Abortion Informed Consent

So what if a doctor specializes in abortions, infertility, etc.? I don’t see how the specialty matters. The person is still a doctor. Back to the original topic!!!

Why wouldn’t it be held to the same standard as any other medical procedure?

Laws like the one passed in Texas actually hold abortion to a far higher standard than any other medical procedure I can think of. I don’t have to show a patient chest x-rays and CT scans of a pneumothorax and then wait 24 hours before I put in a subclavian line.

I don’t have a problem with that, in general–an elective termination is, of course, elective, and there is so much misinformation and the issue is so emotionally charged that I can understand the desire for specific information and time to consider it. The problem is when the “information” is designed solely to emotionally influence the patient against the procedure, as in the color pictures required by the Texas bill, or when the aforementioned misinformation is actually required by the law, as in the new Texas requirement to inform women of the link between abortion and breast cancer (which doesn’t exist).

Dr. J

Aside from paying to appear in searches for “abortionist,” they certainly don’t seem to be fond of referring to themselves that way.

Of course they don’t, that’s not the point.

The point is that the word “abortionist” is not a medical term.

It is simply imflammatory rhetoric to call the clinic doctors “abortionists.” It doesn’t advance the dialog any more than calling the protestors on the sidewalk “screeching stalkers.” This forum, General Questions, is generally limited to civil discourse. That’s my point.

Oh?

http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=abortionist

http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=abortionist&action=Search+OMD

Yes, the word is found in dictionaries. That doesn’t mean that you’ll see someone listed as one by a hospital or other medical setting, which is what your claim of “Um, Joe, there ARE some doctors who do nothing but abortions. They’re called abortionists…” seems to hint at.

Probably not, Ferret. Everyone tends to put themselves in the best light possible, I’m sure abortion providers are no different in that regard. Anything with “ist” on the end isn’t as “pretty” as another term they could think up.

Kinda like people who go to jail for blowing up a clinic or murder doctors who do abortions are often portrayed as martyrs rather than terrorists and murderers.

We’re not going to have this argument.

For purpose of General Questions, absent specific evidence presented to the contrary,

  1. There are Ob/Gyns whose practice consists largely or entirely of performing abortions.

  2. The GQ term for such a person is “Ob/Gyn specializing in abortions,” “obstetrician” or “gynecologist.”

Back to the OP.

Major Kong, the reason you don’t “seem to find anything that says abortion is already held to the same standard of informed consent as other medical procedures in Texas”, is that if there is such a written standard at all, it would apply to all medical procedures without singling about abortion.

The newly passed law discussed in your link now assures that abotion is held to a completely different standard of informed consent than any other medical procedure.

I would be willing to learn the specifics of the abortion procedure to the point of being able to perform it, without bothering to learn the rest of what I’d need to know to be a medical doctor. That way I could help with the shortfall of abortion providers. I could travel through non-metropolitan areas of various states and help out, you know?

Well, that’s illegal. They won’t let me do that. The law says it’s a medical procedure and must be performed by a doctor.

And doctors are held to fairly uniform standards regarding informed consent and surgical procedures.

So I guess the answer is “As long as abortions remain legal, so that they are performed by licensed doctors and not politically motivated half-trained volunteers like AHunter3, the people who perform abortions are held to the same standards as other doctors performing other surgeries and related procedures.”

Since this seems to have become a discussion of Texas law on informed consent and abortion, allow me to provide some relevant legal considerations.

Texas does indeed provide a generally-applicable cause of action for the tort of informed consent. The elements of such a claim are (1) a doctor-patient relationship, (2) the doctor did not inform the pliantiff of a risk associated with the medical treatment of surgical procedure, (3) the plaintiff developed the undisclosed risk, (4) the plaintiff’s development of the risk was proximately caused by the physician. See Tex. Rev. Civ. Stat. art. 4590i, § 6.02; Marks-Brown v. Rogg, 928 S.W.2d 304 (Tex. App.–Houston [14th Dist.] 1996, writ denied).

The Medical Malpractice Liability and Insurance Act also provides for a Medical Disclosure Panel, under the auspices of the Texas Department of Health. The Panel is tasked with identifying “all medical treatments and surgical procedures in which physicians and health care providers may be involved in order to determine which of those treatments and procedures do and do not require disclosure of the risks and hazards to the patient or person authorized to consent for the patient.” Art. 4590i, § 6.04. The Panel then draws up lists of treatments and procedures and the disclosures that are or are not required to be made for each in order to meet the requirements of informed consent. Those lists are published at 25 Tex. Admin. Code § 601.1 et seq. If a treatment or procedure is not on the list, the physician’s duty is to disclose all risks that could influence a reasonable person in making a decision to consent to the treatment or procedure.

The Panel’s list of procedures and treatments in the Administrative Code includes the following, which looks to me like your standard abortion:

If an abortion provider does not give written disclosure of those risks (for that specific procedure) to the patient, and the patient subsequently suffers from one of the undisclosed risks as a result of the procedure or treatment, the doctor had better hope his malpractice insurance is paid up.

Importantly, if the physician warns of the risks required by the Panel’s list, that creates a rebuttable presumption that the physician has complied with the requirements of informed consent. In other words, if the procedure is on the list but a particular risk is not included on the list, there is a presumption that the doctor has not been negligent in failing to disclose the asserted risk. Art. 4590i, § 6.07.

What’s new in all this is a bill that was just passed by the Legislature, but not yet signed or vetoed by the governor (anti-abortion, Republican, Aggie). House Bill 15 establishes all kinds of new requirements for informed consent to an abortion (and “abortion” is defined very, very broadly, possibly even including morning-after pills). Among the specific things (I will not dignify them by calling them “risks”) that must be disclosed are, “when medically accurate” (which may be a way out when the disclosures are medically baseless):

This is quite different from the disclosures contemplated by the Medical Disclosure Panel, which are not required to be given before the physician performs a treatment or procedure–it just establishes rebuttable malpractice standards. H.B. 15 would flatly prohibit a physician from performing an abortion without making those “disclosures,” under penalty of criminal sanctions.

Not to mention that the breast cancer thing in (iii) is complete bullshit, but that’s a subject worthy of another thread altogether.

If the governor signs the bill, as I expect he will, it will apply to all abortions performed on or after January 1, 2004. A legal challenge is certain, though I hesitate to predict the outcome.