KCStar: 'It broke me as a physician to do this to her': How Missouri harasses women seeking abortion

[hlthe2b]

As Discussed on Rachel Maddow this pm. Happy to see my parents' old home town newspaper is on it
EDITED TO ADD Rachel Maddow Show Vido at bottom

By The Kansas City Star Editorial Board
June 05, 2019 03:23 PM, Updated June 05, 2019 03:23 PM

Read more here: https://www.kansascity.com/opinion/editorials/article231197138.html#storylink=cpy

St. Louis ob-gyn Amy Addante tweeted this week about the real-world effect of the requirements being imposed on patients and doctors at the last clinic performing abortions in Missouri.

“Today,” the doctor wrote, “I was forced by the state of Missouri to perform an unnecessary pelvic exam on a patient terminating her pregnancy for a fetal anomaly. She is heartbroken over her situation, and I was forced to do an invasive, uncomfortable exam. It broke me as a physician to do this to her.”

To her, not for her. Not for any medical reason, but to keep the clinic open, at least for now.

This harassment by the state is not to be confused with Missouri’s new ban on abortions performed after the eighth week of pregnancy, with no exceptions in cases of rape or incest. That law is scheduled to take effect on Aug. 28.

Dr. Randall Williams, an obstetrician and the director of the state health department, told NPR he had “concerns about standard of care and policy” at the sole surviving clinic.

A news release issued by his department says that a March inspection found “failed surgical abortions” after which patients remained pregnant, a lack of “informed consent” and “at least one incident in which patient safety was gravely compromised.”

If any one of those things were true, it would be serious. But if even one were true, don’t you think we’d have heard all about it in the three months since that inspection? The credibility of the state in this matter is not robust, but we look forward to hearing these assertions backed up in court.

In his previous job in a similar position in North Carolina, Williams got into trouble for downplaying risk to public health.

Before disgraced former Gov. Eric Greitens decided that Williams was just the man for the job in Missouri, he was accused by a state toxicologist in North Carolina of trying to “play down the risk” of coal ash contamination in drinking wells by rescinding a “do not drink” order.

Read more here: https://www.kansascity.com/opinion/editorials/article231197138.html#storylink=cpy

Read more here: https://www.kansascity.com/opinion/editorials/article231197138.html#storylink=cpy

Link to tweet

[hlthe2b]

1. Great comment from Planned Parenthood re:

Dr. Colleen McNicholas, of St. Louis Planned Parenthood, put it this way in a statement: “Missouri Governor Parson’s inspections process has become just another vehicle to intimidate doctors like me and to push abortion care out of reach for patients.”

The ob-gyn in charge of our state health department is in effect telling women to have a nice glass of coal ash and call him in the morning.

Read more here: https://www.kansascity.com/opinion/editorials/article231197138.html#storylink=cpy

[DURHAM D]

3. The Governor is a serial rapist. nt

[hlthe2b]

2. Rachel announced part 2 of this story tomorrow night, I have a bet on what she will reveal...

In light of this editorial, I'm betting she focuses on the current Missouri Health Director and his rather controversial past.

[backtoblue]

4. I had three responses ready to click...

But all I have in me is....

[JoeOtterbein]

5. So then, don't do it. And say you did. It's morally correct to lie when asked to do something so...

...evil!

[hlthe2b]

6. Health Care providers can not only lose their licenses but be brought up on charges for falsifying

records. No one in their "right mind" would risk that, as upset as they may be.

[JoeOtterbein]

7. That is a poor excuse to do something evil. I know I've lost more than one job in the food biz...

...because I would not serve unfit food. Any pro would do the same thing.

BTW, one of the times I was fired the word spread in the biz and it really helped my career.

[hlthe2b]

8. Losing a medical license is hardly the same as losing other types of jobs.

One can not practice and the long term ramifications, not to mention the possibility of JAIL TIME for falsifying records is hardly the same. Physicians who likely still owe $$$ in student loans ($100--250K is not unusual) and who complete 10-15 years of training! Hardly just losing a job.

[JoeOtterbein]

9. When asked to do anything evil, it is immoral to comply.

Any pro knows when to refuse.

