Tag Archives: patient privacy

healthcare, law

One brave Texas physician has already defied the new abortion ban…

The featured photo was taken at a Mexican restaurant in San Antonio, where Bill and I lived before we moved back to Germany, and where our absentee ballot votes go when it’s election time.

Abortion is probably the last thing I want to write about today. That’s why I reposted four book reviews. Trust me… this is a topic I’m getting really tired of revisiting over and over again. I feel like this issue should have been settled about fifty years ago. But it’s hot news right now, and too many people seem to think it’s right to deny women this basic right to determine what happens to their own bodies. So here I am, writing about this again…

Actually, today’s post may be a bit more upbeat than outraged. One of the first news items I read this morning was in the Washington Post. It was about San Antonio based OB-GYN Dr. Alan Braid, who wrote an op-ed about how, on September 6, 2021, he violated Texas’s new abortion ban law. A woman received an abortion from him. Although she was still in her first trimester, she was further along in the pregnancy than six weeks. According to the article:

“I understand that by providing an abortion beyond the new legal limit, I am taking a personal risk, but it’s something I believe in strongly,” Alan Braid, a San Antonio OB/GYN, said in an op-ed in The Washington Post. “I have daughters, granddaughters and nieces. I believe abortion is an essential part of health care. . . . I can’t just sit back and watch us return to 1972.”

As I read that part of the article, all I could think of was– wow… what a BRAVE man. This is a man who cares about women and women’s health. He’s put himself at great risk. I would say that not only is his career at risk, but his very life could be at risk. He practices medicine in a state where just about anyone is allowed to carry a gun, and there are many religious nuts running amok.

I had to read Dr. Braid’s op-ed for myself, so I clicked the link in the article I read about it. In his opinion piece, Dr. Braid explains that he started practicing medicine on July 1, 1972. I was eleven days old on the day Dr. Braid began taking care of women’s health. I will be 50 on my next birthday. This is a man who has been in his field for a LONG time, and has seen and done a lot.

Dr. Braid graduated from the University of Texas medical school, and during his time as a med student, he was taught that abortions are an “integral part” of women’s health care. However, when he began practicing, abortions were effectively outlawed. It was only legal for a pregnant woman to get one if a psychiatrist certified that she was suicidal. I find that limitation curious, given that some women have medical issues that would also call for terminating a pregnancy for the sake of her health.

In those days, if a woman wanted an abortion, Dr. Braid would advise her to travel to a state where abortion was legal– California, New York, or Colorado. Some would go over the border to Mexico, which incidentally just recently decriminalized abortion. That’s interesting, isn’t it? It used to be, people from Mexico would come to the United States for medical care; but now, thanks to the extremely high prices of medical care and ridiculous laws such as Texas’s S.B. 8, Mexico may soon see more American women coming into the country for medical care.

As of September 1, 2021, Dr. Braid found himself in a similar situation that he faced in 1972. A 42 year old woman came to see him. She was pregnant, though she already had four children, three of whom were under age 12. Dr. Braid told her she should go to Oklahoma, a nine hour trip one way. He even told her he could help with the funding. The woman said, “Who’s going to take care of my kids? What about my job? I can’t miss work.”

Dr. Braid wrote:

Though we never ask why someone has come to our clinic, they often tell us. They’re finishing school or they already have three children, they’re in an abusive relationship, or it’s just not time. A majority are mothers. Most are between 18 and 30. Many are struggling financially — more than half qualify for some form of financial aid from us.

Several times a month, a woman confides that she is having the abortion because she has been raped. Sometimes, she reports it to the police; more often, she doesn’t.

Texas’s new law makes no exceptions for rape or incest.

And I have noticed that Texas is also doing nothing to help pregnant women, either. I have not read or heard of any child or family friendly policies being put into place to help pregnant women get the care they need. I have not heard for a push for better sex education or making contraception widely available, easily affordable, and accessible to everyone. I have heard a lot of slut shaming, though.

Yesterday, I read another article about this new law. The focus was on Johnathan Mitchell, the main architect of this legislation that violates women’s self-determination and privacy. Mr. Mitchell is a graduate of Wheaton College in Illinois, a very conservative Christian school. I knew about it before I heard about Mitchell, since I once worked with a guy who attended there. It was back in the 1990s. I remember my co-worker was very smart, even though he was selling ice cream at Busch Gardens in Williamsburg, Virginia. He was also VERY Christian. Anyway, I digress… except to say that I know Wheaton College is a prestigious, selective school, but it’s also a school for Christians.

