Posted by Jennifer Dalven,
Reproductive Freedom Project
It's what every pregnant woman I know dreads. Going into that big ultrasound, having the ultrasound tech, who had been so chatty, suddenly go silent. Having her do sweep after sweep across your belly without saying another word, until finally, she gets up and solemnly says, "I am going to get the doctor."
As far as pregnancy nightmares go, I thought that was one of the worst. But now politicians in Kansas are giving pregnant women and their partners something new to worry about. Buried in a sweeping anti-abortion bill is a provision that would immunize a doctor who discovers that a baby will be born with a devastating condition and deliberately withholds that information from his patient. That's right. If the bill passes, a doctor who opposes abortion could decide to lie about the results of your blood tests, your ultrasound, your cvs or your amnio. Lie to you so that you won't have information that might lead you to decide to end your pregnancy or that might lead you to learn more about your child's condition so that you are prepared to be the best parent you can be to your child.
Now, I have been working for a long time defending the right of a pregnant woman to make the best decision for herself and her family, whether that is continuing the pregnancy, adoption, or abortion, based on full, accurate information. I thought I had seen just about every manner of government intrusion into those fundamentally personal and private decisions. I thought I was past the point of being shocked and outraged. But as a mother who has been through those ultrasounds myself, the thought that my doctor could choose to withhold this information from me and take this decision away from me and my husband ... well, let's just say it really touched a nerve.
And, unfortunately, it's not just Kansas. Other states motivated by anti-abortion zeal are jumping on the it's-ok-for-doctors-to lie-to-their-patients-to-prevent-them-from-having-an-abortion bandwagon. Oklahoma recently passed a similar law. And, the Arizona legislature is considering a similar bill.
But I guess I shouldn't be surprised. Despite the rhetoric of anti-abortion politicians about how all these restrictions are necessary to ensure that women's decisions are well-informed, it's never been about that. Doctors who provide abortions already work hard to ensure that every woman has the information she needs to make the best decision for herself and her family. What these bills are about is politicians who think they know better than women and who are trying to impose their own views on abortion on a woman and her family regardless of the circumstances: That's what's behind those now infamous ultrasound bills in places like Virginia, Idaho, and Pennsylvania. That's what's behind the bills in Georgia and Arizona that would ban abortion at the point when a woman often learns about a devastating diagnosis. And that is what is behind so many of the other bills working their way through the state legislatures right now. The Kansas bill is, in a way, just more upfront about it.
Well, enough is enough. We may not all agree about abortion, but we can all agree that these decisions ought to be made by a woman and her family, not a politician. So, whether you are a man or a woman; whether you are already a parent or think you might become one in the future; whether you are blissfully pregnant or unhappily so, if you care about your right to make your own decisions, I ask that you help get the word out. Share this blog on Facebook and Twitter. Send an email with this link to the President of the Kansas Senate. Tell the politicians all over the country to stop interfering in a family's personal and private decisions.
Showing posts with label Scary. Show all posts
Showing posts with label Scary. Show all posts
Sunday, April 1, 2012
Guest Post: A Doctor on Transvaginal Ultrasounds
BY JOHN SCALZI
MARCH 20, 2012
Where Is The Physician Outrage?
Right. Here.
I’m speaking, of course, about the required-transvaginal-ultrasound thing that seems to be the flavor-of-the-month in politics.
I do not care what your personal politics are. I think we can all agree that my right to swing my fist ends where your face begins.
I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise.
In all of the discussion and all of the outrage and all of the Doonesbury comics, I find it interesting that we physicians are relatively silent.
After all, it’s our hands that will supposedly be used to insert medical equipment (tools of HEALING, for the sake of all that is good and holy) into the vaginas of coerced women.
Fellow physicians, once again we are being used as tools to screw people over. This time, it’s the politicians who want to use us to implement their morally reprehensible legislation. They want to use our ultrasound machines to invade women’s bodies, and they want our hands to be at the controls. Coerced and invaded women, you have a problem with that? Blame us evil doctors. We are such deliciously silent scapegoats.
