General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe American Medical Association is no Longer Neutral on Abortion
The group, which represents all types of physicians in the U.S., has tended to stay on the sidelines of many controversial social issues, which, until recently, included abortion and contraception. Instead, it has focused on legislation affecting the practice and finances of large swaths of its membership.
But, says AMA President Patrice Harris, the organization feels that, in light of new state laws in the U.S. that would force doctors who perform abortions to lie to patientsput physicians in a place where we are required by law to commit an ethical violationit has no choice but to take a stand. One of these laws, set to take effect Aug. 1, requires physicians in North Dakota to tell patients that medication abortionsa procedure involving two drugs taken at different timescan be reversed. The AMA said that is a patently false and unproven claim unsupported by scientific evidence. North Dakota is one of several states to pass such a measure.
.....................................................
In recent years, the AMA has taken mostly a back seat on abortion issues, even ones that directly addressed physician autonomy, leaving the policy lead to specialty groups like the American College of Obstetricians and Gynecologists, which has consistently defended doctors rights to practice medicine as they see fit when it comes to abortion issues.
Ziegler said it is not entirely clear why the AMA has suddenly become more outspoken on womens reproductive issues. One reason could be that the organizations membership is skewing younger and less conservative. This year, for the first time, the AMAs top elected officials are all women.
https://time.com/5617960/ama-abortion-lawsuit/
gratuitous
(82,849 posts)Did you finally get tired of watching poorly-informed Republican politicians practice medicine badly? Thanks at last for standing up for your patients and their well being.
ck4829
(35,091 posts)marybourg
(12,634 posts)I guess its true; if you live long enough (77 and counting) you see everything!
Merlot
(9,696 posts)Good gawd, would be funny if not so stupid.
BlancheSplanchnik
(20,219 posts)pecosbob
(7,543 posts)the state government over abortion restrictions on behalf of patients.
Ilsa
(61,698 posts)But I'm not certain. AG Paxton is trying something like that.
Maraya1969
(22,497 posts)"One of these laws, set to take effect Aug. 1, requires physicians in North Dakota to tell patients that medication abortionsa procedure involving two drugs taken at different timescan be reversed. "
Proud Liberal Dem
(24,437 posts)Woe to any woman who is lead to believe this.
ck4829
(35,091 posts)ehrnst
(32,640 posts)And then they want women to ask for drugs that the anti's think will prolong the pregnancy...
Proponents of abortion reversal ― a term used that pro-life groups use even though its inaccurate, as by definition once an abortion has occurred, a woman is no longer pregnant ― claim that medication abortions can be reversed halfway through. They counsel women who have taken mifepristone to forgo the second drug, misoprostol, and instead take high doses of progesterone, often for months.
Leading medical groups, including the American Congress of Obstetricians and Gynecologists and the American Medical Association, oppose this experimental practice, as it has not been clinically tested or approved by the Food and Drug Administration.
They note that medication abortion is most effective when patients take both drugs, and about half of women who take only mifepristone will continue their pregnancies. Taking progesterone to offset the effects of mifepristone has not been evaluated for safety.
https://www.huffpost.com/entry/abortion-reversal-bills_n_5d164c6ee4b07f6ca57cc6fc
Maraya1969
(22,497 posts)Merlot
(9,696 posts)ehrnst
(32,640 posts)to not complete a pregnancy is uninformed, overly emotional, not based in reason, or the result of manipulation by an evil boyfriend/abortion provider, etc ... which means that it's possible they can still be "reasoned with" after starting the process, in case the shaming done to them somehow starts to work.
The shaming being that only sluts who hate babies get abortions.
Proud Liberal Dem
(24,437 posts)why orgs like AMA seem to be quiet on a lot of these anti-choice laws, esp. TRAP laws and laws mandating doctors to provide unscientific information to patients. Glad they are stepping up a bit.
customerserviceguy
(25,183 posts)they don't want their members being in a position of being forced to perform an abortion. Most MD's don't do them.
Proud Liberal Dem
(24,437 posts)That doesn't make much sense to me.
What does advocating for choice and, more importantly, the integrity of the medical profession have to do with "being forced" to perform abortions?
customerserviceguy
(25,183 posts)And they've all seen what has happened to pharmacists and pharmacies that refuse to stock or sell morning-after pills. They don't want that to happen to their members.