Mr. Mitchell wrote, in a brief for the Supreme Court:

“Women can ‘control their reproductive lives’ without access to abortion; they can do so by refraining from sexual intercourse… One can imagine a scenario in which a woman has chosen to engage in unprotected (or insufficiently protected) sexual intercourse on the assumption that an abortion will be available to her later. But when this court announces the overruling of Roe, that individual can simply change their behavior in response to the court’s decision if she no longer wants to take the risk of an unwanted pregnancy.”

Based on this comment, I’m assuming that Mitchell doesn’t believe that women can get pregnant as a result of rape and incest. I’m guessing he’s akin to Missouri Republican Todd Akin, who famously said “If it’s a legitimate rape, the female body has ways to try to shut that whole thing down.”

Did either of these two men ever take a biology class? Have either or them ever studied sex education? Sure, women sometimes get pregnant because they, or their partners, or both parties were “careless”. But not all sexual intercourse is consensual and, in spite of what these men seem to believe, sometimes women DO end up pregnant afterwards.

Aside from that, sometimes pregnancy makes women very sick. Sometimes it even threatens their lives. I don’t understand why, in the age of healthcare privacy laws such as HIPAA, a woman should have to justify her need or desire for an abortion to anyone. But I haven’t heard or seen any provisions in the new Texas law that allows for that scenario, either. Instead, the law encourages neighbors to spy on each other and file lawsuits in healthcare situations that absolutely none of their business. What makes this law even more sickening is the fact that the people might theoretically sue haven’t suffered a personal loss due to a woman’s decision to have an abortion. But, by suing, they may stand to gain a financial incentive, which seems very unethical to me.

I will admit, however, that Mr. Mitchell is certainly correct that a woman can “refrain” (I hate that word) from having sexual intercourse. And, quite frankly, it would serve the men of Texas right if women went on a sex strike and denied them that pleasure. In fact, I hope Mitchell isn’t having sex and never does again. If I were his wife, I would certainly keep my legs closed around him. He should be deeply ashamed of himself.

In another article I read about this issue, author Chavi Eve Karkowsky writes:

“Every week, I see examples of morally necessary pregnancy terminations that, under the Texas law, could put doctors in legal jeopardy. In one case, a 14-year-old with brain damage had been raped by a caregiver. In another, my diagnostic ultrasound 15 weeks into a patient’s pregnancy showed that her fetus had developed an empty space where a brain should be and would not survive more than a few hours past birth. In another case, a patient, whose heart had become weak during her previous pregnancy and had never fully recovered, sought an abortion so she could live to care for her toddler.”

Can you even imagine? Can you fathom being a woman in any of those situations? Or a doctor? It’s sickening.

I totally get that many people find abortion distasteful and morally wrong. I find it distasteful, too. It’s probably not a choice I would make for myself, but I can’t say I would never make it. Because there are situations when it really is the right thing to do. I am lucky enough to be in a situation in which I could go elsewhere for an abortion if I needed one. I am also at a point in my life at which I won’t be affected by potential pregnancies.

However, this new law does open up a Pandora’s Box that could affect other people besides women of childbearing age. Who’s to say that, based on this precedent, lawmakers don’t try to screw with people’s healthcare privacy in other areas? What if a law was designed to deny vasectomies to men? What if we incentivized private citizens into reporting on the men who want vasectomies by offering a $10,000 bounty? That’s just one example off the top of my head. The same theory could easily extend into other controversial areas… say, gender reassignment therapy, or marijuana use, or euthanasia… I’m sure I could think of more if I tried.

Anyway, my hat is off to Dr. Alan Braid. I think he’s a hero. This may be one of the most lifesaving actions he’s ever taken in his entire medical career. I know he’s a good man. I knew it when I read this comment from him:

“I have daughters, granddaughters and nieces. I believe abortion is an essential part of health care. I have spent the past 50 years treating and helping patients. I can’t just sit back and watch us return to 1972.”

What a dedicated, brave, inspirational, kind, and excellent doctor Dr. Alan Braid is. He deserves all of the respect and all of the support that is coming to him.

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Germany, silliness

Greetings from the Schwarzwald… where pan pipes are considered soothing.

Yesterday was a very busy day. We woke up early, with plans to go to Stuttgart and see our dentist. We were long overdue in seeing our dentist, Dr. B. It had been over two years, mainly due to COVID-19, and the inability to travel with ease coupled with conflicts of schedules. Originally, I had planned for us to stay in Stuttgart, but our favorite hotel was totally booked. Then I remembered how much I liked visiting The Black Forest when we still lived near it. So, even though our hotel is 100 kilometers from our dentist’s office, I booked us in a very nice resort for four nights. But we spent most of yesterday in our old stomping grounds.

