Tuesday, June 25, 2013

Doctors Oppose Dangerous New GOP Laws


The Texas legislature is on the verge of approving a new law that will restrict the rights of women to control their own bodies, and will further endanger the health and well-being of many Texas women. The bill will close 37 out of the state's 42 clinics that do abortion procedures, and it will outlaw all abortions after the 20th week (in spite of the fact that these abortions already require a doctor's decision that the procedure is needed to protect the health of a woman). This is in addition to previous laws that closed down dozens of women's health clinics (most of which did not perform abortions) and mandated state-sanctioned rape by requiring any woman seeking an abortion to submit to a forced sonogram with a trans-vaginal probe.

But it is not just Texas that is guilty of passing new (and dangerous) laws regarding women's health and rights. In the last couple of years, hundreds of new laws have been proposed (and many of them passed) by GOP legislators in dozens of states. And this renewed war on women has been picking up steam in states where the Republicans have control. The actions by the GOP-dominated Texas legislature is just the latest of what has been an avalanche of anti-woman legislation -- designed to keep women in a second-class citizenship status by chipping away at their constitutional rights.

But these laws do more than deny women equal rights. They also pose a danger to the health of many women, by interfering with the doctor/patient relationship and mandating that doctor's do unnecessary and potentially dangerous things -- things that are mandated by legislators that know nothing about medicine or medical procedures. That is not just my opinion. It is the view of the American College of Obstetricians and Gynecologists and the American Congress of Obstetricians and Gynecologists. These new actions in Texas seem to have been a tipping point for these organizations, and they felt it necessary to make their views known by releasing a Statement of Policy. Here is what these doctors have to say:


Statement of Policy
As Issued by the Executive Board of the American College of Obstetricians and Gynecologists 
and the American Congress of Obstetricians and Gynecologists


Government serves a valuable role in the protection of public health and safety and the provision of essential health services. The American College of Obstetricians and Gynecologists (the College) and the American Congress of Obstetricians and Gynecologists (ACOG) support this proper role of government. Laws that veer from these functions and unduly interfere with patient-physician relationships are not appropriate. Absent a substantial public health justification, government should not interfere with individual patient-physician encounters.

The patient-physician relationship is essential to the provision of safe and quality medical care and should be protected from unnecessary governmental intrusion. Efforts to legislate elements of patient care and counseling can drive a wedge between a patient and her health care provider, be that a physician, certified nurse-midwife, certified midwife, nurse practitioner, or physician assistant. Laws should not interfere with the ability of physicians to determine appropriate treatment options and have open, honest, and confidential communications with their patients. Nor should laws interfere with the patient’s right to be counseled by a physician according to the best currently available medical evidence and the physician’s professional medical judgment. The College and ACOG strongly oppose any governmental interference that threatens communication between patients and their physicians or causes a physician to compromise his or her medical judgment about what information or treatment is in the best interest of the patient.

Laws that require physicians to give, or withhold, specific information when counseling patients, or that mandate which tests, procedures, treatment alternatives or medicines physicians can perform, prescribe, or administer are ill-advised. Examples of such problematic legislation include laws that prohibit physicians from speaking to their patients about firearms and gun safety; laws that require medically unnecessary ultrasounds before abortion and force a patient to view the ultrasound image; laws that mandate an outdated treatment protocol for medical abortion; and laws that prescribe what must be communicated to patients about breast density and cancer risk, contrary to current evidence-based scientific data and medical consensus.

This type of legislative interference affects all physicians, not just obstetricians-gynecologists. For example, laws that require physicians to follow a specific medical protocol, singled-out by legislators in defiance of current accepted medical practice, are dangerous to patient health and safety. Such laws preclude physicians from offering the best evidence-based care to their patients. Even if the law or regulation is generally consistent with the clinical standard of care at the time of enactment, medical treatment protocols written into law are problematic. Medical knowledge is not static. As knowledge advances, these protocols, tests, and procedures will become outdated. Legislation should not override scientific progress.

The College and ACOG oppose legislation that weakens the patient-physician relationship. We urge physicians to advocate against undue legislative interference in patient care. A patient’s right to be counseled and treated by her physician according to the best available medical evidence and the physician’s professional medical judgment must be protected. 

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