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Old 03-08-2012, 05:49 PM   #1 (permalink)
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Arizona Senate Passes Bill Allowing Doctors to Lie to Pregnant Women

The Arizona Senate has passed a bill that would allow physicians to withhold medical information from a pregnant woman about her unborn child if they think it would lead to an abortion.

Arizona Senate approves lying to women to prevent abortions | The Raw Story
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Old 03-08-2012, 06:08 PM   #2 (permalink)
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what's the chances of this passing in the state house? There is a whole lotta WTF going on there.
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Old 03-08-2012, 08:44 PM   #3 (permalink)
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The Arizona Senate has passed a bill that would allow physicians to withhold medical information from a pregnant woman about her unborn child if they think it would lead to an abortion.

Arizona Senate approves lying to women to prevent abortions | The Raw Story

wat.

So people shouldn't be given all the facts about their own health and/or the health of their baby in order to protect doctors from potential litigation? What a knee jerk reaction!

Wouldn't it be easier long term and more ethical to change the way that litigation laws work?
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Old 03-08-2012, 08:55 PM   #4 (permalink)
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what's the chances of this passing in the state house? There is a whole lotta WTF going on there.
Arizona has always been a WTF state. They're trying to rival California in that sense. Think of the sheriff of Maricopa county and his form of incarceration. Not to mention their stance on immigration.
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Old 03-08-2012, 08:55 PM   #5 (permalink)
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Originally Posted by Circle Widdershins View Post
wat.

So people shouldn't be given all the facts about their own health and/or the health of their baby in order to protect doctors from potential litigation? What a knee jerk reaction!

Wouldn't it be easier long term and more ethical to change the way that litigation laws work?
It is a two-fold agenda. Protect doctors from litigation, and prevent women from aborting babies who may have serious birth defects.
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Old 03-08-2012, 08:57 PM   #6 (permalink)
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WTF.

How is that even possible?
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Old 03-08-2012, 09:06 PM   #7 (permalink)
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It is a two-fold agenda. Protect doctors from litigation, and prevent women from aborting babies who may have serious birth defects.
Thanks. I actually thought they were using the excuse of litigation to more or less hide the anti-abortion slant. I didn't realise they could get away with being so obvious.
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Old 03-08-2012, 09:11 PM   #8 (permalink)
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Thanks. I actually thought they were using the excuse of litigation to more or less hide the anti-abortion slant. I didn't realise they could get away with being so obvious.
They have no fear at all honestly.

A friend's husband put a small caliber gun barrel in her private parts and pulled the trigger (in AZ). She managed to live then spent 3 YEARS trying to divorce him when the Arizona state court kept throwing it back to reconciliation court because HE said he wanted to get back together.

I lost all respect of for that state years ago
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Old 03-08-2012, 09:16 PM   #9 (permalink)
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Now, has anyone explained to these legislators that the physicians' actual office visits are going to be based on ACOG's clinical practice guidelines (CPGs) and/or any additional guidelines from the AMA?

Even if the state enacts this law, the professionals can still draft guidelines saying basically that it would be unethical to withold the information. Honestly I'd be shocked if ACOG's CPGs didn't already mention something along those lines.


ETA: ACOG = American Congress of Obstetricians and Gynecologists, the professional specialty society for OB/Gyns
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Old 03-08-2012, 09:41 PM   #10 (permalink)
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Ignorant question here, but don't physicians still take the Hippocratic Oath?
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Old 03-08-2012, 09:45 PM   #11 (permalink)
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Ignorant question here, but don't physicians still take the Hippocratic Oath?
Sorta, kinda. They take a highly modified from the original version and its not, well, exactly legally binding more of just a doctoral tradition. Their code of ethics is certainly far more binding and far more important obviously and the Oath they take is about like the oath I took to Neptune when I got my Dolphins in the Navy.
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Old 03-08-2012, 10:24 PM   #12 (permalink)
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Now, has anyone explained to these legislators that the physicians' actual office visits are going to be based on ACOG's clinical practice guidelines (CPGs) and/or any additional guidelines from the AMA?

