I write in response to the recent opinion from Thomas Page, D.O. (“The proposed amendment to LD 1619 is a ‘farce,’” June 14).
The Maine Medical Association includes members with diverse opinions on many topics, including abortion. We’ve long recognized personal values influence those opinions, but no physician is compelled to participate in the provision of abortion services, and that is a core part of the American Medical Association’s Code of Medical Ethics.
Physicians are obligated to advocate for access to the full scope of medical care a patient may need, and our role in the public policy debate is to protect the physician-patient relationship. It is based on trust and an ethical responsibility to place patient interests above the physician’s, using sound medical judgment, and to advocate on their behalf. Abortion care is medical care.
The MMA supports Gov. Janet Mills’ initiative to ensure continued access to abortion care through L.D. 1619. A decision whether to have an abortion is deeply personal, complex, and often involves a balancing of medical interests through the appropriate standard of care.
What is “standard of care?” The most common legal definition is, “how similarly qualified practitioners would have managed the patient’s care under the same or similar circumstances.” While lawmaking is seen as black and white, medical care is not.
The American Congress of Obstetricians and Gynecologists is a national organization of more than 60,000 physicians specializing in all women’s health care. They are unquestionably the leading source of information in women’s health care, speaking for and guiding the profession through exhaustive reviews and discussion of medical evidence in consultation with legal and ethical experts. Leading obstetricians and gynecologists use clinical guidelines set forth by ACOG with the understanding those guidelines are a recommendation.
Standards of care do indeed exist but are interpretive guidelines developed to assist medical practitioners. Ultimately, the decision on how to proceed lies with the physician and patient after informed consent.
Standard of care deviation on a case-by-case basis must be agreed upon by the physician and patient. Any deviation from commonly accepted standards should be evidence-based and clearly explained in the patient’s medical record, or it could result in disciplinary action by state licensing boards under existing laws made by state legislators, or lawsuits or criminal charges.
So, while ACOG guidelines are considered appropriate “standard of care,” implicit in “standard of care” is the option to deviate as needed in order to provide the best care available based on each patient’s medical history, diagnosis and need.
The concept of the standard of care has always evolved and will continue to change as science and technology advances.
It must.
Erik Steele, D.O., Yarmouth, Maine Medical Association president
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