I wouldn't force a Catholic doctor to perform an abortion any more than I would force a kosher or halal butcher to sell bacon.
Farmer-Rick
(10,207 posts)What pills do we let the butcher give the animals???? It's a very, very bad analogy that makes women animals, a pig none the less, to be used as food. How horrible. Sounds like a anti-choice propaganda piece thrown out by the religiously insane.
Let's start taking care of the living, breathing people we have right now before we get our panties into a twist over the not breathing unborn.
customerserviceguy
(25,183 posts)is exactly the attitude that scares them.
Farmer-Rick
(10,207 posts)Last edited Tue Jul 2, 2019, 07:48 AM - Edit history (1)
Maybe cruel and insensitive attitudes concerning living, breathing women who must carry the not-breathing, unborn are what's the real problem here. And where in your bible does it say an unborn fetus is a human? Other religions don't have any problems with abortion. It's the Christians how are trying force women to birth each fetus.
If someone can dehumanize all pregnant women they can dehumanize anyone, even when you join them.
marybourg
(12,634 posts)Theres no need to attack a poster. Attack a concept or idea, but not the poster. This is bullying and doesnt belong on DU
Farmer-Rick
(10,207 posts)ehrnst
(32,640 posts)You might want to rethink the wording on that comparison to pig butchering.
It's offensive.
Any pharmacist that doesn't want to do the job they were hired for in a CVS, and won't abide by the rules that require they either find another pharmacist on duty to fill the script, or refer the woman to a provider that will shouldn't be working as a pharmacist.
If you're a vegetarian, and don't want to serve or stock meat products, you don't get a job at a restaurant that has burgers on the menu, because you'll be fired if don't deal with the fact that customers come in for meat.
Prescriptions are medical care, not pork.
customerserviceguy
(25,183 posts)Making and selling bacon is legal under the Constitution. Making, selling, and using contraceptives is also legal under the Constitution. Performing and having an abortion is legal under the Constitution.
But there are people whose faith forbids them to do those things. We're a live-and-let-live society for the most part, you live in accordance with your religion, and let me follow the dictates of my faith. (By the way, I'm an atheist) However, when you compel people to do things that are in disharmony with their religious/philosophical beliefs, you run into conflicts.
The SCOTUS is still out there on flower arranging and cake designing, with cases being remanded to lower courts. Before the SCOTUS ruled that equal marriage is the law of the land, most of the states that legalized it had provisions that marriage practitioners could opt out of performing a same-gender marriage if the minister/priest/celebrant had objections because of their religious traditions. If those are tested in the courts, we have a clue how the rulings will go.
The AMA is very careful to avoid political controversy, they have an institutional memory of fighting Medicare and losing back in the mid-1960's, and they don't want to take sides very often. Recall where they were on the ACA not too many years ago. They will surely resist single-payer when it becomes an active issue.
I was attempting to answer a question from another poster about why the AMA was quiet on the subject of abortion, and I thought I was giving a perspective that might illuminate an answer.
ehrnst
(32,640 posts)Yes, I know that, thank you.
Those are called 'conscience exemptions' as I pointed out in two of my responses to you.
You see, if one is a medical provider, as is a pharmacist, then there is an obligation to provide health related services (unlike a hog butcheror cake baker) to actual medical patients, especially if one works in a secular public provider.
Do you see where this goes into different territory than hog butchers and cake decorators? Medical services cover "health issues," and retail services are not the same thing.
Still with me?
If one is a devout Roman Catholic, and has an issue with contraception, drugs for Trans patients or other medication that the secular public medical profession refers to as a "standard of care" then you have the option to work in a religious hospital that states up front that they don't provide contraception. You should not work in a CVS, Rite AID or other secular provider that medical patients have a reasonable expectation of recieving access to standard of care services and medications that the secular medical community has established - contraception being one of. Because of the time-sensitive nature of birth control and emergency contraception, delays in dispensing can result in improper use or reduce the medications effectiveness.
Still with me?
