State laws around the country are intruding into exam rooms and jeopardizing the quality of medical care available to patients in a number of areas — from treatment for toxic chemical exposures to gun violence prevention to women’s reproductive health — according to a report released today by an unprecedented coalition of environmental, gun safety, medical and women’s health organizations.
The new report, Politics in the Exam Room: A Growing Threat, results from a historic collaboration between organizations focused on diverse issues: the National Partnership for Women & Families, National Physicians Alliance (NPA), Natural Resources Defense Council (NRDC) and the Law Center to Prevent Gun Violence. Each organization analyzes the ways in which politics are interfering with the professional and ethical standards of health care in their respective areas of expertise. Each organization authored the section related to its subject matter expertise and is responsible solely for that section.
At this time when politicians across the country are increasingly “playing doctor,” it concludes that patients suffer when lawmakers mandate how medicine is practiced and interfere in the relationships between patients and their health care providers. “As state restrictions proliferate, so will the number of people affected,” the new report cautions.
This stark warning is based on:
- The Natural Resources Defense Council’s analysis of state laws, influenced by the oil and gas industry, that interfere with the identification and treatment of people exposed to toxic chemicals used in fracking.
- The National Partnership for Women & Families’ examination of state laws that require health care providers to give patients misinformation about abortion care, mandate unnecessary medical procedures or delay time-sensitive health care.
- The Law Center to Prevent Gun Violence’s review of state laws that gag or threaten to ban informational conversations about gun safety from exam rooms.
- And the National Physicians Alliance’s insight into the unique challenges these laws present for health care providers.
“Quality health care must be based on evidence,” said National Partnership President Debra L. Ness. “Laws that put the words of politicians into the mouths of health care providers or mandate medically unnecessary procedures are outrageous and costly in every way. States have adopted more than 280 abortion restrictions since 2010. This kind of ideological encroachment on medical care must end. Women deserve ready access to high-quality, evidence-based health care, free of politics and ideology. It’s past time that politicians exit the exam room.”
Among the state laws the report describes:
- A Florida law, enacted in 2011, that subjects health care providers, including pediatricians, to disciplinary action for inquiring about whether a patient owns a gun and if it is secured out of reach of children.
- A Texas law that forces health care providers to administer ultrasounds to patients seeking abortion care, display the image and give patients a pre-scripted description of it, even if the patient objects.
- A Pennsylvania law that forces health care providers to choose between risking a lawsuit by violating a required confidentiality agreement drafted by fracking companies to protect their trade secrets, or violating their duties to patients in ways that may expose them to medical malpractice claims.
“Corporate secrets should not trump people’s health,” said NRDC senior scientist Miriam Rotkin-Ellman. “Doctors and patients must have the right to know about toxic chemicals that may be making people sick. When the oil and gas industry — and their supporters in high places — are allowed to play politics with medical treatment, there are serious consequences. With fracking impacting more and more Americans, we need our decision-makers to start prioritizing people’s health over the interests of a dangerous industry.”
“Despite the serious danger guns pose, state legislators are suppressing dialogue between patients and health care providers on gun safety,” said Law Center Executive Director Robyn Thomas. “In addition to the Florida law, gag rules have been enacted in Minnesota, Missouri and Montana, and legislators in other states are considering similar measures. More than 100,000 people are shot every year in America. It’s a deadly mistake to forbid health care providers from talking to patients about gun safety, and the Law Center is proud to partner with the National Partnership for Women & Families, the National Physicians Alliance and the Natural Resources Defense Council to highlight the very real dangers of limiting doctors’ speech.”
Politics in the Exam Room recommends that policymakers reject or repeal proposals that interfere in the patient-provider relationship or force providers to violate accepted, evidence-based medical practices and ethical standards; the medical community, patients and advocates speak out against such measures; and lawmakers take steps to protect the patient-provider relationship, including by ensuring that providers can speak freely and honestly with patients and by securing patients’ ability to receive the information they need so they can help direct the course of their own care.
“The patient-provider relationship should always be grounded in trust,” said Dr. Jean Silver-Isenstadt, executive director of the NPA. “States are passing laws that put providers in the impossible position of having to choose between adhering to their professional and ethical standards or abiding by restrictions that are driven by political ideology. When laws and regulations make it impossible to follow widely accepted medical standards, something is terribly wrong. We must never threaten providers with jail for following medical ethics and providing their patients with high-quality care.