Roe V Wade. Non political!!!

[ventana]

Not at all interested in debating the specifics and if this thread veers off topic it will be edited through deleting posts.  
 

 

the only questions up for discussion is

1)rather there has ever been a medical condition treated differently depending on what state you live in?

2) how does the system try to handle the obvious challenges faced by residents in states banning abortions when they want an abortion. Ie how do other states handle this?

 

again on topic only responses or you response will be deleted with out warning. 

[CAAdmission]

It's hard to say. Each state empanels its own board or other entity to oversee medical practice and by states' rights can establish whatever practices it wishes. I would imagine that there are other differences between states if you care to get down in the weeds. One that comes to mind are some dermatologic procedures. In some states medically licensed people have to do them by law and in others "estheticians" can do them. 

As for challenges facing residents, here's an amusing parallel situation. For a while I lived in a state with very restrictive firearms laws. When I expressed my aggravation to people, many cheerfully recommended that I move to a state that shares my values. So there you go. 

I'll create a separate post in the "Politics and Misadventures" section for those so inclined to partake. 

 

Edited May 3, 2022 by CAAdmission

[rev ronin]

What's interesting is that our own "Guidelines for Ethical Conduct for the PA Profession" defers to legality:

(from https://www.aapa.org/download/89682/)

"Reproductive Decision Making
"Patients have a right to access the full range of reproductive healthcare services, including fertility treatments, contraception, sterilization, and abortion. PAs have an ethical obligation to provide balanced and unbiased clinical information about reproductive healthcare.

"When the PA's personal values conflict with providing full disclosure or providing certain services such as sterilization or abortion, the PA need not become involved in that aspect of the patient's care. By referring the patient to a qualified provider who is willing to discuss and facilitate all treatment options, the PA fulfills their ethical obligation to ensure the patient’s access to all legal options."

The question in my mind... is if Texas bans abortions and Roe is overturned... is it ethical for a Texas PA to say to a patient seeking a now-unpermitted abortion in Texas, "Well, you can go to California; I hear Gov. Newsom is funding travel in support of that"?

[ventana]

So if you are licensed in two states.  One of which abortion is illegal.  Can the other state press charges??

[rev ronin]

2 hours ago, ventana said:

So if you are licensed in two states.  One of which abortion is illegal.  Can the other state press charges??

States are generally pretty reluctant to prosecute doctors. The Pou grand jury no bill is still pretty normative, I would say.

https://www.npr.org/templates/story/story.php?storyId=12205440

[CAAdmission]

13 hours ago, ventana said:

So if you are licensed in two states.  One of which abortion is illegal.  Can the other state press charges??

I don't think so. They couldn't arrest you for going to Colorado to smoke weed if it was illegal in your home state.

Bestiality is also apparently still legal in Hawaii. 

Edited May 4, 2022 by CAAdmission

[CAdamsPAC]

7 hours ago, ventana said:

Not at all interested in debating the specifics and if this thread veers off topic it will be edited through deleting posts.  
 

 

the only questions up for discussion is

1)rather there has ever been a medical condition treated differently depending on what state you live in?

2) how does the system try to handle the obvious challenges faced by residents in states banning abortions when they want an abortion. Ie how do other states handle this?

 

again on topic only responses or you response will be deleted with out warning. 

I think the 10th Amendment of the US Constitution applies here.

[ohiovolffemtp]

I'm licensed in multiple states, with slightly different scope of practice in each.  Each state has jurisdiction over how I practice in their state, not how I practice in others.  So, if state X permits me to do something and I do it in state X, state Y won't do anything to me even if it's not in my scope of practice in state Y.  The only exception is that if any state's licensing board disciplines me, I'm required to notify all other states where I'm licensed and they will most likely pile on.

More directly to the original question, I expect that if regulation of abortion is returned to the state level, patients seeking an abortion will travel from states where it's not permitted to states where it is.  Patients already travel to see specialists, so that's not surprising.

