Doctors, Lawyers, and One Celebrity simply Gave Republicans the Abortion Education They’ve required
The House Judiciary Committee held a hearing on threats to reproductive rights Tuesday. This follows a spate of new laws restricting abortion access that have been recently passed in state legislatures emboldened by the conservative majority in the Supreme Court. For two hours, lawmakers heard from physicians and legal experts explaining the need for safe and legal access to abortion, while others from the anti-abortion movement emphasized the value of the new laws.
Dr. Yashica Robinson, an ob/gyn who provides abortion care in Alabama, spoke out against the state’s recent near-total ban on abortion, which threatens to send abortion providers to prison for 99 years. “HB 314 is blatantly unconstitutional, and would force doctors like me to choose between what is ethically, medically appropriate care, and being criminalized,” she said.
“There is no other area of medicine where we have legislation threatening physicians with criminal prosecutions for simply doing their job.” Melissa Murray, an NYU law professor and a former clerk of Supreme Court Justice Sonia Sotomayor, said that the Supreme Court has consistently upheld the constitutional right to abortion since Roe v. Wade was decided in 1973. “Despite these longstanding precedents, state legislatures have continued to test the constitution’s limits by enacting increasingly restrictive abortion laws,” Murray said. “They purport to promote and protect women’s health, but in fact, these laws are part of a larger effort to legislate abortion out of existence through piecemeal attacks.”
Murray went on the describe the ways that reduced access to reproductive rights disproportionately harms marginalized communities, who often must travel great distances for care, or who are unable to afford childcare or time off from work during mandatory waiting periods before abortion procedures. Actress and fruitful rights advocate Busy Philipps additionally testified. She spoke of the outpouring of support she received after opening up about her abortion on her late-night talk show, and she stressed the importance of removing the stigma around abortion discussions.
The panel also included two representatives from the anti-abortion movement. Christina Bennett, a pro-life advocate, and Christian minister said that when her mother was pregnant with her, she decided to go through with the pregnancy despite pressure from her father and a physician to have an abortion. Melissa Ohden, a self-proclaimed “feminist for life” said that she was the survivor of her mother’s failed attempt at an abortion. Ohden was born live after her mother received a saline abortion—a rare form of late-term abortion. “I am alive today because someone else’s reproductive right failed to end my life,” Ohden said. After Ohden’s testimony, Rep. Louie Gohmert (R-Texas) turned not to Dr. Owen Phillips, an ob/gyn and professor at the University of Tennessee Health Science Center, but to actress Busy Philipps, who was seated to her right. Gohmert asked Philipps if “somebody who has survived an abortion like Melissa Ohden” also had a right to control over her body. “Although I play a doctor on television, sir, I am actually not a physician,” Philipps replied, to laughter from the audience. Watch the entire hearing below.
Education required — for doctors and patients — to scale back inappropriate antibiotic prescriptions
The Chief Medical Officer of England recently warned that one-third of antibiotics prescribed by the National Health Service isn’t prescribed for an appropriate illness. This is a reasonable estimate for Canada and the United States as well, according to Dr.
Michael Silverman, chair of infectious diseases at Western University. Research during this space, overall, indicates that 20%–40% of antibiotics are prescribed unsuitably, which increases the risk of antimicrobial resistance. “Multi-drug-resistant organisms are something that is a major concern in Canada,” Silverman said. “They’re a major concern around the world.”
The Government of Canada sees antimicrobial resistance as a serious and growing health threat, acknowledging that a “post-antibiotic era where common infections and minor injuries are once more deadly could be a terribly real chance for the twenty-first century.” within us, a recent study found that 23% of antibiotic prescriptions filled by outpatients were inappropriate, one year were probably acceptable, and 29% were not associated with a recent diagnosis code.
A separate study found that four-hundredth of antibiotics crammed by older adults within America were probably inappropriate. Silverman has carried out similar research in Ontario. In a 2017 study of the crystal rectifier, forty-sixth of older adults received antibiotic prescriptions for nonbacterial acute higher metabolism infections. His research group is planning a similar study looking at prescription patterns in children and younger adults.
Silverman emphasized that physicians who overprescribe aren’t trying to do harm. They’re following what they believe is the standard of care. Prescription practices might depend on when and where physicians were trained. Silverman’s knowledge showed that mid and late-career physicians and physicians in United Nations agencies were trained outside of North American nations or were additional probably to inflict antibiotics for nonbacterial infections.
Research indicates that 20%–40% of antibiotics are prescribed unsuitably. Image courtesy of iStoc k / Francis black Physicians who have been in the profession for longer may have been educated at a time when there was less awareness of the potential harms of prescribing antibiotics unsuitably, in terms of resistance and patient complications. Silverman said those physicians, in the past, would have been more likely to prescribe antibiotics “to be on the safe side” in cases of diagnostic uncertainty, a practice that could still be the norm for some.
Another problem is that physicians are often pressured to write prescriptions, especially when patients are ill and desperate for something to help them feel better. “It’s a difficult thing to not write a script,” Silverman said. “It takes a lot of emotional, intellectual energy.” It also takes more time to explain to patients why they don’t need a prescription. In Silverman’s study, physicians with higher patient volumes were additionally possible to write down inappropriate prescriptions.
To help address this drawback, Choosing Wisely Canada designed “viral prescription pads” with a written explanation of why a patient wasn’t prescribed antibiotics, along with instructions to rest, drink fluids and take over-the-counter medication as suggested. Dr. Alex Singer, a family physician and clinical champion for Choosing Wisely in Manitoba, said this is a good solution because it gives patients direction and reminds them that they’ll probably feel better in a few days.
Choosing Wisely also created a “delayed prescription” for patients whose symptoms might not resolve on their own. In recent research that established a baseline for several Choosing Wisely recommendations, Singer found that 29% of the Manitoba-based providers involved in the study prescribed antibiotics to a patient with a viral infection, with prescription patterns differing between practices. “This could be a shared drawback that we want to deal with as a profession,” Singer said. Both Singer and Silverman pointed out that shortening the duration of prescriptions is another way to reduce the threat of antibiotic resistance.
A recent Britain study found that an oversized proportion of antibiotics prescribed for common infections exceeded tips for the length of treatment. Together, the patients in the study were prescribed 1.3 million days of unnecessary antibiotics. Silverman is hopeful that medical practitioner and patient education could lead to changes within the manner antibiotics are prescribed. “It’s a critical issue for the long-term sustainability of our health care system,” he said. “We need antibiotics to work for just about everything we do in health care.”
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