OH Bill Would Require Physicians to either Misinform Patients or Face a Felony & up to $1Million Fee

[PL198]

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It's a double negative. You two are agreeing with each other.

I think he was being sarcastic

 

[DermViser]

Definitely don't disobey the law unless you really need to

 

[Sephiroth]

I see your point, technically you would be correct, but I wonder if they could make an argument that by following up your statement informing the patient of the risks with another statement negating that previous statement you have in effect not properly informed the patient of the risks.

Like I said, I'd love to see how this would play out in court if the bill did pass and someone brought it to that. And while I have no intention of going into a field which would relate to this, if I were in the situation, I'd probably go for something like:
"Now according to state law, I am required to inform you of certain risks associated with this procedure. Of those, law dictates I must inform you of an increased risk of breast cancer, so that is what I am telling you, as it is what the state law passed by the Ohio state congress requires of me. Now, The National Cancer Institute of the NIH, the American Cancer Society, the World Health Organization and the American College of Obstetricians and Gynecologists all state that abortion is not related to breast cancer, but I must to tell you that it does. You can decide how to take that into consideration for yourself."

I don't think this thing will pass, but even if it did, there is no ban on stating factual information on what another body, particularly the NCI which is under the federal government, has said. And you can't be held to convince someone of it. Similarly, wit hall these ridiculous requirements being put in place about showing ultrasound and making her listen to heartbeat, they can make you show it and have the patient sign off on being shown it and being told certain things, but they can't make you physically force someone. If you play the video and read off what they say you have to, and the patient signs off on being shown/told all of it, I don't know what they could try if she wasn't looking and listening to music the whole time.

 

[loris]

You don't see how someone who is avidly pro-life and being part of a (likely) radical pro-life group, on a board to license physicians, including OB-Gyns, as a conflict of interest?

Haha, I know, right? Not just part of a pro-life group, but their president, a position that paid him $62,712.00 in 2012 to work just 20hrs a week. In addition to serving as the president of the Ohio Right To Life Society, in 2012 he was also paid $53,391.00 to work 20hrs a week as the as the president of the Ohio Right To Life Society Educational Fund which both funds and is funded by the Ohio Right To Life Society (https://citizenaudit.org/311218303/ ). That’s not even including lobbying.

MLG Capitol Consulting, LLC’s site states, “With a strategic focus on government affairs and procurement, MLG Capitol Consulting is a Columbus based firm specializing in advocating for clients before key decision-makers by incorporating an efficient and integrated legislative and executive agency lobbying approach. Our primary desire is focused on providing high-quality service to ensure success for our clients. With years of experience, our firm can successfully navigate the state governmental processes to best position our clients to achieve and exceed desired results ( http://www.mlgconsulting.org/default.html ).” The site’s biography of Gonidakis, their president, states, “Now in his twelfth year as a practicing attorney and government affairs specialist in both the public and private sector, Michael Gonidakis provides tactical counsel to clients to strategically navigate legislation, government regulations and procurement…Michael represents corporations and nonprofit entities before the state legislature as well as statewide officeholders and numerous state agencies. Michael has been involved with numerous statewide and local political campaigns as well. He served as the Campaign Director for both Justice Robert Cupp and Justice Terrence O’Donnell during their successful 2006 campaigns for the Ohio Supreme Court.”

His professional clients aren’t limited to pro-life organizations (http://www2.jlec-olig.state.oh.us/OLAC/Reports/ViewAgent.aspx?id=1432 & http://www.followthemoney.org/database/lobbyist.phtml?l=238786 ).
For example, Ohio is currently battling a huge opiate addiction problem and the State Medical Board of Ohio is responsible for approving the treatment/facility for physicians with addiction problems as well as aiding the current effort to draft laws involving opiate addiction treatment (Board rule: http://www.med.ohio.gov/pdf/rules/CSI_Packet.pdf , HB 501: http://www.legislature.state.oh.us/bills.cfm?ID=130_HB_501 , HB 341: http://www.legislature.state.oh.us/bills.cfm?ID=130_HB_341 , HB 314: http://www.legislature.state.oh.us/bills.cfm?ID=130_HB_314 ). Gonidakis is a registered lobbyist for Proove Biosciences, Inc., a fairly young company that offers proprietary genetic testing for susceptibility to opiate addiction to aid treatment (http://www.proovebio.com/contact-us/faqs/ ). If the board ever gave Proove Biosciences preferential treatment by proposing or interpreting policy so that addiction patients were required to undergo Proove’s genetic testing regardless of their physician’s professional opinion, it would be an egregious conflict of interest.

