Medical Privacy? Have an Abortion and Kiss It Good-Bye
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Tue Mar 06, 2007 at 01:23:05 AM EST
Photobucket - Video and Image HostingMolly Ivins once called Texas the national laboratory for bad government. To cite only one example, laws regulating abortion just don't come much worse than ours.

There is a growing trend for politicians to dodge this powder keg issue by mouthing innocuous-sounding platitudes about "reducing the number of abortions." But with a Christian right-approved Democratic initiative as political cover, two Republican state legislators are leading a full-on charge, mounted for battle on a Trojan donkey.

Should they succeed, the confidentiality of personal information, and medical privacy as we know it, will become a thing of the past for women in Texas.

The latest assault on women's medical privacy is being led by two Texas Republican women who will never have to worry about access to health care for themselves or for their daughters.

Photobucket - Video and Image HostingState Senator Florence Shapiro (right) learned how to run a statewide campaign at the knee of Karl Rove.

"The skill I think Karl brings is to take the long view," says Shapiro. "He knows every possible move, and he knows every possible response. He lays out a plan for you that is day-in, day-out." ... She learned her lessons well.

What Flo Shapiro wants, a dozen years in the state senate have taught her how to get.

Like Shapiro, Rep. Geanie Morrison (below left) earns a rating of over 100% from the Texas Right to Life Committee. Morrison takes pride in her efforts to deprive other women of reproductive autonomy, and of the support they need to care for the children she insists that they should bear.

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HB 15 (Morrison - Co-Author) requires that abortions performed at or after the 16th week of pregnancy be performed in a licensed hospital or ambulatory surgical center. Additionally, this legislation requires that a mother seeking an abortion be provided with material containing information regarding pregnancy and adoption. Upon receiving this information, the mother must then wait 24 hours before an abortion can be performed.
Texans must promote the involvement of charitable and faith based organizations. These institutions should be welcomed partners in our efforts to build a better society. With a proven record of delivering morally grounded services, these institutions can provide the type of guidance that rejects government handouts and promotes self-reliance.

What better candidates to lead a bipartisan rapprochement with Democrats for Life of America?

The national push to collect detailed information from women who seek abortion care originated with the 95-10 Initiative of Democrats for Life (DFLA), a group with deep ties to the Christian right and various militant anti-choice organizations. (One of these groups, Life Dynamics International, also began another intrusive anti-choice campaign being furthered by Rep. Robert Talton, author of a current bill requiring doctors to collect and preserve tissue from the bodies of girls who have abortions before age 14, and turn that tissue over to the state police for DNA analysis.) 95-10 is currently awaiting action by Congress in the guise of the Pregnant Women Support Act (PWSA) introduced by Rep. Lincoln Davis.

The PWSA has garnered support from many who, informed only by DFLA's candy-coated press releases, have little idea of what 95-10 actually contains. This section from the official 95-10 brochure [pdf link] sounds fairly innocent at first blush.

Conduct a National Study & Update Abortion Data

The Centers for Disease Control will collect accurate data on why women choose abortions. Within five years of enactment, the CDC will present its findings to Congress.

The CDC would collect that data from the same sources it uses now -- abortion surveillance reports from the individual states -- and therein lies the rub. Like most states, Texas compiles statistics on induced terminations of pregnancy, and has done so for years.  The state's current abortion statistics report form already requires a woman's date of birth, her race or ethnicity, her marital status, her state and county of residence, her number of previous live births, her number of previous abortions, the type of abortion procedure she had, the date of her last menstrual period, and the length of gestation of her pregnancy.

For "family values" lawmakers such as Rep. Geanie Morrison and Sen. Florence Shapiro, that's just not enough personal information to pry out of a woman before she's allowed to have access to abortion care. Like all other anti-choice politicians, they keep coming back for more -- and this year, they intend to get it.

The "Abortion Reporting Requirement Act" -- introduced by Morrison in the house as HB 1750 and by Shapiro in the senate as SB 785 -- delves more intrusively into a woman's personal, medical and financial privacy than most well-meaning supporters of the 95-10 Initiative could imagine. Further, although it denies a woman access to abortion care unless she opens the details of her personal life to the state, none of the data mined by its provisions has much to do with reasons why a woman might have an abortion. But this legislation indeed might serve to reduce the overall number of abortions, if only by intimidating women forced to provide what should be confidential information to a state government deeply permeated [pdf link] by the influence of the Christian right.

