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  • sdadmin
    Keymaster
    September 20, 2018 at 3:25 pm #1461
    1. WHEREAS, Targeted Regulation of Abortion Providers (TRAP laws) are defined as legislation and
    2. policy that apply ambulatory surgical center standards to family planning clinic; require specific
    3. physical outlays to such clinics; require facilities or clinicians to have attending rights at local hospitals;
    4. and/or require clinicians to be board-certified in specific specialties in order to provide medication based
    5. and/or surgical-based abortions1, 3; and
    1. WHEREAS, TRAP laws single out medical practices of providers who provide abortions and impose
    2. on them requirements that are different and more burdensome than those imposed on other medical
    3. practices2 which necessitates significant patient and provider adaptation6; and
    1. WHEREAS, there is no statistically significant evidence that performing an abortion at an ambulatory
    2. surgical center reduces the risk of morbidities and adverse effects when compared to a standard family
    3. planning clinic4; and
    1. WHEREAS, providers of abortion reported heightened levels of stress, increased costs, and lowered
    2. productivity when complying to TRAP laws without any change in outcome6; and
    1. WHEREAS, TRAP laws specifically governing abortion are more prevalent and impose more stringent
    2. requirements than laws governing office-based surgeries, procedures, sedation, or anesthesia5,3; and
    1. WHEREAS, countries with less restrictive abortion laws have lower rates of abortions when compared
    2. to countries with more restrictive laws8; and
    1. WHEREAS, it is reported that TRAP laws directly interfere with the patient-physician relationship6,3
    2. which is in violation of AOA policy H307-A/13 INTERFERENCE LAWS7; and
    1. WHEREAS, it is the recommendation of the American College of Obstetricians and Gynecologists to
    2. end legislation, including TRAP laws, that impedes access to abortion services and interferes with the
    3. patient-provider relationship3; now, therefore, be it
    1. RESOLVED, that the Student Osteopathic Medical Association oppose the Targeted Regulations of
    2. Abortion Providers (TRAP laws) that impede and discriminate against a physician’s ability to provide
    3. appropriate care to patients seeking family planning services, including abortion; and, be it further
    1. RESOLVED, that the American Osteopathic Association oppose the Targeted Regulation of Abortion
    2. Providers (TRAP laws) that impede and discriminate against a physician’s ability to provide appropriate
    3. care to patients seeking family planning services, including abortion; and, be it further
    1. RESOLVED, that the American Osteopathic Association combat existing and future efforts to create,
    2. enforce, and/or legislate the Targeted Regulation of Abortion Providers.

    Explanatory Statement
    In light of recent bills passed in Iowa that would ban abortions on detectable heartbeat of the fetus, it is prudent that SOMA and the AOA take an official stance on laws that would prevent abortion providers from providing care to patients seeking abortions. Many TRAP laws are essentially backdoor abortion bans, especially in rural and underserved communities where there are insufficient resources to comply with these targeted regulations.

    References

      1. Targeted Regulation of Abortion Providers. (2018, September 04). Retrieved from https://www.guttmacher.org/state-policy/explore/targeted-regulation-abortion-providers
      2. Targeted Regulation of Abortion Providers (TRAP). (2012, February 29). Retrieved from https://www.reproductiverights.org/project/targeted-regulation-of-abortion-providers-trap
      3. Committee Opinion No. 613. (2014). Obstetrics & Gynecology,124(5), 1060-1065. doi:10.1097/01.aog.0000456326.88857.31
      4. Roberts, S. C., Upadhyay, U. D., Liu, G., Kerns, J. L., Ba, D., Beam, N., & Leslie, D. L. (2018). Association of Facility Type With Procedural-Related Morbidities and Adverse Events Among Patients Undergoing Induced Abortions. Jama,319(24), 2497. doi:10.1001/jama.2018.7675
      5. Jones, B. S., Daniel, S., & Cloud, L. K. (2018). State Law Approaches to Facility Regulation of Abortion and Other Office Interventions. American Journal of Public Health,108(4), 486-492. doi:10.2105/ajph.2017.304278
      6. Mercier, R., Bryant, A., Buchbinder, M., & Britton, L. (2014). “Its persuasion disguised as information”: The experiences and adaptations of abortion providers practicing under a new law. Contraception,90(3), 308. doi:10.1016/j.contraception.2014.05.057
      7. AOA Policy H307-A/13 INTERFERENCE LAWS
      8. Haddad, L. B., & Nour, N. M. (2009). Unsafe Abortion: Unnecessary Maternal Mortality. Reviews in Obstetrics and Gynecology, 2(2), 122–126
      9. Raymond, E. G., & Grimes, D. A. (2012). The Comparative Safety of Legal Induced Abortion and Childbirth in the United States. Obstetrics & Gynecology,119(6), 1271-1272. doi:10.1097/aog.0b013e318258c833

