Saturday, April 30, 2005

Segregated Medical Care

As per our politicians, you might be a woman if you aren't Dr. Condoleezza Rice, First Lady Laura Bush, Senator Clinton, or one of the millions of reproductive age XX persons unable to become pregnant (e.g., 9.3 million who've ever used some kind of infertility service, over 3 million who've had a hysterectomy, etc.).

Unfortunately, just because the state of the lining of some of your internal organs makes you a woman, that isn't enough for you to receive proper medical care.

It appears* the politicians have also decided that, in order to receive appropriate medical care, those persons fortunate enough to qualify as women must pass one more hurdle.

If a woman is raped, just having an anatomically intact reproductive tract, and a functioning pituitary/ovarian/uterine axis is no longer enough to guarantee she will be treated according to the standard of care. No! Only women raped during the follicular phase of their monthly cycle are to be given adequate medical care:

The protocol of six Catholic hospitals run by Centura calls for rape victims to undergo an ovulation test.

If they have not ovulated, said Centura corporate spokeswoman Dana Berry, doctors tell the victims about emergency contraception and write prescriptions for it if the patient asks.

If, however, the urine test suggests that a rape victim has ovulated, Berry continued, doctors at Centura's Catholic hospitals are not to mention emergency contraception.

Hmm, any chance I might have something to say about this? Well, since you asked:

First, assuming [and this is a big assumption] optimal testing conditions, a urine ovulation test only tells you whether or not you have elevated hormone levels, and that is all. It offers no indication [if a viable egg will be released] about fertilization.

Second, when it comes to rape patients and emergency contraception (EC), what is the medical standard of care? Both the American College of Ob/Gyns**, and the American Medical Association*** recommend that physicians treating rape patients inform women about EC, and offer the patient EC.

Third, the available evidence indicates that the EC pill does not prevent implantation [the burrowing of a fertilized egg into the uterine lining]:

Recently, treatment with either 10 mg mifepristone or 1.5 mg of levonorgestrel [Plan B] has emerged as the most effective hormonal method for emergency contraception...

When summarized, available data from studies in humans indicate that the contraceptive effects of both levonorgestrel and mifepristone, when used in single low doses for emergency contraception, involve either blockade or delay of ovulation, due to either prevention or delay of the LH surge, rather than to inhibition of implantation.

Finally, here are some interesting results from a 2002 survey of 589 Catholic hospitals emergency rooms [scroll to bottom of page]:

  • 82% of those questioned in emergency rooms refused to administer emergency contraception- even to women who have been raped.

  • [W]here emergency contraception was not available, only 22% of emergency rooms at Catholic hospitals provided a useful referral.

  • There are currently 91 counties that have a Catholic hospital operating as a sole provider-a 20 percent increase over 1997. Ninety-five percent of these hospitals are in counties with a minority-Catholic population.

    If Catholic hospitals may ignore the standard of care, and treat patients based on religious doctrine, any and all hospitals should be able to do the same. This means we abolish the FDA, and any government regulation of hospitals and the practice of medicine, and allow anybody to set up and run a hospital according to whatever criteria they deem acceptable.

    Bottom line: It will be most interesting to see what happens when men in this country manage to finally achieve equality with women, and can look forward to hospitals where only, for example, men with a sperm density greater than or equal to 20 million per milliliter are to receive adequate medical care.

    [P.S. Despite writing a book about period control, I must admit it hadn't occurred to me that one emerging indication for suppressing the period is to increase your likelihood of receiving proper medical care.]

    *I have not personally verified the information in the article, so it's still possible that the article is a joke. [We can only hope.]

    **American College of Obstetricians and Gynecologists, 242 Educ. Bull. 3 (Nov. 1997).

    ***American Medical Association, Strategies for the Treatment and Prevention of Sexual Assault (1995).

    (via feministe)


    At 5:21 AM, Blogger andi said...

    it's all so sad about the e.c. pill for rape victims. the other problem i see with this urine ovulation test is the possibility that sperm can live up to 5 days in quality cervical fluid, and if the woman is just beginning to prepare for ovulation, she may not have high enough hormone levels to register on the test.

    At 6:08 PM, Anonymous Anonymous said...

    So your argument is that if ACOG or the AMA recommend a practice, Catholic hospitals must fall in line or they are anti-women and discriminatory?

    Who made ACOG and/or AMA the Supreme Deity? Don't we have the freedom in this country to fund those medical service that we believe act morally and respect human life?

    Yr best argument is that Catholic hospitals must make clear their practice and offer referral. Although, by their lights, that would make them accessories to murder. Do you want to force doctors to commit what they consider murder? Oh, but you wouldn't call it murder. Oh, but isn't that what the Nazis said . . . .

    If religious freedom means anything, everyone (including rape victims) must take responsibility and seek treatment at a facility consistent with their belief tradition.

    At 9:41 PM, Blogger Dr. Charles said...

    i am truly convinced that history will regard our times as belonging to a dark age. thankfully there are bastions of sensibility but for the most part we are living in unenlightened days. thanks for this post to remember, and to redouble efforts to preserve women's choices.

    At 10:32 PM, Anonymous Anonymous said...

    The Catholic Church practices fetus-worship, but women and girls can go to hell. But what can you expect from the world's oldest, sex-negative, woman-hating cult?

    At 2:55 AM, Anonymous Anonymous said...

    And, thankfully, we have Dr. Charles. He, like this blog, is a tiny point of light in our unenlightened times. That is, of course, when he's not talking about the pleasures of making young female med students in his office examine the genitals of strapping firemen--ahh, I remember that post well.

    At 3:26 AM, Blogger Dr. Charles said...

    hey check this article out :,0,700609.story?coll=sfla-home-headlines


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