Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

We allow the legal system to contaminate evidence based guidelines

Jennifer Gunter, MD
Physician
July 8, 2013
Share
Tweet
Share

The American Congress of Obstetricians and Gynecologists (ACOG) issued a recently regarding legislative interference and health care decisions. Specifically, the release states that: “Government should not interfere with the patient-physician relationship without a substantial public health justification.”

The full Statement of Policy was approved by ACOG’s Executive Board. Some recent examples of government interference include mandatory age requirements for Plan B, transvaginal ultrasounds before abortion, prohibiting doctors from asking about firearms, and laws that force doctors to lie to women about a link between suicide, breast cancer, and abortion. These laws are in direct violation of evidence based medicine and are therefore, quite simply, public health hazards. Yes, mandated public health hazards.

According to ACOG President Jeanne A. Conry, MD, PhD, “Given the relentless legislative assault on the patient-physician relationship that we’ve seen in the past few years—and unfortunately continue to see—we were compelled to issue a formal Statement of Policy.”

“We are speaking out not just on behalf of ob-gyns, but for all physicians and patients,” said Dr. Conry. “Many of these laws are dangerous to patients’ health and safety. As physicians, we are obligated to offer the best evidence-based care to our patients. Government should stay out of imposing its political agenda on medical practice.”

But legislative interference is not limited to reproductive health as now we see parents suing about age discrimination and lung transplants. These recent cases involve two children in desperate need of lungs and parents who are beyond desperate. I’ve lost a child and have a son with severe lung disease who has been in and out of the intensive care unit multiple times so I know a little about that kind of visceral desperation. My heart aches for these families.

A judge agreed has already intervened in the first case ordering that then 10-year-old girl (in the first suit) be placed on the adult list.

But here’s the thing. I’m fairly well-educated person from a medical standpoint, but I don’t know the first thing about how to allocate organs. I know there is a complicated matching process that involves blood type, antigens, a severity score, organ size and probably hundreds of other factors that I can’t know and frankly a judge can’t either. That’s why doctors do fellowships in transplant medicine. It’s very, very complex.

And then what if doctors follow the variety of rulings that are likely to be handed down? (because when one lawsuit is successful, more will follow). In one court a judge might rule one way and in another court the exact opposite might happen. How is that good medicine?

I don’t fault the parents for trying. Not at all. And maybe organ allocation for children does need to be addressed. Raising public awareness to assess the situation is only a good thing, because if guidelines are truly robust they can handle the scrutiny. However, that scrutiny should come from educated peers, not a judge. Deciding who gets an organ must be evidence based (like all medicine) although there is evidence that some who are more connected or with more money may manage to work the system to get to the top of the list and I’d love to see legislation against that type of maneuvering.

When we allow the legal system to contaminate evidence based guidelines we get bad medicine. That is fact. In five states doctors must lie to women about a link between abortion and an increase risk of breast cancer. The growing number of ill-conceived reproductive laws (and now firearm laws) in this country already tell us that the legal system is incapable of interpreting medical literature or listening to guidelines from medical societies.

Just think of the Pandora’s box that government interference opens when every well thought out medical guideline can be tossed aside or suspended by a judge or a politician whose last biology course was 20 or more years ago.

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

Prev

Declining board exam pass rates: Blame millennial doctors?

July 8, 2013 Kevin 21
…
Next

How Katie Couric continues to influence the colonoscopy debate

July 8, 2013 Kevin 8
…

ADVERTISEMENT

Tagged as: OB/GYN

Post navigation

< Previous Post
Declining board exam pass rates: Blame millennial doctors?
Next Post >
How Katie Couric continues to influence the colonoscopy debate

ADVERTISEMENT

More by Jennifer Gunter, MD

  • The Ellen Show broadcasts potentially harmful information about ovarian cancer screening

    Jennifer Gunter, MD
  • Dear science: an appreciation

    Jennifer Gunter, MD
  • Are there too many female OB/GYNs?

    Jennifer Gunter, MD

More in Physician

  • Demedicalize dying: Why end-of-life care needs a spiritual reset

    Kevin Haselhorst, MD
  • Physician due process: Surviving the court of public opinion

    Muhamad Aly Rifai, MD
  • Spaced repetition in medicine: Why current apps fail clinicians

    Dr. Sunakshi Bhatia
  • When diagnosis becomes closure: the harm of stopping too soon

    Ann Lebeck, MD
  • From flight surgeon to investor: a doctor’s guide to financial freedom

    David B. Mandell, JD, MBA
  • The surgical safety checklist: Why silence is the real enemy

    Brooke Buckley, MD, MBA
  • Most Popular

  • Past Week

    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • My wife’s story: How DEA and CDC guidelines destroyed our golden years

      Monty Goddard & Richard A. Lawhern, PhD | Conditions
    • The gastroenterologist shortage: Why supply is falling behind demand

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • Alex Pretti’s death: Why politics belongs in emergency medicine

      Marilyn McCullum, RN | Conditions
    • U.S. opioid policy history: How politics replaced science in pain care

      Richard A. Lawhern, PhD & Stephen E. Nadeau, MD | Meds
  • Past 6 Months

    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
  • Recent Posts

    • AI censorship threatens the lifeline of caregiver support [PODCAST]

      The Podcast by KevinMD | Podcast
    • Demedicalize dying: Why end-of-life care needs a spiritual reset

      Kevin Haselhorst, MD | Physician
    • Physician due process: Surviving the court of public opinion

      Muhamad Aly Rifai, MD | Physician
    • Spaced repetition in medicine: Why current apps fail clinicians

      Dr. Sunakshi Bhatia | Physician
    • When the doctor becomes the patient: a breast cancer diagnosis

      Sue Hwang, MD | Conditions
    • My journey with fibroids and hysterectomy: a patient’s perspective

      Sonya Linda Bynum | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • My wife’s story: How DEA and CDC guidelines destroyed our golden years

      Monty Goddard & Richard A. Lawhern, PhD | Conditions
    • The gastroenterologist shortage: Why supply is falling behind demand

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • Alex Pretti’s death: Why politics belongs in emergency medicine

      Marilyn McCullum, RN | Conditions
    • U.S. opioid policy history: How politics replaced science in pain care

      Richard A. Lawhern, PhD & Stephen E. Nadeau, MD | Meds
  • Past 6 Months

    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
  • Recent Posts

    • AI censorship threatens the lifeline of caregiver support [PODCAST]

      The Podcast by KevinMD | Podcast
    • Demedicalize dying: Why end-of-life care needs a spiritual reset

      Kevin Haselhorst, MD | Physician
    • Physician due process: Surviving the court of public opinion

      Muhamad Aly Rifai, MD | Physician
    • Spaced repetition in medicine: Why current apps fail clinicians

      Dr. Sunakshi Bhatia | Physician
    • When the doctor becomes the patient: a breast cancer diagnosis

      Sue Hwang, MD | Conditions
    • My journey with fibroids and hysterectomy: a patient’s perspective

      Sonya Linda Bynum | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

We allow the legal system to contaminate evidence based guidelines
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...