cruces, New
Mexico.
I've been a board--I've been an obstetrician/gynecologist
for 33 years, and the early part of my career, I performed over
1,200 abortions. Over 100 of them in the second trimester, up
to 24 weeks of gestation.
Imagine, if you can, that you're an obstetrician/
gynecologist and a pro-choice obstetrician/gynecologist like I
was, and your patient today is 17 years old. She's 24 weeks
pregnant from last period. Her uterus is two finger breadths
above her umbilicus. She has been feeling her baby kick for
over a month. She is asleep on an operating room table, and you
are there to help her with her problem.
The first thing you do is withdraw the laminaria that was
placed in the cervix. The dilation of the cervix that's
required for a D&E abortion at that level takes at least 36
hours. Later abortions can--dilation of the cervix can
necessitate almost 3 days of preparation prior to performance
of the procedure.
The first thing you are going to reach is for a suction
catheter. This is a 14-French suction catheter. It's about 9,
10 inches long. It's about \3/4\-inch in diameter. And picture
yourself, if you can, placing this through the cervix and
instructing your circulating nurse to turn on the suction
machine.
What you'll see is pale yellow fluid running through this
into the suction bottles of the machine. That was the amniotic
fluid that was there to protect the baby.
If this was a first trimester abortion, when her child
would be that size or smaller, you could essentially do the
entire abortion with this one instrument. A 24-week baby that
we're describing here from last period is the length of your
hand and a half again from head to rump, not counting the legs.
Babies that size don't fit through catheters this size.
When you're done, reach for a Sopher clamp. This is one
that I brought along so you could see what we're talking about.
It's about 13 inches long. It's stainless steel.
The business end on this clamp is about \1/2\-inch wide and
about 2\1/2\ inches long. And there are rows of sharp teeth on
this instrument. It's a grasping instrument. When it gets a
hold of something, it does not let go.
A second trimester abortion at that stage is a blind
procedure. You can't really see anything. Everything has to be
done by feel.
Picture yourself, if you can, reaching in with this
instrument and grasping blindly anything you can and pull hard.
And when it finally pops free, out comes a leg that big, which
you put down on the table next to you.
Reach in with this again and grasp and pull hard. Out comes
an arm about the same length, which you put down on the table
next to you. And reach in with this instrument again and again
and tear out the spine, the intestines, heart, and lungs.
Head of a baby about that age is maybe the size of a large
plum. Again, the procedure is blind. You reach in, being
careful not to perforate the uterus, and you have a pretty good
idea you have it, if you have your clamp around something and
your fingers are spread about as far as they will go.
You know you did it right if you crush down on the clamp,
and white material runs out of the cervix. That was the baby's
brains. Then you can pull out skull pieces. If you had a day
like I had a lot of days, sometimes a face comes back and
stares back at you.
Congratulations, you just successfully performed a second
trimester D&E abortion. You just affirmed her right to choose.
These procedures are brutal by their nature. In later
abortions, when you are preparing that cervix for even more
extended periods of time, you can have situations where you
will get into preterm labor or even precipitous deliveries of
these children. The Gosnell situation is a situation that has,
I think, brought to the public's attention what we're talking
about when we're talking about this level of abortion.
It was mentioned earlier that the idea that abortion is
not--is needed to save women's lives is one that must be under
consideration. As a faculty member at the Albany Medical
College, I have treated hundreds of women with severe problems
with their pregnancies. Pregnancies that were life-threatening
to them. Cardiac disease, diabetes, cancers, toxemia, elevated
blood pressure in pregnancy.
I'll illustrate with one case that I dealt with personally.
A patient came in at 27 weeks of gestation, blood pressure 220
over 140. You know a normal blood pressure is 120 over 80. This
woman is moments or hours away from a stroke.
We stabilized her, delivered her. She had a healthy baby in
the end, and she did well as well. But I was able to stabilize
and deliver her within an hour because that was required when
you have an emergency of that magnitude.
Abortion would be worthless in that situation. As I told
you, at 27 weeks of gestation, it would have taken at least 3
days to even prepare her to be able to go through the
procedure, and this is an important point when we talk about
abortion in terms of saving women's lives.
I appreciate your attention. I guess I'll just end,
Chairman Franks quoted President Obama earlier. I'm going to
quote him one more time.
He said recently, ``If there is just one thing, one thing
that we could do that would save just one child, don't we have
an obligation to try?''
Thank you.
[The prepared statement of Dr. Levatino follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
__________
Mr. Franks. Thank you, Dr. Levatino.
And Dr. Condic, I will now recognize you for 5 minutes.
We have some audio/visual? Yes, ma'am. And would you turn
your mike on and pull that close to you, please?
TESTIMONY OF MAUREEN L. CONDIC, Ph.D., DEPARTMENT OF
NEUROBIOLOGY AND ANATOMY, UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Ms. Condic. Yes. Okay, can you hear me?
Mr. Franks. Yes, ma'am.
Ms. Condic. Great. Chairman Franks, Congressman Nadler,
distinguished Members of the Subcommittee, I'm Dr. Maureen
Condic, associate professor of neurobiology and adjunct
professor of pediatrics at the University of Utah School of
Medicine.
I thank you for this opportunity to testify.
[Slides.]
Ms. Condic. So the experience of pain is obviously very
complex. Here I have summarized the important events of brain
development relevant to pain perception. The three points I'd
like to emphasize are these.
First, brain development begins very early, by 4 weeks post
fertilization. Second, the neural circuitry underlying the most
basic response to pain is in place by 8 weeks. This is the
earliest point at which a fetus can feel pain at any--in any
capacity. And finally, the circuitry in the thalamus that's
primarily responsible for both fetal and adult pain perception
develops between 12 and 18 weeks post fertilization.
At this stage, a fetus is very well developed. All of the
organs and structures are fully formed. She has a face,
fingerprints, and based on my own experience with three
pregnancies, a definite personality.
The debate over fetal pain is not whether pain is detected
by a fetus at 20 weeks. There is essentially universal
agreement on this point in the scientific community. Rather,
the debate concerns how pain is experienced, whether a fetus
has the same pain experience as a newborn or an adult.