[hlthe2b]

11. Oh, fer gawd's sakes. That is damned ridiculous.

Are you trying to be facetious, because your suggestion would only destroy the clinic leaving it with no physician, likely ending up with that physician and his staff facing jail and losing their licenses? How, pray tell is that helpful? (don't bother, I have to assume you are being facetious)

[JoeOtterbein]

14. When is it ever good to comply with a immoral act to simply protect oneself?

Your responses are depressing. We are nothing as humans, if not standing solidly against such a horrible excuse to molest women?

[WhiskeyGrinder]

17. She's not protecting only herself by complying. She's also protecting future patients. She can

either refuse to comply, risk getting caught and leave the state down by one abortion provider, or comply and continue to provide abortion care they work to change the laws. Many providers in this position would rather help their patients as much as they can by "working to rule" and doing the bare minimum under the law with the utmost care, compassion and dignity, while also fighting the law itself.

[JoeOtterbein]

19. All she has to do is lie on a form. That is really not all that complicated.

Who is going to know? Just perform the abortion and sign the form. That is her job. I'm hopeful that our court system has not deteriorated to the point of clearly allowing privacy to be violated. The state, and the doctor, have no Constitutional right to violate a woman's privacy with sexual abuse.

Sometimes, a pro has to stand up for their patient's rights. Of course it's difficult. But it is the correct path. Always.

[WhiskeyGrinder]

20. Anti-abortion people send in fake "patients" all the time to trap and spy on providers.

[yardwork]

47. What you're suggesting is ridiculous.

[hlthe2b]

49. Not to mention a poster downstream.

[yardwork]

52. It's so easy to be ideologically pure from a distance.

[hlthe2b]

18. Leaving them w NO providers while you've destroyed your own ability to practice is not a moral stand

Doing what they are doing-- court challenge and publicizing what is happening is taking a stand.

[LanternWaste]

56. What leads you to allege it's done only to protect oneself?

What leads you to allege it's done only to protect oneself rather than the additional possibilities you ignore?

[USALiberal]

59. You are way wrong on this topic!!! Nt

[sheshe2]

22. Comparing her job to the "food biz" is...I really have no words for that.

McNicholas is one of a dwindling group of doctors performing abortions in the Midwest, which, along with the South, is known to pro-choice advocates as the abortion desert. According to the Guttmacher Institute, as of 2011, the most recent year for which data are available, 94 percent of counties in the Midwest had no abortion clinic to serve the 13.2 million women of reproductive age who live there. She works two days every three weeks at the Planned Parenthood in St. Louis—the only remaining abortion clinic in Missouri—flies once a month to the Wichita, Kansas–based clinic where Dr. George Tiller practiced until he was shot dead in 2009 by an antiabortion zealot, and in June will begin traveling to Oklahoma City to work at a newly opened clinic. "Part of the problem with being so committed and feeling so passionate about an issue is that it's hard to say no," McNicholas, 35, says. "It's hard to say, 'I can't do that,' because that means somebody is going without care, and what that means is, they're probably going to have a baby they don't want. So ultimately, I end up saying, 'I can do one more day' or 'I can go one more place.'"



When she's not crisscrossing the Midwest, she's treating patients at her obstetrics and gynecology practice at St. Louis' Washington University School of Medicine, where she is an attending physician and assistant professor. She also drives two hours to Jefferson City, Missouri, a few times a year to testify before the state Legislature in opposition to bills restricting access to abortions. Once a year, she goes to Washington, D.C., with other doctors to lobby legislators that science ought to trump politics when it comes to providing a procedure that, according to Guttmacher, one-third of all American women will have before age 45. Some nights, she meets with the board members of the abortion-access fund she founded to help Missourian women afford the procedure. (At Planned Parenthood in St. Louis, patients pay from $545 to $1,470, most often out of pocket, as state law prohibits Missouri-based insurance companies from covering the cost, except when the woman's life is at risk.) Whatever precious hours she has left are spent at home with her 5-year-old son (a basketball star in the making) and her partner, an anesthesiologist, who didn't want her name used out of concern for her safety.

https://www.marieclaire.com/culture/a20565/mission-critical-abortion-rights-midwest/

Sure. Great idea. Let her say no and lose one more of the dwindling troop of doctors that are helping these women. She is putting her life on the line helping these women, just ask Dr Tiller. Oh, wait you can't. He was shot dead by an anti abortion zealot.

Your responses make me want to cry.

[WhiskeyGrinder]

23. Well said.

There are a lot of people in this country who truly have no idea what people go through to access or provide abortion care.