    Submitted by:
    Jordan Allen, OMS II – Des Moines University
    Elizabeth Hohl, OMS II – Des Moines University
    Aaron Magaña, OMS II – Des Moines University
    Melissa Zapata, OMS II – Des Moines University
    Jacob Gianuzzi, OMS II – Des Moines University
    Collin Beyer, OMS II – Des Moines University
    Jacob Nelson, OMS I – Des Moines University

    Action Taken:

    Date:

    Effective Time Period: Ongoing

  1. Tyler King
    NYITCOM Arkansas
    Posts:
    October 1, 2018 at 8:03 pm #1955

    This is a high quality, well researched resolution. What makes this issue so difficult is that it usually has to be fought at the state level (states trying to chip away at the protections guaranteed in Roe v. Wade). And since the AOA is a national organization and mostly lobbies at the federal level, this issue often has to be tackled within osteopathic state societies and state legislatures.

    One thing I would change is the third and final resolved statement. I would suggest adding something like “lobby Congress and/or state legislatures and/or osteopathic state societies to” after “American Osteopathic Association” and before “combat”.

  2. Wessley Square
    PCOM
    Posts:
    October 2, 2018 at 6:25 pm #1961

    I agree that this is an excellent topic and I love the first Resolved as I feel SOMA should take a stance on this as well and as we have chapters all across the country, it would be something we could advocate for in most states as well as at the federal level. I do however ask for clarification as to how this would differ from the cited AOA policy which says that the AOA shall oppose legislation such as TRAP laws. The conclusion of the policy seems quite thorough and reads as follows:

    Conclusion
    The AOA supports the protection of the patient-physician relationship as especially paramount to the osteopathic medical profession. The osteopathic care model is based upon the treatment of the whole patient and the use of preventive medicine. The patient-physician relationship is a critical aspect of osteopathic care, due in large part to a partnership that is created between the physician and patient which relies heavily on communication. Interference laws encroach on this relationship and undermine the osteopathic care model by preventing DOs from providing treatment in a manner they believe is best for their patients.
    The AOA affirms that legislation which interferes with the patient-physician relationship impairs the autonomy of osteopathic physicians and prevents osteopathic physicians from using their best judgment based on years of rigorous education and training. The AOA asserts that physicians must be able to communicate freely with patients without fear of government intrusion in order to assure safe, comprehensive and effective medical treatment.
    The AOA considers that legislation which undermines physician judgment is a barrier to evidencebased medicine.
    The AOA supports the use of evidence-based medicine to ensure high quality patient care. Statutorily required medical practices interfere with evidence-based medicine by mandating a “one size fits all approach,” thereby preventing an individualized assessment of what is in a particular patient’s best interests.
    The AOA affirms that legislation which interferes with the patient-physician relationship undermines patient-centered care. Patient-centered care actively involves the patient in making decisions regarding their own medical care. Statutorily required medical practices prevent patients from being involved in making medical decisions, because the patient has no choice.
    The AOA affirms the ethical principle of informed consent is undermined when patients are statutorily required to undergo certain treatments or procedures, because the patient has no choice.
    The AOA opposes all legislation at the state and federal level which requires physicians to discuss or perform certain treatments or procedures not supported by evidence-based guidelines, because such legislation undermines physician judgment.
    The AOA opposes all legislation at the state and federal level which prevents physicians from discussing certain health-related risk factors with their patients, because such legislation violates the First Amendment rights of physicians and patients.
    The AOA believes that physicians should be free to counsel patients on end-of-life care on a caseby-case basis rather than an across-the-board mandate. The AOA supports court challenges of interference laws that violate First Amendment and Fourteenth Amendment rights of physicians and patients under State and Federal Constitutions.
    The AOA will monitor state and federal interference laws on an ongoing basis and update this policy as needed.