Recently, the American College of Obstetricians and
Gynecologists, or ACOG, the Royal College of Obstetricians and
Gynecologists, and a review in the Journal of the American
Medical Association have all addressed this point. Yet these
reports have received serious scientific criticism.
And surprisingly, they all assumed without evidence that
for a fetus to have a conscious experience of pain, certain
late-developing cortical structures must exist. Yet many
conclusive modern lines of evidence contradict this view, and
I'm going to present just two of them.
First, it's clear that children born without cortical brain
structures are capable of consciousness, including smiling when
pleased, having preferences for particular kinds of music, and
having adverse reactions to pain. Here is a picture of such a
patient recognizing her physician.
This little girl was described in this case report as being
a very happy child who particularly liked dancing to rock
music. Yet, well over 80 percent of her brain is missing, and
therefore, she does not possess the structures that ACOG and
others erroneously insist are required for conscious
recognition of her physician, for example.
This is a scan of the little girl's brain. The red star
here indicates the limited area of the cortex that she
possesses, and the yellow stars indicate empty space in the
regions that ACOG and others claim the parts of the brain that
are required for conscious pain perception should exist.
The blue star indicates the position of the thalamus, which
is the region of the brain that is, in fact, responsible for
pain perception in this patient and in all human beings at all
stages of life. And as I've noted, the pain perception
circuitry in this region of the brain is in place by 18 weeks.
So a second line of evidence against the conclusions of
ACOG and others is the large body of direct experimental data
from adult humans that demonstrates that neither removing nor
stimulating the cortex changes our experience of pain, whereas
stimulating or removing lower brain structures, such as the
thalamus, does.
So, for example, a recent study analyzed on videotape the
behavioral responses of adult alert patients to 4,160 cortical
stimulations, and the authors note that pain responses were
very scarce, representing less than 1.5 percent of all the
responses they observed. These authors then conclude that even
for adult humans, in contrast to the JAMA report, the ACOG
report, and the Royal Society reports that have been cited, the
cortex is largely not involved in the conscious perception of
pain. Pain perception is localized to the thalamus, and this
circuitry is in place by 18 weeks post fertilization.
In addition to the neurobiological information I have just
presented, what we directly observe about a fetus's response to
pain is also very clear. Fetuses delivered prematurely exhibit
pain-related behaviors, such as those shown here. Pain response
observations are very precise, and they're based on objective
criteria.
Strikingly, the earlier fetuses are delivered, the stronger
their response to pain. And this is due to the absence of
later-arising brain circuitry that actually inhibits a pain
response in older infants and in adults.
Similarly, fetuses at 20 weeks post fertilization have an
increase in stress hormones in response to painful stimuli that
can be eliminated by appropriate anesthesia, just as for an
adult. These and many other direct observations of fetal
behavior and physiology have resulted in a clear consensus
among professional anesthesiologists that the use of anesthesia
is warranted in cases of fetal surgery, not based on pragmatic
considerations like the suppression of fetal movement but,
rather, based primarily on the fetus's experience of pain.
Finally, I'd like to conclude by saying we really must
consider our own experience and ask what kind of a society we
want to be. You know, we're all horrified by the pictures of
the infants that were brutally killed by convicted murderer
Kermit Gosnell, and yet we tolerate this same brutality and
even worse for humans at 20 weeks of development.
Imposing pain on any pain-capable living creature is
cruelty, and ignoring the pain experienced by another human for
any reason is barbaric. We don't need to know if a fetus
experiences pain precisely in the same way we do. We simply
have to decide whether we're going to choose to ignore the pain
of the fetus or not.
It is entirely uncontested in the scientific and medical
literature that a fetus experiences pain in some capacity from
as early as 8 weeks, and most modern neuroscientists conclude
that the thalamic circuitry that's in place by 18 weeks post
fertilization is primarily responsible for human experience of
pain at all stages of life.
Given that fetuses are members of the human species, human
beings like us, they deserve the benefit of the doubt regarding
their experience of pain and protection from cruelty under the
law.
Thank you very much.
[The prepared statement of Ms. Condic follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
__________
Mr. Franks. Thank you, Dr. Condic.
And Ms. Zink, we will now recognize you for 5 minutes.
Thank you for being here.
TESTIMONY OF CHRISTY ZINK, WASHINGTON, DC
Ms. Zink. Good morning, Mr. Chairman, Representative
Nadler, and other Members of the Committee.
My name is Christy Zink. Late afternoons in May, my family
is on the lookout for monarch butterflies. It's spring
migration time, and the butterflies have winged their way from
Mexico through Texas, moving now up through the country.
My daughter learns, as we all do, by sharing the stories of
what she knows. Monarchs identify food with their feet, she
tells me. They sip nectar through a proboscis, a word we work
together to spell out on paper.
In our yard, as we spy out for the monarchs, her brother
keeps his own watch. A toddler, he names what he sees in quick
bursts. Grass. Truck. Tree.
For me, it's as if I'm learning along with him, trying out
those words anew. My family teaches me every day, and I hold
dear the privilege it is to raise my children and to be student
to their wonder.
All families know this delight in their own way. There are
families like mine who understand that joy in more complicated
ways, earned through hard lessons and harder decisions. I'm
here today to share my story with you so that you can
understand why this bill that purports to prevent pain is
instead harmful to families and to women in situations like the
one I faced, and why all women in this country need access to
safe, quality medical care.
In addition to the pregnancies with my two children, I was
also pregnant in 2009. I wondered who my child might grow up to
be. Would she inherit her father's love of the pitchers' duel
in baseball? Would he make a habit of skipping to the last page
of a book, peeking at the end as I do?
I looked forward to the ultrasound when we would get a
chance to have a look at the baby in utero to learn a little
bit more. I certainly hadn't imagined that we'd learn terrible
news and that after the doctor's visit, my husband and I would
have to make the most difficult decision of our lives.
I took extra special care of myself during that pregnancy.
I received excellent prenatal attention from an award-winning
obstetrician. Previous testing had shown a baby growing on
target with the limbs and organs all in working order.
