China relentlessly harries Japan in island dispute

BEIJING (AP) — Chinese patrol boats have harried the Japanese Coast Guard many times a week for more than a month in an unusually relentless response to their latest maritime spat.

Four Chinese craft typically push to within hailing distance of Japan's ships. They flash illuminated signs in Japanese to press Beijing's argument that it has ancient claims to a set of tiny East China Sea islands now controlled by Tokyo. China says its craft have tried to chase the Japanese away at least once, although Japan denies any of its ships fled.

The huge uptick in incidents has brought the sides into dangerously close proximity, reflecting a campaign by Beijing to wear down Japanese resolve with low-level, non-military maneuvers but also boosting the risk of a clash.

Although China wields a formidable arsenal, it has yet to deploy military assets in such encounters. Instead, Beijing has dispatched ships from government maritime agencies — only one of which is armed — to keep a lid on gunfire. Those agencies are now receiving added attention, with new ships on order and a national call going out for recruits.

China says ships from its Marine Surveillance service are merely defending Chinese sovereignty and protesting illegal Japanese control over the uninhabited islands, known as Senkaku in Japan and Diaoyu in China. The missions began after Japan's government purchased three of the five islands from their private Japanese owner in September, enraging a Chinese government that saw it as an attempt to boost Japan's sovereignty claim. It also sparked violent anti-Japanese protests in dozens of Chinese cities.

China's short-term goal has been primarily to force Japan to at least acknowledge that the islands are in dispute — something it has refused to do — but the boost in patrols raises the likelihood of a bigger confrontation, said Wang Dong, director of the Center for Northeast Asian Strategic Studies at Peking University.

"I'm very concerned about the current situation. The possibility of escalation cannot be ruled out," Wang said.

With emotions running high, any accident or miscalculation in these maritime missions could yield unexpected outcomes.

"One side might deploy a naval vessel in a support fashion, a move that the other would match," said M. Taylor Fravel of the Massachusetts Institute of Technology, who is closely following the dispute.

Japan has made it clear that it intends to meet the Chinese challenge in kind.

Japanese Coast Guard spokesman Yasuhiko Oku said the dispute was a factor behind the government's allocation last week of 17 billion yen ($212 million) to beef up the Coast Guard fleet with seven new patrol ships and three helicopters, though he said the new assets are not only for use around the islands.

Oku declined, for national security reasons, to say how many ships patrol the islands. But he said the dispute has been a "significant draw" on resources.

Tensions in the region were highlighted by U.S.-Japan naval exercises that began Monday at various locations, involving some 37,400 Japanese and 10,000 U.S. troops. At the same time, Japanese and Chinese diplomats were in consultation in the central Chinese city of Wuhan, the Japanese Foreign Ministry said.

China's Foreign Ministry said the exercises were "not conducive to mutual trust in regional security," and urged the parties to "do more that helps regional peace and stability."

Already, the near-constant presence of Chinese ships around the disputed islands has stretched the Japanese Coast Guard, which pulled out of a recent fleet review to free up ships for patrols. That's a victory of sorts for Beijing's vow to claim what it calls sacred territory, between Taiwan and Japan's Okinawa. Taiwan also claims the islands, which were under U.S. administration after World War II before reverting to Japanese control in 1972.

Chinese outrage stems partly from lingering resentment over Japan's brutal World War II occupation of much of China, feelings that are constantly stoked by China's education system and state-controlled media. But control of sea lanes and potentially rich undersea minerals are also at play, along with China's burning desire for respect as a world power.

China and Japan have no formal agreement on preventing unintended incidents at sea, making it easier for events to spin out of control as they did when a Chinese fishing boat rammed a Japanese cutter in 2010, leading to a diplomatic standoff and anti-Japanese protests in China.

U.S. Assistant Secretary of State Kurt Campbell said last week that the sides need to calm down. "It's incredibly important that both countries appreciate what they have built and step back from the brink," Campbell said in Washington.

Chinese craft entered waters near the islands for the third consecutive day on Sunday, marking at least the 11th incursion in recent weeks. The Japanese Coast Guard has described all the incidents as routine without a risk of clashes, and said none of its ships have backed down.