And if you are working at a CVS or RiteAID, and they state that you must fill a prescription or find an on-duty pharmacist who will, and you do not, you are violating the requirements of your job.
https://www.managedhealthcareconnect.com/content/cvs-pharmacist-no-longer-employed-after-prescription-fill-refusal
One's faith does NOT give you the right to, as some have done, berate the person who is filling a prescription for being a sinner and keep their job.
Wouldn't you agree?
Because it sounds like you don't. Your complaining about when medical providers are held to providing standards of care leads one to believe that.
https://www.psychologytoday.com/us/blog/you-it/201006/how-walmart-intimidates-people-not-buy-plan-b
https://www.nbcnews.com/news/us-news/can-pharmacist-legally-deny-patient-prescription-it-depends-n894871
What are your feels about Kim Davis refusing marriage licenses to same sex couples?
customerserviceguy
(25,183 posts)with your assessment of the chain-store pharmacy worker. I feel the same way about the Muslim cab driver who refuses to pick me up because I'm carrying an alcoholic beverage in my luggage. Kim Davis got squashed on her ass like she deserved. She is not a private provider of services, she is a government worker, and those workers must serve the public in accordance with the laws of the land. And when the Supreme Court has made a decision that equal marriage is the law of the land, then anyone in a government office that issues marriage licenses needs to either comply with that, or find another job.
I use the pharmacy example as a means to describe why the AMA has been reluctant to enter the abortion debate until now. I'm sure some of their members see it as a slippery slope. What they're worried about is having abortion be a choice for a physician to becoming a requirement for licensing. Even the Catholic hospitals are in fear of losing Medicare/Medicaid reimbursements over their refusal to perform procedures that are at odds with the tenets of their faith.
On this issue, as with so many, we are moving from a range of opinions to complete polarization. When you have that, you risk a situation where your minority position is not respected, not made allowances for, or even criminalized as hate speech. It is tearing this country in two.
ehrnst
(32,640 posts)Then yes, they need to know how to perform a dialation and curettage, which is not only the most commonly used abortion method, it's also a procedure to remove fibroids in the interior of the uterus, and to complete a miscarriage.
An ER doctor who will not treat a woman who is having their period because of religious beliefs about touching a woman who is having her period should not be licensed to work in the ER. Neither is someone who won't perform a D&C on a woman who is bleeding badly from miscarrying because they refused to even learn that "abortion procedure." If a surgeon becomes a Jehovah's Witness, should they be allowed to refuse to order a unit of blood transfused to a patient?
CVS and RiteAID are not religiously held businesses, so they are subject to the laws governing public health and standards of care for pharmacies, and that includes non-discrimination laws. Again - if someone refuses to fill a contraceptive scrip, they can go work at a pharmacy in a RC hospital, or politely have another person on duty fill it, or if they're alone - such as the overnight shift, and it's time sensitive (like contraception) they need to refer the patient to the NEAREST provider who will - and that provider should be confirmed as someone who will. Trying to humilate or otherwise violate the privacy of a trans person who disgusts you with their very existence is not "religious freedom."
BTW - there is an issue with the RC church purchasing up rural hospitals where they are the only ER/ surgical facility in an area. If that is the case, then they should be subject to the laws concerning public health and standards of care, ESPECIALLY if they want to be reimbursed with public funds for their services. They will never be requred to provide a non-emergency or therapuetic abortions to receive government funding - in fact the Hyde Amendment prohibits it.
https://fivethirtyeight.com/features/how-catholic-bishops-are-shaping-health-care-in-rural-america/
That is an untenable situation from a public health perspective - religious leaders determining the health care that will be provided to a population that has no alternative but to use their facilities.
If end of life care includes a DNR order, according to a patient's or their next of kins' directives, (taking a brain dead child or pregnant woman off life support) and a hospital keeps that patient on life support instead, then that hospital should not be reimbursed for that ongoing life support -either by public funds or private insurance. They should also NOT be billing the family for that treatment that went beyond their consent.
https://www.dallasnews.com/news/news/2014/01/26/fort-worth-hospital-withdraws-life-support-for-pregnant-brain-dead-woman
https://www.texasmonthly.com/the-daily-post/who-has-to-pay-marlise-munozs-medical-bills/
ACOG supports that any physician who refuses to do a procedure (tubal ligation, abortion, etc.) on documented religious beliefs be required to refer the patient, in a timely manner, to a provider of that procedure.
