posted
I'm shocked to hear that offices doing conscious sedation, or surgical procedures such as colonoscopies, wouldn't at least have a crash cart with code meds and a defibrillator. In fact, I just don't believe it. MY office has a crash cart about 15 feet from this computer I'm using and we don't do anything more invasive than vaccinations here.
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posted
A defibrilator is on a crash cart, Sunenun, in our regular doctor's office. To get any test more invasive than a Pap smear or to even to get a Rhogam shot when I'm pregnant, I've had to go to the hospital or the woman's clinic that is in a wing off the hospital.
posted
Thanks for the personal evidence, but that's not what i'm looking for. I'm looking for a federal law that states what all medical offices need to have. If they're all required to have life saving equipment, then I totally support extending that to all clinics/offices that do procedures.
What I'm saying is, I haven't figured out whether or not it's illegal to not have these devices in a private office doing procedures. So far, I found on allnurses.com a thread about crash carts which seemed to imply it was optional. Surely an important thing to have, but not illegal to not have it.
Therefore, I reiterate: Saying that every office and clinic that performs any surgical procedures should have X devices is great. Saying that a specific type of clinic must while ignoring the others is mainly political in nature and I could see why some people would be opposed to it.
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posted
Do you recognize the difference between having teeth extracted and extracting a fetus from INSIDE SOMEONE'S BODY?
I see the differences. I can understand why there would need to be more precautions in the second case.
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posted
It is basically a curved knife they are sticking in your body to scrape the baby off the uterus.
If what you want is a law that would require any clinic that performs a similarly invasive procedure to have a crash cart, I'm not opposed to that.
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quote: I assure you that there are fatal risks in colonoscopies and endoscopies. There were perforations in 1.96/1000 colonoscopies in one study. For endoscopies, "Between 0.1-0.2% of complications considered directly related to the procedure resulted in morbidity and 0-0.7% were fatal."
Wait, let me make sure I have the facts straight.
1.96/1000 colonoscopies result in perforations?
0-0.7% of complications related to endoscopies are fatal?
That doesn't actually give me any numbers, does it? What percent of the perforations from the colonoscopy result in death? And what percentage of endoscopies have complications? Aren't the numbers from the colonoscopies and endoscopies unrelated?
Saying that 0-0.7% of complications related to endoscopies are fatal doesn't tell me how many. What if only one in a million endoscopies have complications? I'm sure that's unrealistic, but there's no way to tell from your post. Or am I reading it wrong?
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posted
Scott, Amka, you guys are missing Suneun's point.
Many private offices perform various types of procedures. Many of these procedures may or may not have morbidity rates similar to mother fatality rates from abortion complications (lets set aside the issue of the status of a fetus; if you think it's a life, then this whole safety argument is moot, since fatalities are an inevitable consequence, so why even put forth a safety issue as support?).
State laws likely vary quite a bit on the required safety devices for medical offices, and the actual reality of it is likely that certain facilities are more up to code than others (loosely based on the socioeconomic climate of the area, I bet). So here is the thing, if the law is requiring abortion clinics to buy possibly quite costly equipment for procedures that have comparable complications to other medical procedures that are performed in facilities that are not required to have the same equipment, then I think we can agree that this is largely a political move to cause abortion doctors to go out of business since some may stop doing the abortions to avoid buying the equipment, right?
That is what Suneun is saying, I think. Abortion doctors are [EDIT: possibly] being singled out in a way that may cause many of them to be forced, financially, to stop performing abortions, without actually outlawing it. This legislation is only fair if other facilities with similar are REQUIRED to have it as well. Sure, maybe 99% of these facilities have the equipment anyway, but they aren't required to, so likewise neither should abortion clinics. I don't think this is weird, or crazy, or irrational. It's the equivalent of an amusement ride operator having different height requirements based on whether he/she liked the person trying to get on the ride.
Of course, this is all irrelevant if you think the fatality rate is high, because of your belief of fetus personhood. So if that is the case, each side is arguing past each other.
quote: This legislation is only fair if other facilities with similar are REQUIRED to have it as well. Sure, maybe 99% of these facilities have the equipment anyway, but they aren't required to, so likewise neither should abortion clinics.