It is our responsibility, as always, to protect our patients from things that would harm them. Therefore, as physicians, it is our duty to refuse to perform a medical procedure that is not medically indicated. Any medical procedure. Whatever the pseudo-justification.
It’s time for a little old-fashioned civil disobedience.
Here are a few steps we can take as physicians to protect our patients from legislation such as this.
1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on.
2) Reinforce patient autonomy. It does not matter what a politician says. A woman is in charge of determining what does and what does not go into her body. If she WANTS a transvaginal ultrasound, fine. If it’s medically indicated, fine… have that discussion with her. We have informed consent for a reason. If she has to be forced to get a transvaginal ultrasound through coercion or overly impassioned argument or implied threats of withdrawal of care, that is NOT FINE.
Our position is to recommend medically-indicated tests and treatments that have a favorable benefit-to-harm ratio… and it is up to the patient to decide what she will and will not allow. Period. Politicians do not have any role in this process. NO ONE has a role in this process but the patient and her physician. If anyone tries to get in the way of that, it is our duty to run interference.
3) If you are forced to document a non-indicated transvaginal ultrasound because of this legislation, document that the patient refused the procedure or that it was not medically indicated. (Because both of those are true.) Hell, document that you attempted but the patient kicked you in the nose, if you have to.
4) If you are forced to enter an image of the ultrasound itself into the patient chart, ultrasound the bedsheets and enter that picture with a comment of “poor acoustic window”. If you’re really gutsy, enter a comment of “poor acoustic window…plus, I’m not a rapist.” (I was going to propose repeatedly entering a single identical image in affected patient’s charts nationwide, as a recognizable visual protest…but I don’t have an ultrasound image that I own to the point that I could offer it for that purpose.)
5) Do anything else you can think of to protect your patients and the integrity of the medical profession. IN THAT ORDER. We already know how vulnerable patients can be; we invisibly protect them on a daily basis from all kinds of dangers inside and outside of the hospital. Their safety is our responsibility, and we practically kill ourselves to ensure it at all costs. But it’s also our responsibility to guard the practice of medicine from people who would hijack our tools of healing for their own political or monetary gain.
In recent years, we have been abject failures in this responsibility, and untold numbers of people have gleefully taken advantage of that. Silently allowing a politician to manipulate our medical decision-making for the purposes of an ideological goal erodes any tiny scrap of trust we might have left.
It comes down to this: When the community has failed a patient by voting an ideologue into office…When the ideologue has failed the patient by writing legislation in his own interest instead of in the patient’s…When the legislative system has failed the patient by allowing the legislation to be considered… When the government has failed the patient by allowing something like this to be signed into law… We as physicians cannot and must not fail our patients by ducking our heads and meekly doing as we’re told.
Because we are their last line of defense.
MARCH 20, 2012
Where Is The Physician Outrage?
Right. Here.
I’m speaking, of course, about the required-transvaginal-ultrasound thing that seems to be the flavor-of-the-month in politics.
I do not care what your personal politics are. I think we can all agree that my right to swing my fist ends where your face begins.
I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise.
In all of the discussion and all of the outrage and all of the Doonesbury comics, I find it interesting that we physicians are relatively silent.
After all, it’s our hands that will supposedly be used to insert medical equipment (tools of HEALING, for the sake of all that is good and holy) into the vaginas of coerced women.
Fellow physicians, once again we are being used as tools to screw people over. This time, it’s the politicians who want to use us to implement their morally reprehensible legislation. They want to use our ultrasound machines to invade women’s bodies, and they want our hands to be at the controls. Coerced and invaded women, you have a problem with that? Blame us evil doctors. We are such deliciously silent scapegoats.
It is our responsibility, as always, to protect our patients from things that would harm them. Therefore, as physicians, it is our duty to refuse to perform a medical procedure that is not medically indicated. Any medical procedure. Whatever the pseudo-justification.
It’s time for a little old-fashioned civil disobedience.
Here are a few steps we can take as physicians to protect our patients from legislation such as this.
1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on.
