Arizona lawmakers have stepped into the doctor’s office

Imagine you want health care. You go to your doctor who recommends a medication. Your doctor tells you that the medication used to be prescribed one way 14 years ago, but very rigorous, more recent studies indicate a lower dose is just as effective. And has fewer side effects. And is less expensive.

You are pleased because a) your doctor is up on the latest medical therapies, and b) the least amount of medication is always best. Except if you want a medical abortion in Arizona. In that situation your doctor can’t offer you the latest state of the art care, she/he will be forced to give you a higher dose of medication in a way that is less optimal. And yes, this is legal.

When the medical abortion regimen involved mifepristone (RU-486 or Mifeprex) and misoprostol was originally submitted for approval to the FDA the literature supported a dose of 600mg of mifepristone followed by 400mcg of oral misoprostol 3 days later and only up to 7 weeks. Subsequent studies (because that’s what happens in medicine, doctors continue to study things) have shown that a dose of 200mg of oral mifepristone followed by 800mcg of misoprostol vaginally 6-24 hours later is 95-99% effective at terminating a pregnancy up to 63 days gestational age (9 weeks) with fewer side effects and less expense than the older regimen. This 200mg RU-486 protocol is now (and has been for a while) the standard of care. Except in Arizona

In 2012, Arizona legislators voted to force doctors to go back to the older, higher-dose-more-expense-more-side-effects regimen. Planned Parenthood stepped in and filed suit, however in what sounds like a cruel joke, a federal judge refused to block the bill so it went into effect. Science tells us 600mg of RU-486 offers nothing positive for the patient or her provider, but somehow a federal judge doesn’t find substandard medical care an undue burden.

So let’s be very clear about this, Arizona lawmakers have stepped into the doctor’s office and insisted medications be prescribed in a way that is no longer supported by medical evidence. And this is legal, because the people who want to advance their personal agendas also write the laws. Why go to a doctor when you can get medical advice from your state legislator! Maybe we can now sue the state for malpractice?

The idea that legislating outdated medical care is not an undue burden is so outlandish that you’d think it would have to be a joke.

But it’s not.

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

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  • John C. Key MD

    Medical abortion is a poor example, for in the opinion of many the procedure should be everywhere illegal. However, the larger point is well taken: neither the legislatures nor state medical boards should be in the business of micromanaging medical practice.

    • Lisa

      i always find it ironic that anti-government conservatives are quite willing to make laws regarding abortion.

      • gyrfalcon

        Regulating business is obviously wrong and immoral, but regulating women’s uteruses and adults’ sexual choices is virtuous and necessary, apparently.

        • Lisa

          Personally, I think they have it backwards. ;-)

  • Thomas D Guastavino

    I must have missed it, Exactly when did routine pregnancy get classified as a treatable disease?

  • NewMexicoRam

    I’m sorry, but abortion should never have become a part of “medical practice.” It’s barbaric, a taking of life for convenience 97% of the time, and a tragedy of monumental proportions.

    • SarahJ89

      No, we should turn the clock back so women have to travel 200-300 miles to have a catheter inserted in their cervix on the kitchen table of a total stranger in a large city. When the girl/woman gets home she removes the catheter and hopes the resulting infection doesn’t kill her. She bleeds profusely, is abandoned if anything seems to be going wrong by her frightened young friends who are afraid of getting arrested.

      This is what you prefer over safe, legal abortion? Really?

      And if you think I’m exaggerating, I am not. I wish I were, but at least eight of my nice, middle class college friends went through this. One of them died. One friend was lucky because she got pregnant by a rich guy. He paid for her to go to Japan for a safe, legal abortion.

      I was lucky because abortion was legalized in New York state in the nick of time. I traveled 300 miles on a bus to be treated at a safe, clean facility. With a cleverly positioned billboard outside on the EXIT driveway that proclaimed “Aborton is Murder!” in case anyone missed the fact the goal was punishment not prevention.

      I thank God for safe, legal abortion. My teacher friend would be thankful too, except she died from her illegal abortion after being refused treatment by a hospital afraid of legal consequences. .

      Don’t fall off your high horse NM Ram.

