Exploring Human Potential

Note To AMA: Reversing Roe v. Wade Threatens the Patient-Physician Relationship and Societal Trust in Doctors.

Posted on | December 9, 2021 | 1 Comment

Mike Magee

“Should anyone present know of any reason that this couple should not be joined in holy matrimony, speak now or forever hold your peace.”

The admonition above first appeared in the marriage liturgy section of the Book of Common Prayer in 1549 that laid out Church of England guidelines for worship leaders at the time.

Three hundred years later, Charles Dickens said his piece in the opening lines of the Tale of Two Cities. “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, …”

Dickens was exposing an unhappy union on a grand scale – the contrasting realities and uneasy coexistence of human prosperity and despair, class warfare where joy and hope seem incapable of overcoming suffering and anguish.

A century and half after Dickens shined a light on two cities – London and Paris – and dipped into themes like income inequality and political chaos, our own nation served up its own Dickenesque character in the form of a plucky 44 year old self-promoter, born in 1964 in Sandpoint, Idaho. Her name was Sarah Palin.

Her unlikely rise from Mayor of Wasilla, Alaska (population 11,562) to John McCain’s choice for Vice President of the United States on August 29, 2008, has been well documented elsewhere. What has been less well recognized is that the behaviors and tactics she exhibited helped inform Trump and whet his appetite for politics years before he threw his hat into the Presidential ring.

Palin was crude, flamboyant, and lied with ease. She was unfazed when lampooned, calm and supremely confident as she displayed instincts for the political jugular. Most important, even in the face of withering criticism, she never ever backed down, and her people (soon to be Trump’s) loved her for that.

Let’s take just one example – Palin’s “death panels.”

Sarah Palin invented “death panels” out of thin air, much as Trump invented “The Big Lie” of voter fraud. At the time her claim first appeared in a Facebook post in August, 2009, many of us were busy promoting “Living Wills”, “Advanced Directives” and end-of -life discussions, and never thought she would be taken seriously, even though there was a past history to this distortion.

We thought her laughable antics would fall flat. They were totally and wildly inaccurate.  Her claims that elders across America had much to fear were panned and exposed for what they were – a pack of lies.

Here’s a sampling collected and published by American Medical News at the time :

End-of-life discussions are useful
“In truth, there are no “death panels” in the proposed legislation to overhaul the health care system. HR 3200, the main proposal in the U.S. House, makes periodic, voluntary end-of-life discussions with your doctor a covered expense under Medicare (Sec. 1233). In truth, Republicans supported such discussions in Medicare proposals when George W. Bush was president. That’s it. No euthanasia, no arbitrary decisions about who should live or die, no mandatory anything.” Miami Herald, Aug. 20, 2009

Distortions doom end-of-life counseling
“This is not a proud moment in American politics. Financing beneficiaries’ optional consultations about a range of end-of-life care is a good idea. Families need it. Patients benefit. But a well-orchestrated rumor campaign ensured this element of the plan could not survive.” Seattle Times, Aug. 16, 2009

Stop distortion: There’s no “death panel”
“End-of-life care is a difficult issue, but one Americans should discuss — with family members, attorneys and doctors. Especially doctors. They will likely be involved in end-of-life care, if it becomes necessary. They should be compensated for consulting with patients on the issue. That is what the House legislation strives to allow: consultation. It’s not about death panels. It’s about planning, which is important for individual patients and the health-care system as a whole.”
Des Moines (Iowa) Register, Aug. 14, 2009

In truth, health professionals made a huge mistake in believing that logic, knowledge, and well-established professional practice would easily counteract Palin’s irresponsible actions. Their collective voice was weak. They largely “held their peace” in order to keep the peace.

A simple check of top Google searches at the time (with “death panels” beating all comers) should have forecast what happened next. The fact that the bill wouldn’t require patients to receive counseling sessions, nor would it require a doctor to offer one didn’t matter. Nor that it simply modified Section 1861(s) of the Social Security Act, defining what services Medicare will pay for and allowing a patient receiving an end of life counseling session from a doctor or health care practitioner, to have Medicare pay for it.  No matter it earned Politifact’s “Lie of the Year.” Within weeks, the proposed coverage was gone.

Palin’s intrusion into well-established medical terrain did not receive an adequate and sustained counter-punch from health professionals and their societies around the country. And once the public endorsed Palin’s lie, it was difficult to reverse.

The 2012 lackluster performance of traditional Republicans Mitt Romney and Paul Ryan provided the ideal foil for the full-blown high octane “Palinesque” takeover of the party in 2016. Trump had been toying and experimenting and learning the game of politics as part of a Brand-extension strategy. In 2011, during a Conservative Political Action Committee address when he first admitted to considering a run for President, he tried out the Obama “birther” claim.  To John McCain’s campaign director, Steve Schmidt, his choice of Palin for VP had unleashed Trumpism. As he said of Palin in 2020, “She is the first of a generation of politicians who live in a post-truth environment. She was, and there’s no polite way to say it, but a serial liar.”

What Trump understood in 2011 was that Palin’s only mistake was being a woman and not lying enough.

A quick examination of the map of our United States, color coded for regressive legislation and tactics to disenfranchise women and children, people of color, the poor and the vulnerable, well illustrates that we too are a tale of two cities.

Attacks on women’s rights are the underpinning of current and future assaults on democracy. With women’s rights comes trust in physicians (and the patient-physician relationship) to help negotiate the individual and complex choices that come with child bearing.

On September 21, 2021, the AMA with 25 other medical organizations filed an amicus brief in opposition to the restrictive Mississippi abortion law, Dobbs v. Jackson Women’s Health Organization.  On  October 12, 2021, 19 medical societies, with the AMA in the lead, filed  an amicus brief in U.S. v. Texas, the abortion vigilante law signed by Gov. Greg Abbott. But in the court of public opinion, there has been minimal investment of time and resources by these same medical associations over the past two months considering all that is at stake in the upcoming Supreme Court decision.

As the Supreme Court deliberates the future of Roe v. Wade, health professionals and their societies should not make the same mistake they did in 2009 on “death panels.”

“Speak now or forever hold your peace.”



One Response to “Note To AMA: Reversing Roe v. Wade Threatens the Patient-Physician Relationship and Societal Trust in Doctors.”

  1. vimsrc
    December 16th, 2021 @ 7:05 am

    We should trust the doctors, should not over trust the doctors or anything. Always even we should have our knowledge.

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