However, the Chinese government said last week that its boats had performed "expulsion measures" against Japanese ships.

"Chinese law enforcement vessels have a foothold in the waters around Diaoyu and are expanding their activities to safeguard Chinese sovereignty," China's stridently nationalistic Communist Party tabloid Global Times said last Wednesday. It called that a warning to the Philippines, Vietnam and other neighbors to "think twice before they provoke China."

Some scholars say China's apparent strategy to gradually erode Japanese control through low-key actions has been abetted by a non-committal response from Washington, who has said it takes no stance on the islands' sovereignty despite recognizing its treaty obligations to back Tokyo in a conflict.

China uses a similar approach in the South China Sea where it has maritime disputes with several other nations.

Earlier this year, Beijing managed to nudge the Philippines out of a disputed shoal by entering a lengthy but nonviolent maritime standoff. After both sides stood down, China set up barriers with ropes and buoys to block further access. Chinese ships have also sought to cut sonar cables and otherwise harass ships of the U.S. Navy.

___

Associated Press writers Eric Talmadge and Mari Yamaguchi in Tokyo contributed to this report.

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Apple sells 3 million iPads over first weekend

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MTV to air fundraiser for devastated Jersey shore

NEW YORK (AP) — MTV, home of the "Jersey Shore" reality show, plans to air a fundraising special to help rebuild New Jersey's devastated shoreline.

The one-hour program will air Nov. 15 from MTV's Times Square studio in New York City. It will feature the cast of "Jersey Shore" along with other guests.

The network said Monday the program will solicit contributions for the rebuilding of Seaside Heights, the heart of the Jersey shore and the principal setting for the "Jersey Shore" series.

For this effort, MTV will be partnering with Architecture for Humanity, a nonprofit organization that provides design and construction services to communities in need.

Seaside Heights was among numerous coastal areas devastated by Sandy last week.

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Doctors debate value of 'fringe' heart treatment

LOS ANGELES (AP) — A heart disease treatment that many doctors consider to be fringe medicine unexpectedly showed some promise in a federal study clouded by ethical and scientific controversy, causing debate about the results.

The study took 10 years, cost taxpayers $30 million, involved several doctors convicted of felonies and spurred a federal probe into patient safety. Even the lead researchers say the treatment cannot be recommended without further research.

The study tested chelation (pronounced "kee-LAY'shun") — periodic intravenous infusions that proponents say may help remove calcium from hardened arteries around the heart. Chelation has long been used to treat lead poisoning but its safety and value for heart disease are unproven.

The heart disease version involves a different drug that does not have government approval for any use in the United States. However, alternative medicine practitioners have been ordering it custom-mixed from compounding pharmacies — businesses like the Massachusetts one involved in the current meningitis outbreak — and treating people with it.

More than 100,000 Americans use chelation, often out of distrust of conventional medicine and sometimes in place of established treatments such as cholesterol-lowering medicines and stents to open clogged arteries. Treatments cost $90 to $150 apiece, usually are done weekly for 30 weeks and then less often, and are not covered by insurance.

On Sunday at an American Heart Association conference in Los Angeles, researchers said that a chelation mixture they tested in a study of 1,708 heart attack survivors led to fewer complications — repeat heart attacks, strokes, deaths, hospitalization for chest pain or need for an artery-opening procedure.

Four years after treatment, 26.5 percent of the chelation group had one of these problems versus 30 percent of those given dummy infusions.

However, 17 percent of participants dropped out before the study ended, and only 65 percent had all 40 infusions they were supposed to get. The missing and incomplete results make it unclear whether the benefit credited to chelation could have occurred by chance alone. The results have not been published in a medical journal or vetted by independent scientists, another reason doctors are leery.

"The study in my view is inconclusive," said Dr. Steven Nissen, the Cleveland Clinic's cardiovascular chief who had no role in the research.

"Chelation has been practiced by physicians on the extreme fringes of medicine" and many involved in this study offer "a variety of other quack therapies," Nissen said. "I'm really worried about harm coming to the public. Patients should not seek this therapy on the basis of this trial."

Others including the Heart Association praised the government for doing the study.

