Internet articles have appeared as well. 36 Letâs hope that our media will continue to spread the word and that eventually their efforts will result in changes.
Litigation can also have an effect on the Cytotec problem, but almost all Cytotec cases are settled out of court and the settlements include gag orders, so the public never hears about them. Of course, insurance companies, hospitals, and pharmaceutical companies do hear about the big settlements. Their initial response is to rush to their political friends and try to lobby the government to cap malpractice awards or limit the right of patients and families to sue. But it is only a matter of time before hospitals and insurance companies will begin to put pressure on doctors not to use a drug that is not approved by the FDA and could end up costing them lots of money in litigation. In chapter 7 we will look further at the important role âdrug regulation by litigationâ plays in our society.
In the United States, many obstetricians have no faith in democratic institutions such as the FDA. They express disdain for the public realm and contempt for any attempts to monitor, much less regulate, their practices. Their attitude reveals a desire to go it alone that, when combined with decades of a reactionary approach to medical care, undermines the social contract between doctor and patient. It is an underlying problem that touches many areas of American reproductive life.
Most obstetricians are also gynecologists, and the hot new field in gynecologyâartificial reproduction (in vitro fertilization, etc.)âis also full of hype, false promises, and malpractice. 37 Every other industrialized country has found it necessary to develop government regulations around artificial reproductive services. But in the United States, after congressional hearings, regulations were adopted for the laboratories used by the reproductive services, but the clinical part of the practice, the part that involves gynecologists, was left unregulated, even though that is where malpractice is rampant.
American medical practice overall has far and away the least amount of regulation of any country in the worldâmaking it fertile ground for vigilante practice. Not only do many of our doctors lack faith in democratic institutions, so do many of their patientsâthe American public. Health care consumers in the United States are generally timid and have been quick to acquiesce to doctorsâ complaints of encroachment by HMOs and government, allowing the tyranny of an obstetric monopoly to continue. They put physicians on a pedestal because they need to believe that doctors canhelp them when theyâre sick, and as a result, doctors believe that they are above the law. These attitudes create an environment where vigilante practice is possible, and nowhere is this more apparent than in the use of drugs and technology by American obstetricians.
In the United States, the obstetric establishment is powerful and the government regulatory bureaucracy is too weak to stand up to pressure from the pharmaceutical industry, the insurance industry, and the medical industry (doctors and hospitals). The results are underregulated drugs, a lack of safety studies and studies of questionable quality, seduced or sleepy media, and underinformed women and families. We must do all we can to turn this around. On a grassroots level, there are encouraging signs, such as several Internet support groups formed by women who have suffered from uterine rupture and survived. One has more than 350 members. 38 The question now is: How many women and babies will have to die or be damaged before the tragic practice of inducing labor unnecessarily is ended?
FIVE HUNTING WITCHES: MIDWIFERY IN AMERICA
Because the midwives feared God, they did not do as commanded by the king.
EXODUS 1:17
A midwife is lectured at by committees, scolded by matrons, sworn at by surgeons, bullied by surgical dressers, talked
Litigation can also have an effect on the Cytotec problem, but almost all Cytotec cases are settled out of court and the settlements include gag orders, so the public never hears about them. Of course, insurance companies, hospitals, and pharmaceutical companies do hear about the big settlements. Their initial response is to rush to their political friends and try to lobby the government to cap malpractice awards or limit the right of patients and families to sue. But it is only a matter of time before hospitals and insurance companies will begin to put pressure on doctors not to use a drug that is not approved by the FDA and could end up costing them lots of money in litigation. In chapter 7 we will look further at the important role âdrug regulation by litigationâ plays in our society.
In the United States, many obstetricians have no faith in democratic institutions such as the FDA. They express disdain for the public realm and contempt for any attempts to monitor, much less regulate, their practices. Their attitude reveals a desire to go it alone that, when combined with decades of a reactionary approach to medical care, undermines the social contract between doctor and patient. It is an underlying problem that touches many areas of American reproductive life.
Most obstetricians are also gynecologists, and the hot new field in gynecologyâartificial reproduction (in vitro fertilization, etc.)âis also full of hype, false promises, and malpractice. 37 Every other industrialized country has found it necessary to develop government regulations around artificial reproductive services. But in the United States, after congressional hearings, regulations were adopted for the laboratories used by the reproductive services, but the clinical part of the practice, the part that involves gynecologists, was left unregulated, even though that is where malpractice is rampant.
American medical practice overall has far and away the least amount of regulation of any country in the worldâmaking it fertile ground for vigilante practice. Not only do many of our doctors lack faith in democratic institutions, so do many of their patientsâthe American public. Health care consumers in the United States are generally timid and have been quick to acquiesce to doctorsâ complaints of encroachment by HMOs and government, allowing the tyranny of an obstetric monopoly to continue. They put physicians on a pedestal because they need to believe that doctors canhelp them when theyâre sick, and as a result, doctors believe that they are above the law. These attitudes create an environment where vigilante practice is possible, and nowhere is this more apparent than in the use of drugs and technology by American obstetricians.
In the United States, the obstetric establishment is powerful and the government regulatory bureaucracy is too weak to stand up to pressure from the pharmaceutical industry, the insurance industry, and the medical industry (doctors and hospitals). The results are underregulated drugs, a lack of safety studies and studies of questionable quality, seduced or sleepy media, and underinformed women and families. We must do all we can to turn this around. On a grassroots level, there are encouraging signs, such as several Internet support groups formed by women who have suffered from uterine rupture and survived. One has more than 350 members. 38 The question now is: How many women and babies will have to die or be damaged before the tragic practice of inducing labor unnecessarily is ended?
FIVE HUNTING WITCHES: MIDWIFERY IN AMERICA
Because the midwives feared God, they did not do as commanded by the king.
EXODUS 1:17
A midwife is lectured at by committees, scolded by matrons, sworn at by surgeons, bullied by surgical dressers, talked
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