But if 99% of other facilities can have them, then why wouldn't abortion clinics be able to afford them?
I know that wasn't exactly accurate, but it doesn't seem like making the abortion clinics have that equipment would cause them to stop practicing. Are you sure that's the reason they want the clinics to have them?
And, yes, if abortion clinics are forced to have them, then any other clinics with comparable fatality stats should as well.
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posted
I have no problem with all clinics that perform procedures where a knife is scraped around in someone's insides being required to have a crash cart.
There's a trend here of ignoring safety for the purpose of making a political point. I don't like it.
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posted
PSI, honestly? I bet it's because in many states being an abortion doctor doesn't pay all that well, and there is likely enough stigma that they can get associated with a medical group to help share costs. That's just one possibility.
afr, I figured many people here would have that response as I was writing that. It's still an underhanded way of going about it.
quote: Financial In 2001, the average cost of an abortion at 10 weeks was $372. For low-income and younger women, gathering the necessary funds for the procedure often causes delays. Compounding the problem is the fact that the cost of abortion rises with gestational age: in 2001, the cost of an abortion performed at 16 weeks gestation was $774 and $1,179 at 20 weeks. For various reasons, most patients pay for abortions out-of-pocket. For example, in 2001, only 26 percent of patients received services billed directly to public or private insurance (Henshaw & Finer, 2003). For some, these costs can pose significant barriers to access.
From Planned Parenthood's website. $372 dollars to pop in and have a chemical abortion? That's pretty expensive.
Posts: 6367 | Registered: Aug 2003
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posted
kat, that's nice imagery to use; a good self-righteously comfortable image. Of course, if that knife scraping is no more dangerous than a colonoscopy to a patient (setting aside the personhood issue, since that makes the safety issue completely nonsensical), why are abortion clinics being targeted by the law?
Now you can question the point of whether an abortion is safer or more dangerous than a colonoscopy (or any other medical procedure); the more pertinent question, however, is how are safety requirements for abortion procedures compared to medical procedures with similar complication/fatality rates? The answer to that (which has yet to be answered on either side here) will determine if the opponents of the law are/were wacky or sane.
posted
All right, that was my kneejerk reaction. I guess if someone were going to have an abortion, they'd be much better having a qualified doctor do it for them than trying to do it themselves. Having abortion doctors go out of business isn't going to make people suddenly decide not to have abortions.
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posted
Wait,a moment to say that the $372 could have been used for the suction-type abortion, too. Still pretty expensive. I'm thinking of prices of comparable surgeries, and abortions don't even require you be knocked out, which is often a large chunk of the cost in other surgeries.
AFR- Should we make abortion accessable and legal for everyone just because a few loo-loo's out there are willing to try it with a kitchen knife?
posted
Actually compared to most surgical procedures it is quite cheap. It cost more to have warts removed from my foot then that, though I wasn't paying out of pocket.
You know I was anesthestized but not with the nasty generals anesthetics like in the hospital at the podiatrist while the wart removal was happening and I don't know whether they had a crash cart avaliable or not. I know the anesthesiologist was an independent contractor.
So yes I think mandatory crash carts everywhere would be a good thing, but like Suneun says it should be applied by a fair standard.
posted
Dude, quick anecdote about general anesthesia:
When I had surgery recently, I went under. I remembered everything until right about when they wheeled me into the OR. I later assumed that the anesthesia they gave me had the effect of making me forget the last few mintues before the injection. Out of curiosity, I asked the doctor if I had said anything during that time. Apparently I said this:
"Ah! It burns! It burns, make it STOP! Oh God!"
o_O
And I have a pretty high tolerance for pain. (Not to mention I don't normally use the Lord's name in vain, not even when I was in labor.) It immediately made me think of somec. It's kind of creepy, and makes me not want to have surgery ever again.
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I just don't think that's a really effective solution. I'm strongly opposed to abortion--it's one issue that I will budge very little on. I would very much like to see abortion end, but I don't think the path to that lies in putting abortion clinics out of business. The solution would come through a large shift away from the "me first" mentality that puts the mother's comfort ahead of all other considerations. Then the abortion clinics would go out of business naturally due to lack of demand.
