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That’s one way to shut down an abortuary

posted by awelborn

A new Missouri law:

Abortions will still be available in Columbia and St. Louis, but the Springfield clinic might have to shut down under the law, said Peter Brownlie, president of Planned Parenthood of Kansas and Mid-Missouri. The law states that doctors performing abortions must have clinical privileges at hospitals within 30 miles of where abortions are performed.

The Springfield abortion clinic doctor has had difficulty obtaining privileges at local hospitals because of political reasons, Brownlie said.

Requiring hospital credentials could pose a challenge, Brownlie said, because hospital employees are hesitant to involve themselves in medical controversies such as abortion.



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Therese

posted September 17, 2005 at 7:23 am


Actually this will come back to bite pro-life hospitals and physicians. It will end up forcing them to give priviliges to these doctors or actively participate. The other side’s goal is to force every medical provider to have to participate and not awknowledge any freedom of conscience.



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scotch meg

posted September 17, 2005 at 7:41 am


Actually, this is a very interesting approach. One would think hospital privileges are sort of automatic for doctors, but it ain’t so. It really is political, especially if it’s someone from outside the area who prances in and wants to use the local facilities without being responsible to the local medical community. The local hospital board is going to have to answer for letting the doc into their facility if anything goes wrong, and if that doc isn’t local, they don’t have as many ways to check on him/her and keep him/her in line with local practice standards (which EVERY hospital thinks are better at THAT hospital). One might be able to imagine that this is particularly problematic with the doc who flies in from out of state to do abortions…
But from the patient’s standpoint, admitting privileges in case something goes wrong might easily be assumed and (especially for abortion patients who rarely even meet the doc before the procedure) not exactly the subject of inquiry.
So this law is very patient-friendly in an objective way but I can see how it could cause problems for abortionists.
As I understand it, the hospitals are not (and really could not be) forced to grant privileges. With the malpractice risks, one couldn’t challenge a hospital board’s judgment call very easily. That’s why it’s a problem for the one Missouri clinic.



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Yvonne

posted September 17, 2005 at 7:44 am


Wow, what a good thing.. Now, does MO have a health care conscience law? That would also post problems for abortionists at hospitals, no?



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Sean Gallagher

posted September 17, 2005 at 9:03 am


In the Indianapolis area, where I live, a number of those who perform abortions come in from outside the state. I wonder how if a law similar to the one in Missouri were in place here, what effect it would have?
I wonder if those who perform abortions (I *really* try to avoid calling them doctors) would need to have a medical license in the state to get privileges at a local hospital? I presume they would but are able to work at abortion facilities because of the low level of regulations surrounding them.



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amy

posted September 17, 2005 at 9:04 am


I think most abortion clinics depend on circuit-riding doctors who go from clinic to clinic through the week. That was what I saw in Florida, at least.



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Nancy

posted September 17, 2005 at 10:44 am


Abortion politics entirely aside, it makes sense to me that any doctor performing dangerous surgery of any kind whatever should be subject to the kind of review, supervision and support referred to by scotch meg.
Admitting privileges. Well, of course.



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Slurms McKenzie

posted September 17, 2005 at 10:54 am


Yet another inconsistency in the pro-abortion argument. They insist that abortions be legal to prevent unqualified and incompetent back-alley doctors from performing them, but then they object to any kind of quality standards being placed on “doctors” and clinics that perform abortions, so that they end up with the very same hacks that could never be relied upon to save lives, but are qualified only to take them.



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Dorothy

posted September 17, 2005 at 10:59 am


Unfortunately, this law has already been blocked by a federal judge.
They sure didn’t waste any time.



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anon

posted September 17, 2005 at 11:04 am


Sorry to inflame the sensibilities of anyone with such politically incorrect thoughts, but has a study ever been done regarding the so-called “doctors” who perform abortions and their general philosophy toward women? I ask because I have noted that many of the common, everyday abortionists who operate these drive-through clinics seem to come from a particular non-Christian, non-Jewish culture (hmm, I wonder what culture he means?), which in many respects considers women to be not much more worthy than are dogs — hardly the champions of women’s rights that the national organizations make them out to be.



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sj

posted September 17, 2005 at 11:37 am


“I ask because I have noted that many of the common, everyday abortionists who operate these drive-through clinics seem to come from a particular non-Christian, non-Jewish culture (hmm, I wonder what culture he means?), which in many respects considers women to be not much more worthy than are dogs”
That’s not peculiar to abortion: that is, all undesirable specialties and practice settings are dominated by the lowest status doctors. Meaning that it’s unlikely animus towards women causes them to “choose” their specialty- rather, they can’t make it in a more attractive line of work.
As far as the hospitals’ obligation to grant privileges, it depends on their motivation. Quality-based denials will be ok, other denials will run the risk of anti-trust or other liability.



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Hennessy's View

posted September 17, 2005 at 1:40 pm


Shocking Coldness

The New York Times Online, today, is drumming up sympathy for abortion.
Venetia Grunder, 21, viewed an ultrasound image of the fetus in her womb. She was 12 weeks pregnant, though she had taken birth control pills as directed. I feel pretty m…



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jane

posted September 17, 2005 at 4:20 pm


I heard Father Frank Pavone, Priest for Life founder, speak at a dinner last month. He said that in the past ten years (or maybe twenty, I can’t quite recall) half of all abortion clinics in the USA have been closed.
Another approach to closing them down is to do what was done here in Providence. Open an unplanned pregnancy center with a Blessed Sacrament chapel next door to the clinic. The clinic closed within a year of the Mother of Hope Center opening.



