Part of me just shrugs my shoulders at the new laws being promulgated by state legislatures that require ultrasound prior to performing an abortion.
After all, in most practices, getting an ultrasound before doing an abortion is pretty much routine already. Doctors who do abortions don’t want to be surprised by an unexpectedly advanced gestational age, a uterine anomaly, an erroneous diagnosis or an ectopic pregnancy. Since most Ob-Gyns have an ultrasound machine in their office, the sono is fast and easy to do. Those docs who don’t have their own sono machines will refer out. And higher volume providers may employ a radiologist or sonographer to do the sonos in their practices.
So if we’re all doing ultrasounds anyway, what’s the big deal?
This is not about abortion – It’s about the practice of medicine and the rights of patients
The big deal is that patient and physician rights are being violated by legislators with an agenda that has nothing to do with the public health and everything to do with restricting access to a legal medical procedure.
We are not talking about a doctor ordering a radiologic test. We are talking about state legislators mandating that a patient undergo a medical procedure without her consent.
It’s not only invasion of privacy, and the physician-patient contract, it’s assault on the patient. It’s mandating that “as a component of informed consent”, a woman undergo a procedure without her consent. (Amendments that require the woman to consent for the ultrasound were voted down.)
HC 462 – The Virginia Ultrasound Law
Abortion; informed consent. Requires that, as a component of informed consent to an abortion, to determine gestation age, every pregnant female shall undergo ultrasound imaging and be given an opportunity to view the ultrasound image of her fetus prior to the abortion. The medical professional performing the ultrasound must obtain written certification from the woman that the opportunity was offered and whether the woman availed herself of the opportunity to see the ultrasound image or hear the fetal heartbeat. A copy of the ultrasound and the written certification shall be maintained in the woman’s medical records at the facility where the abortion is to be performed. This bill incorporates HB 261.
Do you see the legal precedent being made here?
Forget for a moment that this is about abortion.
Imagine instead that there is a law requiring you to get a chest x-ray before you can be treated for pneumonia. Or mandating that as a doctor, you order an MRI and show the patient the images before treating a headache. Or forcing a male patient to undergo a rectal exam before being treated for urethritis.
We’re not talking about whether or not these are things that are happening anyway as part of the current practice of medicine. We’re talking about a law requiring them to be done as a condition of treatment. The doctor must order the test and the patient must undergo the procedure. Or the doctor is breaking the law.
This is not just about abortion. Or women’s rights. Or Planned Parenthood.
It’s about the practice of medicine and the rights of our patients. It’s about physician-patient privacy and the authority of doctors to practice medicine without the fear of breaking the law.
All physicians and patients, whether they are male or female, pro-choice or pro-life, Republican or Democrat, should be outraged. Our medical societies and our patient advocacy groups – every single one of them, whether related to reproductive care or not – should be fighting these laws, and engaging physicians and patients everywhere to fight back. Publicly and vocally.
With the passage of Virginia HB 462, eight states now have laws mandating that a woman have an ultrasound prior to an abortion.
How soon before it’s your state? Or your specialty? Or your practice? Or your body?
So true. This is about controlling and manipulating women, not about our health. How ironic that the Virginia law says that this obviously politically contrived intrusion is about “informed consent.”
Governmental intrusion is rarely a good and the present political climate is riff with control and power plays. If it is OK for the government to tell a religious employer how to run its benefit plan, forcing it to perform acts that are contrary to the employer’s practices and beliefs; on behalf of a third party that is not asking for protection or assistance; then it logically follows that this same government can intrude on the practice of medicine (which like religion is essentially a type of tribe), forcing it to perform acts that are contrary to its belief (although not in a religious sense) and practices.
The ultrasound and contraception mandates are both windows and mirrors into the same use of intrusive force on behalf of parties that did not request it.
Daniel — I do not see these two issues as at all similar. Or, at least, I see the problem differently, because I believe that health care choices belong to the women who need to make them, and not to the people who want to tell them what to do (the interlopers having no grasp of the individual woman’s circumstances, no respect for her own personal beliefs, and no interest in what happens after they pronounce judgment).
Coverage of contraception as part of a woman’s health care is basic health care. It should, after all, be the choice of the woman involved whether she wishes to plan for childbearing, since that has a significant impact on her own life. The cost of providing contraceptive care is far less than the costs if that care is not provided. I’m not not just talking about financial costs, either: bearing and raising a baby carries health risks and a very long-time commitment.
Under Virginia’s law, every woman who seeks abortion, no matter how early, would be subject to ultrasound. In early pregnancy, the only way to do it is vaginally — even without consent — and nobody can tell me that is always medically necessary, because it isn’t. The reason for this law is NOT “informed consent.” It is to intimidate. Penetration with an object without consent is rape.
I do not usually speak so strongly or bluntly, but this situation has me very upset. As Dr. Peggy said, this should be a matter between a patient and doctor — not a vote of a legislature that has lost track of the boundaries of its responsibilities.
I do not pretend to speak for Dr. Peggy. She may have different views on the particulars of my views.
“Jobs are not in my uterus!” Melissa Harris-Perry on MSNBC…that’s the title of my post yesterday. I’m calling out to other bloggers to post about politicians threating the health of ALL women.
Many of us have been speaking out for Choice since the 1970s. We urge younger women to use their outside voices to protest what is happening. It’s about your daughters, my granddaughters!
Thanks, Dr. P. for all you do.
Oh my God!!! What’s next? Congress telling us we MUST purchase health insurance? ::gasp::
I changed a patient’s diet yesterday without ordering an expensive, video fluoroscopic, modified barium swallow study. I dared to use my brain, my vast experience, and allow the patient and her husband to participate in a conversation about the risks of aspiration pneumonia, rewards of thickening her liquids and functional ways to modify her diet. She’ll be back in a week for a follow up.
She left happy, confident and most importantly, on a modified, yet safe, diet. I did my damn job and did it well. If legislators want to tell me how to do it and force me to order tests, then they’d better,
A) Be happy with my shitty salary and
B) Be forced to live and die by press-ganey scores like we all have to.
Well-said! In an era where the government is pushing for lowering health costs, states mandating additional costly tests makes no sense.
[…] posts this week. Here’s one on laws mandating ultrasound before abortion and whether or not politicians should get involved in medical best practice more generally. She also highlights another blog with very thought provoking posts on the subject. One of the […]