Abortion Provider Gosnell Guilty of Murder, Other Charges

Nick Mulcahy

May 13, 2013

PHILADELPHIA, Pennsylvania — Kermit Gosnell, MD, the long-time owner and operator of a Philadelphia abortion clinic that was dubbed the "House of Horrors" by city prosecutors, has been found guilty in the first-degree murder of 3 infants by a Court of Common Pleas jury here.

Dr. Gosnell, 72, was also guilty of conspiracy to murder in 2 infant deaths. In addition, he was convicted of involuntary manslaughter in the 2009 death of Karnamaya Mongar, 41, of Virginia, a patient who underwent abortion and died of a cardiac arrest in 2009 after a meperidine (Demerol) overdose dispensed by unlicensed, untrained, and unsupervised clinic employees.

The jury, which consisted of 7 women and 5 men and was racially balanced, took 2 and a half weeks in their deliberations about events that transpired during abortions at the Women’s Medical Society clinic in the city’s Powelton Village neighborhood.

The first-degree murder verdict means that there will be a penalty hearing at which the jury will hear evidence to decide whether Dr. Gosnell should be executed by lethal injection or sentenced to life in prison without chance of parole.

Dr. Gosnell was also convicted of multiple counts of performing abortions past Pennsylvania's 24-week legally allowed gestational age as well as multiple counts of performing abortions before the expiration of the mandated 24-hour waiting period and of operating a "corrupt organization."

The trial began in early March and increasingly climbed into national headlines when the closing arguments were made on April 30. It was a long trial but, compared with headlining trials that last 6 months, it was "not that long of a trial," assistant district attorney Edward Cameron told Medscape Medical News in a brief courtroom interview this afternoon.

The trial of Dr. Gosnell featured grisly descriptions of how some aborted infants were stabbed in the neck with a scissors to ensure their demise; the cutting of the spinal cord, which the staff euphemistically called "snipping," results in suffocation, said assistant district attorney Edward Cameron during his final argument.

At the heart of the trial were the differing accounts of 4 infant murders, those of babies A, B, D, and E. Dr. Gosnell was acquitted only of the murder of baby E.

Jack McMahon, defense attorney for Kermit Gosnell, speaks at the courthouse in Philadelphia on Monday. AP Photo/Matt Rourke

Dr. Gosnell did not testify at the trial. However, his defense attorney Jack McMahon said that, in each case, Dr. Gosnell administered digoxin (Lanoxin), a heart drug indicated for atrial fibrillation but used off-label in abortion. The drug, which is injected into the fetus via a long needle, "causes intrauterine fetal demise," he said. "Digoxin always did its job," McMahon stated.

But prosecutors said that Dr. Gosnell was forgoing the expense of digoxin and resorting to "back alley abortion" methods for the sake of profit. The clinic methods included using heavy doses of labor-inducing misoprostol (Cytotec) and then "snipping" necks when needed.

Various staff members offered differing accounts as to how many necks were "snipped" over time. However, when the clinic was raided by authorities in 2010, 4 of the 47 fetuses that were found on site had the tell-tale neck trauma.

The trial also featured remarkable accounts of a rogue medical operation, with witness descriptions of uncleanliness, inappropriate staffing (including a high school student who managed and administered medications), ill-functioning and unsterilized equipment, violations of informed-consent laws, no crash cart in the facility, manipulating sonogram images to suggest earlier gestational age, and a host of other infractions that the defense largely ignored. The purpose of the trial was not a "government inspection," said McMahon.

Somehow, Dr. Gosnell’s clinic did not come under scrutiny of Pennsylvania state regulators; for 17 years, the clinic did not receive a visit from state inspectors.

Dr. Gosnell is "an anachronism," said medical ethicist Arthur Caplan, PhD, of New York University in a recent essay in Time magazine.

He argued that the need for late-trimester abortion is going to disappear. Even surgical abortion will be a thing of the past, as the abortion clinic slowly gives way to pharmaceutical abortion, Dr. Caplan stated.

The medical ethicist also said that "more and more women" will be using cheap and readily available emergency contraception, not abortion. The FDA recently announced that Plan B can be sold over-the-counter to buyers as young as 15; other women will use mifepristone when they choose to end a pregnancy within the first seven weeks. "They won’t be faced with the choice of a third trimester abortion because they will be able to easily access pharmaceutical options," wrote Dr. Caplan.

However, other commentators think such comments miss an important point. Clinics like the Women’s Medical Society exist — and will continue to exist — because there is a market for abortion among poor teens and women. Lack of access to — and knowledge about how to access — drugs are great obstacles to this new era of birth control, they argue.

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