2) Reinforce patient autonomy. It does not matter what a politician says. A woman is in charge of determining what does and what does not go into her body. If she WANTS a transvaginal ultrasound, fine. If it’s medically indicated, fine… have that discussion with her. We have informed consent for a reason. If she has to be forced to get a transvaginal ultrasound through coercion or overly impassioned argument or implied threats of withdrawal of care, that is NOT FINE.
Our position is to recommend medically-indicated tests and treatments that have a favorable benefit-to-harm ratio… and it is up to the patient to decide what she will and will not allow. Period. Politicians do not have any role in this process. NO ONE has a role in this process but the patient and her physician. If anyone tries to get in the way of that, it is our duty to run interference.
3) If you are forced to document a non-indicated transvaginal ultrasound because of this legislation, document that the patient refused the procedure or that it was not medically indicated. (Because both of those are true.) Hell, document that you attempted but the patient kicked you in the nose, if you have to.
4) If you are forced to enter an image of the ultrasound itself into the patient chart, ultrasound the bedsheets and enter that picture with a comment of “poor acoustic window”. If you’re really gutsy, enter a comment of “poor acoustic window…plus, I’m not a rapist.” (I was going to propose repeatedly entering a single identical image in affected patient’s charts nationwide, as a recognizable visual protest…but I don’t have an ultrasound image that I own to the point that I could offer it for that purpose.)
5) Do anything else you can think of to protect your patients and the integrity of the medical profession. IN THAT ORDER. We already know how vulnerable patients can be; we invisibly protect them on a daily basis from all kinds of dangers inside and outside of the hospital. Their safety is our responsibility, and we practically kill ourselves to ensure it at all costs. But it’s also our responsibility to guard the practice of medicine from people who would hijack our tools of healing for their own political or monetary gain.
In recent years, we have been abject failures in this responsibility, and untold numbers of people have gleefully taken advantage of that. Silently allowing a politician to manipulate our medical decision-making for the purposes of an ideological goal erodes any tiny scrap of trust we might have left.
It comes down to this: When the community has failed a patient by voting an ideologue into office…When the ideologue has failed the patient by writing legislation in his own interest instead of in the patient’s…When the legislative system has failed the patient by allowing the legislation to be considered… When the government has failed the patient by allowing something like this to be signed into law… We as physicians cannot and must not fail our patients by ducking our heads and meekly doing as we’re told.
Because we are their last line of defense.
Saturday, March 31, 2012
National Republicans Declare War on Women Over, But State-Level Battles Still Exist
By Susan Kraykowski
Recently, Republican politicians of national stature called for a cease-fire in the GOP War on Women – if not an outright withdrawal. Senator John McCain (R – Ariz.) has acknowledged that this strategy is a loser for the GOP, and Representative Richard Hanna (R – NY) has told his female constituents their rights are under assault and to “contribute your money to people who speak out on your behalf, because the other side — my side — has a lot of it.” You can’t get much more specific than that.
How then is it possible for the very same Republicans to be both on the right and wrong sides of this issue at the very same instant? Put on your waders; these are muddy waters and ‘gators lurk in this swamp.
Exhibit A: Helen Brosnan’s fine article on PolicyMic, which appeared a few weeks ago when the brou-ha-ha over inappropriate language to women came to its inevitable head. Few men, whether R’s or D’s realized that this wasn’t a free speech issue at all. To their credit, the Republican women on PolicyMic knew it immediately.
Exhibit B: Rachel Maddow’s interview with former Surgeon General (to George W. Bush) Richard Carmona. Maddow sets up the interview with about 3 minutes of metaphorical amplification of her thesis that Republicans are muddying the waters around a number of issues, but the point Carmona makes is quite significant. He recognizes an assault on women’s rights and women’s health when he sees one and has switched political parties to run for the Senate in Arizona on the Democratic ticket.
Arizona is one of the states which has passed or is currently working on more restrictive legislation on abortion and other women’s health issues. Very often these bills are similar sounding and mandate unnecessary procedures and/or the reading to women of scripts that contain misinformation regarding the association of breast cancer with abortions. (IRONY ALERT: why are Republicans mandating procedures and protesting the ACA mandate to buy health insurance at the same time? I told you there were ‘gators in the swamp) Other states busily restricting women’s rights and trying to return us to the status of chattel are: Texas, Idaho, Virginia, Pennsylvania, Kansas, New Hampshire, Florida, South Dakota, Nebraska, Ohio and Utah.