I am pleased to report that I had a good checkup. Bill was not as lucky. He’s been complaining about his teeth recently and, sure enough, as the dentist was probing, one of Bill’s fillings fell out. Bill has to come back to Stuttgart next week. He’ll just take the ICE train and do a one day visit. We both got very thorough cleanings that were much needed and appreciated. My gums are a little sensitive today.

After our dentist visit, we had a hearty lunch at a steak joint. Then we met someone in my wine group who was going to be picking up corks. I collect corks from our many bottles of wine to give to the crafters among us. After chatting with the lady from the wine group, we headed back to the hotel, spent a little time at the pool, and then I hung out at the bar, while Bill talked to his therapist online. It was a little strange sitting alone in the bar. This resort is loaded with German couples and families, most of whom don’t seem to speak English. I caught the bartender glancing at me, probably wondering where Bill went.

Over the sound system, they were playing music from the 80s and 90s. We’re talking Celine Dion, All 4 One, Boys to Men, and Phil Collins. It was actually a little depressing. For one thing, those songs were all hits when I was a lot younger. As I was listening, I was reminded of my 20s, when I was younger, healthier, and probably prettier, although you’d never know it by my non-existent love life in those days. I had images in my head of going to bars and feeling invisible and broke.

Add in the fact that while this hotel is very pretty and has old school charm, it’s also a bit dated. And so, I felt almost like I was in a time warp, accented by the outfits some of the people were wearing. Not that I can talk about that myself…

This hotel also pipes annoying Muzak into the halls and restaurant. It’s basically a step up from the horrible Muzak my dad used to force me to listen to on our car trips. Bill and I were eating breakfast and “Careless Whisper” by Wham came on, only it had been softened into a soothing version of the original. And that arrangement included pan pipes!

Who in the hell wants to listen to pan pipes in an 80s song about breaking up? It reminds me of the time I heard a Muzak version of “Welcome to the Jungle” by Guns n’ Roses.

I know… I know… who pays attention to the music piped into restaurants? I do. I’m obviously not the only one. I am a frustrated musician. Every time I hear pan pipes, I’m reminded of Zamfir. He used to be on ads in 80s and 90s, selling his pan pipe versions of the day’s hit songs. It made me want to tear out my hair.

Yikes! This gives me chills.

In college, I joined Sigma Alpha Iota, which is an honorary music fraternity for women (as opposed to a sorority). Pan pipes are part of SAI’s insignia. Members have pins they wear that have pan pipes in the middle of them. I appreciated being a sister of SAI, but I’ll be damned if I will willingly listen to pan pipes by choice. I’d rather visit the dentist, as long as he doesn’t play Zamfir’s greatest hits during the exam.

As Bill and I were discussing the pan pipe infused hit song, “Careless Whisper”, originally made famous by George Michael, somehow our conversation morphed into chat about patient privacy. Germans actually have a very interesting approach to privacy. Bill was lamenting about how our dentist, who was trained in the United States and is half-American on his dad’s side, doesn’t have any qualms about talking about other people’s issues. HIPAA does not exist in Germany. So Dr. B will tell Bill about my teeth, and he will tell me about Bill’s teeth. He doesn’t bat an eye… and in fact, he speaks loudly enough that anyone in the waiting room can hear him.

But… people who commit crimes in Germany are often not publicly named. Here, there exists the right to be “forgotten”. They don’t go in for canceling people. So, if someone commits a crime, he or she can do time and then try to rejoin society. Read a newspaper about a crime and you’ll see a photo of the alleged perpetrator, face blocked by a binder and first name and last initial used instead the whole name.

Germany also has an annoying Data Privacy law, which requires Web sites to state upfront that they use cookies. Every time I hit a site in Germany, I get a pop up that tells me about cookies… and any site that doesn’t want to comply is unavailable over here without the use of a VPN.

I’m sure there’s more to the privacy law than pop up ads. A few years ago, when I was having issues with quitting Hello Fresh, I read that if I wanted to make a big stink, I could remind them of the data security law to light a fire under them. Fortunately, it didn’t come to that, although there was a lot of swearing involved with getting them to completely delete my account.

Anyway, no one screams about HIPAA here, because there is no such thing. Our dentist will happily talk about my last remaining baby tooth, which will turn 50 next year, should I live that long and it doesn’t get abscessed or anything. He’s probably told his other patients about it. Every time I see him, he mentions it. I think he said that prior to meeting me, the oldest person he had ever met with baby teeth was about 35.

