Roe v Wade 51st Anniversary
A free public service for a better community
A Good Day To Advocate for Better Healthcare
If there are subjects you’d like to see or improvements made, please let me know using the comment button below. Videos of these newsletters appear on Youtube on this channel. Let me know what you think.
Roe v Wade Anniversary News
Today marks the 51st anniversary of the Supreme Court confirming the constitutional right to choose in Roe v. Wade, and the second since that right was stripped away by extremist right-wing justices. Let’s mark this day by recommitting ourselves to fighting to restore guarantees for reproductive freedom. (Rogan’s List)
Today, the Washington Post reports that the Biden administration is taking new actions to strengthen access to abortion and contraception. Federal agencies are issuing guidance that would make no-cost contraceptives more available under the Affordable Care Act and take similar actions to expand contraception access for federal employees. Health and Human Services Secretary Xavier Becerra also plans to send a letter to health insurers instructing them of their obligation to provide no-cost contraceptives. A new team has also been authorized and they are dedicated to enforcing the administration’s interpretation of a law, known as the Emergency Medical Treatment and Labor Act, or EMTALA, which requires hospitals to provide emergency abortions nationwide, including in the 21 states where the procedure is limited or banned. We mentioned this last week as active court cases are involved.
A Doctor’s View
This weekend I was reading medical newsletters and I came across an article written by a physician about abortion. I am reproducing it here because it is worth learning how doctors feel about the subject. The article was published in MedPage Today by Chloe Nazra Lee, MD, MPH.
“Politicians Must Stop Playing Doctor”
Lately, I've found myself using the words "irrational" and "U.S. Court of Appeals for the Fifth Circuit" in the same sentence with increasing frequency. To that mix, I add, "dangerous."
The latest misadventures from the Fifth Circuit include a ruling in favor of Attorney General Ken Paxton and anti-abortion groups that Texas hospitals receiving Medicare cannot be required to perform life-saving abortions to stabilize patients, despite federal guidance.
This grim beginning to 2024 in Texas comes on the heels of the Kate Cox case, one that I believe Paxton pursued without empathy or reason.
The same day that a lower court granted Cox the right to abortion for an unviable and complicated pregnancy that threatened her health and future fertility, Paxton fought the decision and intimidated physicians and hospitals with a threat that the ruling would not shield them from criminal charges for violating Texas' abortion laws, should they be involved in Cox's care. He was successful.
In his argument, Paxton belittled the original ruling: "Judge Guerra Gamble is not medically qualified to make this determination," ignoring his own lack of medical qualifications.
I see a couple of concerning themes here. The first is that the state of Texas has determined itself to be more qualified than trained physicians to practice medicine. Had Paxton been genuinely concerned with medical expertise, he would have respected the professional opinions of Cox's physicians and would not need to threaten them with litigation.
The second is that Texas politicians' "practice" of medicine is decidedly antithetical to the practice of medicine that I was taught. Our Hippocratic Oath is succinctly distilled into the phrase: "First, do no harm." I do not see Paxton abiding by that credo either in his challenge to the federal guidelines on EMTALA and emergency abortions or in his efforts against Cox. Neither bullying patients by weaponizing the legal system against them nor prioritizing personal ideology over scientific evidence are considered good medical care. Furthermore, denying an emergency abortion to a medically unstable patient who needs one is the exact opposite of preserving life, especially when the fetus carries a deadly condition.
Ideology has governed the state of Texas's "practice" of public health, as well as its "practice" of medicine. In November, the Supreme Court reviewed U.S. v. Rahimi, the decision issued by the Fifth Circuit upending decades of federal law that had previously disarmed people subject to restraining orders for domestic violence.
The original Rahimi Fifth Circuit ruling ignores the facts: access to firearms is a highly significant predictor for intimate partner homicide, increasing the risk by 1,000%. Furthermore, the children of abusive relationships are not exempt from abuse, and firearms are the leading cause of death among children in this country. The Fifth Circuit ruling disregards public health expertise and consequently endangers women and children.