(I think of abortion clinics as nice, relaxing places with the cheeriness of a normal doctor's office where the mother is welcomed, reassured, her choice reaffirmed, while something terrible and monstrously inhumane is quickly done to her child.)
It would be wonderful if not having a facility for getting an abortion performed would cause the mother to choose another alternative like adoption, or I guess even sacrifice. But taking the facilities away is only going to make many people mad without solving much.
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posted
Bok: Thanks. That's the pont I was trying to get across. Apparently still failing at that.
Abortions cost money. You may think it's an absurd amount. But that money has to pay for MANY people who are there in the office. When I volunteered, there were about 4 nurses, one registered nurse, three secretaries, two counselors, a lab tech, a doctor, and an anaesthesiologist. Getting sedation costs more, of course (something like the difference of $350 and $450).
Posts: 1892 | Registered: Mar 2002
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quote:how are safety requirements for abortion procedures compared to medical procedures with similar complication/fatality rates?
Does that statement sound funny to anyone else? Or, what other medical procedures have an almost 100% fatality rate?
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Bok, Suneune-- I got the point-- I'm just incredulous that you're standing by it.
One of the things we hear screamed at pro-abortion rights rallies is that if abortion is outlawed, then women will be forced to perform abortions on themselves with coat hangers. Back alley abortions will become the norm.
And yet, for all their concern about women's health, here are pro-abortion activists actively opposing a measure that could help save a woman's life-- because they're afraid that it is a measure intended to put abortion clinics out of business.
Do you catch the hypocrisy of such a stance?
As far as funding for abortion clinics that need it-- well, pro-abortion activists are always telling anti-abortion activists to pony up for childcare for the children they want to save; let pro-abortion activists do the same for the clinics they want to save.
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posted
"because they're afraid that it is a measure intended to put abortion clinics out of business"
Before moving on, will you concede, Scott, that it IS exactly such a measure? Heck, I'm anti-abortion, myself, and I'm even willing to recognize that.
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Only the first 3 or 4 points are pertinent. The rest is irrelevent.
-Bok
PS- Sorry about my snippy reply, kat, I realized when I reread it later that you weren't trying to use emotionally charged imagery to inflame.
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If it was (is? What's the status on the bill?), it was ill thought out; abortion clinics (in my research anyway) don't seem to be lacking funds. The people who are asking for money to enable the procedure are the patients.
Given that (and I'm willing to be wrong-- I've found one abortion clinic in Kansas that shut down because of financial difficulties, and none else), why would passing this bill be a problem?
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quote: Fact Sheet: The Shortage of Abortion Providers
* 87% of all U.S. counties and 97% of all rural U.S. counties have no abortion provider.1 * Since 1982, the number of abortion providers has decreased by 37%.1 * 58% of all OB/GYN doctors who provide abortions are 50 years of age or older. This means the number of providers will continue to decline as current providers reach retirement age, unless younger clinicians learn to perform abortions.2 * In 1983, 42% of all OB/GYN doctors performed abortions. In 1995, only 33% did. The overwhelming majority of abortions are performed by a small group of doctors: Only 2% of U.S. OB/GYN doctors perform more than 25 abortions per month.3 * 72% of OB/GYN residency programs do not train all residents in abortion procedures.4 * From 1982 to 2000, the number of hospitals providing abortions has decreased by 57%.1 * Only 15% of chief residents in family medicine residency programs have clinical experience providing first trimester abortions.3 * “Physician-only” laws in most states require careful legal research to ascertain whether advanced practice clinicians (nurse practitioners, nurse midwives, and physician assistants) can provide medical and/or surgical abortions under their professional regulations. * Many nursing programs do not adequately prepare students to care for women having abortions, contributing to a shortage of nurses willing and trained to assist abortion providers. Lack of faculty qualified to teach about reproductive options, fear of anti-choice backlash, and the absence of appropriate didactic materials are barriers to incorporating abortion into existing curricula. * Abortion is one of the only medical procedures with a “conscience clause” that allows medical providers to refuse to participate in the care of a patient. * There have been 15,087 reported instances of violence and/or harassment against abortion providers since 1977, including 7 murders and 17 attempted murders (actual instances are most likely much higher.)5 In 2000, more than half of all providers experienced anti-choice harassment.6
You'll note that funding is NOT one of the issues brought up-- availability of the operation, and doctors willing to carry it out are.