However, when I was 21 weeks pregnant, an MRI revealed that
our baby was missing the central connecting structure of the
two parts of his brain. A specialist diagnosed the baby with
agenesis of the corpus callosum. What allows the brain to
function as a whole was simply absent.
But that wasn't all. Part of the baby's brain had failed to
develop. Where the typical human brain presents a lovely
rounded symmetry, our baby had small globular splotches. In
effect, our baby was also missing one side of his brain.
Living in a major city with one of the best children's
hospitals in the country, my husband and I had access to some
of the best radiologists, neurologists, and geneticists not
just in this city or in the country, but in the world. We asked
every question we could. The answers were far from easy to
hear, but they were clear.
There would be no miracle cure. His body had no capacity to
repair this anomaly, and medical science could not solve this
tragic situation. This condition could not have been detected
earlier in my pregnancy. Only the brain scan could have found
it.
The prognosis was unbearable. No one could look at those
MRI images and not know instantly that something was terribly
wrong. If the baby survived the pregnancy, which was not
certain, his condition would require surgeries to remove more
of what little brain matter he had, to diminish what would
otherwise be a state of near constant seizures.
I am here today to speak out against the so-called Pain-
Capable Unborn Child Protection Act. Its very premise that it
prevents pain is a lie.
If this bill had been passed before my pregnancy, I would
have had to carry to term and give birth to a baby whom the
doctors concurred had no chance of a life and who would have
experienced near constant pain. If he had survived the
pregnancy, which was not certain, he might never have left the
hospital. My daughter's life, too, would have been irrevocably
hurt by an almost always absent parent.
The decision I made to have an abortion at almost 22 weeks
was made out of love and to spare my son's pain and suffering.
I'm horrified to think that the doctors who compassionately,
but objectively explained to us the prognosis and our options
for medical treatment and the doctor who helped us terminate
the pregnancy would be prosecuted as criminals under this law
for providing basic, safe medical care and expertise.
This bill does not represent the best interests of anyone,
especially families like mine. What happened to me during
pregnancy can happen to any woman regardless of her health,
race, ethnicity, economic status, or where she lives. The
proposed law is downright cruel, as it would inflict pain on
the families, the women, and the babies it purports to protect.
It's in honor of my son that I'm here today speaking on his
behalf. I'm also fighting for women like me to have the right
to access safe, legal, high-quality abortion care when we need
to beyond 20 weeks, especially for those women who could never
imagine they'd have to make this choice.
Women across this country need to be able to make this very
private decision with their partners, their doctors, and
trusted counselors. I urge you not to pass this harmful
legislation.
[The prepared statement of Ms. Zink follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
__________
Mr. Franks. Thank you, Ms. Zink.
And I would now recognize Ms. Stanek, and Ms. Stanek, thank
you for being here. Ms. Stanek?
TESTIMONY OF JILL L. STANEK, RN, MOKENA, IL
Ms. Stanek. Thank you. Thank you for having me.
When I testified before this Committee in 2000 and 2001, it
was to tell of my experience as a registered nurse in the labor
and delivery department at Christ Hospital in Oak Lawn,
Illinois, where I discovered babies were being aborted alive
and shelved to die in the hospital's soiled utility room.
Among other familiar faces that I see here today is
Congressman Nadler, who was a Member of the Committee at that
time, as he indicated earlier, and he said that he was appalled
by the incidents I described and found them heart wrenching.
Indeed, I was traumatized and changed forever by my experience
of holding a little abortion survivor for 45 minutes until he
died, a 21- to 22-week-old baby who had been aborted because he
had Down syndrome.
Since then, other appalling stories of abortion survivors
either being abandoned or outright killed have been trickling
out. The Kermit Gosnell case provides further evidence that the
lines between illegal infanticide and legal feticide, both via
abortion, have become blurred.
This abortionist was convicted only last week of three
counts of first-degree murder in the deaths of three born
babies whose spinal cords we all know were snipped, as he
called them. Also last week came the revelation and photos from
three former employees who allege that Houston abortionist
Douglas Karpen routinely kills babies after they are born by
puncturing the soft spot on their head or impaling the stomach
with a sharp instrument, twisting the head off or puncturing
the throat with his finger.
It is easy to be horrified by heart-wrenching stories such
as this and to imagine the torture that abortion survivors
endure as they are being killed. But it is somehow not so easy
to envision preborn babies the same age being tortured as they
are killed by similar methods.
Today, premature babies are routinely given pain relief,
who are born at the same age as babies who are torn limb from
limb or injected in the heart during abortions. The World
Health Organization goes so far as to recommend pain relief for
preemies getting a simple heel stick to draw a couple of drops
of blood.
Likewise, prenatal surgery is becoming commonplace, and
along with it, anesthesia for babies being operated on, even in
``the middle of pregnancy'' as the Cincinnati Children's
Hospital says. Meanwhile, babies of an identical age are torn
apart during abortions with no pain relief.
It must be that some people inexplicably think that the
abortion provides a firewall against fetal pain or that babies
marked for abortion are somehow numb while their wanted
counterparts aren't. This thinking is better suited for the
Middle Ages than for modern medicine.
Yet while NARAL Pro-Choice America eventually expressed
neutrality on the Born-Alive Infants Protection Act, which
provides legal protection for born babies no matter what
gestational age and no matter if wanted or not, NARAL opposes
legislation protecting babies of the same age from barbaric
abortions after the point they are known to feel pain.
Abortion proponents attempt to say that abortionists who
commit abortions past 20 weeks are rare. This is a myth. The
National Right to Life Committee, perusing a report from
Guttmacher Institute, which is a research arm of the abortion
industry, in 2008 found that at least 300 abortion providers
across the U.S. perform abortions after 18 weeks post
fertilization, and then at least 140 abortionists commit
abortions on pain-capable children at 20 weeks post
fertilization.
As for the number of late-term abortions committed in this
country, nobody knows. There are no standardized mandatory
Nationwide abortion reporting requirements, and some of the
most liberal jurisdictions, such as California, Maryland, and
D.C., don't report at all. And it is questionable that
abortionists even comply with regulations and, as we know by
Gosnell, that enforcement agencies enforce these reporting.
