THE DEVASTATING MEDICAL problems cover a wide range - anencephaly, polycystic kidney disease, trisomy 13, among others. But the heartbreaking stories that brought so many women and couples to the Wichita, Kan., clinic of Dr. George Tiller are tragically similar:

They begin with a wanted pregnancy, hopes and dreams for the child to come. Then an ultrasound at 20 weeks of pregnancy - and evidence that something might be wrong. Then other, more detailed tests revealing undeveloped hearts or brains or other organs and a diagnosis that the child could not survive much past birth - or, if it did, would never know anything but pain.

But by then, the pregnancy is in its third trimester. In most states, including Pennsylvania, late-term abortion is illegal, even in circumstances like these. And until Sunday, those women were referred to Tiller and his staff, who braved protests and death threats and bogus criminal charges to help them through the worst days of their lives in safety and with dignity.

To these women and their loved ones, late-term abortion is not an ethically dubious procedure, but a life-affirming, necessary medical service. And George Tiller was one of the few doctors in this country who provided it.

And now he is gone, murdered in the Lutheran church where he regularly worshipped the same "awesome God" regularly invoked by the people who presumed to judge him.

It already was a national disgrace that so many women, some living in the world's great medical centers, were forced to travel to Wichita to get the care they needed. Highly restrictive state laws have meant that very few doctors perform late-term abortions, making those who remain even bigger targets. George Tiller knew every day that his life was at risk.

So now, who will help women like these? And how can this country free itself from continuing blackmail by a minority that expertly wields the threat of violence?

Even after his death, this courageous doctor still is being demonized by antiabortion extremists. The stories of the people Tiller helped are harder to find, but there are some on a Web site, www.aheartbreakingchoice.com. Other testimonials on Tiller's obituary Web site, www.legacy.com, come from physicians and genetics counselors who sent their patients to Tiller because their own state laws keep them from helping their patients in this way.

Following Tiller's death, Attorney General Eric Holder sent U.S. marshals to protect some clinics and individuals, but what's also needed is a true cultural shift. We must no longer tolerate an atmosphere in which abortion providers have to defend not only their work but their lives, and move toward a public recognition of the need for this medical service and a respect for the people who provide it.

We wish President Obama success on his quest for "common ground" in the abortion debate, but that won't eliminate circumstances that lead to late-term abortions. State legislatures must make laws that reflect reality. Medical schools, many of which have stopped providing training, need to start, so a new generation of doctors may provide late-term legal abortions, and not fear harm for serving patients.

As one of the buttons read that Tiller sometimes wore, we must "trust women" - to make their own choices - and protect them when they do. *