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Speak Out Rheum: To Prescribe Is Humane (Unless You’re In Texas)

Raymond Scalettar, MD, DSc  |  Issue: November 2022  |  November 7, 2022

The prosecution, citing the National Academy of Medicine’s controversial and flawed report To Err Is Human, proclaims that you are part of the problem with the medical establishment and that your treatment of the patient is a criminal offense in Texas.22

As you await the court’s judgment and contemplate your future, you ask yourself why anyone would want to go to medical school or apply for residency in a state like this.

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Residency review committees have already documented deficiencies in training in states with injunctions on providing training on such fundamental procedures as dilatation and curettage.

Why would any practitioner want to remain in a state with antediluvian laws that compel the practice of bad medicine at the patient’s expense over supporting best practices of the medical profession? If you want to practice good medicine, why not head to enlightened states and leave ones like Texas to become medical wastelands?

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Finally, you ask when will your colleagues come together across the medical spectrum and exclaim, “We are mad as hell, and we aren’t going to take it anymore!” and then take action?23

Wake Up!

Suddenly, you open your eyes. You’re in bed and in a cold sweat. You shudder, glance furtively around and whisper, “That sure was a scary nightmare!”

Or was it?24


Raymond Scalettar, MD, DSc, MACR, is clinical professor of medicine emeritus, the George Washington University School of Medicine and Health Sciences, Washington, D.C.

References

  1. Sammaritano LR, Bermas BL, Chakravarty EE, et al. 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Rheumatol. 2020 Apr;72(4):529–556.
  2. Teal S, Edelman A. Contraception selection, effectiveness, and adverse effects. JAMA. 2021 Dec 28;326(24):2507–2518.
  3. Cahan E. Lawsuits, reimbursement, and liability insurance—Facing the realities of a post-Roe era. JAMA. 2022 Aug 9;328(6):515–517.
  4. Creinen M, Vittinghoff E. Methotrexate and misoprostol vs misoprostol alone for early abortion. A randomized controlled trial. JAMA. 1994 Oct 19; 1994 Oct 19;272(15):1190–1195.
  5. Cauterucci C. Abortion bans are already messing up access to other vital meds. Slate. 2022 May 24.
  6. Burky A. Backlash against CVS, Walgreens raises questions about role of retail in post-Dobbs world. Fierce Healthcare. 2022 Sep 1.
  7. Feibel C. Pharmacies may violate civil rights if they refuse meds linked to abortion, feds warn. NPR. 2022 Jul 13.
  8. Shepherd K, Stead Sellers F. Abortion bans complicate access to drugs for cancer, arthritis, even ulcers. The Washington Post. 2022 Aug 8.
  9. Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization. (597 U.S. __) (2022). https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf.
  10. 42 U.S. Code § 1395dd (Examination and treatment for emergency medical conditions and women in labor). https://www.law.cornell.edu/uscode/text/42/1395dd.
  11. Centers for Medicare & Medicaid Services. Emergency Medical Treatment & Labor Act (EMTALA). 2022 Aug 25. https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA.
  12. Whelan E. Federal court enjoins HHS EMTALA guidance on abortions in Texas. National Review. 2022 Aug 24.
  13. Woman’s Right to Know Act, Texas Stat. § 170A.002 (2003 & rev. 2022). https://statutes.capitol.texas.gov/Docs/HS/htm/HS.170A.htm.
  14. ACOG, AMA, et al. Brief of amici curiae in support of respondents (No. 19-1392; Dobbs et al. v Jackson Women’s Health Organization et al.). 2021 Sep 20.
  15. Seo P. Set up to fail: The criminalization of clinical practice. The Rheumatologist. 2022 May 12.
  16. 104th Congress Public Law 191. Health Insurance Portability and Accountability Act of 1996. https://www.govinfo.gov/content/pkg/PLAW-104publ191/html/PLAW-104publ191.htm.
  17. U.S. Department of Health & Human Services. Guidance to nation’s retail pharmacies: Obligations under federal civil rights laws to ensure access to comprehensive reproductive health care services. Office for Civil Rights. 2022 Jul 14. https://www.hhs.gov/civil-rights/for-individuals/special-topics/reproductivehealthcare/pharmacies-guidance/index.html.
  18. Radley DC, Baumgartner JC, Collins SR. 2022 scorecard on state health system performance. The Commonwealth Fund. 2022 Jun 16. https://www.commonwealthfund.org/publications/scorecard/2022/jun/2022-scorecard-state-health-system-performance.
  19. Clarida K. 2021 kids count data book: Texas children deserve better. Every Texan. 2021 Jun 21. https://everytexan.org/2021/06/21/2021-kids-count-data-book-texas-children-deserve-better.
  20. Ziegler M. The next step in the anti-abortion playbook is becoming clear. The New York Times. 2022 Aug 31. https://www.nytimes.com/2022/08/31/opinion/abortion-fetal-personhood.html.
  21. Tillman J. A dying woman’s forced C-section launched a fight over fetal rights. The Washington Post. 2022 Aug 21. https://www.washingtonpost.com/history/2022/08/21/angela-carder-fetal-rights-cancer.
  22. National Academy of Sciences. To err is human: Building a safer health system. Institute of Medicine (US) Committee on Quality of Health Care in America. 2000. https://pubmed.ncbi.nlm.nih.gov/25077248.
  23. Wynia MK. Professional civil disobedience—medical-society responsibilities after Dobbs. N Engl J Med. 2022 Sep 15;387(11):959–961.
  24. Arey W, Lerma K, Beasley A, et al. A preview of the dangerous future of abortion bans—Texas Senate Bill 8. N Engl J Med. 2022 Aug 4;387(5):388–390.

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Filed under:EthicsLegal UpdatesOpinionProfessional TopicsSpeak Out Rheum Tagged with:abortionMethotrexatepregnancySpeak Out Rheumatology

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