North Carolina’s state assembly passed the euphemistically titled “Women’s Right to Know” Bill in 2011; mandating that a woman see an ultrasound and hear the fetus’ heartbeat – along with a doctor’s/technician’s scripted description of visible characteristics. The bill was vetoed by Democratic Governor Beverly Perdue, but overridden in a special legislative session. Implementation of the law is suspended pending legal challenge.
Kentucky’s state legislature voted down their version of the ALEC-drafted pre-abortion ultrasound bill.
Answer to the question posed, above: national Republicans can wash their hands of the War on Women because they know that their state and local counterparts are still hard at work; trying to cut women off at the pass.
My solution to this problem is an appeal to all American women across the political spectrum to unite to rid ourselves of these state representatives and state senators who insist upon pursuing legislation inimical to our interests and to our very health and well being (by the way – sympathetic men are invited to join this effort).
This will take thought, research and, definitely, ticket splitting - as is illustrated by the vote on Idaho’s SB1387 ultrasound bill. On March 19, the bill passed on a 23-12 vote but 5 Republicans crossed party lines to vote NAY with the Democrats: James Hammond (R-Couer d’Alene), Shawn Keogh (R-Sandpoint), John Goedde (R-Couer d-Alene), Joyce Broadsword (R-Slagle) and Tim Corder (R-Mountain Home). Thus, for example, if you’re a Democrat in Hammond’s district; you may want to vote for him this time as a reward for his support in trying to defeat the Ultrasound bill. Or, if you’re a Republican and he gets an even more rightwing primary challenger; support Hammond.
Special note to Virginia Democrats: 2 Democrats voted with the Republicans to pass Virginia’s ultrasound bill. We want to get Charles J. Colgen (D-Prince William) and Phillip P. Puckett (D-Russell) out of office, too, if good alternatives present themselves.
Ladies and gentlemen; regardless of your choice for president, please use the 2012 and 2014 election cycles to examine your downballot choices and to replace the paternalistic, authoritarian ilk who are working so hard to return us to the 19th century.
In closing, please read these simple words:
Equality of rights under the law shall not be denied or abridged by the United States or by any state on account of sex.
That is the entirety of the effective language of the Equal Rights Amendment to the Constitution – first introduced in Congress in 1923. Perhaps, if we can weed out our state legislatures, we can finally ratify it.
Recently, Republican politicians of national stature called for a cease-fire in the GOP War on Women – if not an outright withdrawal. Senator John McCain (R – Ariz.) has acknowledged that this strategy is a loser for the GOP, and Representative Richard Hanna (R – NY) has told his female constituents their rights are under assault and to “contribute your money to people who speak out on your behalf, because the other side — my side — has a lot of it.” You can’t get much more specific than that.
How then is it possible for the very same Republicans to be both on the right and wrong sides of this issue at the very same instant? Put on your waders; these are muddy waters and ‘gators lurk in this swamp.
Exhibit A: Helen Brosnan’s fine article on PolicyMic, which appeared a few weeks ago when the brou-ha-ha over inappropriate language to women came to its inevitable head. Few men, whether R’s or D’s realized that this wasn’t a free speech issue at all. To their credit, the Republican women on PolicyMic knew it immediately.
Exhibit B: Rachel Maddow’s interview with former Surgeon General (to George W. Bush) Richard Carmona. Maddow sets up the interview with about 3 minutes of metaphorical amplification of her thesis that Republicans are muddying the waters around a number of issues, but the point Carmona makes is quite significant. He recognizes an assault on women’s rights and women’s health when he sees one and has switched political parties to run for the Senate in Arizona on the Democratic ticket.