Abortion statistics currently are submitted under a designated reporting number for each physician's office or facility, but do not include personal or identifiable information even about physicians -- in fact, reporting rules forbid it. Now, however, Morrison and Shapiro deem it necessary, in every case, for the state to have on file "the signature and license number of the physician who performed or induced the abortion." And personal information about doctors is only the beginning.

Both Shapiro and Morrison have a record of supporting insurance coverage for women. Their new bills show plenty of support for putting the insurance coverage of a woman who has an abortion on the record as well.

The abortion reporting form for each abortion must include:
(14)  whether the abortion was paid for by:
                    (A)  private insurance;
                    (B)  a public health plan; or
                    (C)  personal payment by patient;
 (15)  whether insurance coverage was provided by:
                    (A)  a fee-for-service insurance company;
                    (B)  a managed care company; or
                    (C)  another source;
 (16)  the fee collected for performing or inducing the abortion; ...

In addition to knowing how much a woman paid for her abortion, to whom the fee was paid, and by what method, Florence and Geanie also want to know what town she lives in, the age of "the father of the unborn child," how her pregnancy was confirmed, who referred her to the doctor who performed her abortion, how much her fetus weighed after the procedure and -- only if she feels like telling, mind you -- why the woman was having an abortion in the first place. That information is the only entirely optional detail, which seems to render useless the ostensible purpose of such fact-finding missions as the "Abortion Reporting Requirement Act."

A woman needn't imagine that she can get on her high horse and refuse to answer any of the other questions. If she wants the state to let her have an abortion, she'll cooperate -- on the record.

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The patient must fill out sections of the form applicable to the patient's personal information.  Sections to be filled out by the patient must be at the top of the form.  The bottom portion of the reporting form must be completed by the physician performing or inducing the abortion. The requirement that the patient fill out the top portion of the form may be waived only if the abortion is performed or induced to prevent the death of the mother or to avoid harm to a mother described by Section 164.052(a)(18), Occupations Code, or harm to a mother who is a minor  described by Section 164.052(a)(19), Occupations Code.

"Harm to a mother" means that "the woman is diagnosed with a significant likelihood of suffering imminent severe, irreversible brain damage or imminent severe, irreversible paralysis" in the third trimester, and the doctor can't say no, either. A physician can be fined and found in contempt merely for not getting the mandatory monthly reports turned in on time, let alone for refusing to compile or submit them.

And if a woman should see her own private physician, or any other doctor, for follow-up treatment after an abortion, the reporting process starts all over again.

A physician practicing in the state who treats an illness or injury related to complications from an abortion shall complete and submit an abortion complication report to the department. The report may be submitted by mail or electronically filed on an Internet website created by the department. The report must include:
              (1)  the date and type of the original abortion;
              (2)  the name and type of facility where the abortion complication was diagnosed and treated;
              (3)  the name of the facility and of the physician who performed or induced the abortion, if known;
              (4)  the license number and signature of the physician who treated the abortion complication;
              (5)  the date on which the abortion complication was diagnosed and treated;
              (6)  a description of the abortion complication;
              (7)  the patient's year of birth, race, marital status, and municipality, county, and state or, if the person is not a resident of the United States, nation of residence;
              (8)  the week of gestation at which the abortion was performed or induced based on the best medical judgment of the attending physician at the time of treatment for the abortion complication;
              (9)  the number of previous live births by the patient;
              (10)  the number of previous performed or induced abortions for the patient;
              (11)  the number of previous spontaneous abortions by the patient;
              (12)  whether treatment for the abortion complication was paid for by:
                    (A)  private insurance;
                    (B)  a public health plan; or
                    (C)  personal payment by the patient;
              (13)  whether insurance coverage was provided by:
                    (A)  a fee-for-service insurance company;
                    (B)  a managed care company; or
                    (C)  another provider; and
(14)    the type of follow-up care recommended and whether the physician who filed the report provided the follow-up care.

Reports on follow-up care must be filed not monthly, but within seven days, and may be filed electronically -- yet another risk to medical privacy, given the frequency of data theft. While a woman's name is not to be included in the reports, current law already gives state inspectors an unimpeded right to access her original and complete medical records at any time, and the Department of State Health Services may make and retain copies of her records for its own purposes.  Considering the highly personal nature of the information to be contained in the new reports, it seems reasonable to suspect that a woman's health might not be the primary focus of the state's interest.