 

[PL198]

Like I said, I'd love to see how this would play out in court if the bill did pass and someone brought it to that. And while I have no intention of going into a field which would relate to this, if I were in the situation, I'd probably go for something like:
"Now according to state law, I am required to inform you of certain risks associated with this procedure. Of those, law dictates I must inform you of an increased risk of breast cancer, so that is what I am telling you, as it is what the state law passed by the Ohio state congress requires of me. Now, The National Cancer Institute of the NIH, the American Cancer Society, the World Health Organization and the American College of Obstetricians and Gynecologists all state that abortion is not related to breast cancer, but I must to tell you that it does. You can decide how to take that into consideration for yourself."

I don't think this thing will pass, but even if it did, there is no ban on stating factual information on what another body, particularly the NCI which is under the federal government, has said. And you can't be held to convince someone of it. Similarly, wit hall these ridiculous requirements being put in place about showing ultrasound and making her listen to heartbeat, they can make you show it and have the patient sign off on being shown it and being told certain things, but they can't make you physically force someone. If you play the video and read off what they say you have to, and the patient signs off on being shown/told all of it, I don't know what they could try if she wasn't looking and listening to music the whole time.

You can't say that to a patient. Look at your statement again and pretend you're a patient receiving that information.

 

[SBR249]

The whole point of ethics is to provide a framework for multiple people to agree on a common set of standards.

Ethics =/= morality. Something can be ethical and immoral and something can be ethical but immoral. It's about the prevailing attitudes of the time, not about morality.

So yes, those questions on the boards do have a single right answer because we've decided, collectively as a profession, on how to deal with those particular situations.

Perhaps you should read my comment again. I was using NBME questions as a counter-example.

Who said anything about morality? I was merely stating that physicians who participate in executions violate 3 out of the 4 core principles of ethics that is commonly taught to be fundamental to the medical profession. The poster who replied to my comment said it was my opinion and my response was that ethics is more than an opinion since it is a regulated area of the medical profession with certain standards.

Also what's the difference between ethical AND immoral and ethical BUT immoral? I'm afraid the subtleties in the diction eludes me.

 

[PL198]

Perhaps you should read my comment again. I was using NBME questions as a counter-example.

Who said anything about morality? I was merely stating that physicians who participate in executions violate 3 out of the 4 core principles of ethics that is commonly taught to be fundamental to the medical profession. The poster who replied to my comment said it was my opinion and my response was that ethics is more than an opinion since it is a regulated area of the medical profession with certain standards.

Also what's the difference between ethical AND immoral and ethical BUT immoral? I'm afraid the subtleties in the diction eludes me.

You can't come up with an ethical argument on why it's acceptable for state medical boards to somehow force physicians into doing/not doing things. That's not acceptable on any level. It's not their job. This concept of medicine having some higher set of ethics than society is a joke. If society deems the death penalty to be acceptable, then it's fine by my standards.

P.S. I couldn't care less what the standards of ethics are. If you haven't noticed, 99.99999% of the people behind these "standards" haven't set a foot into a hospital in their life as a professional. The hippocratic oath is a joke. I don't have some special set of ethical obligations, just because I'm a certain profession. All people are held to the same standards. It's hilarious how something like the hippocratic oath is considered so vital to medicine, yet it requires additional responsibilities of physicians, yet gives them no additional reward. Wonder why that is? Wonder why it's shoved down our throats?

