Wednesday, July 26, 2006

Rape victim denied emergency contraception in ER

Guest blogger: Julie Petrella, Director, Duvall Reproductive Rights Project of the ACLU of PA

Yesterday's Harrisburg Patriot News had an appalling article about a rape victim in Lebanon County whose ER doctor refused to prescribe her emergency contraception (a higher dose of regular birth control pills) because of his religious beliefs. The victim was eventually able to obtain a prescription from her gynecologist, only to find that the local pharmacy was out of the medication. She had to travel from eastern Lebanon County to Reading to get the prescription filled.

To add insult to injury, here's what Dr. Joe Kearns, former medical director of Good Samaritan Hospital in Lebanon, had to say:

"People drive to Reading to buy jeans. Even if that were the case, that you had to drive to Reading to get this [prescription], to me that does not rise to a compulsion that you have to pass laws that [doctors] have to do something."


I am struggling to understand how a woman--who has just been raped!--would find a trip to Reading to get a prescription for emergency contraception (EC) similar to a road trip she might take with her girlfriends to buy a new pair of jeans.

The notion of some healthcare providers that their refusal to provide a crucial, time-sensitive medication to prevent pregnancy is merely an expression of their personally-held religious beliefs and of little consequence to their patient is false. Healthcare providers have a professional obligation to their patients-an obligation that trumps their own personally-held beliefs and requires that they act in accordance with the beliefs of their patients. Creating obstacles for women to prevent pregnancy after a sexual assault is cruel and deplorable.

A woman who has recently been raped, who has suffered physical and emotional trauma, and who is fraught with worry about being impregnated by her attacker would probably find that an extra 45 minute drive (if you have a car!) to another pharmacy is not exactly a fun road trip. I'd even be so bold to say that the woman might feel re-victimized by the systems in place designed to care for her after her trauma, as they have forced her to take additional steps to get EC. One might presume that someone in the health care profession would be in tune to this. Sadly, in Pennsylvania and across the U.S., health care providers are acting in ways that harm their patients rather than help them.

When physicians, pharmacists, and other health care professionals protest the passage of state laws that would ensure comprehensive medical care for rape patients in hospital emergency rooms-including the option to receive emergency contraception--they ignore their own hypocrisy. They don't want the government to force them to provide services they don't believe with but want to deny services to their patients that their patient believes in.

In typical Daily Show form, Jason Jones highlighted this double-standard when he interviewed an Illinois pharmacist, Ron Stevens, in an episode this past winter. Mr. Stevens felt victimized by Illinois law requiring him to fill prescriptions for the morning-after pill and stated, "I think the governor is forcing my hand on this issue." Jason Jones retorts, "How dare the government make a moral judgment over you?! You're the one supposed to be doing that to the woman!"

Until Pennsylvania passes legislation like the Compassionate Assistance for Rape Emergencies (CARE) Act, emergency room doctors will continue to be afforded the opportunity to pass moral judgment over women in their most vulnerable states.

If you'd like to find out if your local emergency room provides emergency contraception to rape victims and what you can do on this issue, click here.

9 Comments:

Blogger Tired of Idiots said...

I'm just SICK that the medical director equated having to travel to get the prescription with buying JEANS!

What is this world coming to? If you're a doctor, you HELP people. Yes, you have personal beliefs, but your DUTY is to help people.

Is your god SO unforgiving that he won't allow you to help someone in need if you don't agree with their views?

I think any doctor who refuses medically approved, medically acceptable treatment to a patient should have their license taken away.

If you want to pick and choose your clients, start a private practice and put the Jesus-fish on your storefront.

Just get the HELL out the ER before you kill someone to protect your soul!

(Sorry, this article really, really touched a nerve)

1:53 PM  
Anonymous Anonymous said...

There should be a movement to pressure companies that refuse to fire employees from doing their jobs. Sure it may be against his/her religious beliefs to prescribe birth control but if that is the case he/she doesn't have to be a doctor.

There are plenty of religious folks who think homosexuals are sinners. Should these employees be allowed to not serve homosexuals because it is against their religion to aid sinners or something similarly stupid?

There needs to be a reaction from reasonable people that we as consumers won't tolerate companies that allow this sort of nonsense to continue.

2:58 PM  
Anonymous Anonymous said...

Patients (as well as physicians or pharmacists) may have anti-abortion leanings, or belong to a faith that pproclaims that life begins at fertilization.

All the more reason that we should all pay attention to a pertinent fact that keeps getting lost: the morning after pill normally prevents fertilization, just like most birth control pills.

As the researchers put it: "The mode of action of emergency contraception with mifepristone or levonorgestrel is primarily due to inhibition of ovulation rather than inhibition of implantation." (Emergency Contraception With Mifepristone and Levonorgestrel: Mechanism of Action," Marions et al, Obstetrics & Gynecology 2002;100:65-71).

Fertilization takes time. When E.C. is taken soon after intercourse, it works by preventing fertilization from happening. If the woman waits longer, the risk of the egg being fertilized increases. In other words, holding up the process for 24 hours INCREASES the chance that the drug will have missed that first window of opportunity, and will instead have to work by lowering the rate of successful implantation.

Also, of course, as noted above, the drug has no effect on a pregnancy once implantation has happened--that's why it is not classed as an abortifacient.

Again, regardless of your personal definition of "when life starts" and your stance on abortion, it makes sense for you to support the earliest possible access to E.C.

--J.S. the Ph.D. biologist (who does, in fact, know more about this than many pharmacists).

P.S. (It may also be useful to know that many fertilized eggs fail to implant under normal circumstances; estimates from various studies range from 15-40%.)

4:44 PM  
Anonymous Anonymous said...

Are we forgetting the fundamental right to religious beliefs here people? How about the actual oath a doctor takes to do no harm? Does that not include babies? This girl having to drive 45 minutes is much more the fault of living in the sticks than a doctor who exercises his constitutional rights.

4:50 PM  
Anonymous Anonymous said...

was their only one doctor in the entire facility, who could possibly have provided the patient with the emergency contraception.
Their should be a diversity of medical professionals who have many views so that they may affectivley serve the community even in non emergency situations. That is what is a shame. what kind of hospital is it where their is no mediator to solve the problem for both the patient in need and the doctor who has religious beliefs. Let them both practice their 1st ammendment rights. Get some more help hospital !!!!

2:29 AM  
Anonymous vupper eyelid said...

I am struggling to understand how a woman--who has just been raped!- would find a trip to Reading to get a prescription for emergency contraception similar to a road trip she might take with her girlfriends to buy a new pair of jeans.

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