For instance, when the Elkton, Maryland, office of
abortionist Steven Brigham was raided in 2010, investigators
found 35 fetuses in his freezer. But there were no medical
records documenting 33 of those abortions, much less reporting.
The Gosnell grand jury report said that between 2000 and
2010, Gosnell reported only 1 second trimester abortion when we
know that he probably committed thousands of late-term
abortions during that decade. No one knows how many abortions
are committed after 20 weeks. So it is false for anyone to
claim that they are rare.
It is also a myth that late abortions are mostly committed
on babies with handicaps, although being handicapped is
certainly no excuse for torture. Dr. Leroy Carhart, who commits
abortions in Germantown, Maryland, just 30 miles from here, was
caught on tape by Live Action stating he routinely commits
elective abortions at 26 weeks.
``Saw four this week,'' Carhart quipped to the Live Action
pregnant investigator, also joking that he uses a pickaxe and a
drill bit to kill older babies.
Only two blocks from the White House, late-term abortionist
Cesare Santangelo told a pregnant Live Action investigator he
would kill her healthy 24-week-old preborn baby by snipping the
umbilical cord, which is the equivalent of cutting the hose off
of a scuba diver, causing death by slow asphyxiation. His Web
site states that he will commit dilatation and evacuation
abortions up to 26 weeks.
Having actually held a little abortion survivor, I cannot
imagine standing there in the soiled utility room and tearing
him apart to hurry up his killing. I expect that that thought
horrifies everybody here. But this is what is done to others
just like him on a daily basis, their excruciating fate
determined simply by geography.
Our Nation makes progress when we put an end to senseless
disparate treatment of anyone, and certainly the most
vulnerable in our midst. It is time we apply this standard to
preborn babies, such as what I have described.
Thank you.
[The prepared statement of Ms. Stanek follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
__________
Mr. Franks. Thank you, Ms. Stanek.
Thank you all for your testimony.
We will now proceed under the 5-minute rule with questions,
and I will begin by recognizing Mr. Chabot from Ohio for 5
minutes.
Mr. Chabot. Thank you, Mr. Chairman. I appreciate you
calling me out of order.
Before I ask a question, I would like to recognize Ms.
Stanek. She has been in this fight for a long time. We met many
years ago.
And as a result of your courage to come forward and be
willing to take the criticism from some people that you
revealed what was going on in these abortion chambers, babies
that you knew that survived an abortion, and there were
instances where they were found in a utility closet, in a
garbage can, and a whole bunch of other types of things.
Because of your willingness to come forward, there are at least
two pieces of major legislation that were passed and are now
the law of the land.
One is the Born-Alive Infant Protection Act to protect
those babies that are born when an abortion was intended, but a
live baby was the result. And then also the ban on partial-
birth abortion. Both of those landmark pieces of legislation,
you were absolutely responsible for those things taking place.
So thank you for your work.
Now a question. If I could go to you, Dr. Levatino? Ms.
Zink related her tragic story, and I think we certainly all
sympathize with the situation that she faced. She made her
choice.
Now you were an abortion doctor for a number of years and,
I think you indicated, performed 1,200 abortions altogether.
And some of those--those were the total number of abortions
including late-term abortions, or were they just late-term
abortions?
Dr. Levatino. Those were total number of abortions I
performed in private practice. I performed several hundred more
in training.
Mr. Chabot. Okay. So my question is, of those--and I know
you have changed your position 180 degrees since then, and I
respect you greatly for doing that. But in those abortions that
you performed, how many of those abortions would you estimate
were cases where you had a baby which faced a severe health
problem and maybe a matter of life and death versus babies
which would have been born healthy, perhaps lived 70, 80 years,
had children and grandchildren themselves, experienced the same
experiences that all the people in this room have, that would
have experienced the life that we have?
How many of those that faced the tragic things that Ms.
Zink faced versus probably a healthy existence that we all
have? What would be your estimate of that?
Dr. Levatino. I think I can estimate that very well,
Congressman. My partners and I did very thorough histories on
all of our patients who came in for abortions. We weren't
running an abortion mill. This was a routine obstetrics and
gynecology practice.
We did OB. We did GYN. We did abortions. We did deliveries.
We had no financial incentive to push a patient one way or the
other. If she wished to have an abortion, we could take care of
her. If she wished to deliver her child, we could take care of
her.
Of the 1,200 abortions that I performed, 2 were cases of
rape or incest. Of the other 1,200, approximately a dozen were
for fetal malformations. The rest were elective.
Mr. Chabot. So the vast majority of the babies would have
been healthy and probably led a productive life?
Dr. Levatino. The vast majority, yes, sir.
Mr. Chabot. And had children themselves and grandchildren
themselves someday?
Dr. Levatino. Probably so.
Mr. Chabot. And I am not trying to make the pain that you
went through any harsher here, but the reality is most of these
babies--we talk about the exceptional cases here like Ms.
Zink's, but in the vast majority of the cases, we are talking
about ending the lives, the existence of human beings just like
ourselves.
My next question. You had mentioned--well, let me ask you
this, and I had asked you this question in a previous hearing.
What was it that made you change your point of view on this?
Dr. Levatino. I was very pro choice through medical school
and my training, and I guess I proved that by doing abortions
in my private practice. In 1984, I lost a child of my own to an
auto accident and through that experience looked very hard at
what I was doing as an abortionist. And it became quite
intolerable, and I stopped.
Mr. Chabot. Thank you.
And finally, you mentioned what a brutal procedure this is
and the nature of it, arms and legs, et cetera. But there has
also been this idea that a war on women, which I think is
repugnant that people would say that. But is there not a danger
to the women themselves that are going through these procedures
when you are reaching in?
I mean, you mentioned the uterus, for example. You have to
be careful you don't perforate the uterus. So is there a danger
to the woman that undergoes one of these procedures?
Dr. Levatino. There is always a risk. There is a risk with
child birth. There is a risk with abortion. There is a risk
with every medical procedure. There is a risk of infection.