[LT_Oneal_PAC]

To your last question, states cannot enforce their laws outside their jurisdiction. 
 

the system will adjust by 2 methods. Those of means will travel for their abortion. The disenfranchised will go back to back alley abortions and all their complications. 
 

I suspect the next legal restriction will be facilitating any abortion, I.e. giving information on the nearest abortion facility outside the state jurisdiction. Next will be prohibition of state funded insurance from providing payment for complications of any abortion, performed illegally in the state or legally outside of it.

If states are allowed to prohibit abortion, it will be interesting, from a pure cold scientific perspective, if violent crime will increase in 15-20 years after. It’s theorized that the exploding crime rate was abated in the 90s, at least in part, by roe v wade.

 

ETA: purely speculative and scientific. If too far off topic please modify.

[ventana]

9 hours ago, LT_Oneal_PAC said:

To your last question, states cannot enforce their laws outside their jurisdiction. 
 

 

unfortunately not so

https://www.theguardian.com/world/2022/may/03/us-abortions-travel-wave-of-restrictions

 

who knows what will become of this, but it appears they are trying to reach beyond their own borders....

 

[CAAdmission]

11 hours ago, LT_Oneal_PAC said:

states cannot enforce their laws outside their jurisdiction. 

Is that 100% accurate? Don't they prosecute pedophiles that travel to Asia to do pedophile stuff? Or maybe that is due to some kind of Interpol treaty?

Edited May 4, 2022 by CAAdmission

[ventana]

the whole wrinkle that started this is the law that allows an individual to sue another individual for an action, it is not the state enforcing it....

[LT_Oneal_PAC]

1 hour ago, ventana said:

unfortunately not so

https://www.theguardian.com/world/2022/may/03/us-abortions-travel-wave-of-restrictions

 

who knows what will become of this, but it appears they are trying to reach beyond their own borders....

 

This proves two of my points. First, they can’t prosecute the abortion because it’s outside their jurisdiction, but they may make the travel for an abortion, which occurs in state, illegal

[greenmood]

To the first point, I'm not sure if there are other specific medical procedures that have illegalized treatment options on a state level, but for sure there are plenty of people who are forced by various circumstance to travel out of state to get care for other issues.

Thousands and thousands of people come to my town and my hospital every year for specialized care they cannot get (or think they cannot get) at home. The way my little micro-climate has handled this is interesting. An entire community of service has been built on the presence of healthcare tourists. We joke that there is a hotel room for every permanent resident but the reality isn't far off, and the hotels are routinely 90-100% booked even in the dead of winter. There are shuttles going everywhere at every hour of the day to get people where they need to be. The hotels advertise special rates for people arriving for medical care. There is a cottage industry of long term furnished rentals for families whose loved ones are hospitalized or need care for days-weeks-months. If you have breast cancer/lymphoma/name your specific disease, there is probably a support group in town that will visit you in the hospital and bring your family gifts and care packages. The restaurants overtly cater to sick folk and families. Discounts everywhere, and I've personally seen servers write off portions of checks just because they feel so bad for the guest. This is sanctioned activity - the business owners here want to be friends to patients and their families. The tiny amount they lose in that check is made up for by the insane word of mouth extra business. Everyone drives slower in certain parts of the city, because people are sick/hurt/slow, and the townies all know what places to avoid and when. 

It's a point of PRIDE. It's encouraged and celebrated. There are financial incentives from the city and state to make us more friendly to medical visitors.

I caught part of the NPR discussion on this today. The rep from Colorado pointed out that they have a majority of counties in the state without an abortion provider, so they "have a long way to go on the home front" before becoming an abortion oasis or whatever, and that they can't even start to think about protecting their providers from lawsuits based in neighboring states until next year. I do think lawsuits are coming, maybe in 3-5 years, attempting to punish providers who perform these services for out of state patients. Every state who continues to allow it or protects it in their own constitution is going to have to think about how to shield the people who actually provide the care.