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scotch meg

posted September 17, 2005 at 5:01 pm


In my (admittedly VERY limited) experience, any political decision about admitting privileges can be made to look like a quality decision, and the doctors in charge are smart enough to know how in most cases.
Medical licensure is a state-by-state phenomenon. When you move, you have to relicense. It’s usually just a question of submitting enough paperwork and enough money — but the recommendations can sometimes slow things down or even stop them, if they are checked thoroughly. And BTW it doesn’t matter where you come from or how many other states have granted you licenses, you must be licensed in the particular state in order to work as a doctor in that state. Including performing abortions. Although being licensed in other states may ease up the amount of scrutiny in granting you a license in a new state (although that hasn’t been our experience).



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sj

posted September 17, 2005 at 5:13 pm


As a lawyer who works for a medical society and also being current chair of my state’s health law bar, my experience is that it could be put the other way just as easily — that is, any quality decision can be made to look like it’s based on impermissible anti-competitive reasons and a clever lawyer can usually do so. My experience is that hospitals, like most institutions, usually fail to dot every “i” and cross every “t” and consequently get themselves into a position where their risk aversity leads them to pull their punches on quality issues.



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Julianne Wiley

posted September 17, 2005 at 7:45 pm


This was struck down less than 24 hous later by a Federal judge.



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Sean Gallagher

posted September 17, 2005 at 7:54 pm


Does anyone know the ground on which the law was struck down?



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sj

posted September 17, 2005 at 9:35 pm


See http://www.kansascity.com/mld/kansascity/news/12668295.htm
“Laughrey ruled that the law ‘imposes an undue burden on a woman’s reproductive rights without providing added health or safety benefits, perhaps causing additional risks.’”
Same old story.



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Slurms McKenzie

posted September 17, 2005 at 11:50 pm


the law imposes an undue burden
Lets see how long O’Connor’s nonsensical contribution to abortion jurisprudence lasts.



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Ken

posted September 18, 2005 at 4:15 am


without providing added health or safety benefits
Are there any reliable stats on health and safety in abortion clinics? I have read part of one book on the subject, but it was anecdotal and poorly documented. Thanks.



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Donald R. McClarey

posted September 18, 2005 at 5:55 am


This case is another example of how abortion is an endless Pandora’s box for the federal judiciary. 32 years since the end of Roe and the cases keep coming in a seemingly endless stream. I am sure this case will one day come before the Supreme Court. Sooner or later, and I pray it is sooner, five justices on the Court will realize that the battling over Roe will never end, and the Court will decide that it is time to get out of the abortion legislation business and return the matter to the States.



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Sean Gallagher

posted September 18, 2005 at 7:29 am


without providing added health or safety benefits
It seemed to me that the law was directly crafted to provide just that. But perhaps I need to know more about the particular situation on the ground in Missouri regarding medical licensing and the ability of doctors to be able to admit a patient to a hospital.



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sj

posted September 18, 2005 at 11:26 am


The judge’s decision was to issue a 10 day TRO against enforcement so the decision wasn’t a final one by a long shot.



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alicia

posted September 18, 2005 at 3:52 pm


Hospital privileging is an arcane area – very subject to the prevailing winds, and often used to exclude various classes of health care providers under the guise of protecting patients. Getting hospital privs can be expensive, time consuming, and downright impossible in some places (except for the members of the ‘old doc’s network’) and in other places it is merely a rubber stamp from a committee.



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Anthony

posted September 18, 2005 at 4:35 pm


I would suspect that the decision was based on an extension of Doe v Bolton, where requirements that abortions be performed in a hospital were ruled unconstitutional. By typical liberal legal logic, if it’s unconstitutional to require that abortions be performed in a hospital, then it’s unconstitutional to require that abortions be performed by a doctor with hospital privileges.
Given the shortage of doctors willing to perform abortions, I wonder how long it will be before a liberal judge rules that it’s unconstitutional to require a licensed physician to perform abortions, opening it to LVNs or RNs.



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Sean Gallagher

posted September 18, 2005 at 8:43 pm


Given the proliferation of freestanding surgical centers, it seems to me a prudent move for more state legislatures to require doctors practicing in them and other similar facilities, including abortion facilities, to have clinical privileges in nearby hospitals.
While I suspect that most doctors who practice in freestanding surgical centers to have such privileges, it would still be a good law to have on the books.
Could such broadening of the horizon of such a law make it easier to gather legislative support, make it harder for it to be overturned?



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sj

posted September 18, 2005 at 10:49 pm


Probably- free-standing clinics are recognized as a likely source of upcoming problems. The issue of whether the MDs have admitting privileges at a hospital is only the beginning. Perhaps a bigger issue is who the ancillary personnel are and who has trained them, especially anesthesia providers. What sort of QA is being done by the ambulatory surgery centers?
Then there’s the complaint of the hospitals that the free standing clinics are siphoning off the best-paying procedures, leaving them to handle the high cost, low reembursement procedures. That in turn leads to attempts by the hospitals at “economic credentialing”, i.e., denying privileges to providers who are taking their lucrative work elsewhere.
Yes,there’s a lot of room for more regulation here.



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Sean Gallagher

posted September 19, 2005 at 8:32 am


My point is, though, that any consideration of regulating free-standing surgery centers should include facilities that provide abortions. In principle, they are no different.



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sj

posted September 19, 2005 at 4:18 pm


Absolutely.



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