      • NewMexicoRam

        Sorry, I know that there’s lots of reasons women feel they must have an abortion.
        But at least one person always dies during an abortion.

        • SarahJ89

          No. Very frequently a life is saved, that of a living, breathing human being.

          I raise poultry. The fertilized egg I ate for breakfast was an egg, not Kentucky Fried Chicken. This is such simple logic it beggers belief that anyone capable of reading and writing cannot figure this out.

          • NewMexicoRam

            Sorry you feel that way. A life is more than the baby born at gestation.
            It’s a miracle.

          • EmilyAnon

            NMR, I believe you’re a physician. Just curious, how would you deal with a patient who seeks an abortion. Would you reveal your personal beliefs, then try to dissuade her?

          • NewMexicoRam

            Of course, both sides of the issue are discussed. I’ve done it before, multiple times. Sometimes the woman chooses life, other times abortion. I don’t try to create guilt either way–I point out the issues and try to make sure she understands options available. And I make sure she understands I am willing to be her physician, either way.

          • EmilyAnon

            That was a fair reply. Thanks for responding.

          • SarahJ89

            “I don’t try to create guilt.” Baloney. Couching it in terms of “choosing life” when you make it clear whose “life” you believe another sentient human being should choose is precisely guilt tripping.

          • NewMexicoRam

            Sorry, but your opinion is yours, and has nothing in common with millions of other women out there. I hope and pray that someday you can understand that the unborn is not a blob, but life that deserves protection.

    • guest

      Dude, way to step into a minefield. I’m going to run for cover.

  • gyrfalcon

    Given that this quite obviously has nothing to do with Medicare or the federal government, I fail to see the connection.

    • QQQ

      Listen to the video and it helps the quote on how the doctor loses control like what Dr. Gunter is seeing on her practice!

  • NewMexicoRam

    I am “against the right to choose”, in your opinion. And in my opinion, you are “against the right to life.” But, nowhere in my reply above did I say I was against compelling the man involved from supporting the woman and child. I strongly support laws that require such support, up until the child is 18. So, if I am the only “pro-life” person who supports such actions, there you go. You now know of at least one who supports your idea,

    • SarahJ89

      Mr. Ram,
      As a former fetus, I totally RESENT your having the gall to speak for me. You have NO idea what goes on in the lives of others. I have a happy life now, but I will not live long enough to make what I went through as a child and most of my adult life–decades of repairing the damage–worth it.
      There is simply no question my parents should never have had children. You have NO right to “choose life” for my fetal self.

      To be blunt, I would have been far better off had my mother aborted my fetal self. .

      I repeat, you have no right whatsoever to choose the life for a fetus. None. Nothing annoys me more than that level of arrogant ignorance. You have your life, be grateful and stay out of the lives of strangers about whom you know nothing.

      • NewMexicoRam

        Sorry you can’t reply to the REAL point of the argument. YOU tried to put “words in my mouth” or ASSUME what my position is. I pointed out YOU were wrong to assume that. Then you put up a straw man argument.
        To take such a position about life as you do is very, very sad indeed. God help us all.

        • SarahJ89

          Really? You presume to speak for a fetus and accuse someone who calls you on it as putting words in your mouth? Interesting logic.

          • NewMexicoRam

            Another straw man. You were making a point about how those who are against the “right to choose” never seem to want to make the man involved responsible. I replied to that in a way you seemed not to make any sense of. So you responded with a straw man argument. Consider this advice: When making argument, stick to the argument and don’t go on bunny trails.
            By the way, someone needs to speak for the fetus. Just like someone needs to speak up for those who are unjustly treated all over the world. I’m thinking currently of women in Muslim nations who are mistreated in horrible fashion. There’s a movie out about that. I’d encourage you to see it.

          • EmilyAnon

            NMR, may I ask your gender, and if you are guided by religion? Also, what is the name of the movie?

          • NewMexicoRam

            “Honor Diaries”

          • guest

            I saw a preview of that movie. I cannot remember the name, but the preview was brutal stuff. I cannot imagine watching the whole thing.

          • SarahJ89

            You have no right to speak for any fetus but your own. None.

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