The Ongoing Battle to Get Politicians Out of My Exam Room

This article was written by Kimberly Mohabir on September 16, 2021. Find original posting on: https://www.plannedparenthoodaction.org/blog/the-ongoing-battle-to-get-politicians-out-of-my-exam-room

I am a board-certified family medicine physician who has been working with Planned Parenthood Federation of America as part of a fellowship focused on sexual and reproductive health policy. Patients come to me with certain expectations — importantly truth, empathy, and help.

“The relationship between a patient and a physicians based on trust, which gives rise to physicians’ ethical responsibility to place patients’ welfare above the physician’s own self-interest,”1 according to the American Medical Association (AMA),

Trust is under greater strain than ever as states continue to pass the harshest abortion bans and restrictions since Roe v. Wade. Health care conversations are no longer one-on-one between a patient and a trusted provider. The government has become an intrusive third party interfering in the relationship — intentionally eroding patient trust and our responsibility as providers to inform and deliver the highest standard of care.

I am unnerved by the relentless efforts of state lawmakers to pass harmful legislation to control our patients’ reproductive health decisions. Once and for all, it is incumbent upon providers, policymakers and advocates to affirm every individual’s right to full reproductive freedom and bodily autonomy and fight vigorously against any and all attempts by the government to restrict the ability of our patients to decide when and if they are ready to grow their families.

Abortion is a human right.  It’s time our government upholds, protects and defends that right — and our ability as providers to honor our oaths to truth, empathy and help.

Truth

It takes four years of undergraduate school, followed by four years of medical school and up to seven years of residency to become a medical doctor. This education is necessary to ensure patients get the most accurate and effective medical care from a provider they can trust. . While abortion is among one of the safest medical procedures, in some states some providers are forced to counsel patients on disproven falsehoods, such as risks of breast cancer and mental illness, fetal pain, and infertility. Telling patients the truth in all circumstances, even when it contradicts with one’s own personal beliefs, is essential and foundational to building and maintaining trust in relationships with patients. No patient should ever have to piece together which information is correct, and no doctor should be forced to violate oaths and knowingly misguide patients with dishonest information.

Empathy

Patients come from all walks of life and from various backgrounds: 75% of patients in need of abortion have low incomes; many are already parents and worry that another child could threaten their family’s financial security. Some are survivors of sexual assault, and seek an abortion for a pregnancy that would force them to re-live an event they are working to overcome. Others seek an abortion simply because they have decided it’s just not the right time for them to grow their families. All of these reasons are valid, and no one has the right to intrude on this deeply personal decision. When someone considering abortion comes to me, my job is to listen without judgment and deliver care. Forcing providers to communicate to our patients that they will have to continue with their pregnancies or take unnecessary steps to get an abortion based on a politician’s moral beliefs is deeply unethical and violates the pledge to practice empathy for all patients regardless of circumstance. Further, the Turnaway Study — a research project that examined the short and longterm physical and emotional impact of individuals being denied access to abortion care — found that being denied an abortion can have a significant health toll on the individual and their families. Indeed, individuals denied access to abortion and forced to continue with their pregnancies are more likely to experience depression, severe pregnancy complications, and are more likely to stay with abusive partners. Studies show children are also affected by their parent’s inability to access an abortion, and are more likely to live in financially insecure households and have delayed childhood development. Practicing empathy as a provider, put simply, means doing no harm. When providers are forced to harm patients by denying them abortions, it can affect mothers, families, and the communities we serve.

Help

When I am asked why I went into medicine, my reflex response is “I wanted to help people.” But there’s more to it. I believe patients are more than their diagnoses. The goal of a physician is to help the patient get to their individual medical goals.

Let’s look at a real-life example. A young woman wants to know what is causing her painful and heavy periods. After careful and thorough examination and tests, I discover she has uterine fibroids. I discuss with her that there are medications to help with her symptoms, but she is not interested in starting these medications; her goal was simply to find out what was happening in her body and we have accomplished that.

Coercing patients into a treatment option they are not interested in pursuing is not only unhelpful; it’s unethical. Aside from severe extenuating circumstances, patients have the right to opt in or opt out of medical care. This same patient ultimately decided to have her fibroids surgically removed. Accordingly, I referred her to a surgical gynecologist who was licensed and skilled to remove her fibroids.

It is our duty as providers to center the patients’ health care needs and decisions and communicate all of their treatment options with medically accurate information. We are not to coerce and deter patients from seeking the care they decide best meets their needs — but many of us are being forced to do exactly that by lawmakers who oppose abortion.

As I go through residency at George Washington University, I remember the oath I made when I first decided to go to medical school. An oath to do no harm, to give only true and accurate information, to center the patient, and always have empathy. In medical school, we are taught that the doctor-patient relationship is a sacred bond and that above all else, must be protected in medicine.

In order to protect trust in the medical system, irrational restrictions that have no basis in evidence must be fought. Doctors must not be forced by anti-reproductive health legislators to manipulate patients. I am disgusted by the deliberate interference that many state governments are imposing between doctors and their patients. The only people that can decide the best course of medical action are the patient and the medical provider. To fight this interference and protect the sanctity of the doctor-patient relationship, I urge you to contact your member of Congress to pass the Women’s Health Protection Act, which would protect, defend, and expand abortion rights for all people regardless of the state they live in — and protect the rights of providers to give the most accurate information to patients and deliver only the highest standards of care. It’s time the government gets out of our exam rooms once and for all.