When I was pregnant with my son, my OBGYN told me that she wanted to perform a chorionic villus test at 3 months to determine if there were genetic anomalies, due to my being past age 35 at first childbirth. She stated that even if I didn't want to know in advance, she did, because surprises in the delivery room are not something an OB wants. She also told me that if there were anomalies that were severe, and that I didn't want to continue the pregnancy that she could not perform a 12 week abortion, due to the limits of what their practice provided, but that she would make sure that I was referred to someone who did. That was comforting, and I felt secure that I was being taken care of, even though everything ended up fine.
What is your source about the AMA being worried that physicians are required to learn abortion procedures against their personal beliefs? OBGYNs have been required to know abortion procedures as part of their clinical competencies training since 1995, as per Accreditation Council for Graduate Medical Education - of which the AMA is part of....
Abortion training to be required in standard Ob / Gyn curriculum
Also, who is calling genuine, properly documented and reffered conscience objections "hate speech?" Which is more akin to what the pharmacist did to the trans woman... Can you provide your source?
yardwork
(61,703 posts)If somebody told you that, they are either misinformed or deliberately lying.
customerserviceguy
(25,183 posts)I'm sure it has crossed the minds of some of them that they might have to choose between their medical license and their principles. Why do you think there have been so-called "conscience rights" rules promulgated by the Trump administration? They didn't come with this idea on their own.
yardwork
(61,703 posts)Vanishingly few doctors perform abortions anywhere. None are ever forced to do so. Ever. Never happens, won't happen.
We are fighting in this country for the right to be allowed to choose and bullshit arguments like this are one of the reasons we're losing rights. Stop it. Educate yourself.
customerserviceguy
(25,183 posts)just trying to come up with a possible answer to a poster's question here. I knew that I was treading on dangerous ground by even bringing it up here. I guess I'll know better next time.
Farmer-Rick
(10,207 posts)And the example about women and pigs is right out of a right wing talking point manual.
yardwork
(61,703 posts)Good people can be misinformed.
Farmer-Rick
(10,207 posts)And you know all about how religious Trump is what with his sex worker partners and all.
Because nothing like a Psychopath without a conscience to show us with a conscious how to Nanny state women to death.
Because those silly little religion hate laws that give people and corporations an excuse to discriminate against others are right up a fascist's alley. Next up, laws that require you to wear a large letter "A" if you ever had sex out of wedlock of course only for women.
ehrnst
(32,640 posts)Those "conscience clauses" were 'promulgated' long ago, so that religious institutions would not have to provide those things for employees (contraception coverage for the RC church secretary, etc). They were not intended for individuals to be able to pick and choose if they were going to provide the services expected of them in the workplace... and knew that they may need to provide.
You seem to be promoting the ability of a medical provider to discriminate on the basis of religion, when most physicians don't go into a practice that would provide services that "go against their principles." Are you also saying that that someone would be able to refuse to treat trans woman coming into the ER based on their "principles," or refuse consult with a same sex partner on care when the patient isn't capable? You really think that an ER physician who has such bigotry to the point of not upholding the hippocratic oath should be able to keep their license - or had any sense whatsoever training for a profession where this would come up?
Isn't that exactly what you said Kim Davis was doing wrong - choosing her bigoted 'principles' over the duties of her office? Anyone who does business in the public sphere should be subject to laws and anti-discrimination - especially in health care, and especially if they expect taxpayer dollars.
In what instance has a physican had to choose between getting a medical license and their principles? Examples, please.
I won't hold my breath...
customerserviceguy
(25,183 posts)between asking a doctor to treat a medical condition of a trans person, and asking a doctor to perform gender reassignment surgery.
And I don't have any examples of a physician having to choose between their profession and their principles, my contention was that the old AMA didn't want to get to that point. Apparently, they're not worried about it anymore.
ehrnst
(32,640 posts)the result of the Trump administration needing to defend 'religious liberty' - who don't differentiate.
And what gave you the idea that a surgeon might refuse to do gender reassignment surgery because of religious objections to transgender people?