[sheshe2]

27. Thank you, WhiskeyGrinder.

There are a lot of people in this country who truly have no idea what people go through to access or provide abortion care.

True. Nor do they know what the providers go through to support these woman at the risk of not only their lives but their families lives.

This place tires me.

[WhiskeyGrinder]

65. "This place tires me."

[sheshe2]

67. Yup.

*SIGH*

[sheshe2]

24. Assassination of George Tiller

On May 31, 2009, George Tiller, a physician from Wichita, Kansas who was nationally known for being one of the few doctors in the United States to perform late-term abortions, was murdered by Scott Roeder, an anti-abortion extremist.[2][3][4] Tiller was killed during a Sunday morning service at his church, Reformation Lutheran Church,[5] where he was serving as an usher. Tiller had previously survived an assassination attempt when a woman shot him in the arms.

Roeder was arrested within three hours of the shooting and charged with first-degree murder and related crimes two days later. In November 2009, Roeder publicly confessed to the killing, telling the Associated Press that he had shot Tiller because "preborn children's lives were in imminent danger."[6][7] Roeder was found guilty of first-degree murder and two counts of aggravated assault on January 29, 2010,[8] and sentenced on April 1, 2010, to life imprisonment without any chance of parole for 50 years.[9]


Shooting and aftermath
George Tiller was shot dead on May 31, 2009, during worship services at the Reformation Lutheran Church in Wichita, where he was serving as an usher. The church is a congregation of the Evangelical Lutheran Church in America. Tiller was shot in the head at point blank range; he was wearing body armor, as he had been since 1998, when the FBI told him he was being targeted by anti-abortion militants.[10] After threatening two others who tried to prevent his departure, the gunman fled in a car. Witnesses described the vehicle as a powder-blue 1993 Ford Taurus.[11]

Calling the murder "an abhorrent act of violence", U.S. Attorney General Eric Holder announced,

Federal law enforcement is coordinating with local law enforcement officials in Kansas on the investigation of this crime, and I have directed the United States Marshals Service to offer protection to other appropriate people and facilities around the nation.[12][13]

https://en.wikipedia.org/wiki/Assassination_of_George_Tiller

[sheshe2]

34. He wore body armor for eleven years.

Eleven years for helping women. My heart hurts.

[sheshe2]

37. I feel your pain.

I am so angry tonight. This hurts my heart.

[Dorian Gray]

53. Think of it this way

It would take one anti-abortion crusader who is pregnant to go into that clinic, claim she wants an abortion and have the doctor tell her he'll sign off on the vaginal exam while not performing it....

I think it's much more practical for doctors (and patients if they are comfortable speaking out) to vocally go to the media and blast out their message.

[WhiskeyGrinder]

10. If they're found out, it leaves the clinic without a provider. Abortion training is not widespread.

[JoeOtterbein]

12. It's a slippery slope to comply with immoral acts for any reason.

This doctor sounds like a rookie.

[WhiskeyGrinder]

15. I can assure you that people who work in abortion care think about these things a lot.

[JoeOtterbein]

16. That's a good thing.

Thanks!

[sheshe2]

36. She is no rookie.

Read up about her.

[Maraya1969]

13. I am becoming more and more pro-choice from listening to the bullshit that

these women haters are throwing around. They seem like anything but caring. They seem like they just want to hurt and control women.

Fuck them.

[Solly Mack]

21. K&R

[procon]

25. No. He took an oath to do no harm.

He had a clear choice, either be true to his Hippocratic oath as a physician and stand against the state to protect his patient, or capitulate and become the cruel agent of the fascist state.

[hlthe2b]

26. always assume a physician to be a male, eh? ok.. hmmm

See sheshe2's post #22 and $24

[sheshe2]

29. ...

[procon]

31. Use the pronoun of your choice if that's what

is most important to you. I wanted to focus on the issues of morality, integrity, honor and ethics, not exactly an exclusive gender based topic, yeah?

[hlthe2b]

33. You obviously know nothing about medicine, licensure, legal implications of falsifying records

and clearly nothing about this incredibly dedicated doctor who you seem to want to smear that I pointed you to in post #22 and #24.