Yesterday, as we were driving back to the Black Forest, we passed by our former digs… or, actually, we didn’t go by where we lived. We just passed the town, and where we used to turn to go home. It was a little surreal. We spent four years there. It was mostly a good time for us, except for dealing with our former landlady, who seemed determined to paint us as people we aren’t and make us pay for things that weren’t our responsibility. That experience kind of soured me a little… I would have preferred to have left on much better terms, as we have in almost every other living situation we’ve been in as a married couple. But I guess this kind of thing happens sometimes.

I tried to appreciate how truly beautiful the area where we lived is. It really was a naturally beautiful place. Where we are now isn’t nearly as idyllic, although it is also an attractive area. It’s just that the Black Forest is extraordinarily beautiful, even at the edges, which was where we lived. I miss being able to take off on weekends and be in the forest, where there are stunning views everywhere you look. And it’s nice to be back down here… Germany is different in this area than it is where we are now. God help me, if you were to ask me where I feel more at home in Germany, I’d have to say the Stuttgart area… as whacked out as it can be on many levels. I do love it here… and it’s great to be back. I hope we can do some more short visits. I guess if COVID keeps up, we may keep traveling within Germany.

Well… Mr. Bill has come back to the room. He’s excited, because the sun is out, and he wants to go for a walk. I suppose I owe it to myself to take a walk and exercise my old bones. It would be a good idea, since today is high falutin’ culinary day. We have reservations at two fancy restaurants today, since there are weddings tomorrow. So I’ll stop here… and try not to get too upset over the news… or pan pipes arrangements in piped in music from the 80s and 90s. The Schwarzwald is beautiful… but it probably appeals most to people of a certain age. Alas, I am reaching that age.

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healthcare, politicians

“Whatever you think is best, doctor.”

I was kind of hoping this morning I’d find something amusing to write about. My last few posts have been downers. Maybe later, once I’ve had a little more time to wake up and cheer up, I’ll find something funny about the world today. Right now, I’m compelled to write about an opinion piece I read in The New York Times.

Dr. Jen Gunter is an OB-GYN who has recently written a number of pieces about her experiences as a doctor who provides abortions. I usually like what she writes about this subject, since she is very knowledgable and reasonable. This morning, I read her piece entitled “Medical School Doesn’t Teach the ‘Woman’s Life Is In Danger’ Curriculum“. As usual, Gunter made a lot of sense. She also brought up some issues with these new abortion bills that I don’t think a lot of people have considered.

In her op-ed, Dr. Gunter wrote about a case she had in 1998. She was called in to perform an abortion on a woman who was very sick and in her first trimester of pregnancy. The woman’s condition was rapidly deteriorating and the pregnancy was making her situation worse. Although her life was not in immediate danger, her caregivers feared that if she continued her pregnancy, her condition would quickly decompensate and she would need dialysis due to kidney failure.

The problem was, this was happening in Kansas, where a new restrictive abortion law was enacted that forbade abortions from being done on state government property, unless the mother’s life was in danger. The medical center where Dr. Gunter worked was on state property. While it’s very possible to manage kidney failure on dialysis, it’s not the ideal course of action. It’s better to prevent kidney damage, which would then prevent a host of other serious medical problems that would put the patient’s life in danger. The patient was not about to die, but her condition might eventually cause death if the doctor didn’t act. On the other hand, thanks to the law, if Dr. Gunter made the “wrong” decision, she could be fired or wind up in legal trouble. She could even be arrested, which would be a real problem, since malpractice insurance does not cover criminal prosecution.

The law was vague regarding what Dr. Gunter should do. She spoke to the hospital’s attorneys, who advised her to call the legislator who had written the law. So, instead of prepping her patient for surgery and taking care of her patient’s private medical issues, Dr. Gunter was forced to call up a legislator who had absolutely no clue about this wrinkle in the law because he wasn’t a medical professional. Moreover, Dr. Gunter was about to talk about this lady’s private medical situation with a man who was completely uninvolved, except for the fact that he’d written the law that was holding up Gunter’s ability to take action. To add insult to injury, he didn’t even seem to care! As Gunter launched into a description of the woman’s medical issues necessitating an abortion, the legislator interrupted her and said, “Whatever you think is best, doctor.”

The woman got her abortion and her medical condition improved. But Dr. Gunter was left fuming, since she’d had to waste precious time calling up a legislator who obviously didn’t actually care that much about this law. He hadn’t even listened to her speak for more than a minute before he basically said “whatever”. Meanwhile, this lady’s health– her very life– was in danger. What would have happened if Dr. Gunter had not taken the time to cover her ass by calling the lawmaker? What if she’d simply done the abortion and gotten arrested for breaking the law, even though she’d made the correct medical decision? What if she’d not done the abortion and her patient died? Then she might be on the hook for medical malpractice. She’d also have to deal with the guilt of knowing that she has the training to help women in these dire medical situations, but can’t act due to restrictive, misguided legislation like the “heartbeat” bills being considered and passed in places like Georgia, Ohio, and Alabama.

