Abortion, Shame, And Hospital Privileges


[warning: post contains discussion of molestation and sexual assault]

In the September issue of Texas Monthly, Erica Grieder has a Q+A with Kyleen Wright, head of the Texans for Life Coalition. It is titled, “The Compassionate Social Conservative.”

In one of her first answers, Wright says this about the new hospital privileges law regarding doctors who perform abortions in Texas:

But the part of the legislation that our organization was so passionate about was the hospital admitting privileges. That was about getting some bad actors out of the industry. We knew that that would mean fewer abortions, but we also knew that it would mean less trauma and a higher standard for women.

First, what is the new hospital admitting privileges law (part of HB2, the omnibus anti-abortion bill passed last year)? It “requires abortion providers to secure admitting privileges at hospitals within 30 miles of where they perform abortion procedures,” as Andrea Grimes writes. It has had a devastating effect on abortion services in Texas since it went into effect last year because many providers have lost or been denied privileges and so can no longer perform abortions. Doctors get admitting privileges to hospitals where they expect to admit patients and hospitals grant privileges to doctors from whom they think they will receive patients. And for hospitals, this is all about making money. Doctors who perform abortions rarely ever admit their patients to hospitals because abortion is an incredibly safe procedure. Also, if there are complications from an abortion, emergency doctors and doctors on staff at hospitals are able to take care of those patients. You don’t get privileges because you are a good doctor and denied them because you are a bad one. You get privileges because you are going to make money for the hospital.

And so, if hospitals fear that giving certain doctors privileges will lead to protests outside their doors or donors stopping donations or bad publicity or whatever else could hurt their bottom line, they will just deny or revoke privileges. In April, Grimes reported that doctors in Texas were having trouble getting privileges because of political pressure around abortion:

In court documents, abortion providers say that “pressure from abortion opponents” has prompted Texas hospitals to revoke admitting privileges to doctors who provide abortions. Others, like Hagstrom Miller’s physician in the Rio Grande Valley, have been unable even to obtain applications for admitting privileges from local hospitals in their deeply socially conservative communities.

Back to Kyleen Wright’s new Q+A. For Wright, hospital privileges is about “getting some bad actors out of the industry.”

Grieder then asks Wright how the push for hospital privileges came about. Wright tells a story about a woman who reached out to Texans for Life because she had a bad abortion experience. When Wright told her friend about this woman, the friend admitted to her that she, too, had had an abortion by this doctor and the doctor had molested her. “And I decided that a hospital admitting privilege provision would take care of him in short order,” Wrights says. “It really wasn’t “Oh my God, we can close down all but six or eight abortion clinics this way!”

Grieder then points out that when a doctor molests or assaults you, that is already illegal. So why a new provision specifically about hospital privileges? Wright: “Well, you would think. But this is typical in the abortion industry. You have women who are caught up with guilt and shame. No matter what society says, no matter what pretty signs they have on the clinic’s wall, there is a tremendous amount of secrecy and shame. All of that enables abuse. It’s the perfect hiding place for bad doctors.”

First, it is Texans for Life and people who are anti-abortion that create the shame that Wright is lamenting as the reason that people who are molested or assaulted by abortion doctors stay quiet. If shame and secrecy enable abuse, STOP MAKING PEOPLE FEEL SHAME and want to keep their abortion a secret.

Second, Wright provides no explanation for how a bad doctor having hospital privileges ends abuse. There is no actual line you can draw between ending abuse and a doctor having privileges. There is no logic to these statements.

There are some bad abortion providers, of course. But there are all kinds of bad doctors and being molested or sexually assaulted carries its own shame in our culture that often blames victims, ignores the crime, and defends the perpetrator. There is no way to separate that shame from the shame one may feel from having an abortion (which is, again, perpetuated by people who are anti-abortion). Is someone less likely to report their abortion provider for assault than they are to report their obstetrician or general practitioner, or podiatrist? Getting people to come forward who have been assaulted by a doctor is so much bigger than just the possible shame people may have because the doctor who harmed them did so while providing an abortion.

Is the idea that if doctors have privileges, people will report their assault to a hospital board and the privileges will get revoked and the bad abortion doctors will no longer be able to provide abortions (but will just keep on doing other medicine at their own practice)? I just don’t get this at all.

Oh, and also?

Regulations surrounding medical licenses in Texas are tough to enforce, and the state errs on the side of protecting doctors. That’s not an unreasonable position—health is fragile, even terrific doctors can have results for patients that end badly, frivolous complaints could ruin careers that took decades to build—but what’s hard to accept is what little power anyone has to take action against a doctor like Duntsch, who maimed and killed patients for 18 months, despite complaints to the state medical board from fellow doctors that started very early.

The medical board, though, isn’t the sort of regulatory agency that’s equipped to act quickly or decisively in these situations. […]

If the Texas Medical Board isn’t the entity responsible for enforcing standards of care, that falls on the hospitals that grant surgical privileges to the doctors—but, as the lawsuits that surround Duntsch and Baylor Regional Medical Center of Plano make clear, the legislature has given those hospitals little reason to rein in a doctor like Duntsch.

This is from a Texas Monthly post by Dan Solomon about Dr. Christopher Duntsch, who was allowed by the hospital that granted him privileges to just keep on maiming patients (and Greg Abbott is defending this hospital in court on behalf of the state of Texas). Due to tort reform about a decade ago, it’s much harder to sue doctors and the hospitals where they practice (or for it to be worth it based on the amount for which you can sue). And so, hospitals have little incentive to do anything about bad doctors to whom they give privileges. BECAUSE PRIVILEGES ARE ABOUT MAKING MONEY. That bad doctor isn’t worth worrying about because they will get the hospital more money by bringing in more patients even if some of those patients do sue due to, what is probably under the law, malpractice.

Making abortion providers have admitting privileges is not actually about ending abuse or protecting patients or anything to do with compassion. Please stop pretending otherwise.

UPDATE from Robin Marty after she read this post: “the idea that there is an anti-abortion activist who knows the name of an abortion provider who was gross to one patient and allegedly sexually assaulted another, one of whom is her friend, and she is unwilling to name that doctor is laughable. Especially since she cannot claim it is a privacy issue she since violated the first patient’s privacy by naming that doctor to her friend. That’s what they do, that’s why they have OR and abortiondocs and all the rest of their media network.”

8 Responses

  1. Raphael Kearns says:

    As a long time ER nurse, I can’t count up the number of times we saw patients arrive at my ER who were admitted to physicians other than their private physician. This “admitting privileges” trope is a complete sham.

    I worked in a number of different ER’s in the DFW area and NEVER saw a patient who EVER suffered a complication from an abortion.

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