Additionally, it's funny someone talked about the AMA's stance on an issue. Sorry, I don't recognize the AMA as having any authority over me, because they don't. Just like the UN and how the provisions of the various Geneva Conventions don't apply to me, because I'm not a soldier.

 

[SBR249]

You can't come up with an ethical argument on why it's acceptable for state medical boards to somehow force physicians into doing/not doing things. That's not acceptable on any level. It's not their job. This concept of medicine having some higher set of ethics than society is a joke. If society deems the death penalty to be acceptable, then it's fine by my standards.

P.S. I couldn't care less what the standards of ethics are. If you haven't noticed, 99.99999% of the people behind these "standards" haven't set a foot into a hospital in their life as a professional. The hippocratic oath is a joke. I don't have some special set of ethical obligations, just because I'm a certain profession. All people are held to the same standards. It's hilarious how something like the hippocratic oath is considered so vital to medicine, yet it requires additional responsibilities of physicians, yet gives them no additional reward. Wonder why that is? Wonder why it's shoved down our throats?

Additionally, it's funny someone talked about the AMA's stance on an issue. Sorry, I don't recognize the AMA as having any authority over me, because they don't. Just like the UN and how the provisions of the various Geneva Conventions don't apply to me, because I'm not a soldier.

I don't have to come up with an ethical argument for why state medical boards do this or that. The fact is they either do something or they don't and that's reality, so unless they change the rules such that ethical standards don't matter then they do. Don't like it? Don't practice in that state or don't go into that specialty. I don't make this stuff up. You can live in fantasy land and pretend that this is somehow "bull****" and doesn't affect you, that's your choice. But then again, you don't make the rules.

As for the AMA. No they don't have jurisdiction, but the anesthesiology board does have jurisdiction over anesthesiologists and that board decided to go with AMA recommendations. Again, not your call. If you don't like it, don't become an anesthesiologist. In fact, google it and you'll be able to find many examples of specialty boards sanctioning physicians for ethical violations. So no the AMA won't come after you, but if you hold a board certification, your board might based on AMA guidelines.

Don't like the hippocratic oath? Then don't go to the ceremony, or don't become a physician. Like I said, no one cares whether or not you care about a rule or a standard. If it's there and it's applicable to your profession, then you will be held to it. Unless you are the one making the rules, which as a med student I highly doubt.

 

[PL198]

lol the hippocratic oath has been shown to NOT be legally bind at least 100x in court... I'm pretty sure the current number is 20 % of medical schools use it, so it has nothing to do with being a doctor. It's just something cute that people use to signify the passage into being a student or a doctor.

 

[DermViser]

lol the hippocratic oath has been shown to NOT be legally bind at least 100x in court... I'm pretty sure the current number is 20 % of medical schools use it, so it has nothing to do with being a doctor. It's just something cute that people use to signify the passage into being a student or a doctor.

Hasn't the Hippocratic Oath been thoroughly revised also? But yes, it is nowhere near legally binding. It is used as a way to beat doctors into submission:
@2:52

 

[PL198]

Hasn't the Hippocratic Oath been thoroughly revised also? But yes, it is nowhere near legally binding. It is used as a way to beat doctors into submission:
@2:52

I'm pretty sure the newest planned revisions include things about " reasonable compensation." Not even joking. I'd flat out refuse to do it

 

[RJGOP]

Hasn't the Hippocratic Oath been thoroughly revised also? But yes, it is nowhere near legally binding. It is used as a way to beat doctors into submission:
@2:52

Here's a solution- lower taxes for everybody. And to the lady who remarked about doctors having to pay back their subsidized education, how about the people who attended public school? Should those people, regardless of occupation, have to pay back their subsidized education? I can bet you anything she would say it depends on their income, their occupation. I would say that' pretty damn hypocritical.

 

[DermViser]

I'm pretty sure the newest planned revisions include things about " reasonable compensation." Not even joking. I'd flat out refuse to do it

And according to the hobo guy, "Sharing the love" (salary) is part of doctor's code of conduct/code of ethics.