"Patients are doing this with or without our permission" so it's important to test, said Dr. John G. Harold, president-elect of the American College of Cardiology and a doctor at Cedars-Sinai Heart Institute in Los Angeles. He said at least two of his patients had suffered heart failure after getting chelation in Mexico.

Dr. Gary Gibbons, director of the National Heart, Lung and Blood Institute, which funded the study with the National Center for Complementary and Alternative Medicine, called it "a first step" and urged caution about results that suggest "a marginal benefit."

This chelation seemed safe in this study, where steps were taken to minimize complications and exclude people likely to suffer them, he said. "Further research needs to be done before this can join the mainstream of cardiovascular care."

Other experts questioned the results, especially because 60 more people in the group getting dummy infusions withdrew from the study than in the group getting chelation. Usually, more people in a treatment group drop out because of side effects, said Dr. Christie Ballantyne, a Baylor College of Medicine heart specialist. To find the opposite is "a red flag" that suggests those who got dummy treatments found that out and decided to drop out.

"There's something funky going on here," Ballantyne said. "It raises questions about study conduct," especially since a difference of one or two people or complications could have nullified the small overall benefit researchers reported.

Dr. Clyde Yancy, a Northwestern University cardiologist and a former Heart Association president, agreed.

"It's funny business," he said. "I've never seen a study in which one in five people withdrew consent."

The study's leader, Dr. Gervasio Lamas of Mount Sinai Medical Center in Miami, said: "The trial needs to be taken for what it is — a step towards future investigation."

It initially aimed to enroll 2,400 people in the United States and Canada but recruitment lagged and the goal was reset to 1,700.

In 2008, a group of scientists published a long article criticizing the trial, saying participants had not been warned that others had died from chelation. More than half of the doctors running the study make money by selling chelation treatments — a conflict of interest, they complained.

Investigations by the Office for Human Research Protections and the Food and Drug Administration found that several doctors doing the study had been accused of poor practices by state medical boards or involved in insurance fraud, and at least three were convicted felons. That did not prevent them from doing federal research, the government decided, and let the study go on after corrective steps. By that time, 1,500 participants had already been enrolled.

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Sandy could cast doubt on election results

WASHINGTON (Reuters) - The devastating storm that slammed into the U.S. East Coast last week could send winds of uncertainty through Tuesday's presidential election, narrowing an already close contest and casting doubt on the legitimacy of the outcome.


Though superstorm Sandy is unlikely to determine whether President Barack Obama or Republican Mitt Romney wins the White House, experts said it could expose flaws in how the United States conducts elections, leading to protracted legal wrangling and lingering bitterness in a country already fractured along partisan lines.


In a worst-case scenario, the storm disruption could cause Obama to lose the popular vote and still win re-election, stirring up vitriolic memories of the contested 2000 battle that allowed Republican George W. Bush to triumph over Democrat Al Gore.


Last-minute changes imposed by election officials also could


further arm campaign lawyers looking to challenge the result.


At minimum, low turnout would add another wild card to an election projected to be among the closest in U.S. history. Voting could be an afterthought for hundreds of thousands of people still struggling with power outages, fuel shortages and plummeting temperatures.


"It's a possibility that we'll see significant drops in turnout in some of these densely populated areas," said George Mason University professor Michael MacDonald, a voter turnout expert.


"The effects could be quite dramatic in terms of the popular vote," he said.


ONE MORE HEADACHE


Tuesday's election presents yet another headache for local officials in New York and New Jersey, which were hardest hit by the storm. Rescue workers are still recovering bodies, 1.9 million homes and businesses have no power, and tens of thousands of people are without heat as temperatures dip near freezing.


Sandy, one of the most damaging storms to hit the United States, hammered the region with 80-mile-per-hour (129-kph) winds, while walls of water overran seaside communities. At least 113 people in the United States and Canada died.


Election authorities now face unprecedented challenges. In New York City, 143,000 voters have been assigned new polling stations. New York Mayor Michael Bloomberg on Sunday called the city's elections board "dysfunctional" and warned that it needs to clearly communicate changes to poll workers.