Even if the state enacts this law, the professionals can still draft guidelines saying basically that it would be unethical to withold the information. Honestly I'd be shocked if ACOG's CPGs didn't already mention something along those lines.


ETA: ACOG = American Congress of Obstetricians and Gynecologists, the professional specialty society for OB/Gyns
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I'm not at all sure how much of the electorate can spell ACOG, much less understand it.
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Old 03-08-2012, 10:59 PM   #13 (permalink)
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...because its perfectly ok with some people that the very professionals who see us at our weakest, know our personal medical histories, poke and prod us in the most intimate places on our bodies and get to see us naked can also have highly questionable ethics. When they try to pass laws that allow doctors to be as honest as used car salesmen, something is definitely fucked up.
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Old 03-08-2012, 11:20 PM   #14 (permalink)
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So let me get this straight:

In Virginia, if I'm pregnant and I want an abortion I'm going to have to have a wand shoved up in me, but I have been given the courtesy of having the monitor turned away from me.

In Alabama, if I'm pregnant and I want an abortion they want to make me have a wand shoved up in me, the monitor must be presented to me, but they are giving me the true courtesy of allowing me to "avert" my eyes.

And in Arizona, if I am not even in to see my doctor about an abortion, but I'm pregnant, the doctor has the authority to lie to me to protect my delicate sensitivities so I can't make decisions that others may not deem appropriate. How in the world can I feel I can trust my doctor implicitly?

I cannot think of a single example of a legislative body convening to explicitly give permission to an industry to lie to it's customers, because it's customers can't be relied on to make the "right" decisions with the information provided. What the hell is that?


I'm going to need someone to explain to me how this "war on women" is some media-hyped phenomenon...and I'm going to need it in really small words because obviously as a female I'm not smart enough to figure this out on my own.
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Old 03-08-2012, 11:47 PM   #15 (permalink)
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Ignorant question here, but don't physicians still take the Hippocratic Oath?
The Hippocratic Oath is sort of a tradition, yes. And it's been modified from its original form (which prohibited surgery, since back in Hippocrates time that tended to end badly for the patient).

But there are two sets of standards that govern a physician's behavior. Well, three if you count malpractice concerns, but leaving that aside for a moment, the two main sets of standards are the guidelines set out by various organizations, such as the specialty society for that particular field of medicine (ACOG for OB/Gyn, AAP for Pediatricians, AAN for neurologists, etc), in addition to stuff that might be put out by the AMA as a whole. These are not government regulatory agencies, and so these guidelines are not exactly binding in the legal sense. This is more a matter of ethics and also just plain old common sense. Guidelines are also not intended to be a one-size-fits-all approach, but they give you somewhere to start. Additionally, sometimes governmental organizations like NIH, HHS, CDC, or trans-governmental organizations like WHO will put out guidelines as well.

Now, the practice of medicine is licensed at the state level. A physician has to abide by various laws and regulations established by the state legislature and state board of health, or he risks losing his license and possibly even criminal prosecution depending on the situation. There are also some federal statutes, but again, that's getting far away from the basic point. It is worth pointing out that the specialty and subspecialty society CPGs are likely to be more detailed and more specific than the state laws. This is not so much because the state laws are lax, but rather because the medical experts are much more pedantic and nitpicky, and for very fucking good reasons. Also, it's easier to get a bunch of experts together and change guidelines as needed than it is to convince a bunch of non-expert legislators to do so.

Those are the main two things that govern medical practice: professional guidelines and state health regulations. Now, this law doesn't really seem to be affecting either of these things. What this law seems to be doing is affecting the third thing that can influence a physician's practice: malpractice risk. What they are doing is saying that a patient cannot sue a physician for witholding this medical information. This does not require a physician to withold this information. Likely this would be considered a serious breach of medical ethics to do so. I can't honestly think of any situation where it's acceptable to withold information from a patient like that. I mean, it's one thing when it may be difficult to explain a complicated or technical issue and a physician has to simplify things. The only situation where they might not tell the patient would be for severely demented or otherwise mentally incapacitated patients, but then they would be telling family members or caregivers or whoever was making the patient's medical decisions.