There is a risk of perforation of the uterus. There is a risk
of death. There is a risk of hemorrhage.
In my career, I had the unpleasant experience during one of
these abortions, as I said, when you're reaching in with--
rather, a stainless steel instrument and reaching in, I had the
experience of reaching in and pulling, and instead of getting a
limb, I got the lady's intestines.
Just complications do occur.
Mr. Chabot. Thank you, Doctor.
Dr. Levatino. Thank you.
Mr. Chabot. Thank you. I yield back.
Mr. Franks. And I thank the gentleman.
And I recognize the Ranking Member, Mr. Nadler, for 5
minutes.
Mr. Nadler. Thank you, Mr. Chairman.
When Congress passed the Born-Alive Infants Protection Act,
which I supported, which makes killing any infant born alive
illegal--although it was illegal to start with, obviously--
Congress was very clear that we were not imposing any new duty
on neonatologists to intervene, especially if the live birth
was at a stage where survivability was seriously in doubt.
Given the testimony today, I am concerned that some members
of this panel would want to impose such a duty even at a very
early stage of development, say, 20 weeks. Do you take this
position, and if so, what should be the dimensions of that
duty, Dr. Levatino?
Dr. Levatino. If a child is born alive, that child is a
person under the law and has rights. One of those rights is to
proper medical care, period.
Mr. Nadler. But that is a preexisting medical--I am sorry.
It is a preexisting legal obligation. So you would not agree
that the born-alive bill established new neonatology
requirements that didn't already exist in law?
Dr. Levatino. I would agree that it didn't establish
anything that wasn't already present in law. Unfortunately, it
seems that too many physicians, Dr. Gosnell among them, would
choose to ignore that.
Mr. Nadler. Well, Dr. Gosnell was convicted of murder.
Dr. Levatino. Too many children, in fact, are being born
outside of facilities where they can't even get the care that
they are entitled to as citizens.
Mr. Nadler. Okay. Ms. Zink, first of all, I want to thank
you for agreeing to testify today. As a parent, your story was
very difficult to listen to, and I can't even begin to imagine
how difficult it must have been to live through it, much less
to come here and describe your experience to people.
So I want to thank you for your willingness to put a human
face on this question and for your courage in being here.
One of the really harmful consequences of this bill, in my
opinion, is that there are some fetal conditions that cannot be
diagnosed before the 20th week of pregnancy. In those
situations, the tragedy of learning that there is, for example,
a fetal anomaly that is incompatible with life is compounded by
the fact that this bill would make it impossible to receive
abortion care if that is the medically indicated treatment.
In fact, isn't it correct that the diagnosis in your case
could not have been made before the 20th week?
Ms. Zink. That's correct.
Mr. Nadler. If this bill had been law when you had to face
your ordeal, your doctors would have had to risk jail and a
lawsuit if they provided you with the medical services you
required. Could you comment on that?
Ms. Zink. I think that one of the things that I want to say
is that through all of the presentations about experience, my
experience is not reflected in any of that. We got excellent
medical care. It was connected. All of the doctors were
speaking to each other. We got care before and during and
after, and excellent medical, safe care.
And I think that that sort of notion of not having access
to that and to know that doctors who are looking at their
medical knowledge, looking at each individual case, talking to
women, talking to families in the way that doctors and patients
should be talking to each other about what the prognosis is,
what the steps are, what the range of options are, to cut that
off I think is horrible.
Mr. Nadler. So you think that your liberty, along with your
husband, in consultation with your doctor to do what was best
for your family would have been precluded by this bill?
Ms. Zink. Absolutely.
Mr. Nadler. Thank you. Thank you, Ms. Zink.
We received a letter today, which I ask be placed in the
record at this point, from the American Congress of
Obstetricians and Gynecologists, the American Medical Women's
Association, the American Nurses Association, the American
Society for Reproductive Medicine, the Association of
Reproductive Health Professionals, Medical Students for Choice,
the National Association of Nurse Practitioners in Women's
Health, the National Family Planning and Reproductive Health
Association, Physicians Reproductive Health, and Planned
Parenthood of America.
[The information referred to follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
__________
Mr. Nadler. The letter makes several points. One, that
fetal viability is generally regarded as occurring at 24 weeks
gestation using LMP, last menstrual period, and that this bill,
by counting from fertilization, falsely implies high survival
rates among neonates.
Two, that the generally held view in the profession is that
fetal pain does not occur prior to the third trimester, a view
found in a widely cited Journal of the American Medical
Association study and a review by the Royal College of
Obstetricians and Gynecologists.
Three, that severe and lethal anomalies, such as the
absence of the brain and cranium above the base of the skull,
the failure of the kidneys to form, organs growing outside the
body cavity, severe heart defects, and neural tube defects,
often are not diagnosed before 20 weeks.
In light of this, let me ask Dr. Levatino, do you believe
it should be a crime to perform an abortion post 20 weeks in
these cases of severe and lethal fetal anomalies? And what
would you say to Ms. Zink about her tragic situation?
Dr. Levatino. Ms. Zink lost a child, just as I do. And as I
told her a year ago, I'm sorry for your loss.
As far as the vast, vast, vast majority of those anomalies
are diagnosed prior to this time. Twenty weeks from post
fertilization is 22 weeks from last menstrual period. The vast
majority, and I would point out even Ms. Zink's baby, was
diagnosed prior to that time.
It's rare at this point--there are a few cases where they
will get diagnosed after that time. But the vast majority, you
have mentioned a few in that letter, like anencephaly, easily
seen on an ultrasound at 16 weeks, which is almost routinely
performed.
Mr. Nadler. Excuse me. But the letter that we have from all
these journals or organizations says that many of these things
are not--are often not diagnosed before 20 weeks. You are
saying they are incorrect?
Dr. Levatino. Rare, Congressman. Rare.
Mr. Nadler. It says often.
Dr. Levatino. That's what they say. In my experience, rare.
And I dealt with preemies all the time.
Mr. Nadler. And what about those rare cases?
Dr. Levatino. Rare cases you take on a case-by-case basis.
