Report: State Lawmakers ‘Playing Doctor’ Causing Medical, Ethical Problems for Physicians
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Any legislation inserting politics into the patient-provider relationship should be resisted, according to a coalition of public interest groups.
State laws increasingly force doctors to choose between adhering to their Hippocratic Oath or politically-motivated restrictions, and policymakers should reject or repeal proposals interfering with the patient-provider relationship, according to a new collaborative report.
From reproductive health to environmental health to gun safety legislation, “Politics in the Exam Room: A Growing Threat” details the curtailing of evidence-based medical practices and ethics by lawmakers.
The medical community is encouraged to rebuff such lawmaker-driven measures to allow doctors to provide their unfettered opinions to patients seeking informed, individualized care, in the report authored by the National Physicians Alliance, National Partnership for Women and Families, Natural Resources Defense Council and Law Center to Prevent Gun Violence.
Since 2010, states have enacted more than 280 restrictions on reproductive health, including requiring care providers to misinform patients of health risks, mandating ultrasounds beforehand, delaying time-sensitive procedures and banning prevailing evidence-based medication abortions.
More than 300 restrictions on abortion were introduced in state legislatures in the first three months of 2015.
Informed consent laws often mandate doctors tell patients unfounded information such as, in 12 states, that fetuses can feel pain, in four states, that abortions can inhibit future fertility and, in five states, that the procedure can cause breast cancer. Six states have doctors assert the subjective belief personhood begins at conception.
“Laws that put the words of politicians into the mouths of health care providers or mandate medically unnecessary procedures are outrageous and costly in every way,” Debra Ness, president of the National Partnership for Women and Families, said in a statement. “This kind of ideological encroachment on medical care must end. Women deserve ready access to high-quality, evidence-based health care, free of politics and ideology.”
More than 15 million U.S. citizens live within a mile of a recently drilled fracking well, despite the toxic chemicals involved contaminating soil, waterways and air, according to the report.
Oil and gas companies may refuse to disclose the chemicals in their fracking fluid as a “trade secret,” and while 13 states have passed laws requiring that information to be divulged to doctors, patients are not afforded the same knowledge.
The lack of disclosure can be detrimental to patients’ health, per the report:
Diagnosis and treatment of environmental exposures are often difficult and complex matters and will likely require expertise beyond that of a single health professional. In these cases, health professionals may need to consult with toxicologists, epidemiologists, or other environmental health specialists in order to develop an accurate diagnosis and deliver quality care. Health care providers may also have an ethical, professional and legal duty to warn members of the patient’s family, neighbors or other members of the public when they are aware of potential harm that may arise because of an exposure. Any time a health professional is in violation of a professional duty of this nature, there is a risk of public sanctions or private lawsuits. Thus, the confidentiality obligations imposed in these situations may place health professionals in an untenable position: ignore professional or ethical duties to share information and report public health threats, or violate the law.
Pennsylvania’s law presents such a dilemma because doctors are required to file a written statement of need for the chemical names, while signing a confidentiality agreement that could prohibit disclosure of needed information patients can sue the provider over later.
Gag laws banning proven life-saving exam room conversations between doctors and patients about domestic gun safety are growing in popularity, the report notes.
Clinically provided preventative safe-storage practices are especially important when children, people with mental illnesses and abusive partners are involved.
But since Florida passed a 2011 law disciplining physicians for asking patients if they own a gun and if it’s out of reach of children, 14 other states passed watered-down versions with more expected to be proposed in 2016.
“More than 100,000 people are shot every year in America,” Robyn Thomas, the Law Center to Prevent Gun Violence’s executive director, in a statement. “It’s a deadly mistake to forbid health care providers from talking to patients about gun safety…”
Dave Nyczepir is News Editor for Government Executive’s Route Fifty.
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