Roe v Wade is Just the Beginning

Patrick Koske-McBride
6 min readMay 8, 2022


I was disheartened to learn that Justice Samuel Alito, in a very strange brief that quoted an historical figure who was actually involved in witch trials was accredited as a “jurist” (I’ll give the man points for creative writing), is now allowing states to make their own laws concerning abortion. Which is rather like giving permission for states to deal with “the minority problem.” Those of us with even a passing familiarity of history knows what comes next. Disabled people traditionally aren’t the main course when society descends into cannibalism. Just Google, “Aktion T4.” Holy shit, we didn’t even live long enough to get into the main Holocaust. Talk about complete erasure.

I am, like every other minority, not worried particularly on womens’ behalf (I mean, I am, but I’m far more worried about me), but I am terrified at what it implies. No access to effective, safe contraception. No personal privacy with what I can put in my body. No medical privacy. The list of items thinly saving my ass, thanks to protections enacted by Roe v Wade — or using that case as an establishment — is long, but comes crashing down in a minute. Prior to Roe, the concept of bodily autonomy in medicine was almost an abstraction that some practitioners could choose to incorporate, but, as my bioethics professor once put it, “Beneficence outweighed nonmaleficence.” Put it in today’s speech, “Doing good was prioritized over not doing harm.” And life for medical patients wasn’t good. Patients treated experimentally suffered horrific, Dr. Mengele-type experiments, like the Tuskegee Airmen, or MKUltra, or the horrors enacted on BIPOC or LGBT folk. If you’re a chronic disease patient, I’d like you to imagine a world in which you are not legally entitled to a second medical opinion, can not refuse treatment, and treatment protocols are set by local legislatures or state bodies. This was actually the case throughout most of the 19th century, and, hey, that was the heyday of good health! What child labor?

In this dark, terrifying world imagined by Samuel Alito, I would like all of my fellow cancer survivors to imagine treatment protocols that you have no hand in designing or implementing. Standard of Care is the only treatment available, nothing more or less. No medical marijuana, nutritionists, physical therapy, or non-curative measures not approved by the state. Would you survive? I don’t think I would’ve; certainly, receiving experimental treatment in a controlled, scientific manner wouldn’t exist — we’d go back to the dark days of the 1970s and 80s, when laetrile was a thing, cancer patients had to travel to Mexico for experimental treatment, and absolutely nobody thought we were worth medically treating.

I realize this might seem a little hysterical, but we just had a man quote a Goddamned medieval witch hunter (the irony of Donald Trump’s favorite bogeyman being invoked to repress minorities is probably lost on Alito). It’s at this point that I think the absolute worst, most-nefarious, insidious motives and outcomes can be assumed. Care to know why I think this? Because someone on the Supreme Court thinks that witch burnings were legal proceedings — it’s proof that stupidity is far more lethal than intelligent evil.

If you’re a woman in these trying times, I have some recommendations:

  1. Don’t sleep with men, until your reproductive rights are secured. Not even if you’re married. Unless you’re ready to risk the potentially-lethal consequences of child-birth, don’t even give us the time of day. Yes, withholding sex might seem like an inducement to vote a certain way, but I think we left the idea of “rule of law” long ago. Also, I know that this is an easy solution for an asexual to put forth, but, really, how hard would it be to put off mediocre sex with dullards for a few months, for the benefit of society?
  2. Don’t associate with Christians. Make no mistake, there are some church groups and sects I adore, but they all made this possible. Imagine what would happen if all of them were suddenly forced to find new business partners, accounts, or friends. Again, this is just a fairly moderate extension of the sort of second class citizenship women now must endure. Come to it, maybe don’t give Muslim or Jewish men the time of day, either. It’s the same bloodthirsty God. “Well, we just have to agree to disagree” is always the civil cover that people who think they’re good people use to justify voting for vile policies and politicians. Explain to them how that vote led to a justice that just endangered your medical care. When I started doing that to conservative friends, I started getting a lot of awkward silences. Which is better than letting someone go through life under the delusion that their behavior and choices have no consequences. I feel that, whenever theology is invoked to rationalize decisions or behavior, it’s always in the name of monotheism, and, more critically, our monkey brains are fascinated at the historic “Wow” factor and fail to ask, “Hang on. We are discussing an accidental religion that was created to justify a failed infanticide attempt? That’s the basis of morality? Child murder?” That needs to be at the fore of every conversation on morality that revolves around the Abrahamic faiths. If giving up your festive rituals cold-turkey is a little much to ask, perhaps you’d consider a shrine to Athena, first in her attributes of beauty, war, wisdom, and crafts?
  3. Don’t vote Republican. Ever. Susan Collins and Lisa Murkowski just proved that “moderate Republican” is convenient cover for, “We know it’s hard to get elected if you agree with everything the GOP does, so, we just support 98–99% of it.” Go and vote like your life depends upon it, and, if you don’t like the Democrats, vote third party. Just vote while you still can, because that might be the next right we debate.
  4. Targeted political action. The judicial system has long been allowed to operate with minimal political consequences for overtly political rulings or laws, because we thought the courts were an apolitical system that was bound only to the letter of the law. Don’t like the outcome of this case? Pressure your legislature to write better laws. The court system just showed itself to be a political apparatus with an interest in legislating morality (which, if memory serves, is a violation of the First Amendment), and should be treated as a political entity. Picket and protest courthouses. Light candles on a judge’s home for every woman who dies in a back-alley abortion attempt. Hell, lodge criminal complaints you know have no merit on your neighbors just to drain the court system’s time and resources. What are they gonna do, sue you? That’s what you want. Demand to face your accusers. Insist on a full-jury hearing. These will all take time and resources. And, never forget the potential to embarrass any and all sitting judges. I don’t think anyone wants to make a matter of public record that time you saw them at a swinger’s club, but you can and should do exactly that. Let every cabana boy and au pair who services grody old white men come forth and inform the public just how moral and principled these public servants really are. I know this is “Whataboutism,” but these are the same tactics the courts have now tacitly decided are acceptable arguments. Again, when you quote people who actually believed in literal witches, you can’t escape with your dignity intact/
  5. Don’t follow any rulings you, personally, disagree with. Let me make something abundantly clear: yes, I am endorsing illegal behavior. Let me make another thing clear: this is practiced by every deadbeat dad on the planet, and they don’t receive any consequences for it. The courts don’t have the time, resources, or legal mandates to enforce their rulings; it’s mostly just the norm and tradition that we follow them. If you don’t follow those rulings, as any number of terrible men drinking their kid’s tuition away at Cabo can attest, there’s not a whole lot the courts can or will do. Clarence Thomas is already whining about how the American people need to accept this and move on, because he knows, if every single American says, “Fuck that, I’m going to practice genuine consent practices and offer contraceptives from the back of an ice-cream truck” (yes, access to contraceptives is now up for debate), there isn’t anything he can do about it unless the local cops follow up (despite their ominous abbreviations, I once crunched the numbers on federal law enforcement agencies — even if they brought in every military reservist and active duty serviceman out there, the American public outnumber them by a greater margin than blacks outnumbered white law enforcement in apartheid South Africa). The court system is a paper tiger, and needs to be revealed as such.

Again, chronic disease survivors everywhere need to be especially concerned with the implications of government being able to dictate proper medical care, especially since the lawmakers have no intention of subjecting themselves to the same system. And, I can not begin to imagine that any competent practitioner is interested in working within a system in which standards of care and practice are dictated by a political group and not science and medicine. That’s a system that produces people who only know how to work the system.



Patrick Koske-McBride

Science journalist, cancer survivor, biomedical consultant, the “Wednesday Addams of travel writers.”