Report of Sandra Mahkorn, M.D., M.P.H., M.S.

• Author: Mahkorn, Sandra

Regarding: Karlin et al. v. Foust et al. August 12, 1996

1. I am currently an independent consultant in the health care field and work with management of large scale health delivery systems. I received my M.D. in family medicine from the University of Wisconsin in 1981. In addition, I hold a Master of Science in Educational Psychology (counseling), a Master of Science in Urban Affairs (health care emphasis), and a Master of Public Health in epidemiology.

2. I have had extensive experience as both a physician as well as an administrator. In 1994 I was appointed by Governor Tommy Thompson to the Wisconsin Medical Examining Board. I was appointed by the Bush White House in 1991 to serve as Deputy Assistant Secretary for Public Health Policy at the U.S. Department of Health and Human Services. In that capacity, I was policy advisor to the Assistant Secretary for Health in areas including rural health, health care reform, maternal and child health programs among others. This office had oversight for the nine agencies of the U.S. Public Health Service, including the National Institutes for Health, the Centers for Disease Control and the Food and Drug Administration. In 1992 I was appointed Associate Director for the President's Council on Competitiveness and joined the White House staff of Vice-President Dan Quayle. As part of my duties I routinely advised the executive staff of the Vice-President, the President's Office of General Counsel and the Office of Management and Budget on regulatory and policy issues related to health and healthcare reform.

3. Between 1993 and 1995 I was a Clinical Assistant Professor of Family Medicine at the University of Wisconsin Medical School and interim Medical Director of the Sinai-Samaritan Family Care Center in Milwaukee. I have also taught medical students, residents and nurse practitioners at Louisiana State University and the University of Mississippi. In the course of my practice as a family physician, I have treated women who were victims of domestic violence, sexual assault and incest. In 1973-74 I was a counselor with the "anti-rape unit" of the Milwaukee County District Attorney's Office. For a more complete listing of my education, experience and publications, I attach a copy of my curriculum vitae.

4. The opinions I express herein are based in part upon my clinical experience working with battered women and victims of sexual assault and incest, my research, as well as my accumulated knowledge in the fields of medicine, public health and counseling.

5. I have reviewed AB 441. In my opinion, this law: [a] does not burden women who are victims of family violence, sexual assault or incest in such a way as to prevent them from obtaining an abortion if they so desire; [b] attempts to protect these women from ongoing abuse or harm by requiring that information on counseling and support groups as well as legal protections are made available to them; [c] in the case of sexual assault and incest, encourages reporting to law enforcement authorities by waiving the 24 hour waiting period or in the case of incest, reducing the reflective time period to 2 hours; [d] treats these victims with respect by not withholding information that would otherwise not be available to them at abortion clinics; [e] affords these women protection from potential conflicts of interest of the abortion provider and his/or her staff as to which information may be withheld, thereby precluding informed consent.

6. Rape is a serious and tragic crime against the person. The vast majority of rape incidents are directed against women. Despite recent efforts to educate the public about the realities of sexual assault, myths and misunderstandings still abound.

7. It is often common for even well-meaning, educated and sympathetic individuals to stereotype and categorize the reactions and responses of the rape victim. Often non-victims project themselves into the situation and assume that a sexual assault victim's reaction or a pregnant rape victim's responses will be similar to those they imagine for themselves. These unfortunate stereotypes don't help the victim. In my experience as a counselor of sexual assault victims and as a physician, a victim's reactions, attitudes and responses to the assault are almost as numerous as the victims themselves.

8. One myth is that rape is commonly committed by a total stranger. Stranger rapes account for a small percent of the total, often ten percent or less. In Wisconsin, sexual assault incidents in which the perpetrator is a stranger accounted for only 7.7% of all reported cases in 1995. In fact, sexual assault victims usually know their attacker and may have ongoing social, familial or sexual relationship with him. If such a woman becomes pregnant, she needs a thorough and compassionate exploration of her unique circumstances and all of her options, not medical paternalism that prescribes one course of optimum treatment for her, i.e., termination of the pregnancy. To prevent this from occurring, AB 441...