An anonymous MD has a guest-post on John Scalzi's blog describing her/his medical outrage at being asked to perform medically unnecessary transvaginal ultrasounds on women seeking abortion, in accordance with laws proposed and passed by several Republican-dominated state legislatures. As the doctor writes, "If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise." The article is a strong tonic and much-welcome -- the ethics of medical professionals should not (and must not) become subservient to cheap political stunting, and especially not when political stunt requires doctors' complicity in state-ordered sexual assaults.
1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on.
2) Reinforce patient autonomy. It does not matter what a politician says. A woman is in charge of determining what does and what does not go into her body. If she WANTS a transvaginal ultrasound, fine. If it’s medically indicated, fine… have that discussion with her. We have informed consent for a reason. If she has to be forced to get a transvaginal ultrasound through coercion or overly impassioned argument or implied threats of withdrawal of care, that is NOT FINE.
Our position is to recommend medically-indicated tests and treatments that have a favorable benefit-to-harm ratio… and it is up to the patient to decide what she will and will not allow. Period. Politicians do not have any role in this process. NO ONE has a role in this process but the patient and her physician. If anyone tries to get in the way of that, it is our duty to run interference.