Anullla Linders on Doctors and Demonstrators: How Political Institutions Shape Abortion Law in the United States, Britain and Canada

A couple of weeks ago, the Collective Behavior and Social Movements section of the American Sociological Association held an Author Meets Critics session on the two most recent winners of the Charles Tilly Best Book Award, my book, Doctors and Demonstrators and Kathleen Blee's Democracy in the Making.  My critics were Myra Marx Ferree and Annulla Linder.  Here are Annulla's comments: 

Annulla Linders

CBSM 2014 Author-meets-critic session on Doctors and Demonstrators

Had this been an author-meets-fan session, my task would have been a lot easier. It’s a great book – ambitious, well-written, and deeply engaging – and a model of what comparative work can accomplish. In so many ways, this is a book I wish I had written myself.

The explanation he gives us of the differences and similarities among these three nations is complex and layered. There is no single variable that magically accounts for the dizzying array of sociopolitical action that has surrounded abortion – at least in the US – for the past 50 years. And yet, by focusing on institutional processes, at the precise intersection of social action and political systems, he nonetheless manages to deliver a clean and uncluttered explanation that is wholly satisfying to the reader.  

But since I am recruited to be a critic, I will do my best to live up to the expectations of that role. With the critic’s prerogative, I take some liberties with my comments, sometimes veering off the path Drew has laid out for us and occasionally moving into territories that may better belong in another book.

I focus the discussion on three issues: The first – I call it the boggle line - is linked to abortion as a sociological issue; the second – this one I call cliff hangers – relates to the volatility of abortion politics; the third, to quote one of my former colleagues, deals with the squuishi stuff, that is, meanings, values, interpretations, and the softer side of sociology. These issues are obviously much larger than this particular work, but Drew provides useful insights into all of them…It hardly counts as criticism to say he hasn’t provided the final word on any of them (if he had, what would the rest of us do J?)

The Boggle Line

If you read the opinion piece by anthropologist T. M. Luhrmann a few weeks ago in the New York Times, you may remember his reference to the “boggle line.” The boggle line captures the point at which things no longer make sense – the brain simply won’t compute it, it boggles us. We all have our individual boggle lines and cultures too have boggle lines beyond the noise of social variations and disagreements. And I think sociology also has its boggle lines.

When I came to the US some 30 years ago I was clearly boggled by the abortion mess I encountered. It wasn’t policy—abortion was legal after all. But the mess was seemingly everywhere: in the legislatures, the courts, the doctors’ offices, and on the streets. Why wasn’t it settled? Why was it so volatile, and why only in the US, and not in my native Sweden? It boggled me. And there was the beginning of my dissertation, a historical comparison of abortion politics in Sweden and the US (I threw capital punishment into the mix too, but that’s a different story).

Judging from the size of the literature addressing abortion in the US, I am clearly not the only one boggled. That is, for many of us, it is the US that consistently falls on the other side of the boggle line. And I think that’s how Drew sees it too. It’s not so that abortion is a non-problematic issue in other nations, but rather that abortion politics in the US is so much crazier. I cringe a bit myself when I say that – after all, I keep telling my students that they must treat both sides of an issue as sociological mysteries in need of explanation – and I tried hard as I was reading the book to turn the table and make Canada and Britain the cases that were boggling. But it’s a difficult exercise and, although Drew’s analysis is as evenhanded as may be possible, it is still an account that is designed primarily to explain abortion politics in the US.  

I don’t mean this as a criticism, on the contrary, but as sociologists it should give us pause. Obviously there is a long tradition in social science of approaching the US as an exceptional case, that is, a case that does not quite follow the logic of its western European siblings and hence needs different theories. Although Drew identifies a number of ways that abortion politics is different in the US, he still does not approach the US as a wholesale exception, and rightly so. And yet, it is the boggling US that drives the analysis, and it is to our understanding of abortion in the United States that Drew contributes the most.

Cliff Hangers

Social cliff hangers. Here I am thinking of close votes, last minute vetoes, judicial surprises, unstable and cross cutting coalitions. I also include the kinds of social minutia that invariably come to light when we start digging into the complex historical layers of sociopolitical issues (serendipity, coincidences, unique personal trajectories, and the like). Drew provides several different instances of such cliff hangers and historical minutia, which enrich the account and pull the reader into the volatile unfolding of events. Analytically speaking, though, it is not entirely clear what to do with such cliff hangers. Are they evidence that things could always have gone the other way? Do they signal that much of social life is a series of historical accidents? In short, what do we do with social cliffhangers?

