Modern medicine has allowed humankind more control over life and death than ever before, and yet sometimes, the idea of 'choice' is simply a lie, writes an anonymous US physician.
Whether a lawmaker, a doctor, a nurse or an expectant parent, our hopes, desires, beliefs and choices cannot save those who are doomed.
In these situations "all we can control is our grief", and in some states, this particular doctor argues, we are not allowing pregnant women or the professionals who treat them that ultimate dignity.
Recently published under the title "The Myth of Choice", this doctor's harrowing essay is a vivid reflection on one such experience, when a heavily pregnant woman was forced to give birth to an infant with no skull.
Known as anencephaly, this fatal birth defect affects only 1,206 pregnancies a year in the US, and at the severity this doctor detected - with no brain or skull at all, and only a brain stem - it has absolutely no survivors.
Speaking through an interpreter whose video feed was mounted on a television screen, the doctor had to explain this to the hopeful mother who, due to her circumstances, hadn't had an opportunity to reach a medical facility until that point.
"Her eyes plead with you. End it," the physician recalls. "You talk to the obstetricians, because eventually it will end. But nobody will do it. Not in this state. Not in this hospital. And so, the mother goes home, pregnant and grieving."
A few days later she returns. She is having a miscarriage, and after it is born, the mother cannot bring herself to hold her child. Moments later, the severely deformed infant died.
"Some of the nurses need you to fix it, to save this baby with the magic of medicine," the essay continues.
"You remind them that he is very premature, that he has no brain, that he cannot survive. This is not an ambiguous diagnosis."
With no standard treatment or cure, the hospital staff, who are used to doing everything they can to save a life, understandably feel helpless. Watching them grieve, the doctor recalls all the other women who have had their wishes "warped by politics".
"Dignity in grief is the gift," they conclude. "You've enabled false hopes, not for cures but for time to bond, hope, and heal. It is the parents you are healing. The hopes false. All these children died in the end."
This heart-wrenching, first-person account has been published amid a wave of anti-abortion laws in the US, some of which provide few exceptions, even for incest or rape. In Alabama, for instance, abortions are now only allowed when necessary for the mother's physical health, while her mental health and the health of her infant are rarely considered.
According to the American College of Obstetricians and Gynaecologists, abortions made in the third trimester are extremely rare, account for less than one percent of all cases, and usually involve fetal anomalies, such as anencephaly, which are deemed "incompatible with life".
While laws on this controversial and politically-loaded decision can vary right across the US, currently 43 states have a ban on certain abortions in late-term pregnancy.
Yet however it might sound to the layman, medically, a "late term" is a pregnancy that extends past the pregnant person's due date.
Meanwhile, political opponents use the phrase "late-term abortion" to describe abortions performed after about 21 weeks of pregnancy. (By the same token, a 'heartbeat bill' has nothing to do with an embryo having a real heartbeat.)
In a recent book on the history of abortion, sociologist Ziad Munson explains that there is nothing natural about how we think about abortion or the role it plays in politics and society.
"Instead," he says, "abortion has been constructed as a controversial issue because of a variety of historical events, the decisions of various individuals, organisations and social movements over the course of the country's history, and the ways in which social environments have changed over time."
The abortion debate is, and always has been, a cultural and social divide, based on disparate approaches to the complex question of the beginning of life.
"The Myth of Choice" may well drive the political wedge even further, and yet it brings up an important point: On certain occasions, saving the unborn life is impossible, and abortion may be the most merciful decision for all those involved.
"You've seen these infants cut, lanced, and battered in the name of intensive care," the anonymous doctor writes.
"Do everything. Because who does not want to save her child? Sometimes all we can control is our grief."
The essay was published in the Annals of Internal Medicine.