In New Jersey, where 25 percent of homes and businesses have no power, officials are allowing displaced voters to cast their ballots by email. In battered Monmouth County, officials are spreading the word about new polling locations in at least 29 towns and setting aside paper ballots to use if electronic voting machines fail.


"Whatever it takes, Asbury Park is voting," City Manager Terence Reidy said.


Legal experts said the late changes, however well-intentioned, may give the losing candidate a basis to challenge results.


"The devil is in the details and no doubt these new rules will be fertile ground for those who choose to challenge the results in the election." said Angelo Genova, a New Jersey election law expert who represents Democratic candidates in this election.


The post-Sandy chaos also could expose flaws in the arcane electoral college system the United States uses to elect presidents.


Candidates are not required to win the popular vote nationwide, but they must amass a majority of the 538 "electoral votes" that are awarded to each state based on population. The system was set up when the United States was founded, as a compromise between slave states and free states.


Usually the electoral college winner also wins the popular vote. But in two elections - 1876 and 2000 - the results diverged, creating historic controversies.


This year, Obama is expected to handily win New York, New Jersey and Connecticut, the states most impacted by the storm. But his popular vote total could fall by hundreds of thousands if large numbers of storm-hit voters in Democratic areas are unable to participate. Conceivably, Obama could win the White House while losing the popular vote.


Several experts said they consider that outcome unlikely.


"You'll see lower turnout, yes, but it's not going to change the outcome of the election," said Hunter College political-science professor Jamie Chandler, who predicts Obama will win by at least 1 million votes.


If Obama carries the popular vote by a narrow margin, it could have implications on his ability to govern effectively, according to Ruy Teixeira, a senior fellow at the liberal Center for American Progress.


"The more Obama has a solid popular margin the better his victory," he said.


On Sunday, several Republicans said the storm gave Obama an advantage in the campaign's final week by shifting public attention away from the sluggish economy and other topics they hoped to emphasize.


"The hurricane is what broke Romney's momentum," former Mississippi Governor Haley Barbour said on CNN.


Obama campaign officials said that they are confident the storm will not interfere with the voting process. But they intend to have legal experts on standby just in case.


"We're going to have lawyers who are ready to make sure people can exercise their right to vote. We're going to protect that as fiercely as we can," Obama senior adviser David Plouffe said on Friday.


(Fixes typo in quote in 14th paragraph) (Additional reporting by Jeff Mason, Erin Smith, Jonathan Spicer, Philip Barbara and Andrew Longstreth; Editing by Marilyn W. Thompson and Paul Simao)


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China's Communists endorse Bo Xilai's expulsion

BEIJING (AP) — China's ruling Communist elite have endorsed the expulsion of former high-flying politician Bo Xilai and approved final preparations for the party's upcoming congress.

The closed-door meeting of the Central Committee that ended Sunday was the last before Communist Party leader Hu Jintao and others in his government begin to cede power to Vice President Xi Jinping and others at the congress, which opens Thursday.

The Central Committee said in a statement by the official Xinhua News Agency that it endorsed decisions to expel Bo and former Railways Minister Liu Zhijun from the Communist Party. Bo is accused of a range of misdeeds including covering up his wife's murder of a British businessman. Liu faces corruption charges.

Xinhua said Hu presided over the meeting and delivered a work report. It said Xi introduced a report of the current five-year session and an amendment to the party charter, both of which will be discussed at the congress. It gave no details.

Xinhua said delegates agreed that the past five years had been "extraordinary" because China had faced a difficult international environment as well as arduous tasks of reform, development and stability.

It also said the economy had grown stably and rapidly, there had been major progress on reform and opening-up, and people's living conditions had improved remarkably.

The policy-setting committee also promoted two generals to the party commission that oversees the military: air force Gen. Xu Qiliang and Gen. Fan Changlong, a career soldier who runs the Jinan Military Area Command and took part in relief efforts after the Sichuan earthquake in 2008.

The Central Committee is comprised of about 370 people from the upper ranks of the party, government and military.

Bo's ouster earlier this year widened rifts within a leadership that likes to project an image of unity. It also complicated the bargaining over the roster of new leaders.

