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States Can Combat Antiabortion-Rights Restrictions by Protecting Patient-Provider Relationship

October 15, 2015 — Pennsylvania and several other states have proposed measures that aim to protect "women's access to evidence-based health care" in response to an increase in antiabortion-rights laws targeting the patient-provider relationship, according to a new issue brief in Newsweek from the National Partnership for Women & Families and the Center for American Progress.

Brief Details

The brief was written by Andrea Friedman, senior policy adviser at the National Partnership; Sarah Lipton-Lubet, director of reproductive health programs at the National Partnership; and Donna Barry, director of CAP's Women's Health and Rights Program.

The brief provides a snapshot of laws targeting the patient-provider relationship and highlights two measures -- in Pennsylvania and Ohio -- that serve as "models of [an] emerging effort" to protect that relationship. According to the authors, these proposed measures, if enacted, "could protect health care providers who refrain from providing inaccurate medical information or unnecessary procedures; allow providers to deliver care based on the most up-to-date medical evidence; help protect patients from inaccurate and potentially harmful information and unnecessary procedures; and protect patients from needless delays in accessing time-sensitive care."

Laws Targeting the Patient-Provider Relationship

The authors outline several types of antiabortion-rights laws that target the patient-provider relationship, including biased or medically inaccurate counseling laws, bans on providing medication abortion via telemedicine, laws that require providers to administer medication abortion based on outdated guidelines, and mandatory delays before an abortion.

According to the authors, these types of restrictions "are written by politicians, not the medical community, and are not based on medical or scientific evidence." They cite several medical and advocacy organizations' opposition to legislative interference in the patient-provider relationship, including the Coalition To Protect the Patient-Provider Relationship. The Coalition, launched in 2014 to respond to patient-provider interference laws "in a unified voice," "includes medical societies and advocacy groups working on gun violence prevention, environmental advocacy and access to abortion services."

The authors explain that laws targeting the patient-provider relationship undercut medical professionals' expertise and their ethical obligations to the patients, and they write about how health organizations "have played an important role in court challenges to patient-provider interference laws." They cite amicus briefs filed in a lawsuit challenging North Carolina's mandatory ultrasound law (SL 2011-45) by the American Public Health Association, the American College of Obstetricians and Gynecologists and the American Medical Association. While that law was overturned by the courts, a similar law in Texas was upheld.

Measures To Protect the Patient-Provider Relationship

The authors highlight two types of legislation, originally proposed in 2014 in Pennsylvania and Ohio, that are "designed to keep medical decisions in the hands of patients and trained health care providers, preserving the patient-provider relationship."

According to the authors, "The basic premise of the legislation is that licensed health care providers should not be required to give or withhold information or care when the requirement is not supported by evidence and recognized medical standards."

The Pennsylvania measure (HB 1105), which was reintroduced this year, "aims to ensure that Pennsylvania would abide by scientific and medical evidence in drafting as well as implementing laws by stating that the commonwealth would not require inaccurate or inappropriate care nor prohibit accurate, evidence-based and medically appropriate care," the authors write. The authors cite the widespread support for the measure from women's health groups, other advocacy groups and medical organizations.

The authors explain that the measure is particularly significant in terms of abortion care because current Pennsylvania law requires providers "to verbally share state-mandated information with a woman seeking abortion care, and ... [to] provide state-written materials" that "includ[e] statements that are biased and inappropriate and force health care providers to violate their medical and ethical responsibilities." Further, the state imposes a 24-hour mandatory delay before an abortion.

Meanwhile, the Ohio measure (HB 585) "would have allowed health care providers to decline to follow certain abortion restrictions that are not based on evidence or that would require them to deliver care in ways that contradict their professional and ethical mandates." The authors note that while neither the Ohio measure nor a similar proposal in Texas advanced, "their introductions are part of a broader movement to expand access to abortion and fight against government intrusion in the patient-provider relationship."

The authors write, "Across the country, abortion providers are saddled with requirements that fly in the face of good medicine and are passed by abortion rights opponents who disingenuously claim that abortion restrictions benefit women's health." However, measures that "[e]levate the importance of medically accurate care and protec[t] the patient-provider relationship have the promise of transforming the way abortion restrictions are understood and beginning to reverse the imposition of junk-science laws on abortion care," they conclude (Barry et al., Newsweek, 10/11).