Across the country, legislators are increasingly inserting their politics and non-scientific ideologies into medical exam rooms — a “dangerous trend” that “threatens evidence-based, patient-centered medicine, the delivery of quality care and public health” according to a disturbing report (PDF) by four non-profit organizations that advocate for healthier families and communities.
“The laws they are passing put politicians’ words into the mouths of health care providers, prohibit providers from communicating important health information, mandate medically unnecessary procedures or outdated modes of care and much more,” the report states. “No matter what form these laws take, the result is the same: state lawmakers are undermining quality care by interfering in the patient-provider relationship — a relationship that should be grounded in trust and driven by medical knowledge and evidence.”
The report was issued earlier this month by the National Partnership for Women and Families, the National Physicians Alliance, the Natural Resources Defense Council and the Law Center to Prevent Gun Violence.
Imposing ‘gag’ laws
One tactic by which politicians intrude into the doctor-patient relationship is with medical “gag” laws. In Florida, for example, doctors can have their medical license revoked if they inappropriately discuss gun-safety issues with their gun-owning patients.
Florida’s gag law on this issue is the most restrictive in the country, yet “watered-down versions were enacted in Minnesota, Missouri and Montana, [and] similar bills are expected to be introduced in multiple states for the 2016 legislative session,” the report notes.
Why is it important to let physicians talk about gun safety with their patients? Because “more than 100,000 people in the United States suffer gunshot wounds each year, and approximately 1.7 million children live in homes with unsafe gun practices,” the report points out.
Parents in particular would benefit from a discussion with their family doctor about gun safety, as they are frequently in denial about how easy it is for children to find “hidden” or even locked-up guns. Florida parents are no exception. I did a quick Google search of gun accidents involving children in Florida this year. Tragically, several came up.
Here are three examples: A 3-year-old Florida boy shot his 1-year-old sister in the face last May when the children were left alone in a car that had a gun. A 9-year-old boy shot himself in the cheek when he and his two brothers started playing with a .45-caliber semi-automatic handgun they found in their mother’s locked bedroom. And a 13-year-old committed suicide with a handgun after first killing his 6-year-old brother and wounding another brother during a dispute at the dinner table.
Restricting critical information
Some state legislatures — most notably Pennsylvania’s — have also restricted what physicians can tell their patients about the potential health risks of exposure to certain toxic chemicals.
“In many states, fracking companies have influenced the passage of legislation that interferes with the identification and treatment of associated health problems,” the report explains. “These laws provide trade secret protections for fracking chemicals and mandatory non-disclosure agreements that prevent health care providers from sharing information about their patients’ chemical exposures.”
Yes, that means doctors are prohibited from telling their patients — and public health officials — the specific chemicals that are causing their illness.
“Such rules fail to account for the fact that sharing information about the cause of a patient’s condition with the patient or consulting health professionals and public health agencies may be professional and ethically necessary,” the report stresses.
And it’s not just people working directly with the chemicals who are at risk of becoming dangerously ill, as a case study from the report makes clear:
In 2008, an emergency room nurse named Cathy Behr became critically ill and suffered multiple organ failure after being exposed to fracking chemicals, according to an article in the Denver Post. Behr had helped treat an injured oilfield worker when he arrived in the emergency room after an accident at a well site left him covered in fracking fluid. Behr reported that she breathed in chemical fumes as she helped the worker remove his boots and shower. Later, her vision blurred, her skin turned yellow, she began vomiting and her lungs filled with fluid. For days, the fracking company refused to tell her doctors what chemicals were in the fluid, claiming the information was a confidential “trade secret,” even though her life was in jeopardy. Fortunately, Behr eventually recovered — even though her doctors never got the information they sought.
“More than 15 million people in the United States live within a mile of a recently-drilled fracking well,” the report points out.
Forcing junk science on patients
Some of the most egregious examples of politicians forcing their ideologies into the medical exam room involve, of course, women’s reproductive health.
Since 2010, various states have passed more than 280 laws restricting abortion. “These laws are not evidence-based, and they disregard both patients’ needs and health care providers’ professional judgment and ethical obligations,” the report points out.
Here are some of the report’s examples of the “biased, irrelevant or simply false” information that abortion providers must now tell their patients:
In 12 states, an unfounded assertion that fetuses can feel pain, despite the lack of scientific evidence.
In nine states, content emphasizing negative emotional responses to abortion.
In four states, erroneous statements about the impact of abortion on future fertility.
In five states, false links between abortion and breast cancer.
In six states, assertions that personhood begins at conception.
In two states, the claim that medication abortion is “reversible,” which medical experts have deemed unsubstantiated, inappropriate and non-scientific.
In addition, a growing number of states are requiring women seeking an abortion to undergo a mandatory — and medically unnecessary — ultrasound procedure. Some of these laws, the report notes, require doctors to “display the image and give a pre-scripted description of it — even when a woman objects.”
This presents a serious ethical conflict, as one doctor explains in the report: “The hard part is turning the screen toward a woman who doesn’t want to look at it. Sometimes I find myself apologizing for what the state requires me to do, saying, ‘You may avert your eyes and cover your ears.’ This is unconscionable: My patient has asked me not to do something, and moreover it’s something that serves no medical value — and I, as a physician, am being forced to shame my patient.”
Some 30 percent of women in the United States will have an abortion by age 45, the report points out, and at least 40 million women live in a state with at least one kind of politician-imposed reproductive health restriction.
“Politicians have no place in the exam room,” the report concludes. “It is well past time for them to honor medical decision-making between patients and their trained health care providers.”
You can read the report, “Politics in the Exam Room: A Growing Threat,” in full online (PDF).