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Google's Android software in 3 out of 4 smartphones

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Foxx, Wonder among stars honoring Eddie Murphy

LOS ANGELES (AP) — However riotous the Eddie Murphy stories from Arsenio Hall, Tracy Morgan, Adam Sandler and Russell Brand, the highlight of Spike TV's tribute to Eddie Murphy was the comedian's duet with Stevie Wonder.

Murphy joined the subject of one of his most classic impressions for a rousing rendition of Wonder's 1973 hit "Higher Ground" during the taping of the Spike TV special "Eddie Murphy: One Night Only," which is set to air Nov. 14. The Roots served as the house band.

Jamie Foxx, Tyler Perry, Martin Lawrence, Chris Rock and Keenan Ivory Wayans were also among those paying tribute to Murphy Saturday at the Saban Theater.

Accompanied by a pretty blonde, Murphy beamed throughout the two-hour program Saturday, saying he was touched by the tribute.

"I am a very, very bitter man," he said with a beguiling smile. "I don't get touched easily, and I am really touched."

Morgan called Murphy "my comic hero" and came onstage wearing a replica of Murphy's red leather suit from his standup show "Delirious."

"He set the tone for the whole industry a long time ago," Morgan said before Saturday's tribute. "He inspired me in a fearless way."

Sandler said he was still in high school when he first saw "Delirious," which he described as "one of the most legendary standup specials of all time."

"Everybody on the planet wanted to be Eddie," he said. "He funnier than us. He's cooler than any of us."

Samuel L. Jackson said Murphy "changed the course of American film history" by giving Jackson his first speaking role on the big screen, in 1988's "Coming to America."

"If it weren't for Eddie, we might not have all the wonderful films that I've made," Jackson said.

"He is a true movie star," Jackson continued, lauding Murphy's performance in "48 Hours" and "Beverly Hills Cop." ''You became an inspiration for all young African-American actors."

The program featured clips of Murphy's standup shows, his film appearances in "Shrek" and "Nutty Professor" and his work on "Saturday Night Live."

Murphy insisted before the tribute that he is retired.

"I'm just a retired old song and dance man," he said, adding that he only makes rare appearances these days. "That's what you do when you're retired: You come out every now and then and talk about the old days."

The 51-year-old entertainer took the stage at the conclusion of the tribute to say that he was moved by the honor.

"This is really a touching moving thing, and I really appreciate it," he said. "You know what it's like when you have something like this? You know when they sing happy birthday to you? It's like that for, like, two hours... and I am Eddied out."

___

Follow AP Entertainment Writer Sandy Cohen on Twitter at www.twitter.com/APSandy.

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Floods render NYC hospitals powerless

NEW YORK (AP) — There are few places in the U.S. where hospitals have put as much thought and money into disaster planning as New York. And yet two of the city's busiest, most important medical centers failed a fundamental test of readiness during Superstorm Sandy this week: They lost power.

Their backup generators failed, or proved inadequate. Nearly 1,000 patients had to be evacuated.

The closures led to dramatic scenes of doctors carrying patients down dark stairwells, nurses operating respirators by hand, and a bucket brigade of National Guard troops hauling fuel to rooftop generators in a vain attempt to keep the electricity on.

Both hospitals, NYU Langone Medical Center and Bellevue Hospital Center, were still trying to figure out exactly what led to the power failures Thursday, but the culprit appeared to be the most common type of flood damage there is: water in the basement.

While both hospitals put their generators on high floors where they could be protected in a flood, other critical components of the backup power system, such as fuel pumps and tanks, remained in basements just a block from the East River.

Both hospitals had fortified that equipment against floods within the past few years, but the water — which rushed with tremendous force — found a way in.

"This reveals to me that we have to be much more imaginative and detail-oriented in our planning to make sure hospitals are as resilient as they need to be," said Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health.

The problem of unreliable backup electricity at hospitals is nothing new.

Over the first six months of the year, 23 percent of the hospitals inspected by the Joint Commission, a health care facility accreditation group, were found to be out of compliance with standards for backup power and lighting, according to a spokesman.