Mr. Nadler. No, but should we make it illegal to perform an
abortion after 20 weeks in those rare cases of anencephaly,
failure of kidneys to form, severe heart defects, neural tube
defects, and so forth, if they are discovered, let us say, in
the 21st week?
Dr. Levatino. Yes.
Mr. Nadler. And that is a moral judgment on your part,
obviously----
Dr. Levatino. Yes.
Mr. Nadler [continuing]. Which others may disagree with?
Dr. Levatino. Yes.
Mr. Nadler. Thank you.
I see my time is expired.
Mr. Franks. I thank the gentleman.
And I will now recognize myself for 5 minutes.
You know, over the years, if one has worked in this area a
long time, you become used to people saying, well, you know you
are just focused on the wrong thing or somehow you should be
focusing on more important things. But Dr. Martin Luther King
said something that occurs to me in a very profound way. He
said our lives begin to end the day we become silent about
things that really matter.
And I would just suggest to those in the audience, those
here on the panel that there are some of us that believe this
really matters because whatever else happens during a late-term
abortion, whatever else happens, a child dies a lonely and
often painful death. The mother is never the same and is often,
no matter the circumstances, left with great loss and emotional
heartache. And whatever gifts that child might have brought to
humanity are, of course, lost forever.
And it just occurs to me that if we don't have the courage
or the will to protect the most innocent among us, then I
wonder if we will ever have the will or the courage as a people
to protect any kind of liberty for anyone. I wonder where we go
as a human family.
And with that, Dr. Levatino, I heard a lot of witnesses,
and I find your testimony to be so incredibly compelling. And I
find myself always wanting to just express a sense of
condolence for your loss. But I think your little girl would be
very, very proud of you.
Recently, three former clinic employees have come forward
with allegations against an abortionist in Houston, Texas. One
former employee, speaking out about late abortions, reportedly
alleged that, ``Most of the time, the fetus would come all the
way out before he either cut the spinal cord or introduced one
of the instruments into the soft spot of the fetus in order to
kill the fetus.''
She said, ``Either that or twisting the head off the neck
with his own bare hands.'' She alleged that most of the time,
``We would see the fetus come all the way out, and of course,
the fetus was still alive.'' And allegedly, according to the
news report, ``The abortionist also suffocated babies by
putting his finger down the windpipes.''
Now I'm going to ask for a couple of photos to be shown,
reluctantly. To be put on the plasma screens. And they are
exceedingly gruesome. So I would want to give fair warning to
those who might want to look away, and we would give you a few
moments to do that.
All right. Now, Dr. Levatino, directing your attention to
the two photos on the screen that were allegedly taken at the
abortionist's clinic I spoke of in Houston, Texas, in your
estimation, how old would you say that this baby--there is two
pictures there. How old would you say that this baby is?
Dr. Levatino. It's always difficult to estimate gestational
age just based on a photograph, but comparing to an adult's
hand, I would estimate that child between 24 and 28 weeks of
gestation from last menstrual period.
Mr. Franks. Now if a healthy baby, otherwise healthy, were
born alive at that age, what would be his or her chances of
long-term survival?
Dr. Levatino. The majority would survive.
Mr. Franks. Now looking at the second paragraph--excuse me,
the second photograph.
[Pause.]
Mr. Franks. They may be looking at the wrong one, but there
is a thumb that is inserted in the gash in the baby's neck, and
it was the previous one. What might cause a gash like that?
Dr. Levatino. A gash in the base of a baby's neck is not a
birth injury. There is no condition or no condition of delivery
that I am aware of that could possibly cause such an injury. I
have seen those photographs.
Mr. Franks. And the nature of this would tell you----
Dr. Levatino. The injury would have to be traumatic and
induced and performed on this child after that child was born.
Mr. Franks. And so, it would be made outside the womb
rather than inside the womb?
Dr. Levatino. Correct.
Mr. Franks. Now whether the baby was inside or outside,
would it have been painful to the baby, assuming the baby was
born alive?
Dr. Levatino. Yes.
Mr. Franks. Thank you, Dr. Levatino.
Dr. Condic, I know it is difficult, but do you have any
observations?
Ms. Condic. No, I am not a physician. I'm a scientist.
That's why I really can't comment on those photographs in a
professional capacity. But certainly, as a woman and as a
mother, it's horrifying that a child would be treated in this
manner.
Mr. Franks. Dr. Levatino, did you have a further point?
Dr. Levatino. No, sir.
Mr. Franks. Okay, all right. When we look at these things,
I know they are hard. But one thing they do do is they put out
of reach any claim that we didn't know. And now that we have
seen those, the question occurs as to whether or not we will
come to the rescue of these children and find our humanity and
hope for better days for America, or we will allow ourselves to
slide into that Sumerian darkness where the light of compassion
has gone out and the survival of the fittest is prevailed over
humanity.
And it is an important question. And so, with that, I would
now yield to Mr. Conyers for 5 minutes for questions.
Mr. Conyers. Thank you very much, Mr. Chairman.
This has been a painful and uncomfortable discussion here
today for me personally, and I know that Ms. Zink has probably
been as well. And I wanted to ask you, Ms. Zink, is there
anything that you would like to add to this discussion, since
not an awful lot of questions have been directed to you, about
the issues that bring us here today in the Judiciary
Subcommittee?
If you do, I would welcome hearing from you at this time.
Ms. Zink. I just think it's worth it to add that this is
not a hypothetical situation. This is not a philosophical
discussion. This affects real women, real families, real lives,
and even if our--if my situation is rare, there are many women
that it has affected already and who have gone through this.
And there are many women, unfortunately, it's a community
that grows every day of people who face these really awful
decisions. But it's something that has to be a private decision
to trust the doctors and their knowledge, to work with their
counsel, to talk to our families, and to talk to our
counselors.
And that that's the reality of how all of this works at a
very human level.
Mr. Conyers. Thank you for giving us this viewpoint. It is
important for the record.
Dr. Levatino, might I ask you, sir, if you believe children
are entitled to healthcare once they are born? I presume that
you do.
Dr. Levatino. Yes, sir.
