PHILADELPHIA — A Philadelphia jury began weighing murder charges Tuesday against a doctor charged with killing five people, including four viable babies allegedly born alive at his abortion clinic.
Dr. Kermit Gosnell, 72, performed thousands of abortions over a 30-year career, and authorities say he routinely performed illegal, late-term procedures. He maintains that he helped desperate women and teens who had no other access to medical care.
According to prosecutors, Gosnell cut live babies in the back of the neck to sever their spines because he did not know how to do a proper abortion in utero.
Gosnell is also charged in the 2009 death of a woman patient who was given anesthesia and monitored by two troubled medical assistants and a teenager. By that point, state officials had not inspected Gosnell's clinic since the early 1990s, prosecutors said.
"When people (who are) supposed to regulate these folks don't do it right, that's what happens," Assistant District Attorney Ed Cameron told jurors in closing arguments Monday. "Back alley abortions. Coat hanger abortions. That's what happens."
Gosnell faces 258 counts in all, including four first-degree murder counts, which could bring the death penalty. Clinic workers have admitted killing two of those babies, and accuse Gosnell of killing the other two. But he could be found guilty in all four deaths if the jury finds he shared the intent to kill, the judge said Wednesday in jury instructions.
Other charges against him include one count each of infanticide and racketeering, 24 counts of performing third-trimester abortions and 227 counts of failing to counsel patients a day in advance.
Gosnell's clinic has been shuttered, and two top state health department officials fired, since the FBI raided the clinic one night in 2010 looking for prescription drug abuses. Instead, they found Gosnell's nocturnal clinic in full swing.
Defense lawyer Jack McMahon argued that prosecutors who blasted the clinic as a filthy, flea-infested "house of horrors" in a 2011 grand jury report sensationalized the case to make headlines.
"This isn't a perfect place by any stretch of the imagination — but it isn't what they say it is," McMahon argued.
Eight former workers have pleaded guilty to murder other charges and have testified to seeing babies move, breathe or whine. Yet some said they did not consider the babies fully alive until they were charged after a 2011 grand jury investigation.
McMahon has seized on that point and argued again Monday that the occasional spasms the workers saw were not the wriggling movements of a newborn baby. Under Pennsylvania law, the judge explained to jurors, babies "born alive" must be expelled or removed from the mother and show one of the following signs of life: brain activity, breathing, the definitive movement of a muscle or the pulsing of the umbilical cord.
McMahon acknowledged that jurors have seen graphic, even grisly, photographs of aborted babies and bloody medical equipment.
"Abortion — as is any surgical procedure — isn't pretty," McMahon said. "It's bloody. It's real. But you have to transcend that."
And he refused to back down from aggressive opening remarks in which he called prosecutors "elitist" and "racist" for pursuing his client, who is black.
"We know why he was targeted," McMahon said.
Cameron called Gosnell's operation an assembly line for a stream of poor, mostly minority women and teens, including Karnamaya Mongar, who came from Virginia for an abortion after she was turned away at three other clinics, starting when she was 15 weeks pregnant. Gosnell is charged with third-degree murder in her overdose death.
"Are you human?" Cameron asked Gosnell, "to med these women up and stick knives in the backs of babies?"
The doctor sat calmly at the defense table, as he has throughout the often graphic six-week trial.
Former clinic employee Eileen O'Neill, 56, of Phoenixville, is also on trial, charged with six counts of theft for allegedly billing as a doctor when she was not licensed. O'Neill's lawyer has argued that O'Neill worked under Gosnell's supervision. The jury, asking its first question barely an hour into deliberations, had Common Pleas Judge Jeffrey Minehart repeat that charge, suggesting they may be starting with O'Neill's case.
Gosnell did not testify but might take the stand if he is convicted and the trial moves to the penalty phase. He has described himself as an altruistic doctor who returned to serve his medically needy community.
"He provided those desperate young girls with relief. He gave them a solution to their problems," McMahon argued Monday.
But Cameron said whatever intentions he may have once had turned criminal as he focused more on getting rich than on his patients.
"He created an assembly line with no regard for these women whatsoever. And he made money doing that," Cameron said.