The difference between elective and urgent

[undeterred]

I used to work with surgeons, and I would like to explain how the terms "elective" and "urgent" were used in that setting.

There is a surgical schedule every day and everything on that schedule is "elective". Patients have been referred to surgeons for a procedure, whether its a brain tumor or a rhinoplasty. Let's assume that the hospital keeps a couple of ORs available for cases that come up from the emergency room.

An "urgent" surgery is one that has to be started immediately to save a patients life. Urgent surgeries could be an abortion that needed to take place immediately to save the mothers life, repair of an abdominal aortic aneurysm, or emergency surgery to stop bleeding from injuries in a car accident.

Suppose that there is a major vehicle accident with multiple victims a mile from the hospital and they accept trauma cases. Its possible that some of the "elective" surgeries scheduled for that day are going to get bumped for the "urgent" surgeries that come into the emergency room from the accident. The elective cases can wait till tomorrow or next week, but the urgent ones cannot. Its not a matter of politics or insurance or anything else except saving lives.

Sometimes the same diagnosis (like abdominal aortic aneurysm) could be either elective or urgent. That is a medical judgment. If the surgeon thinks that its likely to rupture in the next few minutes or hours, its "urgent" and the patient goes right to surgery. If the patient probably has time to go home and make arrangements and come back next week, its "elective" surgery, even though it can't be put off for very long.

The vast majority of surgeries are elective. There are many people who aren't getting surgery right now because they don't have the insurance to cover it and they won't die without the surgery, at least not any time soon. Mastectomies for women with cancer are elective surgeries. The vast majority of abortions are elective. Most women who are unable to have an abortion do not die.

That is the usage I am familiar with. I realize that "elective" may have other connotations that are being emphasized in the abortion debate. But the term means something very specific in the surgical setting: not urgent.

[Kerrytravelers]

1. The general person is not speaking from the pov of a surgeon.

In the abortion debate, the word elective is being used to make a very clear anti-choice point. The rw are not concerned with medical terminology, but is simply manipulating medical terminology for their ideology purposes. I, for one, have no intention to assist them in their efforts. Our language needs to be clear and simple. Pro-choice. Period.

[undeterred]

2. I believe the terminology is the same used by insurance companies.

"Elective" is not meant in a perjorative or dismissive sense- its just descriptive of the medical situation. I am 100% pro-choice and I do not have a problem with this language.

[Kerrytravelers]

4. Yes, I understand your point.

Unfortunately, we do not live in a society of people that understand that professional language and common language do not always mean the same thing. I find this commonly in education. Often parents of my young students confuse the terminology regarding reading, reading comprehension, etc. (There is no need to go into lavish details to complete my point.)

The other team likes to use words to pain some ideological picture. "Pro-life" comes to mind. If they were really "pro-life," they would also be again war, for universal health care, for sensible and complete sexual education in school, etc. But they are not. And they are not "pro-life." But it sounds so much nicer then what they are- forced birth. By using the term "elective," they are attempting to regulate the right to abortion as no more meaningful than a tummy tuck or boob job. While to some the tummy tuck or breast enlargement is very important to them, the medical decision to terminate a pregnancy is far weightier.

This is my objection to using language other than "pro-choice" in the general public. (Yes, the language will be very specific in the actual health care reform legislation.)

Already, I've seen posts where one has referred to "elective" abortion not being something necessary. (This is a crude paraphrasing of multiple posts I've read here at DU this week.) Not everyone on the pro-choice side even knows what "elective" means and is using this terminology to make the anti-choicers arguments for them. Eeeek!

Just to be clear, I was not accusing you of not being pro-choice.

[undeterred]

5. Yeah, there are a lot of misconceptions.

I don't have the visceral reaction to "elective" that a lot of people here do because of my background.

And as far as plastic and reconstructive surgery goes- some of the primary recipients are actually burn patients with horrific skin damage and cancer patients who lose a body part. Its a heroic specialty, in my opinion. Giving someone a better nose is a piece of cake compared to repairing people who have become disfigured through illness or injury. It takes a lot of compassion.

[Kerrytravelers]

8. I am of the opinion that plastic surgery is extraordinarilly life transforming.

My dad had skin cancer on his face. Plastic surgery repaired all the scars and dents to such an amazing degree that if you didn't know what had happened, you'd never guess my dad had skin cancer on his face.

I know my dad's plastic reconstruction surgery was labeled "elective" medically, as it wasn't a matter of life or death. I get that. However, in the public arena, clear, concise language that is very clear is always the best. The less play room with words given to the opposite side, the easier our point is made. That is really my only point.

[undeterred]

13. I can't imagine what people would do without it.

Just closing up a cleft palate changes someone's life.

[Kerrytravelers]

22. We always get the requests for money to pay for young children's cleft palates.

it absolutely breaks my heart. Being from Los Angeles, I always bristle with I hear the jokes about plastic surgeons in Beverly Hills.

Do starlets use them for bigger boobs? Yes. They do. But they also do breast reduction to alleviate back pain. And reconstructive surgery after accidents, etc.

[MH1]

7. I have a problem with it

because I think "elective" should be beside the point, when it comes to abortion coverage by insurance.