Mr. Conyers. We all know that the Affordable Care Act
protects women and children to ensure that they have the kind
of care that you alluded to. Do you have any feelings or
viewpoint about the Affordable Healthcare Act?
Dr. Levatino. The Affordable Healthcare Act, with respect,
I don't think is actually all that relevant to today's
discussion. Like most physicians in this country, I guess I
have a lot of feelings about the Affordable Healthcare Act,
sir.
Mr. Conyers. Sure. You are not in support of it?
Dr. Levatino. I'm not sure. It's such a broad topic. Are
you asking about something specifically?
Mr. Conyers. Well, yes. Specifically, since we have voted
on it 37 times in the Congress, I am interested in your view.
Not anything in specific. There are probably a lot of things we
could go into, but not in 5 minutes.
Can you just--well, let me put it like this, Doctor, and I
want to be fair to you. Could you just say you don't like it?
Dr. Levatino. No, I couldn't say that at all.
Mr. Conyers. Could you say that you do like it?
Dr. Levatino. No, I couldn't say that either.
Mr. Conyers. Well, what----
Dr. Levatino. The Affordable Care Act, I think, is an
effort to try to correct a lot of the problems we have with
medical care in our country. There are a lot of things about
the Affordable Care Act that I think are just fine. We're going
to provide insurance for people who had difficulty getting
insurance. We're going to----
Mr. Conyers. So you like parts of it, and you don't like
other parts.
Dr. Levatino. We're going to take away the horrible
situation where--or the difficult situation----
Mr. Conyers. Okay.
Dr. Levatino [continuing]. Where people change jobs and
lose their insurance.
Mr. Conyers. All right.
Dr. Levatino. On the other hand, we are depending on young
people----
Mr. Conyers. Pardon me, sir.
Dr. Levatino [continuing]. To float the system and are just
not going to do it.
Mr. Conyers. I see you are a pretty professional witness,
but just let me--I got the yellow light, and I don't want to
cut you off. But how do you think we should pay for the kind of
care necessary for expectant mothers at 20 weeks or 24 weeks?
Dr. Levatino. I'm not sure I understand your question,
Congressman.
Mr. Conyers. If a fetus is born at 20 weeks, do we have an
obligation to provide the necessary medical care to that
mother?
Dr. Levatino. Yes.
Mr. Franks. The gentleman's time has expired.
Mr. Conyers. Well, that is some progress, and I thank you,
Doctor, for your responses.
Dr. Levatino. Thank you, Congressman.
Mr. Conyers. And thank you, Mr. Chairman.
Mr. Franks. The Chair now recognizes Mr. King for 5
minutes.
Mr. King. Thank you, Mr. Chairman.
I thank the witnesses for your testimony today. As I listen
I can't help but reflect upon stepping into the office of one
of my district employees who happens to also be a State
senator. As I sat down and borrowed his telephone, I looked up
at the shelf, and there was a framed picture of the 4-D
ultrasound of my godson.
And I would ask--I think I would ask Dr. Condic do you have
any--what is your opinion as to the availability of that
technology and how it might have moved hearts and minds?
Ms. Condic. I think the 4-D ultrasound is a very powerful
way of looking inside a situation that has been a black box in
the past, and I think we are very visual creatures. Humans
react to things they can see.
And a lot of the emotional disposition of people in the
abortion debate has centered on the fact that we can't really
see that baby, and everything that's happening, as Dr. Levatino
so graphically described, is happening in the dark. So being
able to open the womb, to a picture of a baby that's moving,
that you can recognize as a baby I think has a strong emotional
effect because it allows people to see what's really there.
Not--not some mass of tissue or blob of cells, but----
Mr. King. It is curious that we call it a 4-D ultrasound,
but yet we can't hear the sound of the baby.
Ms. Condic. By four dimensions, they mean you see three
dimensionally. So you see the baby as not as a flat image, but
as a projection in space. And then the fourth dimension is
time. So you can see the baby moving.
Mr. King. Well, let us explore that other dimension of
sound, and it occurs to me that people are emotionally
sensitive to sound. And I just was thinking this through. I
know people that don't eat any red meat, and part of the reason
is they can hear in their mind's ear the sound of that animal
that is being harvested for our consumption.
So they don't eat beef. They don't eat pork. They say I
don't eat red meat. But they might eat chicken or duck probably
because the sound of a chicken or duck doesn't trouble them as
much. I have heard them say that. And then some will not eat
poultry, but they will eat fish because fish can't scream for
their own mercy.
And so, I go on down the line to the vegan side of it, no
animal products and only vegetables, and it occurs to me that
those that have a dietary preference, that is fine. Those that
have a political position, I guess that is fine. But some of
them, they can't abide the sound of the processing of that
animal in their mind's ear.
And I recall sitting in this Committee during the partial-
birth abortion debates that we had, and the description of the
partial-birth abortion about babies being delivered to just
right an inch before they could fill their lungs with free air
and scream for their own mercy.
And it strikes me that that sound is in the mind's ear of
the jury of Dr. Gosnell, and it is now in the mind's ear of the
people in this country that are deliberating on this. And I
would wonder, Doctor, if you would comment on that?
Ms. Condic. I think anything that allows people to more
realistically understand what a fetus really is and what it's
really capable of--its experiences, its reactions, its
emotions--is a movement toward honesty. And I would fully
support it.
Mr. King. Thank you.
Ms. Stanek, you said that the excruciating fate of the
child is determined simply by geography, and I didn't hear your
testimony expand on that. Could you expand on that thought a
little for us, please?
Ms. Stanek. Yes, the baby that I held who was between 21
and 22 weeks old was about the size of my hand, and he didn't
move very much because he was just attempting to survive by
breathing. And after he was pronounced dead, you know, took him
to the morgue, where we take all our other dead patients.
And that same age baby, who I held, an abortion survivor,
is aborted today, going on right now, limb from limb, drawn and
quartered, as Dr. Levatino described. And whereas, we give pain
relief to born babies that same age, it is well known, in utero
when they are being operated on and after they are born, we
don't seem to give any care or regard to these same babies if
they are not wanted, if the moms want to terminate their
pregnancies.
