What died with Dr. George Tiller

The devastating medical problems cover a wide range - anencephaly, polycystic kidney disease, trisomy 13, among others. But the heartbreaking stories that brought so many women and couples to the Wichita, Kan., clinic of Dr. George Tiller are tragically similar: They begin with a wanted pregnancy, hopes and dreams for the child to come. Then an ultrasound at 20 weeks of pregnancy - and evidence that something might be wrong. Then other, more detailed tests revealing undeveloped hearts or brains or other organs and a diagnosis that the child could not survive much past birth - or, if it did, would never know anything but pain. But by then, the pregnancy is in its third trimester. In most states, including Pennsylvania, late-term abortion is illegal, even in circumstances like these. And until Sunday, those women were referred to Tiller and his staff, who braved protests and death threats and bogus criminal charges to help them through the worst days of their lives in safety and with dignity. To these women and their loved ones, late-term abortion is not an ethically dubious procedure, but a life-affirming, necessary medical service. And George Tiller was one of the few doctors in this country who provided it. When George Tiller was young he dreamed not of being one of the most visible and strident advocates for abortion rights, but of becoming a dermatologist. The 67-year-old physician, who was shot and killed Sunday in his church, had said his path was altered by a 1970 plane crash that killed his father, mother, sister and brother-in-law. The former Navy flight surgeon was left with his father's family practice in Wichita, and he soon learned a secret. One of his father's patients asked him whether he, like his father, would perform abortions. At first, Tiller said, he did not believe his father had risked his medical license by performing then-illegal abortions. But after the Supreme Court's landmark Roe v. Wade decision legalizing abortions in 1973, Tiller began providing them. By the time he was killed, his clinic, Women's Health Care Services, was among just three in the nation to perform abortions after 21 weeks of pregnancy, when the fetus is considered viable. He was a focus of abortion opponents for years, most peaceful, some violent. "George dedicated his life to providing women with high-quality health care despite frequent threats and violence," his Tiller's widow, four children and 10 grandchildren said in a statement. They called him "a good husband, father and grandfather and a dedicated servant on behalf of the rights of women everywhere." Tiller's clinic was bombed in 1985, and he was shot in both arms in 1993 by abortion protester Rachelle "Shelley" Shannon of Grants Pass, Ore. In 1991, the Summer of Mercy protests organized by Operation Rescue drew thousands of anti-abortion activists to Wichita for demonstrations marked by civil disobedience and mass arrests. Federal marshals protected Tiller during the Summer of Mercy protests, and he was protected again between 1994 and 1998 after another abortion provider was assassinated and federal authorities reported finding his name on an assassination list. The women's clinic is fortified with bulletproof glass, and Tiller hired a private security team to protect the facility. Once outside the clinic, Tiller was usually seen accompanied by a bodyguard. Anti-abortion groups condemned Tiller's slaying. "We value life, completely deplore violence, and are shocked and very upset by what happened in Wichita today," said Mary Kay Culp, executive director of the anti-abortion group Kansans for Life. Tiller in 1997 said his "gifts of understanding" helped him bring a service to women that aided them in making their dreams of a happy, healthy family a reality. Tiller, who in his later years largely shunned interviews and public appearances amid his family's increasing fear of violence against him, said abortion was as socially divisive as slavery or prohibition. But he said the issue was about giving women a choice when dealing with technology that can diagnose severe fetal abnormalities before a baby is born. "Prenatal testing without prenatal choices is medical fraud," Tiller once said. Tiller contended that he pioneered the use of sonogram imaging during procedures, a process that has since been adopted by abortion providers nationwide. In 2002, Tiller founded ProKanDo, a state political action committee, to help elect abortion rights supporters and support abortion-friendly legislation. His resume includes the National Abortion Federation's highest honor, The Christopher Tietze Humanitarian Award, as well as the Religious Coalition for Abortion Rights' Faith and Freedom Award. And now he is gone, murdered in the Lutheran church where he regularly worshipped the same "awesome God" regularly invoked by the people who presumed to judge him. It already was a national disgrace that so many women, some living in the world's great medical centers, were forced to travel to Wichita to get the care they needed. Highly restrictive state laws have meant that very few doctors perform late-term abortions, making those who remain even bigger targets. George Tiller knew every day that his life was at risk. So now, who will help women like these? And how can this country free itself from continuing blackmail by a minority that expertly wields the threat of violence? Even after his death, this courageous doctor still is being demonized by antiabortion extremists. The stories of the people Tiller helped are harder to find, but there are some on a Web site, www.aheartbreakingchoice.com. Other testimonials on Tiller's obituary Web site, www.legacy.com, come from physicians and genetics counselors who sent their patients to Tiller because their own state laws keep them from helping their patients in this way. Following Tiller's death, Attorney General Eric Holder sent U.S. marshals to protect some clinics and individuals, but what's also needed is a true cultural shift. We must no longer tolerate an atmosphere in which abortion providers have to defend not only their work but their lives, and move toward a public recognition of the need for this medical service and a respect for the people who provide it. We wish President Obama success on his quest for "common ground" in the abortion debate, but that won't eliminate circumstances that lead to late-term abortions. State legislatures must make laws that reflect reality. Medical schools, many of which have stopped providing training, need to start, so a new generation of doctors may provide late-term legal abortions, and not fear harm for serving patients. As one of the buttons read that Tiller sometimes wore, we must "trust women" - to make their own choices - and protect them when they do.