Arizona is one of the states which has passed or is currently working on more restrictive legislation on abortion and other women’s health issues. Very often these bills are similar sounding and mandate unnecessary procedures and/or the reading to women of scripts that contain misinformation regarding the association of breast cancer with abortions. (IRONY ALERT: why are Republicans mandating procedures and protesting the ACA mandate to buy health insurance at the same time? I told you there were ‘gators in the swamp) Other states busily restricting women’s rights and trying to return us to the status of chattel are: Texas, Idaho, Virginia, Pennsylvania, Kansas, New Hampshire, Florida, South Dakota, Nebraska, Ohio and Utah.
North Carolina’s state assembly passed the euphemistically titled “Women’s Right to Know” Bill in 2011; mandating that a woman see an ultrasound and hear the fetus’ heartbeat – along with a doctor’s/technician’s scripted description of visible characteristics. The bill was vetoed by Democratic Governor Beverly Perdue, but overridden in a special legislative session. Implementation of the law is suspended pending legal challenge.
Kentucky’s state legislature voted down their version of the ALEC-drafted pre-abortion ultrasound bill.
Answer to the question posed, above: national Republicans can wash their hands of the War on Women because they know that their state and local counterparts are still hard at work; trying to cut women off at the pass.
My solution to this problem is an appeal to all American women across the political spectrum to unite to rid ourselves of these state representatives and state senators who insist upon pursuing legislation inimical to our interests and to our very health and well being (by the way – sympathetic men are invited to join this effort).
This will take thought, research and, definitely, ticket splitting - as is illustrated by the vote on Idaho’s SB1387 ultrasound bill. On March 19, the bill passed on a 23-12 vote but 5 Republicans crossed party lines to vote NAY with the Democrats: James Hammond (R-Couer d’Alene), Shawn Keogh (R-Sandpoint), John Goedde (R-Couer d-Alene), Joyce Broadsword (R-Slagle) and Tim Corder (R-Mountain Home). Thus, for example, if you’re a Democrat in Hammond’s district; you may want to vote for him this time as a reward for his support in trying to defeat the Ultrasound bill. Or, if you’re a Republican and he gets an even more rightwing primary challenger; support Hammond.
Special note to Virginia Democrats: 2 Democrats voted with the Republicans to pass Virginia’s ultrasound bill. We want to get Charles J. Colgen (D-Prince William) and Phillip P. Puckett (D-Russell) out of office, too, if good alternatives present themselves.
Ladies and gentlemen; regardless of your choice for president, please use the 2012 and 2014 election cycles to examine your downballot choices and to replace the paternalistic, authoritarian ilk who are working so hard to return us to the 19th century.
In closing, please read these simple words:
Equality of rights under the law shall not be denied or abridged by the United States or by any state on account of sex.
That is the entirety of the effective language of the Equal Rights Amendment to the Constitution – first introduced in Congress in 1923. Perhaps, if we can weed out our state legislatures, we can finally ratify it.
A triumph for the Texas Taliban
Ophelia Benson
March 15, 2012
So there’s this couple in Texas looking forward to their second baby, a brother for their 2-year-old daughter.
Yet now my doctor was looking grim and, with chair pulled close, was speaking of alarming things. “I’m worried about your baby’s head shape,” she said. “I want you to see a specialist—now.”
My husband looked angry, and maybe I did too, but it was astonishment more than anger. Ours was a profound disbelief that something so bad might happen to people who think themselves charmed. We already had one healthy child and had expected good fortune to give us two.
Instead, before I’d even known I was pregnant, a molecular flaw had determined that our son’s brain, spine and legs wouldn’t develop correctly. If he were to make it to term—something our doctor couldn’t guarantee—he’d need a lifetime of medical care. From the moment he was born, my doctor told us, our son would suffer greatly.
And now you’re guessing the rest. You’re no fools; you didn’t miss the deadly “Texas” at the beginning.
Their doctor couldn’t do the abortion, because the hospital she’s affiliated with is Catholic (as so many hospitals, and more all the time, are). They had to go to a clinic. They went straight there.
My counselor said that the law required me to have another ultrasound that day, and that I was legally obligated to hear a doctor describe my baby. I’d then have to wait 24 hours before coming back for the procedure. She said that I could either see the sonogram or listen to the baby’s heartbeat, adding weakly that this choice was mine.