Can you think of why that might be?
[ April 21, 2004, 09:57 AM: Message edited by: Scott R ]
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posted
"You'll note that funding is NOT one of the issues brought up-- availability of the operation, and doctors willing to carry it out is.
Can you think of why that might be?"
I'd imagine it's a combination of several factors, from personal conscience to legal opposition to public intimidation.
---
So, then, you aren't willing to speculate on why a law might have been drafted requiring abortion clinics in SPECIFIC to possess special equipment? Scott, let's face it: it's just another attempt to chip away at the clinics by any means possible.
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posted
jehovoid, I assume you didn't read my various parts that admitted that if you believe in the personhood of the fetus the whole safety argument is nonsensical, right?
Scott, it's a catch-22. I personally would like to see abortion go the way of the dinosaurs. The best way to do it, IMO, isn't to chop the legs out from under "safe" abortions. It's to educate people to the point that only a tiny minority (since I think there will always be a small segment of women who do this) would think of going the abortion route.
If you look at abortion from the perspective of a medical procedure (which some in here are not, as is there right), then from a medical point of view, abortions are being singled out, because there is a large (majority) of people who don't like it. I would love to for there to be a crash cart at every medical facility, period. So ask the lawmakers, why are they restricting this law only to abortion clinics? When kat said that some people are ignoring safety for politics, it could have been just as easily been made for the side she is sympathetic to.
Bok-- When you call a place a 'clinic,' certain laws apply to it. When you call a place a 'hospital,' more laws are applied.
I don't deny that BOTH designations, and the application of the terms to any given office, can be political: the question becomes then, is the medical equipment necessary for the safety of patients undergoing an abortion?
Posts: 14554 | Registered: Dec 1999
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posted
Jon Boy - my immediate reaction was to get angry with your link, but I can't work out whether you meant it as satirical against the anti-abortionist lobby, the pro-choice lobby or some other group.
I'm being quite serious here - I guess I'm just being dense.
But if you let me know, I'll respond appropriately. Posts: 4393 | Registered: Aug 2003
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posted
Imogen, it seems to me that the article is satire against the pro-choice people. I really don't see the difference between killing a five-year-old and killing a baby that's only moments away from being born.
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posted
Scott: Sure, but so should any other medical facility, 'clinic' or otherwise, that performs procedures with similar (or in my case, I'd even say ANY) complication rates.
If the pro-life folks really wanted to help, they'd propose the same law for any facilities that perform operations with certain complication rates. You'd find much less opposition, I'd bet.
Basically, what you conceded to Tom was what I, and I presume Suneun, were saying. This wasn't really about patient safety, this was about making political hay. If you still believe that the opposition should step aside when there are possible long term repurcussions, well, that's a fair difference of opinion. --
As an aside: I can see 2 reasons for the drop in doctors learning the abortion procedures. One is moral, and one is financial (okay, there is also a societal pressure one as well, but that won't change anyone's mind).
posted
So now do we get to talk about the inconsistency with pro-choice advocates' stand on parental consents when compared with consent needed for other surgeries?
posted
Jon Boy - ok. And I can understand that satire in terms of late birth / partial birth abortions. Especially in the terms you couched it - if a baby is "only moments away from being born" then I cannot justify an abortion in any way, shape or form *except* if it is *absolutely* necessary to save the mother's life.
I do see a difference in first trimester abortions, but I guess that's a different discussion for a different thread.
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quote:This wasn't really about patient safety, this was about making political hay. If you still believe that the opposition should step aside when there are possible long term repurcussions, well, that's a fair difference of opinion.
I don't understand your last sentence-- can you clear it up for me?