The Fifth Circuit's practice of medicine continues with further frivolous barriers to care. SCOTUS has agreed to review a decision by the court limiting access to mifepristone (Mifeprex) and imposing wholly unnecessary burdens and confusion for patients who need this medication. These restrictions do nothing to improve patient outcomes or experience with mifepristone.
As physicians, we can follow neither our ethics nor the appropriate standard of care if politicians flagrantly disrespect our training. If they can undermine our careful decision-making so easily, what is the point of our expertise?
The medical students I train are already considering the politicization of healthcare in their future career plans. Despite ob/gyn becoming more competitive, many medical students are reluctant to consider residency in states with rigid restrictions. "I would like to train at an institution that teaches family planning. And I don't think I'll apply to ob/gyn residency programs in states where there are restrictions or bans on abortion," said one of my third-years, who is already a valuable asset to our medical team.
If you drive away physicians with the threat of criminal charges when they don't practice according to your personal beliefs, they will not come to your state.
Another casualty of ideological extremism? Women's access to comprehensive reproductive healthcare.
Anti-abortion advocates will inevitably challenge me on this, but the anti-abortion "murder" argument is an egregious misrepresentation and oversimplification of healthcare decisions in which abortion is determined to be the best option for the patient. This position suggests that hordes of callous and irresponsible women will casually line up to dispose of infant children, given the opportunity. That is not happening. Nor is Texas's misrepresentation of federal guidance on emergency abortions and EMTALA happening: that the guidelines strive to turn emergency departments into abortion clinics.
What is happening is that a group of politicians are dictating medical care without medical training, and endangering women's lives. These decisions are tantamount to enforcing decidedly inferior medical care that disproportionately harms women, prioritizing personal belief over evidence-based medicine, and in my view, effectively codifying misogyny into standard of care. This most recent decision by the Fifth Circuit, which allows the denial of an emergency abortion to a critically ill and unstable pregnant patient, highlights the chilling truth that the life of the mother is not, in fact, a priority in the eyes of the law.
For a group that professes to value life, the politicians and courts of Texas are certainly demonstrating otherwise, with unyielding dedication to preserving a black-and-white ideology and enforcing it without nuance or compassion, without firm grounding in scientific evidence, and even at the expense of women's lives.
I would lose my job very quickly if I practiced medicine this way.
If politicians wish to play doctor, we should hold them to the same standard. The situation has become dire for too many innocent people.
Summary
Politicians are trading women’s lives for power. It is a cruel strategy, but if your desire for power is the only thing that matters then the lives of others matter little.
Remember that according to new polling, three in five Americans now support Congress passing a law to guarantee the right to an abortion. An even greater share oppose a nationwide ban on abortion.
If politicians are supposed to represent us then let’s call on them, long and loud and over and over to do so.
ACTION
There is a bill in Congress, introduced by Rep. Cori Bush, called the Protecting Access to Medication Abortion Act to ensure the legality of mifepristone and guarantee it will remain available through telehealth and mail-order pharmacies. It is H.R. 767 and the companion bill in the Senate is S. 4467. Let’s remind our representatives that they should protect Americans, not relegate them to 2nd class status without bodily autonomy. Their contact info is in the Resources section below or use RESISTBOT to send the email below by sending a text message to 50409 SIGN PVGMLL.
“I am your constituent. Today marks the 51st anniversary of the Supreme Court’s decision to affirm a woman’s right to choose, which is now lost. A full 60% of America supports the right to abortion and even more oppose a nationwide abortion ban.
Women are dying because they cannot get an emergency abortion in time. Women are losing the ability to have children because they cannot get the abortion they need to protect their fertility. This is all because politicians and judges who never went to medical school think they can understand how to treat patients better than a doctor. What HUBRIS!! Literally cruel and inhuman.
You represent me and I want you to do two things for me. I want you to actively support, cosponsor and enact H.R. 767/S. 4467, the Access to Medication Abortion Act, to make sure women can get the medication they need by telehealth and mail.
Then I want you to cosponsor and enact the Women’s Health Protection Act to make sure that Roe V Wade is again the law of the land.”
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
Thanks for reading Healthcare Advocacy! Subscribe for free to receive new posts