Bills are assigned to legislative committees for consideration. There they are often modified, and sometimes allowed to die a quiet and richly deserved death. But probably not this time. The Abortion Reporting Requirement Act will be heard in the House of Representatives by the State Affairs Committee. The past and present Chair of that committee is Rep. David Swinford, himself a joint author of Morrison's version of the bill. His Vice Chair is Ken "Rumpelstiltskin" Paxton, whose own bill creating "Choose Life" license plates will benefit the adoption industry and crisis pregnancy centers -- such as the one that has his wife, Angela, on its board of directors.

In the Senate, Shapiro's version of the bill will be heard by a State Affairs Committee whose Vice Chair, the highly influential Sen. Tommy Williams, was the primary force behind the 2005 crisis pregnancy center funding that has deprived tens of thousands of Texas women of primary health screening and family planning care.

Molly Ivins called our state the national laboratory for bad government because atrocious legislation that is implemented in Texas one year tends to be foisted upon other states by the following year, or the year after. Should the national push to "reduce the number of abortions" become a federal mandate for government intrusion into the intimate details of a woman's life, anti-choice legislators in other states can be expected to show no more respect or restraint than Shapiro, Morrison or any of their cohorts in the Texas Legislature.  

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Their relentless and shameful assault on a woman's medical privacy needs to stop right here, and right now.

[Title image: YourLaw Newsletter]

Do you know if there is any other medical procedure practiced in Texas that is so hemmed in by reporting requirements?  I was thinking some kind of argument for disproportionate state regulation is applicable here.

I'll bet it's a lot easier than this in Texas to own a gun, to die by gunfire, to sell liquor, to embezzle a church, retain custody of a beaten child, get a divorce, sell real estate, open a preschool, molest a child, change a zoning regulation, develop a wetland, log a national forest, commit adultery, receive faith-based funding and other legislative pork, etc, etc.termination of a pregnancy.

One thing in particular that irks me is the reasonable suspicion that a percentage of crusading anti-choice women like Rep. Morrison and Sen. Shapiro must certainly have had abortions in their youth - choices that they probably "learned" to regret.  Isn't it a practice for anti-choice rallies sometimes to feature women who publicly bemoan their choice to terminate a pregnancy?

I think these hand-wringing types of crusaders fail to see three things

First, nothing they can do will ever change the fact of their decision.   The agonizing work of discovering regret and even remorse for a free choice - and owning that wrong choice - is the privilege and attendant duty of free citizens.  

Second - if they are also lawmakers - it is a rank injustice and hypocrisy for a public servant to engineer the destruction of the most basic of constitutional protections - those against undue state intervention in the lives of its citizens - after they themselves have already had full access to such protections in their own private lives, at a time when it seemed not only convenient but necessary to their self-determination.

It would be an abdication of duty for me as a lawmaker to deny rights of certain private deliberations to others simply because I now regret the direction taken by my own private deliberations - as if to say, I had this right, and took what I thought to be my advantage in it, but now refuse its extension in your case, because I am so very sorry that I failed to make the decision which, in retrospect, was best for me!

Lastly (what uneducated minds cannot possibly see), "moral choice" is not a synonym for "good choice," but a synonym for "free choice."  A choice may be either morally good or morally bad only if it is made in perfect freedom.  What is not chosen in freedom can neither be immoral nor moral but is simply amoral.

Thanks for writing about Texas problems.  They are sure to be coming to home states everywhere.

God bless the whole world - - No Exceptions
by John Anngeister on Tue Mar 06, 2007 at 07:43:07 PM EST

is subject to anything near this level of legislation and regulation -- not in Texas, and not in any other state.

And yes, the "abortion hurts women" campaign is booming, promoted by people like Leslee Unruh of South Dakota.

The highly organized Operation Outcry shuttles its troop of well rehearsed "victims of abortion" back and forth across the country, much like bucking stock on the rodeo circuit. You may find them in any statehouse where testimony is heard on an abortionrelated bill, and their performances have to be seen to be believed.

Rank injustice and hypocrisy? For people such as these, they are merely marketable business skills.

by moiv on Tue Mar 06, 2007 at 09:43:02 PM EST

of legislators carrying water for the Christian right, all of them hell-bent on taking control of women's reproduction.

Sometimes it's enough to make a grown woman cry.

by moiv on Tue Mar 06, 2007 at 01:30:22 AM EST

Such moments are the human condition, and that's not an easy lot.

But, you're not only crying.

by Bruce Wilson on Wed Mar 07, 2007 at 12:51:42 AM EST

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