Dec. 20, 2019 (ACP) – State legislators in Ohio are threatening to add a third entity to the patient-physician partnership: the government. The American College of Physicians, which has long advocated against interference in the patient-physician relationship, is opposed to a flawed and dangerous bill that would order physicians to re-implant ectopic pregnancies even though it is clinically impossible.
The bill would endanger pregnant women and subject physicians to prosecution if they provide the standard of care instead of following the mandate of an inappropriate and hazardous law.
“Ectopic pregnancies can be life-threatening and traumatic for patients. Re-implanting an embryo into a woman's uterus would be a medically impossible procedure and could harm the patient,” said Dr. Robert McLean, president of ACP. “ACP stands behind its long-standing policy position that the patient-physician relationship, including access to reproductive health care services, should in no way be restricted by a government body.”
The proposed legislation, known as Ohio House Bill 413, was introduced in November 2019. According to the Associated Press, under the proposed bill, a physician who terminates a pregnancy could face murder charges unless it is done to save a woman's life. Under the proposed bill, physicians could be prosecuted unless they do whatever they can to preserve the pregnancy, including re-implanting an ectopic pregnancy into a woman's uterus.
The New York Times quoted Dr. Daniel Grossman, a professor of obstetrics and gynecology at the University of California, San Francisco, who said, “We have no evidence that an ectopic pregnancy may be transplanted into the uterus and continue to develop normally. The process of implantation is complex … It's not yet possible to disrupt an implanted pregnancy and transplant it from one location to another.”
Dr. Craig D. Nielsen, governor of the Ohio Chapter of ACP, said, “It seems unwise and dangerous to legislate for a theoretical, non-evidenced procedure that is not recommended by any medical society and could put our patients in harm's way. This is not a legislative road we should travel down.”
ACP strongly rejects interference in the patient-physician relationship. McLean highlighted a 2018 ACP position paper titled, “Women's Health Policy in the United States,” which calls for women to have access to comprehensive reproductive health services. “This policy paper stresses the importance of respecting patient autonomy on matters affecting patients' individual health and reproductive decision-making rights,” he said, “including about types of contraceptive methods they use and whether or not to continue a pregnancy as defined by existing constitutional law.”
The new proposed law in Ohio does more than address ectopic pregnancies. According to The New York Times, legislators are considering whether to ban “nearly all abortions from the time of conception, with no exceptions for rape or incest, and the highly unusual step of allowing women who have abortions to be prosecuted for murder.”
“As a physician, I am deeply concerned that the legislation introduced in Ohio may interfere with providing women with medically optimal care,” McLean said in an ACP statement. “ACP opposes government restrictions that would challenge a woman's right to continue or discontinue a pregnancy.”
The 2018 ACP position paper “Women's Health Policy in the United States” is available on the Annals of Internal Medicine website.
Back to the December 20, 2019 issue of ACP Advocate