Most commonly and in the big scheme of things, we often ignore—or gloss over – such minutia and instead focus on the larger trend, as if there were inexorable forces pushing social life in certain directions and moving it away from others. And I think most of us think of abortion in this way: it can really only go in one direction. Hence we find our puzzles where it stops, veers off its path, or even go in reverse direction.

Another way is to move away from explanations that emphasize the predictable character of social life and instead approach social life us fundamentally open-ended and unpredictable– it always could have happened another way.

Yet another way – and this is what Drew is doing in this book, and very nicely too – is to embrace them and try to account for them in ways that support his overall account.  Take the US Supreme Court, for example, which has delivered several abortion rulings over the years that qualify as cliff hangers. Pointing to factors that simultaneously infuse the judiciary with politics (political appointments) and dilute immediate political interests (lifetime appointments), Drew lays bare the process whereby the justices arrive at their decisions, including very surprising ones, like Roe v. Wade.

But it makes me wonder if there is yet another way we could approach cliffhangers, to think of them as social things in themselves, both in terms of form and trajectory. Although this is not where Drew’s analysis lingers, he nonetheless points us in a few directions that can help. For one, his analysis confirms the oft-cited observation that the US political system, because it is so porous, invites continuous conflict where other political systems more effectively close the door on conflict. For another, he shows how the timing and pace at which different social actors enter the debate can have profound impacts on the unfolding of social issues in the political process.

But I keep wondering if it could also be a feature of a particular set of issues that, for one reason or another, generate moral conflict, that is, pit one moral absolute against another. I don’t mean to suggest that some issues are inherently moral, but instead that the moralization of issues is a normal part of the democratic political process (even if more or less). And if so, as this book demonstrates very nicely, the passionate and volatile politics that surround them cannot be relegated to the edges of political analyses where they otherwise often reside. Rather, they are a particular and recurrent form of normal politics.

The Squuishi Stuff

Finally, what about the squuishi stuff? I am using this as an umbrella for things very loosely described as cultural. This is not a book about the culture of abortion politics, and Drew doesn’t claim that it is. Still, one of the great advantages of this book is that Drew does not ignore the importance of the cultural realm. This is so especially in his analysis of the medical profession in the three nations. He very effectively challenges theories of interest groups that link their interests to their objective social position and their success in the political market place to size and other measures of strengths. Instead, he insists, we need to be receptive to all the ways in which the larger social, political, and cultural context shapes how interest groups construct and prioritize their interests. There are times when I wished he had approached the interests of other political actors with the same analytical dexterity—feminist interests, for example, are not subject to the same kind of scrutiny—but the issue I want to address here refers to the  relationship between institutional processes and the interpretive realm, especially in comparative work.

I think of it as a challenge akin to translation. Whenever I am working on a paper involving a comparison of Sweden and the US I sit with a dictionary in my lap, trying to determine how to best translate key passages that capture the essence of what political actors claim. It is a difficult process not only for linguistic reasons, but also for reasons having to do with meaning. Things can mean different things, even when the words are the same.

What I am trying to get at here is not simply that “culture matters” – many of us here, including Drew, would obviously agree with that – but instead that comparisons that take culture seriously always face a translational dilemma not just in relation to the words that political actors use but also the larger sociocultural context that surrounds and penetrates institutional processes and practices. Even something as simple as “abortion on demand” does not mean exactly the same everywhere and certainly – as Drew clearly shows – does not give rise to the same institutional practices when it comes to delivery.

Although this is not the problem Drew set out to resolve, he still has given us some ideas for how to proceed. For example, in his discussion of the limitations of explanations of cross-national differences in terms of “national values” he observes that one the main contributions of the American creed to abortion policy “was the institutions that the founders left behind” (46). This suggests that institutions and the social processes they engender are saturated with meanings; that is, the cultural elements are not simply meat on the bone, so to speak, but part of the very bone structure itself. This observation should serve as a caution when we try to explain cross-national differences with the help of isolated structural or institutional features as if they were easily abstractable, if that’s a word, and hence comparable.  Drew also observes that although “values” “do not determine the content of policies” they do “provide a set of cultural resources for political actors” (45). This is a good reminder that even though we cannot predict with any certainty how political actors will use which of the cultural resources available to them, we know that they will always use some. It is an almost ridiculously simple point to end on, but I’ll do it anyway, since I think it is an important one: political actors cannot make claims, and policy makers not laws, unless they are culturally embedded in recognizable constellations of meaning.