Power failures crippled New Orleans hospitals after Hurricane Katrina. The backup generator failed at a hospital in Stafford Springs, Conn., after the remnants of Hurricane Irene blew through the state in 2011. Hospitals in Houston were crippled when Tropical Storm Allison flooded their basements and knocked out electrical equipment in 2001.

When the Northeast was hit with a crippling blackout in 2003, the backup power at several of New York City's hospitals failed or performed poorly. Generators malfunctioned or overheated. Fuel ran out too quickly. Even where the backup systems worked, they provided electricity to only some parts of the hospital and left others in the dark.

Afterward, a mayoral task force recommended upgrading testing standards for generators and requiring backup plans for blood banks and health care facilities that provide dialysis treatment.

Alan Aviles, president of New York City's Health and Hospitals Corp., which operates Bellevue, said that after a scare last summer when Hurricane Irene threatened to cause flooding, Bellevue put its basement-level fuel pumps in flood-resistant chambers.

It still isn't clear whether water breached those defenses, but when an estimated 17 million gallons of water rushed through loading docks and into the hospital's 1-million-square-foot basement, the fuel feed to the generators stopped working. The floodwaters also knocked out the hospital's elevators.

For two days, National Guardsmen carried fuel to the generators, but conditions inside the hospital for patients and staff deteriorated anyway. The generators were designed to supply only 30 percent of the usual electrical load at the hospital, leaving a lot of equipment and labs hobbled. The hospital also lost all water pressure on Tuesday. Nearly 700 patients had been evacuated by Thursday afternoon.

"The precautions we had taken to date had served us well," Aviles said. "But Mother Nature can always up the stakes."

NYU Langone Medical Center had also tried to armor itself against floods.

All seven of the generators providing backup power to the parts of the hospital involved in patient care are only a few years old and are on higher floors. The fuel tank is in a watertight vault. New fuel pumps were installed just this year in a pump house upgraded to withstand a high flood, said the hospital's vice president of facilities operation, Richard Cohen.

"The medical center invested quite a bit of money to upgrade the facility," he said.

The pump house remained "bone dry," Cohen said. But water shoved aside plastic and plywood defenses and infiltrated the fuel vault, where sensors detected the potentially damaging liquid and shut the generators down. "The force of the surge that came in was unbelievable. It dislodged our additional protection and caused a breach of the vault as well," Cohen said.

The power at NYU went out in a flash, leaving the staff scrambling to evacuate 300 patients with no notice.

Dr. Robert Berg, an obstetrician, said that when he lost power in his apartment, he went to the hospital to charge his cellphone and was stunned to find it in chaos.

"It didn't really occur to me that the hospital was going to be in trouble," he said. Even after finding the lobby dark, "I thought, 'We'll have power upstairs. We're an operating room.'"

He wound up carrying two patients down flights of stairs on a "med sled."

"There was a Category 1 outside and a Category 4 inside," he said. "I can't say that they were very well prepared for it."

That has left only one hospital, Beth Israel Medical Center, functioning in the southern third of Manhattan. It is also on backup power, but brought in two huge new generators Thursday, just in case.

Aviles said Bellevue might be out of commission for at least two more weeks. NYU Langone's generators are operating again, but the hospital is waiting for Consolidated Edison to restore its power before it starts taking patients again. That could happen in a matter of days.

Flooding may pose less of a danger to the hospital's power supply in the future. Construction is under way on a new power plant, at a cost of more than $200 million, that will run on natural gas and supply all the hospital's power needs.

"It's a tremendous facility, with a lot of hardening built into it," Cohen said.

___

AP Medical Writer Mike Stobbe contributed to this report.

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The abortion politics of Campaign 2012: Something that God intended?

By Virginia Heffernan


Happy birthday, abortion! You’ve bedeviled philosophers, politicians and doctors for 25 centuries! That’s right: Since around the 5th-century B.C., when the Hippocratic Oath for physicians first contained a clause about abortion, we’ve driven ourselves insane over the implications of a simple, common, ancient medical procedure.

