Posted on 03/21/2012 5:03:29 PM PDT by a fool in paradise
March 20, 2012 By John Scalzi
A friend of mine is a physician who wants to speak about transvaginal ultrasounds but whose position makes it precarious to speak publicly about it. So I’m letting this doctor borrow my site for an entry to speak anonymously on the matter. Obviously, I will vouch for the doctor being a doctor and being qualified to speak on the subject.
Update, 9:14pm: This post is being linked to far and wide, so we’re getting lots of new readers and commenters. It’s important that before you comment you read the site disclaimer and comment policy. I delete comments I find particularly stupid. Try not to write one of them...
Update: 1pm, 3/21: As a head’s up to people, at 8pm eastern time tonight, I will turning off the comments for this thread permanently. The reason for this is while I can spend a day moderating the thread, I can’t spend the next week doing so. Sorry, folks, I have a book to write. So consider this fair notice. Thanks....
"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.
Then why don't you stand up for the baby's face? Or babies' faces?
Liberal hypocrisy.
Why is TVU “rape” but an abortion involving sticking a vacuum cleaner hose into the uterus, not “rape”?
So abortionists tools are non-invasive?
Keeping the women misinformed about their growing children is what the opposition to ultrasounds is all about.
Abortionists coerce their "patients" all the time. Planned Parenthood has been caught telling minors to lie on the forms about the older men who've impregnated them letting a sex criminal walk to perp his crimes another day.
I am a woman and I’m fairly sure that an abortion is also trans-vaginal.
So how do you stand up for things like minors being able to "consent" to a medical procedure known as abortion even though LEGAL abortions are still botched by trained professionals leading to injury and sometimes death?
When abortionists make a habit of billing the government for medical procedures that weren't even done, lying on another form is just another little ol' crime.
All depends on what INFORMED means. Look it up.
3, 4, 5... "lie... lie... lie..."
Kind of like the government folks who keep telling us a chupacabra ate Obama's birth certificate.
What’s the “doctor’s” position on Catholics being forced to pay for birth control?
If the woman consents to sticking a vacuum cleaner into the uterus, but not to the TVU, then a doctor who performs the TVU has done so without the patient's consent. I don't think either is "rape", but consent to the abortion is not the same thing as consent to the TVU.
I'm not sure these sorts of laws are such a great idea anyway. I understand the point of providing this information to a woman who seeks an abortion, but ultimately don't think it's the government's job to dictate what a doctor must or must not say to a patient. Once we grant the government that kind of power in the doctor-patient relationship, I worry about how that will be used in other contexts (e.g., some Obamacare bureaucrat requiring that a doctor provide "end of life counseling" before a patient can have heart surgery, etc.).
But he hairsplits here with a reasonable law to show ignorant mothers what they are buying when they buy an abortion.
The shame lies with the doctors who do abortions, and those who are not vocally pro-life.
This guy sounds like he does abortions, and the law is seriously going to cut into his income.
He is a coward, too, for not putting his name on the record for such a principled argument (sic).
Actually, he wants anonymity because he knows he is in the wrong.
You may find yourself only with government doctors who are not permitted to inform you that you CAN seek treatment for your illness rather than resigning yourself to an expected death in 6-8 months. "Take the painkiller rather than getting the surgery" is Obama's motto.
He wants anonymity because he advocates lying in medical paperwork, billing for services that are not rendered, and circumventing laws he disagrees with.
At least the Nazis had the mind to make sure their killings were legal. He’s more akin to a Klansman who ignores the law and goes about his reign on violence unchecked.
I do not feel that it is reactionary or even inaccurate to describe abortion as murder”.
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.
Abortion is not a medically indicated procedure.
That too, exactly. The point is, we ought to be wary of expansions of government power, even for noble purposes (perhaps especially for noble purposes).
By the way, Virginia, in the end, passed a law after removing the word "vaginal", that only requires the picture of the fetus be offered to the woman seeking the abortion. Virginia's law does not require a vaginal ultrasound.
I find it hard to believe that those in health care are going to just sit back and allow the government to dictate what medical procedures are performed on a patient and it's refreshing to know that there doctors out there who will not comply with these laws.
As a very young mother, I am completely aware of how terrifying it is to learn of an unwanted pregnancy, to have to make that first visit to an OB/GYN and have to remove your clothes and let a complete stranger examine your most intimate body parts. I myself, made the decision to keep both of babies and I would never regret that decision; however, i did choose not to have the trans-vaginal ultrasound with both my pregnancies because it made me uncomfortable. There is no way in hell I would have been or will be okay with my government telling me who will do it and when I have to have medical instruments shoved inside of me. It's degrading.
I completely understand requiring an abdominal ultrasound prior to an abortion. A doctor does need more information on the specific case before performing a medical procedure but some commenters on this post are going a little far.
Saying that he/she opposes required trans-vaginal ultrasounds does not mean the physician is pro-abortion or even provides them. The decision of what to do when you find yourself pregnant is hard enough with out being forced to be invaded by a doctor and patients have the right to refuse treatment last time I checked.
This post seems to be more about protecting vulnerable patients than whether or not abortions are morally wrong. The relationship between a woman and her obstetrician is one of the most important relationships a patient will have a doctor. You are trusting another human being with your most intimate organs and information and essentially the life of your future child.
So once again, I thank you for posting this. It's refreshing to know that doctors are putting their foot down and refusing to be pawns of the government. Props to you
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.