 

[RJGOP]

And according to the hobo guy, "Sharing the love" (salary) is part of doctor's code of conduct/code of ethics.

Yeah, what the hell does he know about a doctors code of conduct. Also, I would ask him if he'd like to "share the love" with his welfare checks.

 

[SBR249]

lol the hippocratic oath has been shown to NOT be legally bind at least 100x in court... I'm pretty sure the current number is 20 % of medical schools use it, so it has nothing to do with being a doctor. It's just something cute that people use to signify the passage into being a student or a doctor.

You must have a lot of trouble understanding my posts. I never said the hippocratic oath was legally binding. In fact, I said you can skip that ceremony if you want. But whatever actually rules that govern being a physician you do have to obey, and if they pertain to ethics, then you have no choice. Otherwise, don't become a physician.

 

[DermViser]

You must have a lot of trouble understanding my posts. I never said the hippocratic oath was legally binding. In fact, I said you can skip that ceremony if you want. But whatever actually rules that govern being a physician you do have to obey, and if they pertain to ethics, then you have no choice. Otherwise, don't become a physician.

The rules that govern a physician don't come from the AMA or medical specialty society. It's defined at the state level. A state medical board falls under the jurisdiction of the laws for that state and often times people on that board are appointed by the governor of that state.

 

[SBR249]

A medical licensing board is governed by the laws of the state that charters it. However, specialty boards are not governed by the state. Board certified physicians answer both to their state medical board for their license to practice and the specialty board for their certification. At least that's how I understand it. For example, if you are a board certified anesthesiologist, you could be sanctioned by the ABA and lose your certification but still have a license to practice. But then your job may be in danger if your employer requires you to be board certified.

In any case, I'm merely pointing out that there is actual precedent for a specialty board to revoke certification based on AMA ethics guidelines that they've chosen to adopt and that's a fact that is easily googled.

 

[ketosisevangelist]

Word

 

[evilbooyaa]

I think he was being sarcastic

I don't think DV does sarcasm. Unless it has the eye roll smiley.

 

[loris]

I'm pretty sure ohio was doing something similar with death penalty as well, as in it was suggested that physicians that assist with death penalty proceedings in ohio could have their licenses revoked.

I'm pretty sure the recommendation for physicians to not participate in administering the death penalty is from the AMA. If anything, state would probably love to have physicians perform it as it would grant them more legal cover. Assisting in the death penalty would violate the principles of beneficence, non-maleficence, as well as autonomy.

In Ohio, the Attorney General wanted to know if physicians who did not personally participate in an execution should be disciplined if they agree to testify as an expert witness during a trial on the medical effects of the drugs used and the cause of death. A more complete summary of the board’s discussion of this topic can be found on pages 5-8 of their meeting minutes from 05/14/14 (http://www.med.ohio.gov/pdf/Minutes/Minutes-2014/05-14minutes.pdf ), but here is an excerpt:

“Mr. Blanton informed the Board that a letter was received from the Ohio Attorney General’s Office (AG), on behalf of the Ohio Department of Rehabilitation and Corrections (DRC), asking for guidance regarding expert testimony in legal proceedings arising out of or leading to execution by lethal injection. The letter was seeking direction as to whether licensees who testify as a witness about the following issues, would be subject to discipline: 1) the general nature and effects of the authorized dosages of the two drugs used at a recent execution; 2) the physical mechanisms by which the offender died from the intravenous injection of those drugs; 3) whether the offender was conscious when irregular bodily movement were observed; 4) an explanation of those movements, and; 5) whether the condemned person experienced any pain or distress after receiving the IV injection of drugs.
Mr. Blanton noted that this is an area of great public interest nationally and an area where a physician’s unique education and expertise could contribute to the greater good through a factual and scientific examination of past events. The Ohio Medical Practices Act does not have a sub-section speaking to physician involvement in executions by lethal injection. However, that does not mean the Board does not have authority to discipline physicians based on their involvement in that process. Mr. Blanton continued by saying, Section 4731.22(B)(18), Ohio Revised Code, states that the State Medical Board has jurisdiction to impose discipline upon a physician for violations of the code of ethics of the applicable national professional association to which that physician belongs, including the American Medical Association (AMA) and the American Osteopathic Association (AOA).”​