As the explosion of abortion punditry in Campaign 2012 made clear, the issue exerts a radioactive fascination. Millions of temples and keyboards began pounding in August after Todd Akin, the Republican candidate for Senate in Missouri, engaged in some pseudoscientific theorizing on the impossibility of pregnancy after a “legitimate rape.” And the number must have reached Carl Sagan proportions after Richard Mourdock, the Republican candidate for Senate in Indiana, uttered this line: “Even when life begins in that horrible situation of rape, that it is something that God intended to happen.”

Yikes. Did Mourdock say rape is divinely inspired? Not exactly. Journalists sensitive to religious cosmologies like Amy Sullivan of the New Republic explained that Mourdock had seen God’s intention only in the life conceived during rape, not the rape itself.

That clarification was useful. It spared Mourdock from the gruesome charge that his God advocates rape—or is Himself the rapist’s accomplice. The Sullivan exegesis put these distracting and chilling questions to rest, more or less.

But Mourdock’s comment still managed to throw into relief an intense disagreement between atheists and religious people. And by “religious people,” I mean everyone from Buddhists to evangelicals to plain-old “everything happens for a reason” American optimists.

This disagreement concerns the mind-consuming question of whether the full catastrophe of existence—including the fact of violent crime, or Hurricane Sandy, or the next president of the United States—might be said to reflect something like “God’s will” or “the order of things” or even “the spiritual perfection of the moment.”

You think abortion makes people squeamish? Try the idea, common to many contemplative traditions, that everything in reality, however painful, is exactly the way it’s supposed to be. Some people feel liberated beyond all understanding by this notion. Others feel sickened, crippled, outraged, disempowered.

But if that’s Mourdock’s logic, we might hold him to it—for consistency’s sake, if nothing else. If conception during forced copulation reflects God’s will, in other words, and if rape itself might even reflect that inscrutable will (since it too is part of reality), then abortion—common and legal as it is in the United States—also reflects God’s will.

And this is where the tension surrounding abortion has always resided. Is the art of medicine—the protection and promotion of life and health—best practiced by allowing or prohibiting abortion?

I’ve found that this tension is thoroughly resolved in the Hipprocratic Oath, of all places. Back at the start. We need not visit Roe v. Wade or the teachings of Operation Rescue. In the ancient oath, the Apollo-worshiping internist vows above all to protect “health and life.” He then specifically says that, toward this end, he won’t perform euthanasia; he won’t perform abortion; and he won’t remove kidney stones and gallstones.

Does that mean these procedures are in themselves immoral? Far from it—as anyone who has had gallstones removed might agree. Rather, these three procedures, we are made to understand, require both philosophical and manual work for which early physicians, trained in medicine but not abdominal surgery, were not qualified. The gallstone sufferer needs a surgeon trained specifically in the art of cutting for stones, says the oath. For a generic medicine man to undertake it would be to risk doing harm—the signal crime against the art of medicine.

The would-be suicide, on the same logic, should administer poison to himself, or have a trusted and willing friend aid him. A physician is not qualified to determine the wishes of a euthanasia candidate, and thus might again betray his oath by doing harm.

Finally, those early non-surgical doctors, are not qualified to perform abortions because they don’t have the manual skills or the philosophical ones. Internists are not qualified to determine when this surgery, which is prima facie harmful, favors the life of the patient, as stone-removal does.

Every pregnancy, in every woman, under every circumstance, affects her “health and life.” And “health and life” are the very ideals that physicians all first pledge to protect. If a woman doesn’t want to be pregnant or bear a child, she has a complaint that’s deeply psychological and deeply physical—at least as physical as gallstones. If medical men and women don’t feel qualified to gauge the distress and seriousness of a woman presenting with pregnancy and asking for an abortion, they should refer her to someone—a gynecological practice, Planned Parenthood—that is qualified to assess the patient and treat her.

There should be a comparable oath for all politicians. (Would that we had drawn it up four years ago. There’s still time for Campiagn 2016!) Some topics should be left to experts and avoided by male politicians with neither philosophical nor medical training, nor firsthand appreciation of the effects of pregnancy and childbirth on health and life.

Richard Mourdock may have just been voicing an armchair view of an age-old medico-philosophical issue that’s consistent with his religious beliefs. But to present outlandish views on the subject of abortion, without the qualifications to do so—as too many politicians and pundits have done over the past three months—is to do harm.

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