That doesn't show an understanding of specialization in medicine... that physician would have had to specialize in it.
Are you one of those people who think that somehow physicians are obligated by law to do provide any procedure that they might be capable of to any person at any time who wants it? That's not the way it works.
That sounds a lot like the right wing misconception about health care - especially abortion. I know an abortion provider who had a patient who made an appointment, then when the patient came in, the provider recognized her as one of the regular hasslers out in front of the clinic. The provider said, "I will not do this. I will tell you where other providers are, but you will not get any service here." The woman started yelling that the doctor had to do it, because it was abortion "on demand." The provider pointed out that she could not go in and get her arm amputated "on demand" nor even plastic surgery - not without a physician agreeing to do it. She was rejecting a patient on the grounds that this patient was actively looking to shut her practice down.
RWers make it out like someone will walk into a family General medical practice and demand that one of the physicians there perform gender reassignment surgery or an abortion.... and that the physician will be obligated to.
Is that what you think?
Proud Liberal Dem
(24,437 posts)but OTOH with Catholics buying up hospitals left and right, it's making that sort of a hard position to take IMHO.
customerserviceguy
(25,183 posts)were actively engaged in buying up hospitals. I would suppose that is because private hospitals are going broke, and are attractive acquisition targets because of that. It seems to me that fixing this broken part of the healthcare system should be what we're talking about, and not busing.
Proud Liberal Dem
(24,437 posts)ehrnst
(32,640 posts)It's about a law forcing physicians who are performing an abortion - by their own choice - to lie about the procedure.
customerserviceguy
(25,183 posts)Doctors are often viewed as demi-gods by most members of society (trial lawyers are a notable exception) and after decades of this, they resent being told what to do and what not to do. As long as abortion restrictions were modest in scope, the AMA must have been fine with that. Change things the way Alabama and Georgia have, and now you're intruding too heavily on the doctor-patient relationship. That's why they took the stand they did now.
Why not before? They've seen the calls for decertifying Catholic hospitals for not providing abortion services. They've seen pharmacists get fired for refusing to fill Plan B prescriptions. They've seen laws in blue states that do not protect religious-based exemptions for non-physicians. They just chose to stay out of it, to avoid scrutiny of their members.
The current wave of anti-abortion legislation shook them out of their inertia, but if there is a counter-wave that engulfs their profession, expect them to react accordingly to that.
ehrnst
(32,640 posts)customerserviceguy
(25,183 posts)and offered a possible explanation. Is there something in the full article that is relevant that is not in the excerpt, as it concerns my point?
ehrnst
(32,640 posts)Perhaps reading the full piece would be helpful before lecturing others who have...
customerserviceguy
(25,183 posts)and as others have mentioned here, there is a change in the acceptance of abortion among members of the AMA as their membership has changed. But as I said, the extremeness of the positions taken by some states is what has prompted the AMA to take its positions on the North Dakota law.
Is there anything I missed that you can provide me with some perspective on?
ehrnst
(32,640 posts)Which may indicate why there is a better understanding of the issue of pregnancy termination being as neccessary a standard of care as labor and delivery is.
yardwork
(61,703 posts)The AMA has historically been dominated by conservative male physicians representing a few highly paid specialities. It has been a conservative organization that actually played a very active role in politics, preventing universal health insurance, for instance.
The AMA is changing now. Female leadership seems to be making a big difference.
AllyCat
(16,222 posts)True, many of the providers at my facility are not trained in some of the procedures we do, but any can provide this care. If they have a moral objection, they can work with men or geriatrics. Or get a job as something other than a doctor.
Hekate
(90,793 posts)Ya think that just might have something to do with it?
Now if we could just get rid of those all-male Congressional committees making decisions about our health....
ehrnst
(32,640 posts)Malmsy
(297 posts)csziggy
(34,137 posts)That could be called sexual assault. Some states now require unnecessary invasive medical exams that make doctors essentially rapists. I've read one interview with a doctor who objects - but only one. Why aren't more doctors taking a stand against this idea?
