By Olga Khazan
RESHEF’s Comment:
One of the roles of a physician is as a confidante and a patient advocate. If local or federal authorities limit the ability of a physician to discuss medical matters, even those matters that have been heavily politicized, like gun control and abortion, good healthcare is severely impaired. We constantly have to remind our politicians to stay away from practicing medicine and stay out of our offices and our patients’ bedrooms. Strangely, many of these politicians who try to impose restrictions on doctor-patient relationship are the ones crying afoul about governmental over-reach…
Fracking
According to the report, written jointly by the National Partnership for Women & Families, National Physicians Alliance, Natural Resources Defense Council, and the Law Center to Prevent Gun Violence, more than 15 million Americans live within a mile of a fracking well that was recently drilled.
Numerous studies have linked fracking—the process of injecting water into rock in order to extract natural gas—to health risks, and some patients see doctors for illnesses they believe might be related to fracking-chemical exposure. However, the report notes, some states require doctors to sign confidentiality agreements with fracking companies before they can learn what chemicals are used in their we In some cases, these agreements might prevent doctors from discussing those chemicals with other doctors, the patients’ families, and potentially the patients themselves. When Pennsylvania’s law, called a “gag rule” by opponents, was passed in 2012, NPR described how it might tie the hands of doctors who treat patients near fracking sites:
Plastic surgeon Amy Pare practices in suburban Pittsburgh where she does reconstructive surgeries and deals with a lot of skin issues. She tells me about one case, a family who brought in a boy with strange skin lesions.
“Their son is quite ill — has had lethargy, nosebleeds,” Pare says. “He’s had liver damage. I don’t know if it’s due to exposure.” …
Pare’s first step was to figure out what chemicals the [local] drillers were using. But that information isn’t easy to get. In this case, Pare says, the patient’s family had a good lawyer who helped them find out what kind of chemicals the gas company was using.
“If I don’t know what [patients] have been exposed to, how do I find the antidote? We’re definitely not clairvoyant,” she says.
Two lawsuits brought by doctors to challenge Pennsylvania’s laws have so far been unsuccessful.
Abortion
Among the record number of abortion restrictions states have passed in the past five years are laws requiring doctors to give abortion patients information that many obstetricians say is false. According to the report, 12 states force doctors to tell women that their fetus can feel pain, even though evidence is weak that fetuses can feel pain in the first two trimesters, the cutoff for abortions. Other states require doctors to tell patients—falsely, according to ACOG and other doctors’ groups—that abortion negatively impacts their future fertility, that abortion is linked to breast cancer, or that an abortion can be reversed.
Some states also require doctors to perform ultrasounds on abortion-seeking patients and describe what they see. The report quotes one doctor as saying, “Sometimes I find myself apologizing for what the state requires me to do, saying, ‘You may avert your eyes and cover your ears.’”These laws impact roughly 40 million women of reproductive age. Statistically, 30 percent of them will seek an abortion by age 45. Guns
Having a gun in the home is strongly correlated with both suicide and accidental shootings. The report authors say 1.7 million children live in homes with unsafe gun practices. About 7,400 children are hospitalized each year due to gunshot wounds, according to a 2014 study in Pediatrics.Naturally, many pediatricians ask parents whether they have a gun at home, much as they might ask whether their swimming pool is fenced in. When doctors counsel patients about how to store their guns safely, the patients listen—the majority improve their firearm-storage practices, according to some studies. In 2011, Florida passed a law—which is now likely headed to the U.S. Supreme Court—that severely curtailed doctors’ ability to discuss guns with patients, citing the privacy rights of gun-owners. Fourteen states have introduced similar legislation since then, though none as restrictive as Florida’s have been enacted, the report authors write…