Mr. King. So that is determined by the prospect of their
survival, as well as their geography?
Ms. Stanek. It's--I'm sorry. What was that?
Mr. King. By the prospect of their survival? If the child
is receiving surgery in order to save this child----
Ms. Stanek. Right.
Mr. King [continuing]. As opposed to an operation to kill
the child?
Ms. Stanek. Right, right.
Mr. King. So the prospects of survival.
And then if I could just quickly turn to Dr. Levatino, and
I would ask this opinion. I heard the gentleman from Michigan,
Mr. Conyers, say that this was a painful and uncomfortable
experience here. Could you compare that painful and
uncomfortable experience here to the one that a child goes
through?
Dr. Levatino. I have done this my entire professional life.
I've dealt with preemies down to this size and even smaller.
Well, certainly down to this size. And I've done the abortions
firsthand.
I am dismayed sometimes at particularly the American
College of Obstetricians and Gynecologists. I was a fellow in
that organization for over 20 years. I held a leadership post
at one point. And I withdrew my membership several years ago
because of some of--despite all the good things that the
organization does, and there are many, the frankly what I saw
as the obvious political stance they took on this issue.
And it bothers me when they talk about, oh, fetuses don't
feel any pain at all until they're viable. Isn't that amazing?
It just suddenly switches on when they're viable.
And if anybody thinks that ripping off arms and legs and
crushing these children the way we do during these procedures
isn't painful, they are just kidding themselves. They are badly
kidding themselves.
And when you look at those pictures of that, this
abortionist now in Houston, I hope he will be properly
investigated and possibly prosecuted. These children almost had
their heads torn off. And if you don't think that's painful.
I have been sitting here ruminating a little bit about the
letter that was read. Very interesting, you know? Children with
renal agenesis are not entitled to a chance at life? Children
with Down syndrome are not entitled to a chance to life?
Children with different types of brain injuries are not even
entitled to a chance to live? Is that what we're championing
here?
Mr. King. Thank you, Doctor.
I thank all the witnesses, and I yield back the balance of
my time, Mr. Chairman.
Mr. Franks. Thank you, Mr. King.
I am reminded that I had a brother who had Down syndrome
that was given the chance to live for almost 40 years, and we
are very grateful.
The gentleman from Texas, Mr. Gohmert, is recognized for 5
minutes.
Mr. Gohmert. Thank you, Mr. Chairman.
I have a first cousin whose mother and our whole family is
glad that he was--that she carried him and has taken care of
him. And anyway, it raises difficult issues, and having had a
preemie for our first child, we weren't sure what we were
getting. We felt like, apparently, it was going to be a girl.
But she came so early, this was a very difficult time in our
lives.
And Ms. Zink, you have my great sympathy. But having had a
child who was premature and having sat there, we had an
incredible neonatologist in Shreveport, Dr. Tsing, T-s-i-n-g,
and I haven't seen him since then. But he had such a love for
the children, and when we were told we could go either to
Dallas or Shreveport, I asked about the survivability, and he
said we seem to have more children live in Shreveport, for
whatever reason.
My wife and I had talked about it. Well, let us go to
Shreveport, anything we could do for our child, because they
were losing her.
And as you know, among preemies, blindness can be an issue
if you expose to 100 percent oxygen or too much oxygen too
quickly because of the blood vessels. The dilation causes the
separation or the little fingers that come out that separate it
from the retina. And I knew when they went from 20 to 40 to 60
to 80 percent oxygen very quickly that they were--they knew our
baby was in big trouble.
But Dr. Tsing said it is so important that the baby hear
your voice. Please talk to your baby. Here is a stool beside
the isolette, and caress her, talk to her. She--her eyes don't
work very well. She won't recognize you, but she will know your
voice because she has heard you in utero.
And as you would know, the lungs are about the last to
develop. They have trouble breathing. Breathing is so shallow
and so rapid, and the heart rate so erratic.
But I would, as my wife had said, go do anything you can
for our baby. They said you can sit for 2 hours, and so I sat.
And he said caress her, talk to her, and as I did, the little
bitty fingers grasped around the end of my finger, and I sat
there for an hour or so.
Dr. Tsing came by and said, ``Have you noticed the
monitors?'' Breathing still very shallow, heartbeat fast, but
they had stabilized and not become so erratic. And Dr. Tsing
said, ``She is drawing strength, she is drawing life from
you.''
Well, with that, I couldn't leave. And after 8 hours, they
told me I had to take a break. I couldn't keep sitting there.
But I'm helping my child. How could I leave?
But when I read and hear of your account, Doctor, of how a
child like mine would have the Sopher clamp placed on a leg and
then ripped from the body, grab an arm and ripped from the
body, and I think about our little Katie, hanging on to my
finger for dear life, it is pretty difficult as well.
Being there in an advanced neonatal ICU, I did see there
was one child that was born that was missing parts, including a
spine. And the parents ended up--when it was very clear there
was no brain activity whatsoever, there was nothing--there were
decisions that they had to make at that point.
Ms. Zink, having my great sympathy and empathy both, I
still come back wondering, shouldn't we wait like that couple
did and see if the child can survive before we decide to rip
them apart? So these are ethical issues. They are moral issues.
They are difficult issues.
And the parents should certainly be consulted. But it just
seems like it is a more educated decision if the child is in
front of you to make those decisions. So I appreciate all that
each of you bring.
Ms. Stanek, I have known and loved you before I ever saw
your picture, and I just read the account of what I knew you
endured. But thank each of you for being here. Thank you for
the input that each of you bring to this difficult issue.
Thank you, Mr. Chairman.
Mr. Franks. ``This is our first task, caring for our
children. It is our first job. If we don't get that right, we
don't get anything right. That is how as a society we will be
judged.
``Are we really prepared to say that we are powerless in
the face of such carnage, that the politics are too hard? Are
we prepared to say that such violence visited on our children
year after year after year is somehow the price of freedom?''
I pray that we would all heed the words of our President,
and with that, this meeting is adjourned.
[Whereupon, at 12:11 p.m., the Subcommittee was adjourned.]