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Wednesday, January 1, 2020

When Lawmakers Try to Play Doctor





State Representatives are elected officials who are tasked with drafting legislation.  Very few of them have been trained in medicine or practiced in a hospital or clinic, even in a part-time legislature like our state's. Unfortunately, looking across the country today it's too easy to find cases of these untrained legislators exceeding their mandate to advocate for unproven treatments, often setting dangerous precedents.

Take Ohio, for instance.  That’s where Representatives Candace Keller and Ron Hood introduced House Bill 413 to create a new felony called “abortion murder.” If passed, this measure will punish those who have or perform abortions with 15 years to life in prison and will be the most restrictive abortion law in the nation.  But that is just the beginning of a story that affects far more women than just those seeking an abortion.

Ohio sprinkled a little “fake” science into their anti-abortion legislation by allowing physicians to be charged with “abortion murder” if they provide the standard treatment to pregnant women with a life-threatening condition.  According to the bill, physicians must “take all possible steps to preserve the life of the unborn child… Such steps include, if applicable, attempting to reimplant an ectopic pregnancy into the woman’s uterus” or face criminal prosecution. 

The problem with that language is that reimplantation is pure science fiction, akin to mandating teleportation or time travel. Ohio lawmakers are not only trying to play doctors, they want to play God.

In a normal pregnancy, the fertilized egg must implant in the uterine wall, which has been specially prepared to support the growth and development of the embryo.  When the fertilized egg implants somewhere outside the uterus, such as the fallopian tubes, it is known as an ectopic pregnancy.  1-2% of all pregnancies are ectopic and account for 3-4% of pregnancy-related deaths.  In fact, ectopic pregnancies are “the leading cause of pregnancy-related death during the first trimester.” To save the life of the mother, the ectopic tissue must be removed.
 
An ectopic pregnancy cannot be relocated like a potted plant. 

In response to Ohio’s physician criminalization efforts, the American College of Obstetrics and Gynecology, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Psychiatric Association released a joint statement opposing “efforts in state legislatures across the United States that inappropriately interfere with the patient-physician relationship, unnecessarily regulate the evidence-based practice of medicine and in some cases, even criminalize physicians who deliver safe, legal and necessary medical care.”

Lawmakers got the hairbrained idea from a century-old case report published in the journal Surgery, Gynecology and Obstetrics, by C.J. Wallace. The author claimed to have successfully transplanted an ectopic pregnancy from a woman’s fallopian tube to her uterus in 1917.  A more recent case report was written by a British physician who was later fired for falsifying the data he used.  Case reports are not subject to the same rigorous scientific standards as most academic papers, but gullible Ohio lawmakers on their crusade aren’t looking for facts.

Instead, legislators are using propaganda—in the form of “fake” science—to remove protections for vulnerable pregnant women under the guise of saving unborn children who cannot be saved. It is reprehensible that these lawmakers are increasing barriers to life-saving care for women during a time in this country when maternal morbidity and mortality rates are skyrocketing.  Women facing an ectopic pregnancy need more than the involvement of their local elected official to save their lives.  Without intervention by a properly-trained physician, women could die.

Representative and bill co-sponsor John Becker, acknowledges that the law is more “wishful thinking for the future treatment,” than it is a reality.  He forgets the fact that many ectopic pregnancies happen to women who desired to be pregnant.  Circulating misinformation through this bill gives women false hope, which is cruel to those grieving a pregnancy loss.  In addition, women may feel guilty or their misinformed partners might blame them for not risking their lives in the quest for “reimplantation.” The premise of reimplantation is so farfetched that one has to wonder if Ohio lawmakers paid attention during human growth and development class in the 5th grade at all. 

As strict anti-abortion laws sweep the country, I am afraid of a future where medical decision-making prioritizes the moral compass of the political party in power instead of evaluating the scientific evidence.  Representative Keller comments that “the time for regulating evil [abortion] and compromise is over,” but to me, this legislation is practically sanctioning manslaughter.  It is dangerous and irresponsible for lawmakers to enforce the use of a medical treatment that does not exist.  The ethical standards and practice of medicine should not be at the whim of politicians.  Ohio should be ashamed of the fact they are risking the lives of women everywhere.