National Partnership for Women & Families

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Debra L. Ness, President

From the desk of ... Debra L. Ness

Politics in the Exam Room: A Growing Threat

October 14, 2015 | Health Care > Reproductive Health

“Do no harm.” Health care providers take this oath. It underpins clinical decision-making and the essential relationship built on trust between providers and patients.

So what happens when a health care provider is forced to choose between doing no harm and following the law?

Unfortunately, even more of us are about to find out because politicians in states across the country are passing laws that dictate what providers can and cannot – and sometimes what they must – say to patients. It sounds incredible, but it’s true. And that’s just the tip of the proverbial iceberg, as some of these state laws mandate medically unnecessary procedures, outdated modes of care, and more.

For example, this year lawmakers in Arizona and Arkansas mandated that medical professionals providing abortion care tell their patients that medication abortion may be reversible – a claim wholly unsubstantiated by any reliable evidence, with no basis in medical science. In 2011, Florida enacted a law that prohibits physicians from asking patients whether they own a gun and if it’s stored out of reach of children. In 2012, Pennsylvania lawmakers passed legislation that could force health care providers to choose between risking a lawsuit by violating a required confidentiality agreement drafted by natural gas drilling (fracking) companies to protect their trade secrets, or violating their duties to patients in ways that may expose them to medical malpractice claims.

These laws force providers to violate their medical ethics, sometimes by withholding essential information patients need and sometimes even by lying to them. They put politicians’ ideology ahead of patient needs, medical evidence and the informed judgment of medical professionals. That is outrageous and harmful.

It’s not just bad politics; it’s also bad medicine. Health care providers must be able to deliver individualized, evidence-based care and put the patient first. Patients must be able to trust that their physician or other health care professional is sharing solid medical information and guidance that is relevant to their needs. Ultimately, interference in this unique, trust-based relationship threatens the delivery of quality health care and public health.

To call attention to the dangerous proliferation of these laws, the National Partnership joined with the National Physicians Alliance, Natural Resources Defense Council and the Law Center to Prevent Gun Violence to release a powerful new report. In it, we call on lawmakers not only to reject this type of legislation, but to pass laws that prohibit states from interfering in the patient-provider relationship. A strong model exists in the Patient Trust Act, introduced last month in Pennsylvania.

In recent years, our country has spent billions of dollars to improve the quality of care and ensure we make medical decisions based on evidence. When state legislators interfere in these decisions by requiring health care providers to violate their oath and ignore years of training and expertise, it undermines that investment and harms us all.

If we’re serious about improving the quality of care in this country, if we respect the medical professionals we train and the oath they take, if we care about our health and our ability to make informed decisions about our medical care, it has to stop. Politicians must exit the exam room and instead support the practice of high-quality, evidence-based medical care. That’s the kind of care doctors and all health professionals want to provide and all patients deserve.


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