[EMEDPA]

4 hours ago, CAAdmission said:

Is that 100% accurate? Don't they prosecute pedophiles that travel to Asia to do pedophile stuff? Or maybe that is due to some kind of Interpol treaty?

I think a better example would be that someone can legally travel to Las Vegas and hire a prostitute and if it becomes known back in their home state they are not guilty of solicitation. 

[ventana]

Since enforcement is provided by enabling private citizens the right to sue somone that leaves the state for an abortion why couldn't the state in which abortions are performed pass a law stating that anyone that sues a patient(or someone helping a patient) for abortion care can themselves counter sue for double or triple damages?  Using their own loophole against them???

[CAAdmission]

2 hours ago, ventana said:

Since enforcement is provided by...

They could probably try, but I'd guess a state might not be willing to extradite one of its residents to face charges under the circumstances. 

Edited May 4, 2022 by CAAdmission

[rev ronin]

Rather than looking at suing providers, I think it's more than ever incumbent on PAs to provide medically accurate informed consent. A fetus is a human being--an H. sapiens. It's one that's utterly dependent on its mother for ongoing survival, such that whether abortion is ethical or not is a matter of a conflict of rights, and one that currently is not a legal person in America.  (Of course, a corporation is considered a legal person, per Citizens United... Maybe SCOTUS should look at revising that, too?)

Since the topic is very emotionally and values-driven, from either side, there is a paucity of good evidence: neither side would be swayed by it, and the other guys could try and use it against us, so why collect it?  But from a utilitarian perspective, a decision needs that data: How safe is surgical abortion? Medical? We don't track, so we don't know. How can you have an informed consent discussion with a patient when you have no idea what the complication rate is?

[UGoLong]

I would think that it would be difficult for a state you aren't in, don't live in, and don't work in to prosecute you for activities involving patients from their state who happen to come to your state on their own free will for services.

I'm not a lawyer but I would suspect that the interstate commerce clause (Article 1, Section 8 ) in the Constitution would give the federal government jurisdiction, not the patient's state.

But who knows these days?

[Cideous]

Good luck with this ruling, women are not going back to pre-roe.  49 years of deciding what they do with their own bodies is not going away.  Sue them, put them in jail, go after them in other ways and it will just motivate them more.  Not to mention, 69% of ALL Americans did not want roe overturned.  When do almost 70% of Americans agree on anything?  This court is going to face hell going forward.

As someone without a uterus, I will trust those with one to do what they feel is correct with theirs.

Oh and btw, if this goes into effect, those 16 red states with trigger laws ready to go will officially be more strict on women than sharia law when it comes to abortion choice.  Don't believe me?  Look it up.  Who would have thought....

[CAAdmission]

6 hours ago, Cideous said:

Oh and btw, if this goes into effect, those 16 red states with trigger laws ready to go will officially be more strict on women than sharia law when it comes to abortion choice.  Don't believe me?  Look it up.  Who would have thought....

Perhaps we can also compare the permissiveness of current American abortions laws, to, say Europe:

 

[ANESMCR]

10 hours ago, CAAdmission said:

Abortions in the U.S. over 20 weeks account for less than 1%. That’s pretty small. Comparatively speaking, very similar. Once Roe is overturned it won’t even be comparable.

[ventana]

https://abcnews.go.com/Politics/senate-democrats-tee-doomed-vote-protecting-nationwide-abortion/story?id=84522975

 

So if abortion supporters come out in droves for the mid term election can they push a bill through? 

Again not wanting to get at all political, just a question

[rev ronin]

1 hour ago, ventana said:

So if abortion supporters come out in droves for the mid term election can they push a bill through?

The way the economy is, the way the violent left has alienated middle America, I just don't see it happening. Moderates are moderate on everything and they're the swing voters.

[EMEDPA]

19 minutes ago, rev ronin said:

The way the economy is, the way the violent left has alienated middle America, I just don't see it happening. Moderates are moderate on everything and they're the swing voters.

We always hear about The Evangelical Christian Right as a voter block. Where is the Christian Left? And don't they vote?