Despite the fact that I roll my eyes any time I hear anyone discuss law, I am going to attempt to blog about law.
This semester, my MPH cohort and I have been arguing every Tuesday in an amazing Health Law course. Our professor literally wrote the book on Health Law, and we have learned a lot of terrifying things about what we should and shouldn't do as doctors. Like give out free health advice. So, present friends - all of my present and future advice means NOTHING. I am NOT your doctor, and you should go see your real doctor if you are less than perfectly healthy. So throughout the course, all that my class of future doctors can do is groan in anguish that yet another case seems to say that even when the doctor tries to do the right thing, they are liable for their human mistakes and tough cookies, but they are going to pay the price.
Enough on law class. Now, a case. I recently researched this case for a meeting I helped host for pro-choice grad students in Boston (if you want to come to these meetings, let me know!!). The following is what I was able to decipher from the legal jargon, along with a heaping dose of my opinion, and a pinch of medical fact.
A woman from Idaho found an online physician to prescribe and send her an FDA approved pharmaceutical called RU-486, which she used to end her pregnancy (medical abortion). In the case (McCormick v. Heidman), the 9th circuit court decided that she could not be prosecuted because of limited access to abortion and her right to life and liberty (14th ammendment) up until fetal viability (24 weeks).
When patients are counseled and followed by health professionals, medical abortions are very safe. Women take mifepristone (RU-486) which blocks progesterone, causing the lining of the uterus to break down and the cervix to soften. Misoprostol completes the procedure, by causing the uterus to contract and empty. Women undergoing medical abortions experience some pain, cramping, and heavy bleeding. About 98% of the time, medical abortions successfully end the pregnancy with no complications. Few women may need a procedure to empty their uterus, very few women may need a blood transfusion, and of a whopping 1.1 million cases, only 7 have been fatal. Biggests risks: blood loss and infection.
If you know me at all, you know that I am pro-choice (and pro-life according to this great article). My issue is - if this woman got RU-486 online, how did the doctor know how far along she was, or if she was eligible for this type of abortion. This doctor is not available to help in the rare case of complication. The patient can't follow up to make sure the medication worked. There are definite ethical implications of this court decision. I am not sure if proper care can be given over the internet. Then again, if the government didn't limit women's reproductive choices and more physicians became abortion providers, these types of problems wouldn't be encountered. I am glad that the 9th circuit decided that McCormick
could not be penalized for making a decision about what was best for herself and her family. I just wish that McCormick had more options.
On that note, you can find a pro-choice voter guide here --> CLICK ME!
(And Floridians - vote no on amendment 6!)
Lis, did you ever see the Newsweek article about this case? at PP, we use mife up to 9 weeks GA, and Jennie thought she was close to 12 - not unimaginable. It turns out she was closer to 20 when the state evaluated the POC. I can't imagine how terrifying an experience this was for her, and all because her state has ridiculous laws - namely a 24 hour waiting period - and few trained health care providers. This termination should have been done in two days w laminaria and vacuum aspiration (not to mention sedatives!) and instead, this is the best we can do for women in this country who need safe abortion services - treat them like criminals. but hey, they didn't send her to prison in the end. Lucky her! It makes me so sad.
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