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09-08-2012 | Article

ACP cautions government to respect MD-patient relationship

Abstract

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MedWire News: The American College of Physicians (ACP) has called for a more hands-off approach to government regulation of the physician-patient relationship.

The College has issued a statement outlining the principles it believes should underpin such regulation, placing a greater emphasis on the ethical responsibilities to the patient and freedom for doctors to treat patients according to best practice.

Recently passed and proposed laws at the state level threaten to undermine evidence-based clinical practice and tamper with the patient-physician relationship, according to authors Jack Ginsburg and Lois Snyder, writing on behalf of the Health and Public Policy Committee of the ACP.

They note that a new law passed in Florida would prevent healthcare practitioners from asking patients about gun ownership or gun safety measures in their homes, and would bar inclusion of such conversations in the medical record. Physicians who disobeyed would be subject to fines or even permanent revocation of their licenses to practice medicine in the "Sunshine State." Only an injunction (subject to appeal) from a federal judge stayed implementation of the law.

Similarly, "in Pennsylvania, physicians can access information about chemicals used in the 'fracking' process to extract oil and natural gas, but they are prohibited by law from discussing their findings with patients who may be suffering from consequent harm," the authors write.

Other states mandate treatments or procedures; in Arizona, women who want to have an abortion must have an ultrasound at least 24 hours before the procedure, and in Wisconsin, doctors must have three office visits with a woman before prescribing a drug-induced

abortion. "Physicians who fail to abide by the mandate could be subject to criminal penalties, including imprisonment," Ginsburg and Snyder write.

The ACP statement highlights the responsibility of all healthcare providers to support the patient-physician relationship and to recognize the ethical obligations of physicians towards their patients, and stresses that legislation should not mandate the provision or withholding of information or care in a way that goes against the physician's clinical judgment and clinical evidence. In addition, it observes that medical evidence evolves over time and both clinical practice and legislation must change to reflect this.

By Neil Osterweil, MedWire Reporter