News Congress begins attack on women's right to choose

[loseyourname]

To clarify what McGyver is saying, the reason this got brought up by Lockyer is that, in California, the state mandates that all physicians must perform any procedure necessary to help a patient whose life is in immediate danger, which includes emergency abortions. The Weldon Amendment conflicts with that law, saying that a physician cannot be penalized by the state for refusing to perform an emergency abortion needed to save a woman's life.

I would imagine, however, that any claimant would at least need to produce a case in which a woman incurred serious harm or death due to this amendment in order to be able to bring a challenge that will actually win. I understand Lockyer's reasoning, but what is the chance that a physician will refuse to perform an emergency abortion for a dying woman and no other physician will be around to do it in his place?

This is what happens when an amendment is tacked onto a bill and passed without debate, though. This could have been brought up and the amendment altered to provide an exemption in cases in which the woman's life is in direct and immediate danger. Then again, doesn't the Hippocratic oath itself dictate that an attending physician must perform any procedure necessary when a patient's life is in direct and immediate danger?

 

[Curious3141]

This is a very complex case. I read through the "appeal" and the Court's decision to reverse. As a matter of law, I believe the problem here lies mostly with the Weldon Amendment. It has interjected itself and created a conflict between federal appropriations moneys and treatment and decisions involving a patient. I believe, in difference to our doctor here, that the health and welfare of the patient "trumps" a physicians personal beliefs about his/her medical decisions. Physicians oath is to protect the interest and welfare of the patient. It then becomes a matter of "fact" in each case whether a doctor's decision and denial of service placed a patient in jeopardy. The Weldon Amendment does not appear to absolve a physician from civil actions that may arise should a patient allege harm. The physician must still perform his duty to counsel and refer the patient, even if such advice contradicts the will of the patient. This preogative of the physician would be his/her care provided.

Clearly, the "emergency status" of the abortions denied substantive claim in the action filed by CA's Lockyer was in error. The remaining points the Court stipulated in their reversal are complex, and I think the Court is saying "go back and correct your legal points and claims," and separately address the Weldon Amendment, which I believe Congress errored in passing. This is what the petitioners should challenge. This may well later end up in the higher U.S. Supreme Court, who would rule on the constitutionality of the Weldon Amendment.

The more concerning route (for all patients) that physicians could pursue is to have new and current patients sign an advance waivor that "this physician" will not treat patients in the event of a request for abortion, not withstanding an emergent needs occasion. It would be legally tough to break if patients once patients signed it. Physicians could then start adding all kinds of advance notice of exclusions to care, and we'd really have a mess. Of interest today, Health and Human Services Secretary in Washington is now requesting more intervention and activism by health insurers on behalf of their insured patients, primarily for improved costs and efficiency out of health care providors and physicians. However, this could lead to insurance companies advocating in matters on "behalf" of the patient. This would improve checks and balances in health care.

As for Congress's actions in this matter, insertions of unrelated bills is a widespread practice. Hopefully, voters will hold any and all accountable for not only interfeering in the care of a patient, but also for any harm caused by delay/compromise of the primary intended bill.

Well, I'm just a simple doctor, unaware of all the legal complexities of this situation (and I don't practice in the US). I will say this, however, and it should apply to all physicians practising anywhere : the needs of the patient never trump the proper values of a physician. In certain instances those needs may *apparently* override the "usual" objections a physician may have (like when a patient needs a life saving termination) - however, one indispensable value every good physician has is to put the life of his patient first. This "trumps" everything, so in situations where saving the life of the mother is a priority, there is no conflict. Every doctor, no matter how opposed to taking the life of a fetus, must do whatever it takes to save the life of a patient.

In elective circumstances, the demands of the patient can never be allowed to override a deeply held value of a physician. However, I believe every physician should have the duty to refer the patient to a colleague who does not share those objections.

I googled the "Weldon amendment", and I think it's worded in a dangerous fashion (which I didn't initially realize). I believe all references to protection of a physician's "right to refuse to refer" should be expunged. In reality, the physician really never had such a right - in fact, timely referral is part of the duty of care. I also feel that emergent care should be carefully stipulated as an exemption to the refusal clause.

Life-saving terminations almost never happen in this day and age. Rare cases of uncontrollable ecclampsia may necessitate this. In these cases, the mother does not wish to lose her child, and she is just as much against the termination as anyone else. This is a life-saving procedure, and I know of no physicians (among the conscientious objectors) who would refuse to save her life by taking that of her fetus.

It is only the *elective* situation when the woman actively wants to end the life of her unborn healthy fetus that we conscientious objectors feel is not justified. We should never be forced to provide such a service, but we should always be willing to refer the patient to someone else who will, that is our ethical duty.