Doctors, providers fight back against 'legislative interference'
BY JANET PEARSON Associate Editor
Sunday, January 06, 2013
1/06/13 at 8:00 AM
The leaders of the five professional societies that represent the majority of American physicians have a message for lawmakers like some of our own: Stay out of the doctor-patient relationship.
In a strongly worded article published in the Oct. 18 edition of the prestigious New England Journal of Medicine, the executive staff leadership of the five groups singled out a type of law passed in Oklahoma several years ago - and since found unconstitutional by the state Supreme Court - as an example of this "alarming" trend and "inappropriate legislative interference."
Will this unusual response from the medical community make much if any difference in the antics of legislatures across the land? It's doubtful. But we can still hope that this growing chorus of professional voices, joined by those voices of more and more everyday citizens every day, might eventually get their attention.
In fact, maybe that's already happening. In the last legislative session, nearly three dozen measures having to do with women's health and reproductive issues were filed, but thankfully only a few were adopted. The fact some particularly onerous measures have been stymied in the last few years - either by legislative leadership or the courts - is heartening. But equally disheartening are some of the ones that made it through.
In the medical journal article, "Legislative Interference with the Patient-Physician Relationship," the leaders of the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians and the American College of Surgeons, declared: "Some recent laws and proposed legislation inappropriately infringe on clinical practice and patient-physician relationships, crossing traditional boundaries and intruding into the realm of medical professionalism."
The writers "find this trend alarming and believe that legislators should abide by principles that put patients' best interests first."
Four specific types of legislation were cited as being of particular concern." They included laws banning the discussion of gun safety with patients; mandating the discussion of end-of-life options; limiting the information doctors can disclose to patients regarding exposure to chemicals; and mandating medical procedures not supported by evidence, such as the ultrasound requirement prior to abortion that has been passed in several states.
Oklahoma was one of the first states to pass a mandate requiring an invasive ultrasound procedure before an abortion. It has since been declared unconstitutional by the Oklahoma Supreme Court.
The journal article referred to a similar law that was passed in Virginia; a modified version requiring a less invasive procedure was ultimately signed by the governor.
"Lawmakers, regrettably, often propose new laws or regulations for political or other reasons unrelated to the scientific evidence and counter to the health care needs of patients," the writers say, adding that "government must avoid regulating the content of the individual clinical encounter without a compelling and evidence-based benefit to the patient, a substantial public health justification, or both."
Mind the state's business
It's not just doctors feeling the brunt of this legislative interference. Planned Parenthood's leaders know as well as anyone - better than most - what it feels like to be a legislative target. In recent years, lawmakers have introduced measures seeking to remove the agency, which provides a variety of health-care and screening services (but not abortions) in Oklahoma, from the federal Women, Infants and Children nutrition program. Similar efforts targeting Planned Parenthood funding have sprung up in other states.
While legislation to remove the eastern Oklahoma affiliate from the WIC program didn't succeed, ultimately a state agency decision backed by a federal judge did mean the end of the local agency's participation in WIC, at least for now.
While there was widespread suspicion that the decision to kick Planned Parenthood out of the WIC program was political - especially coming on the heels of the Legislature's attempt - state Health Department officials and staff insisted the decision had to do with performance and caseload numbers, and not politics.
U.S. District Judge Stephen Friot backed them up, finding that Planned Parenthood failed to make its case that the contract termination "was based on impermissible factors such as the advocacy and other abortion-related activities."
Several other cases involving Planned Parenthood also have been decided recently, all court battles spawned by state legislation. A Texas judge recently ruled that the state can cut off funding to Planned Parenthood's family planning programs, simply for the reason that the agency supports abortion rights.
The ruling meant that the tens of thousands of women who receive preventive care such as cancer screenings and family planning services such as birth control must seek out new clinics and doctors, in a state where such shortages already are severe.
In other states, rulings involving Planned Parenthood have played out differently. In Indiana and Arizona, federal courts have ruled that states may not penalize the agency because of its stance on abortion.
Obviously there will be lots more of these legislative and court battles to come. But little by little, person by person, doctor by doctor, pressure is mounting to get lawmakers to quit practicing medicine and running clinics. While the attacks on Planned Parenthood have been relentless, they've also attracted 1.5 million new supporters. Even here in Oklahoma, doctors and patients have become more vocal in opposing legislation they feel goes too far.
Maybe some day lawmakers will finally get the message that most people want them to tend to the business of the state, not the business of doctors.
Original Print Headline: Fighting back
Janet Pearson 918-581-8328
Demonstrators march during a women's rights march to the Oklahoma State Capitol in April. The demonstration was put on by Unite Women, who organized other demonstrations throughout the world to protest legislation that restricts reproductive rights. The Oklahoman file