Should it pass, Gov. Brownback is set to sign a piece of legislation that, among other things, shields doctors from malpractise suits when they withhold medical information from a pregnant woman in order to prevent an abortion. I will ignore the other absurd provisions of this bill (requiring mothers to hear the fetal heartbeat before getting an abortion, removing tax exemptions for medical providers because they provide abortions, etc.) and the fact that Gov. Brownback has publicly stated that he intends to sign the bill despite not having read it. Nay, I shall focus my attention on something in which I see no reasonable controversy.
Doctors take an oath in order to practise medicine; an oath which obliges them to act in the interests of their patient, avoid actions which would harm their patient, ensure that medical decisions are made at the patient's informed discretion whenever possible, and to give each patient the same high quality of care. This bill is a legalised desecration of the ethical responsibilities to which doctors are bound.
First, and most simply, this legislation permits doctors to restrict their patient's capacity to make informed decisions about their health. It is, in this country, a woman's right to decide whether or not to go through nine months of discomfort, to put herself in a situation which could jeopardise her health, and to either have her abdomen cut open or pass a massive, unwieldy object out of her vagina. It is her decision alone. By withholding information which would be relevant to the patient making an informed decision about whether or not to carry on her pregnancy, the doctor takes this decision into his or her own hands. This is, in itself, a grave violation of medical ethics.
By making this decision, the doctor violates his or her obligation to protect the interests of the patient as the patient sees fit. The patient could very well decide that the risks which a pregnancy poses to her health are too great and that she no longer feels comfortable continuing the pregnancy. One can see that this would be a heart-wrenching decision for the mother, but it is hers alone to make. Our courts have ruled that the father of a fetus does not have standing in preventing its termination. If the fetus' own flesh and blood does not have the authority to prevent abortion, what reason do we have to believe that a doctor should have this right?
This bill also permits doctors to violate their obligation to provide care in a fair and just manner by allowing them to treat women with a lower standard of autonomy. When becoming pregnant, a woman gives up a great deal in order to preserve her health and the health of her fetus. But she makes the choices to give those things up of her own volition, and she in no way surrenders her medical autonomy.
One may argue that the doctor could be justified in withholding information in order to protect the fetus. This argument, however, does not have logical or legal traction. When treating a pregnant woman, the patient is the mother. That is who the law recognises as an autonomous person, and that is who doctor is obligated to serve. The doctor's obligations to the fetus derive from his or her obligations to the mother's wishes that her fetus be healthy. But the doctor has no legal authority to compel the woman to come to OB/GYN appointments, to abstain from tobacco, drugs, and alcohol, or to take care of her body. If the doctor does not have the right to violate the patient's autonomy for the sake of fetal health in this manner, there is no conceivable reason why he or she should have the right to violate the patient's autonomy by mandate these actions on behalf of the fetus, there is no conceivable legal reason why he or she should have the right to do so in regards to whether or not the fetus is carried to term.
Shame on the Kansas legislature for even considering such an abominable affront to medical ethics, and shame on Gov. Brownback for blindly throwing his support behind it.
Shame on the Kansas legislature for even considering such an abominable affront to medical ethics, and shame on Gov. Brownback for blindly throwing his support behind it.
