One thing is puzzling about the Anti-Abortion rhetoric surrounding the late George Tiller. I know I heard Fox News and Bill O'Reilly in particular state that "Dr. Tiller performed abortions "for any reason" after a women's 24th week of pregnancy", but ...
Now, I'm not going to get into the pro or con of abortion. The issue I have is that it's difficult to challenge or confirm the veracity of a statement like that when it's based upon medical records you aren't allowed to read due to HIPAA restrictions. That should raise serious doubts of anyone who claims that Dr. Tiller performed abortions "for any reason" after a women's 24th week of pregnancy.
Sometimes you have to consider the audience as much as the source of such things. Maybe this argument is lost on the average person who knows very little about HIPAA, so, today, I'm choosing to look at abortion through the HIPAA lens.
HIPAA is a poorly crafted law that is meant to preserve patient privacy and medical providers must comply with the law at their expense. It has worked reasonably well for abortion seeking patients. Simply put, HIPAA requires
- Notifying patients about their privacy rights and how their information can be used.
- Adopting and implementing privacy procedures for its practice, hospital, or plan.
- Training employees so that they understand the privacy procedures.
- Designating an individual to be responsible for seeing that the privacy procedures are adopted and followed.
- Securing patient records containing individually identifiable health information so that they are not readily available to those who do not need them.
Generally, you can only release medical information to third party payers and other entities with a legitimate reason to see them, like other medical providers that see you or medical researchers (with restrictions). Anyone not employed by the physician, who is allowed to see these records, has to sign a confidentiality agreement and has to agree to be bound by HIPAA rules. It's that last item, "Securing patient records containing individually identifiable health information so that they are not readily available to those who do not need them" that gives me the most trouble in the rhetoric surrounding Dr. Tiller. Just saying or thinking the medical necessity behind a late term abortion is questionable isn't probable cause to go snooping through anyone's medical records.
So when some abortion foe says some one violated abortion law, I have doubts and ask:
- How do you know someone violated abortion law?
- Where did you get your information?
- Who gave it to you?
- How did you verify the source or content?
- If you did verify source and content, then a clear HIPAA violation occurred and how did you dodge the office HIPAA designee who is responsible for stopping this type of violation?
Based on the allegations spewed by Fox news over the last few years it would seem that Fox News gets people to skirt the law. They get people who have accessed the medical records appropriately to discuss the records. They tease the public with snippets of untraceable rhetoric. They haven't been prosecuted, but how does Fox News confirm or deny the allegations? When it comes to abortion, simply knowing the date of service and the diagnosis code for the abortion would be enough in most cases to ID the patient (which would be a HIPAA violation). Despite what the other side is saying, late term abortions aren't that common of a procedure. Fox isn't interested in accuracy, they want drama. Fox News doesn't need no stinkin' facts to get in the way of red meat being thrown at their viewers.
One of Fox News' talking points is about former Governor Sebelius vetoing the Kansas legislature when they passed a bill saying that Tiller had to provide the state with specific medical reasons for all of his late-term terminations. Maybe Sebelius knew (like I do) that the state law would likely be set aside by the courts because HIPAA (federal law that dictated the regulation) would supercede State Law. Maybe Sebelius knew a law meant for one person might as well be wrapped in a red shirt as far as the courts are concerned.
Another talking point surrounds a supposedly real patient who presumably wanted an abortion because the pregnancy would stop her from going to concerts. Frivolous? or are we dealing with something on the fringe? Something blown out of context? I only know one reason why a remark like that would be recorded on a medical chart and that would be to demonstrate some type of social issue like suicidal thoughts, delusions or another form of extreme mental duress. And we only have Fox's word that she did not have some other physical reason or that it was even considered a late term abortion.
Out of context statements that may support the anti-abortion position are reported without disclaimer. These statements are meant to inflame the anti-abortion crowd and get the sympathy of some pro-choice with restrictions folks. They don't care if the only way the statement can be verified is by violating HIPAA or a woman's 4th amendment rights. Taking quips like this from a medical record, out of context, leads to the kind of conclusions Fox News loves to promote and pro-choice advocates have difficulty challenging. It's ignorant, unsupportable and wrong. Yet, the anti-abortion crowd gets traction.
Why a women seeks to end her pregnancy is none of our business. It's private and HIPAA requires the medical provider to maintain all patients' privacy. The anti-choice advocates think they are entitled to examine the individual medical records of every woman who makes this choice and pass judgment on the reasons for her choice. That's Orwellian.
The mental gymnastics of people like Scott Roeder (who is so anti-government that he doesn't believe in paying taxes and is paranoid about his social security number) want to interrogate a woman for her reasons for ending her pregnancy are incredible. These same people would likely be infuriated if medical records detailing their treatment of chronic disease, cancer or a sexually transmitted disease were made public; but it's ok to invade a woman's abortion medical record.
Anti-abortion advocates demand their 1st amendment rights to scream and terrorize people who work at or utilize abortion clinics, but can't see they are denying women their 4th amendment right against unreasonable search when they publicize the reasons they think some women end their pregnancies. To them a woman's 4th amendment right and HIPAA are an inconvenience they hope to circumvent. They don't see the hypocrisy or irony of their position.
Interestingly it seems as if HIPAA may well fill in the blank left open by the 4th amendment in the abortion debate. Anti-abortion proponents feel it is reasonable to search anyone's medical records for improperly performed abortion procedures. Who knew that it would be HIPAA, a law co-sponsored by former Senator Nancy Kassebaum R-Kansas and a law that many medical workers find to be a total PIA, would become a safeguard of a woman's right to privacy when she seeks to end her pregnancy should the 4th amendment fail her.
That's amusing. Well, God has a sense of humor or karma "gets" irony.