Ilsa
(61,698 posts)Informed their state health department that they will not comply with this new rule of forcing pelvic exams 3 days before a surgical abortion. They followed the rule for two weeks, then told them no more, it was assault and unnecessary. The health dept backed down.
csziggy
(34,137 posts)But other states have attempted to require it and I have not heard of any other doctors refusing.
i could have missed it - the last two years I have had three hospital stays and extended recovery times.
hunter
(38,326 posts)They were crushed by the insurance industry and sold out to the pharmaceutical industry.
They are junk mail.
ehrnst
(32,640 posts)Are they a member of the AMA or not?
Do you ask them up front if they are a part of that professional association?
Do you then walk out?
hunter
(38,326 posts)... offering them free or deeply discounted memberships.
But most eventually discard these offers as junk mail. Physicians get huge amounts of junk mail.
I don't have any personal physicians lately. Physicians I could tolerate have said "FUCK THIS SHIT!" in so many words and retired.
Now I bounce about in a U.S.A. ruled by Insurance Companies.
At times it's been easier to go to Mexico for my prescriptions but I have been severely punished for that.
My current insurance is like "whatever," at least with the asthma meds.
My personal and professional associations with U.S.A. medicine, too many associations toxic, are deep.
ehrnst
(32,640 posts)Last edited Tue Jul 2, 2019, 10:26 AM - Edit history (1)
Didn't think so.
hunter
(38,326 posts)ehrnst
(32,640 posts)I take it you go to alternative medicine practitioners?
nolabear
(41,991 posts)Theyre conservative and leery of lawsuits so try hard to stay out of such things. Im really glad they have stepped up. Tells you how egregious even the conservative (as opposed to fanatical) organizations are finding these fools.
spanone
(135,873 posts)Sgent
(5,857 posts)among their members. Elective abortion itself is still controversial, but being forced to spew government lies to patients violates every code of ethics in medicine.
UTUSN
(70,740 posts)drmeow
(5,024 posts)Lancero
(3,013 posts)They're suing because these laws force doctors to make false claims - As the article outright says - rather than any attempts to restrict abortions.
This isn't a new stance for them, and is in fact in line with previous cases they've been a part of.
https://www.ama-assn.org/delivering-care/ethics/pregnant-women-deserve-get-whole-truth-their-options
But the real issues at stake in National Institute of Family and Life Advocates v. Becerra are medical ethics and a patients right to informed consent, according to an amicus brief filed by the AMA. In its brief, the AMA argues that laws seeking to compel or restrict physician speech should be subject to strict constitutional scrutiny and concludes that a California law aimed at ending deceptive pregnancy counseling meets that high bar.
...Arguing on behalf of the respondents in NIFLA v. Becerra, the brief lists three reasons for the AMAs interest in the case. They are to ensure that physicians:
Can care for patients without governments undue interference.
Can enjoy the right to speakor not to speakwithout government constraints arising from partisan objectives.
Practice ethically without misleading patients to satisfy a personal moral or religious belief.
And as for them breaking neutrality on abortion, they have yet to take a official stance for or against it.
https://www.ama-assn.org/press-center/press-releases/ama-adopts-new-policies-2019-annual-meeting
That said though, if one wants to argue that this breaks their neutrality well... Hardly the first time they've taken this particular stance, so its still incorrect to claim that they have just now broke their neutrality.
DFW
(54,436 posts)They are right-wing religious zealots interested in conserving exactly nothing. All they are is nasty control freaks who get their jollies telling other people what they can and cannot do. Evil, yes. Conservative, no (except as defined in Foxese/Republicanese).
ehrnst
(32,640 posts)It's a tribal label now.
You can't be a 'conservative" and support Planned Parenthood, even if you know that Planned Parenthood prevents more abortions than any clinic hassler, and far more than it performs.
True Blue American
(17,988 posts)riversedge
(70,299 posts)....But, says AMA President Patrice Harris, the organization feels that, in light of new state laws in the U.S. that would force doctors who perform abortions to lie to patientsput physicians in a place where we are required by law to commit an ethical violationit has no choice but to take a stand. One of these laws, set to take effect Aug. 1, requires physicians in North Dakota to tell patients that medication abortionsa procedure involving two drugs taken at different timescan be reversed. The AMA said that is a patently false and unproven claim unsupported by scientific evidence. North Dakota is one of several states to pass such a measure.
.....................................................