[procon]

39. 30+ years a working RN and I have seen good and bad

physicians struggle to do the right thing. Some have varying degres of fortitude and a few might have the will to risk everything for their integrty. Others sold out for money or to curry favor from the powerful few.

It's their decision to make, but at least they do have an option. The women really have no choice. That's part of the untenable dilemma these Republican politicians have deliberately created. They'll continue to ruin lives and get away with it until pubic sentiment swings in favor of women's rights and a sweeping national legal ruling finally stops them.

[hlthe2b]

40. The physicians do not have an option except to deny the abortion IF after presenting the choice to

woman, the woman opted not to have the second unnecessary pelvic exam (one would be normally done immediately prior to the abortion regardless). If you actually saw the TRMS piece, they made it clear that the women were apologizing to the DOCTOR for having to do what the state is making them do. One was a woman with a fetal defect and she could not risk further delays.

Blaming the physician is abhorrent to me. You should read the full details so that you know BETTER. She is the heroic one in this story.

[procon]

43. Why does a doctor comply with a political order?

Think about it. What if he proceeded according to best practices and left the neanderthal politicians out of the treatment room? That's a medical decision made by a licensed phyician in conjunction with his patient's needs. The state's political officer is unqualied to offer anything more substantial than a magazine to peope in the waiting room.

What's to argue about? I disagree with your opinion and it doesn't matter to me whether you like mine or not. At issue is stopping these egregious Republican politics that have no place in anyone's personal and private decisions.

[hlthe2b]

45. Falsifying records as you are suggesting violates Federal laws

you, as a supposed nurse of 30 years should KNOW that. Good gawd. That isn't a matter of opinion.

If you did that as a nurse, heaven help your patients. If you did that--if you falsified records as you are advocating, you should have been prosecuted for the protection of all patients.

This doctor and the Planned Parenthood clinic she is endeavoring to keep open, is trying to help her patients in a very difficult situation and to ensure abortion remains an option for the women of Missouri despite the risks to her personally, professionally, and to her colleagues and while PP challenges this corrupt Missouri effort to deny legal abortion. She's a hero for doing this and for working with PP to legally fight this. What you are suggesting will suggest she will not only fail in that, but likely never be able to help another patient again. Nor will anyone else in Missouri.

This is who you attack, since you won't bother to read the previous threads:

Dr. Colleen McNicholas zig-zags across the Midwest—considered an "abortion desert"—to provide women with care that's harder and harder to come by. In part two of Marie Claire's series on reproductive rights, she takes us with her.
McNicholas is one of a dwindling group of doctors performing abortions in the Midwest, which, along with the South, is known to pro-choice advocates as the abortion desert. According to the Guttmacher Institute, as of 2011, the most recent year for which data are available, 94 percent of counties in the Midwest had no abortion clinic to serve the 13.2 million women of reproductive age who live there. She works two days every three weeks at the Planned Parenthood in St. Louis—the only remaining abortion clinic in Missouri—flies once a month to the Wichita, Kansas–based clinic where Dr. George Tiller practiced until he was shot dead in 2009 by an antiabortion zealot, and in June will begin traveling to Oklahoma City to work at a newly opened clinic. "Part of the problem with being so committed and feeling so passionate about an issue is that it's hard to say no," McNicholas, 35, says. "It's hard to say, 'I can't do that,' because that means somebody is going without care, and what that means is, they're probably going to have a baby they don't want. So ultimately, I end up saying, 'I can do one more day' or 'I can go one more place.'"

When she's not crisscrossing the Midwest, she's treating patients at her obstetrics and gynecology practice at St. Louis' Washington University School of Medicine, where she is an attending physician and assistant professor. She also drives two hours to Jefferson City, Missouri, a few times a year to testify before the state Legislature in opposition to bills restricting access to abortions. Once a year, she goes to Washington, D.C., with other doctors to lobby legislators that science ought to trump politics when it comes to providing a procedure that, according to Guttmacher, one-third of all American women will have before age 45. Some nights, she meets with the board members of the abortion-access fund she founded to help Missourian women afford the procedure. (At Planned Parenthood in St. Louis, patients pay from $545 to $1,470, most often out of pocket, as state law prohibits Missouri-based insurance companies from covering the cost, except when the woman's life is at risk.) Whatever precious hours she has left are spent at home with her 5-year-old son (a basketball star in the making) and her partner, an anesthesiologist, who didn't want her name used out of concern for her safety.