I concede that the the bill may have been introduced to 'chip away' at abortion rights; however, my question stands: is it a good idea to have this equipment? If it is, no matter what everyone else in the medical field is doing, isn't it JUST to require it?
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posted
Scott, I think it IS good to require it. To put it in more neutral terms, I think the law is poorly written because it only applies to a subset of medical facilities that ought to have these safety requirements. I think the state legislative body ought to go back and draw up a more comprehensive law that will protect more patients. Why should abortion seekers get more safety than some other patient with a comparable (in terms of complications) medical procedure?
posted
Then only Jorge would survive the car crash.
Proof that America cares about immigrants.
Tom, I get where you're going-- but the simple fact is that, as I stated earlier, there's a big difference between having a tooth extracted, and having a fetus pulled out of your body.
I am fine with having all invasive surgeries require the same type of safety precautions as is required with abortive surgery.
Why were the clinics not required to implement these safety precautions in the first place? To turn the argument on its head, why did the law seem to state, 'Everyone but Hispanics needs to wear seat belts?'
Who is to say that this law wasn't a rectification of an oversight?
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posted
But did the law actually say the equivalent of "evryone but..."?
I think that is an assumption that has yet to be tested. I think it's more likely that there are many "out-patient" procedures [EDIT: done] at doctor's offices separate from hospitals that may not have the same safety equipment.
quote:Bok-- When you call a place a 'clinic,' certain laws apply to it. When you call a place a 'hospital,' more laws are applied.
This is misleading. I attended a lecture today by a Reproductive Rights advocate (medical director of Planned Parenthood of RI). He told us that at Four Women, the abortion clinic at which I volunteered for several afternoons last summer, the hallways must be wider than at the hospital, the OR room must be bigger than at the hospital, and there is more "life saving equipment" present in the room than in the hospital OR. There was a law passed (not sure what state) stating that an abortion clinic OR must have fresh air pumped in 6 times the volume of the room every minute. Doesn't that seem a little excessive to you?
Yes, if "Seat belts for all non Hispanics" was the legal rule beforehand, then extending it makes sense. I've agreed to this since the VERY BEGINNING of this conversation.
But through some basic poking around, it seems that such "seat belts" are only recommended in private offices and clinics. Therefore I maintain my stance that the reason it received opposition was because of singling out a particular practice for the main purpose of making it more difficult to perform.
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posted
Then I come back to my question as to why abortion rights advocates want different parental consent laws for abortion than for other surgery?
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posted
The kind of parental consent law I currently support allowed the child to petition a judge for permission for the abortion. The adolescent is asked to show that they are making a choice free of coersion and with all relevant knowledge at hand.
It's tough to defend why this procedure should be allowed such an exception while others not. I guess any procedure should allow this sort of exception. It just seems most necessary for this procedure, because of the politics and social stigma. A fifteen year old girl should not be forced to keep the baby if she doesn't want it, the same way a fifteen year old cancer patient shouldn't be refused treatment because her parents don't want her to get treatment. It's just that in the second case, it's often exterior forces acting.
If a child feels threatened by her parents, and sees potential for an abusive situation to arise, I'd like her to be able to petition a judge for permission to waive parental permission.
Posts: 1892 | Registered: Mar 2002
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quote:A fifteen year old girl should not be forced to keep the baby if she doesn't want it, the same way a fifteen year old cancer patient shouldn't be refused treatment because her parents don't want her to get treatment. It's just that in the second case, it's often exterior forces acting.
In this case, though, who is legally responsible for the baby that is born? Can the 15 year old even be responsible, given that she's a minor? Doesn't the responsibility fall to the parents anyway? I'm asking because I really don't know, if anyone has specifics on the legal ramifications that'd be helpful.
I would support a law saying that parental permission is required, but if the girl wants an abortion and the parents don't, then the parents become the permanent legal guardians of the baby. As in, they can't force the kid on the girl when she turns 18 and the girl can't turn around and demand custody 5 years down the road.
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posted
I think that's not too bad of an idea. I also believe that in most states the mother, 15 or not, is the legal guardian of the child. I could be wrong though.
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