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Applying the quality technology
to help resolve controversial issues such as abortion 

Updated October 5, 2000. Version 1.3.

The intent of this article is to help illustrate how the quality principles, methods and tools can provide a structure. focus and common language to help resolve controversial issues such as abortion.  Generally, people that have  passionate differences can agree on facts and ideals and can choose to work together to reduce common causes that may eventually eliminate the problems that cause the disagreements.

Problem Recognition.   Compare the desired and ideal outcomes to the actual situation and determine if an alternative course of action is wanted.

 1. Identify the facts. In 1973, the Supreme Court in Roe v. Wade 410 U.S. 113 (1973), determined that the right to “liberty” guaranteed by the Fourteenth Amendment, included the right to make personal decisions to include the right to terminate a pregnancy. 

Appendix A provides data on the number of abortions performed each year from 1973 – 1996 as well as a few other additional facts.   Additional facts and information can be obtained from the Center for Disease Control, National Center for Health Statistics (www.cdc.gov) and the Alan Guttmacher Institute (www.agi-usa.org).  

Number of Abortions -- 1973 - 1996

 2. Identify and define the process.  The Supreme Court defined the current process via a trimester system. They determined that during the first trimester and before viability of the fetus, a patient in consultation with a physician, can determine, without regulation by the state, to terminate a pregnancy. After the first trimester, the state can regulate procedures depending upon circumstances to include prohibiting the procedure to protect the life of a viable fetus.

Basic needs (step 2a), a few key stakeholders, (step 2b) services and desired outcomes (step 2c) are provided in Figure 1. The challenge in process improvement is improving something in one area without making it worse in another.  Process stakeholders make the determination as to better or worse, based on their desired outcomes.

Figure 1 – Process Stakeholders

Desired outcomes include alternatives that if or when implemented, create opposition or in other words, some people feel like they won and some lost resulting in a win/lose situation. On many issues, opinions range in three categories: A relatively few people may be passionately for or against a respective course of action and most everyone else is somewhere in between.  For example, people working to resolve the abortion issue could rate their beliefs using the scale provided in Figure 2.

Issue: Current Law Regulating Abortions

Figure 2 – Level of Support or Opposition

Identifying desired outcomes provides the opportunity for people to try and understand other peoples points of view, i.e., putting yourself in other peoples shoes. If you were immersed in the same environment and circumstances as the other person, would you share the same beliefs?  (This step is also referred to as dialog where people try to develop a shared understanding and meaning). Improving the process does not require people to abandon their beliefs as to what they perceive to be right and wrong.  In fact, applying the quality technology congruent with those beliefs can gain the trust, respect and admiration of the “opposition.” 

 2d. Identify ideal outcomes. An ideal outcome is one in which there is no disagreement. For example, an ideal may be that the causes that lead to abortion are prevented. 

 2e.  Ascertain commitment.  Describe what the situation would be like if the ideal was achieved. The quality of this step is one of the better predictors for determining if change is going to result in improvement.  The desired end state must be compelling.  A survey similar to the one provided in Figure 2, would help assess the level of desire and commitment.

 3. Plot points.  Identify the feedback needed that progress towards the ideal is being achieved.  Although national level data might be helpful, local community based data would be more helpful and immediate in determining if changes made locally are having a positive impact.

Decision Making. Identify and select alternatives.

 1.  Identify causes and/or develop alternatives.  A few causes and alternatives are provided in Figure 3.  Once causes and alternatives are identified, it is helpful to identify the degree of control the individual or group has over their ability to bring about change to include identifying the expected outcome or result. 

Issue: Why are there unwanted pregnancies that result in termination?

2.  Select the best alternative (s).  An optimum solution is one that has a positive impact on everyone affected by the solution both in the short and long term. People that disagree as to desired outcomes (see step 4) can usually find a common cause that they can work together to resolve, e.g., helping to prevent rape and incest.

 3. Develop an action plan to implement the selected alternative. An action plan (Figure 4) identifies tasks, timelines, resources, and responsibilities.  

Figure 4: Action Planning Matrix

 Problem Resolution.  Choosing to test an alternative (s) course of action. 

 1. Take action to implement the selected alternative (s). This step could include repeating the cycle substituting the new expected outcome identified in Figure 3 for the abortion issue.  

 2. Compare actual results with expected outcomes. This is among the most important steps for individuals and groups working to resolve the respective issue.  Application of the continuous improvement and learning process is always successful if you learned something new.  When tracking trends, you need at least seven data points either above or below the center line or seven consecutive points going up or down to indicate a change in the process.

Follow-through.  This phase involves either abandoning the change because it didn’t work, adopting it and repeating the cycle (s) until you achieve the ideal. 

Summary.  The advantageous of the quality technology is that people that have passionately different points of view can usually agree to facts and ideals and can agree to work together to find and reduce common causes until the ideal is achieved. Is there a better way?

Feedback. I would appreciate your constructive feedback on the article. Please send comments to tjclark@SuccessThroughQuality.com

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Appendix A  -- Abortion Facts

Differences in totals reported by Alan Guttmacher Institute (AGI) and Center for Disease Control (CDC) are due to differences in data collection methods.  CDC gets its data from health agencies and AGI gets its numbers from direct surveys of all known providers.

 Other facts reported by the AGI

1. On average, the three top reasons women give for choosing abortion are: that having a baby would interfere with work, school or other responsibilities; about 2/3 say they cannot afford a child; and ½ say they do not want to be a single parent or are having problems with their partner.

2. About 14,000 women have abortions each year because they become pregnant after rape or incest.

3. When women have abortions – Pareto Chart.

4. 49% of pregnancies among American women are unintended, ½ are terminated by abortion.

5. Each year, an estimated 50 million abortions occur worldwide. Of these 20, million procedures are obtained illegally.

6. Age of women who have abortions.  52% of U.S. women obtaining abortions are younger than 25: Women aged 20-24 obtain 32% of all abortions, and teenagers obtain 20%.

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