[VOX]

28. A man named "Amy"??? n/t

[procon]

32. Seriously? This is where you make your stand? nt

[yardwork]

50. And just let the only abortion provider in the state be shut down?

[LanternWaste]

57. It's the only abortion provider in the state, yes?

Due to that, it's under an extreme scrutiny by the state and local GOP politicians as well, yes? Also (potentially) by outside, anti-choice groups, all doing their best to find any t not crossed or i dotted in order to shut the clinic down, yes?

If that's the case, you believe the doctor's dismissal would be the ONLY consequence of her falsifying patient records? Or do we conclude that by not doing as stipulated, she would quickly be found out, and the only provider in the state would be shut down... to satisfy self-righteousness?

And that would prove a net benefit to the state of Missouri exactly how?

[SunSeeker]

38. Thank you, Rachel, for exposing the state-mandated sexual assault of women in Missouri.

This should have been headline news.

[certainot]

41. missou GOP needs the university of missouri to keep supporting 6 limbaugh stations -

some of those are probably the loudest in the state and they all support these shit for brains

protests at the uni of missou to get them to look for apolitical alternatives to broadcast sports on will freak out the local GOP

media will notice

whatever the uni does, advertisers will head for the hills

some of those stations will have to change programming from RW anti choice bullshit to anything else

all the rw radio stations in the state will lose advertisers

state and national GOP will freak out

media will notice

others of the 88 universties supporting 260 limbaugh stations will be shamed into following

and all those local blowhards on those stations are weighing in on this in support of republican misogynists and they can be recorded by internet and with AI assisted transcription like at sonix.ai fast for $5/hr and all their advertisers and their contact info can be listed with little listening required with the process described at republiconradio.org

those stations have played a huge part in electing these shit-for-brains and a small number of people anywhere can destroy that propaganda operation

and so on

[pstokely]

44. might be a good idea to complain to the alumni assocation or some student groups

Last edited Fri Jun 7, 2019, 09:54 PM - Edit history (1)

https://www.facebook.com/MizzouAlumniAssociation/

[certainot]

64. maybe so with a forum that a number of them can actually see vs going through

the usual gatekeepers at initial contact who immediately fall in with the usual excuses and pass it on the athletic admin

i still think it's up to the students to protest and then alum get involved when it gets their attention

[StevieM]

42. This is reprehensible. (eom)

[treestar]

46. I'm actually kind of surprised it is not needed

I remember back in the day, a doctor would not write you a birth control pill prescription without doing a pelvic exam.

[hlthe2b]

51. A pelvic exam is administered before the abortion. This is second, unnecessary exam required BEFORE

the three day waiting period begins on a separate visit--a visit which would normally include only routine paperwork, and noninvasive confirmatory pregnancy test, BP, etc. There is no medical justification for this second exam.

[treestar]

60. Oh, oK thanks,

Yeah what will change in 3 days.

[WhiskeyGrinder]

66. This is not a pelvic exam. This is an ultrasound conducted with the transducer wand inserted in the

person's vagina.

[yardwork]

48. I see that Randall Williams is the new state health director in MO.

That's not good.

[Blues Heron]

54. Violation of the hippocratic oath

Doc has a duty to not do it. The only option is to resign and force the issue.

[hlthe2b]

55. Here is the video of the full Rachel Maddow segment.

Link to tweet

[leftyladyfrommo]

58. I live here. It's been this way for 40 years. It has just gotten worse or it has just gotten more

out in the open.

[treestar]

61. If they could get a patient willing to

be a plaintiff, they could take the case to court protesting the unnecessary exam and making a claim for damages. The doctor could be a co-plaintiff also claiming damages (mental distress) and sue the state over the provision.

Though when it gets up to Kavanaugh and Co. they could uphold it, but even the right wing on the court might find it without rational basis.

[hlthe2b]

62. It is being taken up as part of the larger suit against the state's antiabortion laws and regulation

that they are using to drive out this last remaining clinic. It is part of the wider suit by Planned Parenthood and others. Virginia tried similar with required transvaginal ultrasounds--a procedure that is not only invasive and unnecessary. It never made to court because the publication and resulting outrage were too much and Bob McDonnell (governor at the time was about to be drummed out anyway).

[treestar]

63. That's good, thank you

Legislative and not medical requirements - they'll try anything.