I doubt that very many abortions are chosen in cases where the condition of pregnancy was "elected". (I am sure there are a few, due to changed circumstances, but that is hardly the norm.) Terminating an unwanted pregnancy is NOT the same as getting a nose job, or even having a benign mole removed.

[shadesofgray]

3. +1

[MH1]

6. To an RWer, every abortion is "elective"

whereas to someone who understands the impact of overpopulation on the fate of future generations of humans on this planet, access to abortion (pretty much) on demand is "urgent".

Funny how these things work.

[GreenPartyVoter]

11. Yep. I still can't wait for the day we can transplant embryos. Let the RWers

(hopefully the men, if we can pull that off) give birth to and raise those babies they care so much about.

[tonysam]

12. Let's quit distorting the meaning.

Somebody on another thread is trying to distort the fact abortion is a form of birth control and trying to paint that reality as a RW talking point.

It's utter bullshit, and people here need to stop it.

[MH1]

14. It *IS* a RW talking point

the sad fact is that sometimes it is actually true - as with MANY right wing talking points.

Abortion is absolutely needed when other methods of contraception fail - for whatever reason. I guess technically some might still define that as "birth control" but the implication is that in most cases it was the ONLY means of contraception used - and that is what makes it an RW talking point. Because that is bullshit.

[Hello_Kitty]

15. For the woman who doesn't want to have a baby, it's a medical necessity.

In addition to the population issue, I'm rather astounded by a lot of people's blase attitude about pregnancy, birth, and bringing a human being with needs into the world. There is no hell on earth like that for an unwanted child.

[MH1]

16. Exactly. It is frustrating, isn't it,

the way people just bandy about the "right to life" as if that life will necessarily be all cute cuddly warm and wonderful. Toy trains at Christmas, kitties and puppies and pony rides and ribbons for her hair. Yeah right.

[undeterred]

20. Calling something "elective" does not imply that it isn't

a medical necessity. It just means that the patient won't die if the procedure isn't done immediately.

[Hello_Kitty]

21. I totally understand the point of the OP.

But there's a difference between terms used in a proper medical context and how they are used by laypeople. When people on DU refer to abortion as "elective" most of the time it's to compare it to cosmetic procedures. In fact, that exact comparison is the one that is most used.

[undeterred]

23. The right is misusing the term by implying it means

medically unnecessary. It doesn't mean that for insurance coverage.

But having said that, I think that the real problem is that insurance is gradually deciding that more and more procedures are medically unnecessary because they don't want to pay for it. Abortion has been singled out because of the amendment, but on an individual basis, other procedures are too.

Your gallstones hurt, but you won't die if you don't have them out... so if you "elect" to have it done anyway, you can pay for it out of pocket.

[MH1]

26. Yes, it does. To the average person who hears this bandied about in everyday discourse.

THAT is why the RWers are emphasizing the point. It makes no difference what the truth is, what matters to them is whether they can influence people by using language a certain way. They specifically use it to imply that abortion is not necessary therefore should not be covered by insurance.

[PeaceNikki]

17. Very well put! I hope you don't mind...

that I quoted(ish) it here: http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=7162261&mesg_id=7162381

[Kerrytravelers]

25. I don't mind one bit.

:hi:

[tonysam]

9. A big rec for common sense

I HATE this phony parsing of words.

[Kerrytravelers]

24. I take objection to "phony parsing of words"

In the public arena, words are what one has to maintain their rights, solidify rights or make a public point. Since I don't advocate violence, I must use words. And using very specific words is necessary. While medically, the OP has made a very clear point that the word "elective" is used in many procedures, surgeries, etc., the public debate/battle over abortion really isn't based on professional medical verbiage, as we've seen with terms like "partial birth abortion." Medically, there is no such thing, but is has become part of the American vernacular. It is very important to not let a layperson use a word like "elective" to people who do not understand the professional medical use of the word.

In essence, the likening the choice of abortion to a starlet's boob job is beyond condescending to women. That is the overall objection.

[Hello_Kitty]

10. But abortion is a time-sensitive procedure.

It's best and safest when performed as early in the pregnancy as possible.

[MH1]

18. Excellent point.

[undeterred]

19. Most medical conditions are time-sensitive but not urgent.

You need to have the cancerous tumor removed, but you won't die if it doesn't happen today.

It isn't a judgment on the merit of the procedure, but on whether death will occur if the procedure is not performed.

If you have no insurance but go to an emergency room, they are legally required to perform whatever urgent procedure is required to keep you alive. If you go to an emergency room with cancer they aren't going to provide curative cancer surgery. You're still alive and you will be tomorrow. That's our system. We will save you from dying quickly, but not from dying slowly.

Again, the vast majority of surgical procedures are elective, not urgent, no matter how important the procedure is to quality of life or long term outcome.

[MH1]

27. When will we hear the RWers start referring to cancer surgery as "elective"?

[undeterred]

28. Why is the way we speak determined by the RWers?

[PeaceNikki]

29. By twisting these medical terms to make anti-choice arguments, conservatives have put

progressives firmly on the defensive.

And here we are now watching "Democrats" use the same twisted logic to MAKE the arguments for them.