Doctors and lawyers lay the "last mile" of the laws legislators pass
I don't know if your article would be the place for this, but I would personally really like to know exactly what health conditions or medical emergencies are involved in situations where the mother's life is at risk(or where her health could be severely at risk), and what procedures pro-choice and pro-life doctors would normally use to treat them. I would honestly really appreciate something like a table listing these out, along side columns containing information about typical treatments for these conditions, which ones could be banned under pro-life laws, which ones would not, how common these cases are etc. Most news articles about these cases that I've read don't go into these details in a very clear way, so I find it hard to understand exactly what's going on, and feel like I just have to decide whose conclusions to trust. I'd like to have more information to be able to decide myself!
Questions I'd be interested in asking a hospital attorney: Is there any insurance/legal reason for medical sexism in general? It seems like SO MUCH women's health care is a band-aid approach. I watched the first part of the panel (and will finish it later!), and I heard abortion referred to as a band-aid approach, which struck a chord with me because I've had to work really hard to get healthcare for myself that isn't bandaid. These seem to be the bandaid approaches to 99% of problems women present with:
- birth control, if she doesn't want to get pregnant
- clomid, if she does want to get pregnant
- charting, if the doctor is napro
- SSRIs, if she finds her symptoms upsetting
RARELY have I been able to find a healthcare professional who (a) believed what I told them about my symptoms and (b) wanted to figure out if the symptoms were indicative of a problem that should be addressed. I and may other women have spent years suffering from symptoms of undiagnosed (and sometimes severe!) medical problems because boxes were checked and root causes were not explored.
And I'm wondering if the legal thing is part of the reason for this. You're not going to get into legal trouble if you check the right boxes, and these are acceptable boxes to check. If you explore deeper issues, like maybe she has endometriosis or PCOS or a thyroid problem, if you acknowledge the symptoms as *real* and not the product of an anxiety disorder, then you have a much more complex problem to deal with that doesn't fit as neatly into legal checkboxes.
I am so grateful for this work that you are doing, Leah.
The question that I want answered is a numeric one, and it might be better answered by someone in the insurance industry because I suspect the answer is in how procedures are coded. As you mentioned Leah, in some cases, watchful waiting is an option for treating a pending miscarriage (and I also used it for mine, I did not require a D&C). My understanding of the post-Dobbs world (and this may be an imperfect understanding) is that the treatment protocol is now moving toward more watchful waiting and removing the option for women to bypass watchful waiting and proceed straight to D&C. This is because there needs to be a demonstrated medical reason to complete a D&C beyond no fetal heartbeat or similar in order for the care provider to feel they are less likely to be prosecuted for intervening. I assume watchful waiting is not coded itself as such because insurance is not billed for it, so in order to ascertain if there are more women choosing (or being pushed into) watchful waiting as a treatment, we have to look elsewhere for the change in pattern. Perhaps we see something different in the pattern of visits? A visit to an OB or a midwife, a pause of days or weeks, and then some patients would need D&Cs and some would not. Would there be fewer D&Cs in the post-Dobbs world because more patients would miscarry at home? Would there be additional procedures around the post-Dobbs D&Cs because these patients are there for some other reason or require additional treatment to manage complications (e.g. extreme blood loss due to an incomplete miscarriage)?
There are a lot of other important aspects of law as written vs law applied! Some that come to mind which I'd love to see you ask these lawyers:
> As an attorney for a hospital, what is your obligation to protect doctors from directly being sued as a result of these laws? In what circumstances would they have to retain their own attorney? Who would pay for that attorney (insurance?)? And how does that vary by state - for instance, SB8 allows anyone to sue a doctor for performing a suspected 'illegal' abortion after six weeks and does not allow the doctor to recoup legal fees.
> As an attorney for a hospital, what is the hospital's obligation to provide information to law enforcement about patients? How does that run up against doctor patient privilege? How have you seen this play out in cases of suspected self induced/at-home abortions?
For textbook vs actual medical practice, there's a long history of how medicine is actually practiced (has been, continues to be) in Catholic hospitals to look at what happens when women face life threatening complications and yet a fetal "heartbeat" continues to be detected.