“I don’t want to have to do this at all,” I told her. “I’m doing this to prevent my baby’s suffering. I don’t want another sonogram when I’ve already had two today. I don’t want to hear a description of the life I’m about to end. Please,” I said, “I can’t take any more pain.” I confess that I don’t know why I said that. I knew it was fait accompli. The counselor could no more change the government requirement than I could. Yet here was a superfluous layer of torment piled upon an already horrific day, and I wanted this woman to know it.
But it couldn’t be helped.
“I’m so sorry that I have to do this,” the doctor told us, “but if I don’t, I can lose my license.” Before he could even start to describe our baby, I began to sob until I could barely breathe. Somewhere, a nurse cranked up the volume on a radio, allowing the inane pronouncements of a DJ to dull the doctor’s voice. Still, despite the noise, I heard him. His unwelcome words echoed off sterile walls while I, trapped on a bed, my feet in stirrups, twisted away from his voice.
“Here I see a well-developed diaphragm and here I see four healthy chambers of the heart…”
I closed my eyes and waited for it to end, as one waits for the car to stop rolling at the end of a terrible accident.
When the description was finally over, the doctor held up a script and said he was legally obliged to read me information provided by the state. It was about the health dangers of having an abortion, the risks of infection or hemorrhage, the potential for infertility and my increased chance of getting breast cancer.
March 15, 2012
So there’s this couple in Texas looking forward to their second baby, a brother for their 2-year-old daughter.
Yet now my doctor was looking grim and, with chair pulled close, was speaking of alarming things. “I’m worried about your baby’s head shape,” she said. “I want you to see a specialist—now.”
My husband looked angry, and maybe I did too, but it was astonishment more than anger. Ours was a profound disbelief that something so bad might happen to people who think themselves charmed. We already had one healthy child and had expected good fortune to give us two.
Instead, before I’d even known I was pregnant, a molecular flaw had determined that our son’s brain, spine and legs wouldn’t develop correctly. If he were to make it to term—something our doctor couldn’t guarantee—he’d need a lifetime of medical care. From the moment he was born, my doctor told us, our son would suffer greatly.
And now you’re guessing the rest. You’re no fools; you didn’t miss the deadly “Texas” at the beginning.
Their doctor couldn’t do the abortion, because the hospital she’s affiliated with is Catholic (as so many hospitals, and more all the time, are). They had to go to a clinic. They went straight there.
My counselor said that the law required me to have another ultrasound that day, and that I was legally obligated to hear a doctor describe my baby. I’d then have to wait 24 hours before coming back for the procedure. She said that I could either see the sonogram or listen to the baby’s heartbeat, adding weakly that this choice was mine.
“I don’t want to have to do this at all,” I told her. “I’m doing this to prevent my baby’s suffering. I don’t want another sonogram when I’ve already had two today. I don’t want to hear a description of the life I’m about to end. Please,” I said, “I can’t take any more pain.” I confess that I don’t know why I said that. I knew it was fait accompli. The counselor could no more change the government requirement than I could. Yet here was a superfluous layer of torment piled upon an already horrific day, and I wanted this woman to know it.
But it couldn’t be helped.
“I’m so sorry that I have to do this,” the doctor told us, “but if I don’t, I can lose my license.” Before he could even start to describe our baby, I began to sob until I could barely breathe. Somewhere, a nurse cranked up the volume on a radio, allowing the inane pronouncements of a DJ to dull the doctor’s voice. Still, despite the noise, I heard him. His unwelcome words echoed off sterile walls while I, trapped on a bed, my feet in stirrups, twisted away from his voice.
“Here I see a well-developed diaphragm and here I see four healthy chambers of the heart…”
I closed my eyes and waited for it to end, as one waits for the car to stop rolling at the end of a terrible accident.
When the description was finally over, the doctor held up a script and said he was legally obliged to read me information provided by the state. It was about the health dangers of having an abortion, the risks of infection or hemorrhage, the potential for infertility and my increased chance of getting breast cancer.
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