I wonder if the untrained politicians who are making these laws have considered the second and third order effects of forcing women to birth. One thing I think will happen, right off the bat, is that malpractice coverage will have to be expanded. Perhaps another type of insurance will be created to help physicians who are criminally charged in situations like the one Dr. Gunter describes. That will mean higher healthcare costs for everyone, since everyone practicing in a healthcare setting will need coverage.

Next, legislators will start getting phone calls at all hours from medical professionals who need clarification of the laws. Senator So and So might be enjoying a night out with his wife and have to answer a frantic phone call from a doctor who is trying to treat a pregnant woman whose pregnancy is making her health worse. And the doctor will have to listen to an untrained legislator offering his opinion.

Patient privacy will go out the window. It will have to, since physicians will have to seek advice from legal people on what they should or shouldn’t do for a patient like the one Dr. Gunter describes. Moreover, doctors, who already have a lot to do and huge loans to repay, will have to waste time with legal red tape and possibly money trying to defend themselves from legal action. A lot of them will have to go to court and may even risk being arrested simply for trying to do their jobs.

I haven’t even touched upon what will happen when sick women with health problems are forced to give birth. They will probably need more healthcare, since the pregnancy has made their condition worse. And their babies will probably need more healthcare, too– if they survive. That will mean more work for healthcare providers and higher costs for both insurance companies and uninsured people. Uninsured people will likely have more bad debt, which could ruin their ability to make major purchases like cars, education, or homes. That will affect business… well, maybe not for undertakers, who will probably get more business as more people die.

The legal system will get more business as more cases regarding abortion wind up in court. More people will go to prison, which is already a shameful big business in the United States, where in 2016, 2.2 million people were already behind bars. Maybe it’s not such a bad thing for the people who profit off of incarcerating others– privately run prisons are a thing in the United States. However, it will not be a good thing for families and individuals directly affected by having a loved one in prison. A lot of the “babies” legislators were so keen to see born could wind up with parents in prison, if they’re lucky– the cemetery if they’re not.

I can see why people are “pro-life”. A lot of folks believe it’s a matter of personal responsibility to prevent pregnancy. I happen to agree that, at least for me, it wasn’t hard to avoid getting pregnant. But I don’t represent everyone. Sometimes even when a person uses birth control– or even after they get a procedure like a vasectomy or a tubal ligation– pregnancy can still happen at the worst possible time. Sometimes birth control methods fail. Sometimes even vasectomies and tubal ligations can fail, though that is admittedly a rare situation.

And so many of them think that because they more often pay child support, they should have the right to enslave a woman by forcing her to give birth.

I’ve been paying attention to a lot of rhetoric spouted by “pro-lifers”, many of whom are men. I’ve seen a lot of men equating their duty to pay child support to a woman’s duty to give birth. First off, men aren’t the only ones who pay child support. Sometimes women pay child support. Secondly, having to pay child support is really no comparison to having your health on the line while gestating a baby. And before the baby is born, the name on the hospital’s and doctor’s bills is not that of the father’s.

I’ve seen other people, again mostly men, tossing out the statistics of when an abortion is “medically necessary”. One guy claimed it was about 4%. He did not provide the source of his statistic, but even if he had, I would be skeptical about its veracity. I don’t see how it’s possible to really know how many abortions are simply done for convenience. Everyone who seeks one has a story. Besides that, I can’t imagine any woman having an abortion for “fun” or even convenience.

I’m as big on personal responsibility as anyone is. I just think that abortion, just like any other medical procedure, should be entirely private. We don’t force people to donate organs to others, even when doing so would save another person’s life. We don’t begrudge people who defend themselves against intruders by using deadly force– one could argue that when a pregnancy threatens a woman’s life, that person has the right to use deadly force for her own self-protection. We have a big, complicated law called HIPAA that is supposed to protect our right to privacy in a medical setting. There is no reason why Dr. Gunter, an eminently qualified physician with excellent medical judgment, should have to call some legislator for permission to take care of her patients, particularly when the legislator isn’t even trained in medicine.

I’ll close with a direct quote from Dr. Gunter’s opinion piece. “Abortion is sometimes medically necessary, and women will have abortions whether they are safe and legal or not. Creating legislation that suggests otherwise does not change that truth.” Not allowing physicians to make medical decisions for their patients is a terrible idea.

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