Here are excerpts from the official position statement that the board drafted:

“The Board does not believe that testimony carefully limited to the issues described would constitute statutory grounds for it to impose discipline…If the testimony is truly restricted to matters that do not violate AMA Opinion 2.06 and do not violate AOA Policy Compendium H215-A/05, whichever is applicable to the specific physician providing the testimony, the State Medical Board would have no authority to pursue discipline pursuant to Section 4731.22(B)(18) of the Revised Code.
Physicians should take notice that this position statement is only a guideline and should not be interpreted as being all inclusive or exclusive. The board will review possible violations of the medical practices act and/or rules promulgated thereunder on a case by case basis (http://med.ohio.gov/pdf/position_statements/capital-punishment-and-physicians.pdf ).”​

 

[PL198]

In Ohio, the Attorney General wanted to know if physicians who did not personally participate in an execution should be disciplined if they agree to testify as an expert witness during a trial on the medical effects of the drugs used and the cause of death. A more complete summary of the board’s discussion of this topic can be found on pages 5-8 of their meeting minutes from 05/14/14 (http://www.med.ohio.gov/pdf/Minutes/Minutes-2014/05-14minutes.pdf ), but here is an excerpt:

“Mr. Blanton informed the Board that a letter was received from the Ohio Attorney General’s Office (AG), on behalf of the Ohio Department of Rehabilitation and Corrections (DRC), asking for guidance regarding expert testimony in legal proceedings arising out of or leading to execution by lethal injection. The letter was seeking direction as to whether licensees who testify as a witness about the following issues, would be subject to discipline: 1) the general nature and effects of the authorized dosages of the two drugs used at a recent execution; 2) the physical mechanisms by which the offender died from the intravenous injection of those drugs; 3) whether the offender was conscious when irregular bodily movement were observed; 4) an explanation of those movements, and; 5) whether the condemned person experienced any pain or distress after receiving the IV injection of drugs.
Mr. Blanton noted that this is an area of great public interest nationally and an area where a physician’s unique education and expertise could contribute to the greater good through a factual and scientific examination of past events. The Ohio Medical Practices Act does not have a sub-section speaking to physician involvement in executions by lethal injection. However, that does not mean the Board does not have authority to discipline physicians based on their involvement in that process. Mr. Blanton continued by saying, Section 4731.22(B)(18), Ohio Revised Code, states that the State Medical Board has jurisdiction to impose discipline upon a physician for violations of the code of ethics of the applicable national professional association to which that physician belongs, including the American Medical Association (AMA) and the American Osteopathic Association (AOA).”​

Here are excerpts from the official position statement that the board drafted:

“The Board does not believe that testimony carefully limited to the issues described would constitute statutory grounds for it to impose discipline…If the testimony is truly restricted to matters that do not violate AMA Opinion 2.06 and do not violate AOA Policy Compendium H215-A/05, whichever is applicable to the specific physician providing the testimony, the State Medical Board would have no authority to pursue discipline pursuant to Section 4731.22(B)(18) of the Revised Code.
Physicians should take notice that this position statement is only a guideline and should not be interpreted as being all inclusive or exclusive. The board will review possible violations of the medical practices act and/or rules promulgated thereunder on a case by case basis (http://med.ohio.gov/pdf/position_statements/capital-punishment-and-physicians.pdf ).”​

How is that even a thing... Like the AMA has no actual authority. I don't understand how they're using AMA ethics to set precedent. So they're literally saying that they can basically manipulate whatever you said, into you requiring discipline. f*ck ohio

 

[touchpause13]

This came up on my newsfeed:
http://www.salon.com/2014/07/28/sat...aw/?utm_source=facebook&utm_medium=socialflow

I know it's salon but still