Keep politicians out of the examination room

As ob / gynecologists, we care for patients with various gynecological and reproductive health issues that can be emotionally charged and intensely deprived. Although gynecological health issues are medical issues, just like headaches or ankle sprains, the extent to which individuals want to talk openly about them varies. In our practices, patients share their fears, pains and hopes and discuss their sexuality, gender identity and sexual behaviors. We talk with tweens going through puberty, with teens about their period, with women who can’t wait to be pregnant, and with those who aren’t. We talk to women who have never told anyone about a past sexual assault. We speak with women who are facing infertility or who need a hysterectomy. Our patients know that we will listen to them and treat them with dignity and provide them with accurate health education that will enable them to be a partner in their health care decisions.

Three recent legislative texts highlight a threat to the doctor-patient relationship. The proposition of laws that interfere with this complex and intimate relationship is a step too far. These laws illustrate this excess of the state: dictating the medical care of transgender adolescents (Arkansas and 18 other states),1.2 make medically inaccurate information on abortion mandatory (18 states),3 and requiring resuscitation for newborns with fatal diagnoses (New Hampshire).

As Frank Bruni pointed out in his recent New York Times In the opinion column, politicians are currently demonizing trans people in a new culture war, similar to how they vilified gays and lesbians, accusing same-sex marriages of somehow undermining them. heterosexual marriages.4 Politicians, including former President Donald Trump, say trans equality “would destroy women’s sport.”5 It is a political strategy that ignores the realities of patients in our offices. It ignores the transgender individual who found puberty blockers extremely helpful or trans people who had previously been suicidal trying to fit into a gender binary world. It ignores parents who have struggled with their child’s assertive gender identity, conducted extensive research and reading on the issue, and who love their child and support therapy and potentially medication to help relieve gender dysphoria. of their child. He ignores our medical judgment and recommendations after listening to the patient and his parents. It ignores the expertise of our colleagues in endocrinology, psychology, adolescent medicine, adolescent gynecology, urology and social work who work with transgender youth. As Bruni describes it, these lawmakers are incredibly arrogant and “stand between doctors and patients.”4

It is not controversial to agree that our obligation as physicians is to care for our patients in the way that best meets their needs. We should also agree that legislatures have no role to play in dictating the details of medical care. The Patient-Provider Relationship Protection Coalition is made up of non-partisan, not-for-profit organizations united in “opposing inappropriate interference in the relationship between patient and health care provider”. 6 Member organizations include the American College of Obstetricians and Gynecologists (ACOG), American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Medical Association, American Medical Student Association, American Medical Women’s Association, American Nurses Association , American Osteopathic Association, American Public Health Association. The coalition states that “patients deserve accurate information, high-quality care and the treatment options that best meet their needs. Doctors and other health care providers should be able to follow the best scientific knowledge and medical training based on the available evidence, and meet their ethical obligations. “6

It is not only in the areas of women’s health that we must protect this relationship. Other health and safety issues that politicians pass laws that pit us against our patients include gun safety and environmental hazards. Resources for clinicians include a report titled “Politics in the Exam Room: A Growing Threat,” by the National Partnership for Women & Families, the National Physicians Alliance, the Natural Resources Defense Council, and the Giffords Law Center to Prevent Gun Violence.7 According to ACOG’s policy statement on legislative interference in patient care, medical decisions and the patient-physician relationship, “Laws should not interfere with the ability of physicians to determine appropriate treatment options. and to have open, honest and confidential communications with their patients. Laws should also not interfere with the patient’s right to medical advice based on the best medical evidence currently available and the physician’s professional medical judgment. ACOG strongly opposes any government interference that threatens communications between patients and their physicians or causes a physician to compromise medical judgment on information or treatment that is in the best interests of the patient. “8

When state legislators try to come between us and our patients, we need to speak up. We must not allow politics to trump science or interfere with our sacred patient relationships. Our patients must be able to count on us to provide appropriate and confidential care, based on science and our medical judgment.

The references

1.Legislative follow-up: bans on anti-transgender medical care. Freedom for all Americans. Accessed April 13, 2021.

2.Cox C. While Arkansas bans treatment for transgender youth, 15 other states are considering similar bills. USA today. April 8, 2021. Accessed April 13, 2021.

3. An overview of abortion laws. Guttmacher Institute. Updated April 1, 2021. Accessed April 11, 2021.

The Republicans of Bruni F. find a new cultural war cruel. New York Times. April 10, 2021. Accessed April 11, 2021.

5.Ennis D. What Donald Trump’s Transphobia Really Means For Women’s Sport. Forbes. February 28, 2021. Accessed April 13, 2021. sh = 3fac76545e66

6. About the coalition. Coalition to Protect the Patient-Provider Relationship. Accessed April 13, 2021.

7. Politics in the Examining Room: A Growing Threat. National Partnership for Women and Families. October 2015. Accessed April 13, 2021.

8. Legislative interference in patient care, medical decisions and the patient-physician relationship. ACOG. Updated July 2019. Accessed April 13, 2021.

About Hector Hedgepeth

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