It is possible that some physicians might take advantage of these laws to avoid telling a patient about potential birth defects. I suppose it might make sense if the physician's judgement is that the test result is a false positive for some reason, but you don't pass laws like this for rare situations like that, as I mentioned above, there are medical experts who can determine the proper ethical action in those situations. I really can't imagine that there are many physicians who wouldn't tell a patient in those situations, and this law wouldn't prevent them from telling the patient.

So because this isn't directly affecting state health regulations, and because there are likely ethical concerns and guidelines that would advise a physician to ignore this law, it's likely that it won't have a huge effect. Also, just as a pragmatic issue, I can't imagine that even the physicians who would withold this information would really think it's worth becoming a test case on the constitutionality of this law. If anything, it might ironically highlight a potential malpractice risk from not informing a patient about potential health concerns.
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Old 03-09-2012, 12:12 AM   #16 (permalink)
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The scenario is somewhat different from the Arizona example, but there was a controversial editorial piece in a recent issue of the Canadian Medical Association Journal calling for a policy of postponing the disclosure of a certain piece of information to a pregnant woman until after 30 weeks of pregnancy. Can anyone guess what that info might be? Fetal sex.

Current ob/gyn standards are such that fetal sex determination are part of a routine obstetrical examination but should not be prolonged or repeated solely to determine fetal sex and if the sex has been determined, a patient's request for disclosure should be respected.

I'm not sure if I can link the editorial as it's behind a paywall but the premise of the author was that the withholding of medically irrelevant information of fetal sex, with some rare exceptions like sex linked illnesses, does not affect care, is a reasonable ethical compromise, and would help to curb the rare but abhorrent practice of female feticide in Canada as abortions are rarely performed here after 22 weeks.

Here's a pdf link to the CMAJ editorial
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Old 03-09-2012, 08:50 AM   #17 (permalink)
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IANAD but it seems to me that informed consent is a pretty solid core value of medical practice, and something you would not fuck with even obliquely.

Similarly the proposition negates most if not all the point of seeing a Dr in the first place, since if you cannot rely on your Dr to tell you what their findings are, why are you going? that's the entirety of the reason to see the Dr. in the first place.
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Old 03-09-2012, 09:10 AM   #18 (permalink)
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I read about this yesterday, and was totally mind blowing for me, how is tax payers money and goverment time spent on things like this that seem totally upfront illegal to me.
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Old 03-10-2012, 02:11 AM   #19 (permalink)
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Originally Posted by Joshooah Lovenkraft View Post
The scenario is somewhat different from the Arizona example, but there was a controversial editorial piece in a recent issue of the Canadian Medical Association Journal calling for a policy of postponing the disclosure of a certain piece of information to a pregnant woman until after 30 weeks of pregnancy. Can anyone guess what that info might be? Fetal sex.

Current ob/gyn standards are such that fetal sex determination are part of a routine obstetrical examination but should not be prolonged or repeated solely to determine fetal sex and if the sex has been determined, a patient's request for disclosure should be respected.

I'm not sure if I can link the editorial as it's behind a paywall but the premise of the author was that the withholding of medically irrelevant information of fetal sex, with some rare exceptions like sex linked illnesses, does not affect care, is a reasonable ethical compromise, and would help to curb the rare but abhorrent practice of female feticide in Canada as abortions are rarely performed here after 22 weeks.

Here's a pdf link to the CMAJ editorial
I'll read through it tomorrow, but I wonder if that might be for a different reason: avoiding repeated and unnecessary ultrasound exams. Ultrasound is relatively safe, and certainly far better than using X-rays (ughh), but it's not without minor risks. Usually the benefits outweigh the risks, but doing it repeatedly just to determine gender probably wouldn't.
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