AMA lawsuit to protect patient-physician relationship in North Dakota

Yet another outrageous action that needs a vigorous response from the AMA:

The American Medical Association (AMA) today filed a lawsuit to challenge the constitutionality of two North Dakota laws that compel physicians and other members of the care team to provide patients with false, misleading, non-medical information about reproductive health. The AMA is filing this lawsuit in partnership with Center for Reproductive Rights, Red River Women’s Clinic—the only abortion clinic in North Dakota—and its medical director, Kathryn Eggleston, M.D., as co-plaintiffs.

Filed in the United States District Court, District of North Dakota, the lawsuit asks the court to block enforcement of North Dakota’s compelled speech laws, which the AMA argues would inflict irreparable harm on patients and force physicians to violate their obligation to give honest and informed advice.

“The patient-physician relationship is the cornerstone of health care, and depends upon honest, open conversations about all of a patient’s health care options,” said AMA President Patrice A. Harris, M.D., M.A. “North Dakota’s law undermines this relationship by requiring physicians to mislead and misinform their patients with messages that contradict reality and science. The AMA will always defend science and open conversations about all health care options available to patients.”

The two laws being challenged would force physicians to misinform their patients that medication abortion may be “reversible,” which is contrary to science, and require that physicians convey ideological, government-mandated messages that are false or misleading:

  • H.B. 1336, which was passed earlier this year and is scheduled to take effect August 1, 2019. This law would force physicians to tell patients that a medication abortion may be “reversed”—a patently false and unproven claim unsupported by scientific evidence. Under this law, doctors must also give patients government-scripted information on where to find a medical professional who will provide an experimental and unethical treatment to “reverse” an abortion—a treatment that is already seemingly prohibited by North Dakota law.
  • An existing North Dakota law that forces physicians to tell patients that abortion terminates “the life of a whole, separate, unique, living human being”—a controversial, ideological, and non-medical message – and unconstitutionally forces physicians to act as the mouthpiece of the state.

“Lawmakers are forcing falsehoods and propaganda into the mouths of physicians against their will, effectively forcing them to violate their ethical obligation to do no harm,” said Nancy Northup, president and CEO of the Center for Reproductive Rights, which is filing the lawsuit in partnership with the AMA. “The First Amendment prohibits the government from hijacking the doctor-patient relationship to advance a political agenda.”

“The women we serve come to us assuming we will provide them with medically-accurate information and care,” said Tammi Kromenaker, Director of Red River Women’s Clinic. “North Dakota’s laws are forcing us to say things that violate our medical ethics and will soon force us to say things that are simply false and not backed up by science.”

In the lawsuit, the plaintiffs argue that these laws violate the First Amendment rights of physicians by forcing them to convey false information and non-medical statements with which they disagree. The lawsuit asks the court to block H.B. 1336 before it takes effect on August 1.

The lawsuit argues that just last term, the U.S. Supreme Court held in National Institute of Family & Life Advocates v. Becerra that candor is crucial in the patient-physician relationship, and that the government cannot regulate the speech of medical professionals to advance controversial ideas or to discriminate based on the content and/or viewpoint of the speaker. But this is precisely what North Dakota’s compelled speech laws do.

Eight states—Arkansas, Idaho, Kentucky, North Dakota, South Dakota, Oklahoma, Nebraska, and Utah—have passed similar laws requiring abortion providers to tell patients about so-called medication-abortion “reversal.” Five of those states—including Arkansas, which expanded an existing law—passed the legislation in the past year.

In the lawsuit, the AMA and Center for Reproductive Rights state: “The Compelled Reversal Mandate forces physicians to tell their patients that medication abortion may be reversible, a claim wholly unsupported by the best, most reliable scientific evidence, contravening their ethical and legal obligations as medical providers. The Compelled Personhood Mandate forces physicians to also tell their patients that abortion terminates ‘the life of a whole, separate, unique, living human being,’ compelling medical providers to convey a controversial and ideological message about fetal personhood that is unmoored from medical science. Plaintiffs object to this forced speech, which requires physicians to deliver to their patients false, misleading, non-medical information with which they disagree, to advertise an experimental treatment that runs counter to their patients’ best interests, and to violate their medical ethics.”

You can read the full complaint for this case here.