MCMSPhysicianSpring2017 - 6

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Editor's Comments

Politics Blur Lines
Between Fact and Fiction
The world is upside-down.
As I sit here, Sunday, the
19th of February, it's 69 degrees
outside. Two of my kids are
running around the front yard in
long pants and short sleeves. Our
newest addition, Maxwell Jacob,
is napping in the stroller wearing
late-spring clothes. Just shy of
five weeks old, he knows nothing
about the outside world, and that's
fine with me. He'll learn soon
enough.
When I stare down into his liquid-brown eyes, watching
the binky bounce up-and-down between two rapidly-growing
cheeks, I can't help but wonder what kind of America he will
come of age in. We are at a crossroads, this nation of ours, and
ever since he arrived, I've found myself pondering what role, if
any, physicians will play in America's future.
I don't mean professionally, of course. We all know what
doctors do, and my comment wasn't meant to imply that there
would no longer be a use for us. Rather, I'm thinking about
social responsibility, and the special bond between physician
and patient. I've written about this theme many times, but like
a moth drawn to a flame, I keep coming back to it. Especially
now.
We've all heard the terms "patient autonomy" and "shared
decision-making," but at what point does our duty to the truth
outweigh another human being's thoughts and feelings? Some
lines, such as the long-debunked link between vaccines and
autism, are clear. Others, like opinions based on the dreaded
'Google search', seem less so. It's easy to point out information
which is blatantly false - the idea that antibiotics are an
effective treatment for viruses comes to mind - but what
does one do when confronted with a worldview that holds any
viewpoint grounded in science with suspicion, or even disdain?

With all Due Respect: Science Trumps Opinion
I'm talking about politics.
Now, before I proceed any further, I'm going to make it
clear that I believe conversations about a patient's political
views, voting habits, and positions on hot-button issues
are clearly off-limits and have no place in the exam room.
However, in our current adversarial and disruptive era, how a
patient views politics may have a direct impact on how they
perceive educated professionals, and potentially disrupt the
patient-physician relationship. And in our current political
climate, nowhere is this more pronounced than women's
health. Charges that physicians routinely perform elective lateterm abortions (and are illegally compensated with taxpayer
funds) or the erroneous idea that birth control pills promote
promiscuity have become a rallying cry for those whom this
particular social issue is near and dear. As both a physician and
a person, I respect that point of view as a personal belief, but
not as the foundation of public policy. And recently, I've found
myself questioning even that respect. (Full disclosure - I
would personally support legislation banning elective abortions
at 20 weeks or earlier, but only if they contain exceptions for
the life and health of the mother, and granted final decisionmaking authority to the patient and her physician).
The Pennsylvania Senate has once again introduced
legislation to prohibit the termination of pregnancy beyond
20 weeks. Despite unified opposition from the American
Congress of Obstetrics and Gynecology - both nationally
and the Pennsylvania chapter - the legislation passed the
Senate and now it moves to the House. While Gov. Wolf will
certainly veto the legislation should it make it to his desk,
the fact that it is even being debated begs the question: is the
outcome preordained? Can we simply guess what type of bills
legislators will introduce based on whether they have a 'D' or
'R' next to their name? Despite overwhelming evidence that
a) the majority of abortions performed in the United States
happen in the first trimester and b) later-term procedures are

MCMS PHYSICIAN 6 SPRING 2017

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