Legally Mandated Lies: The Dangers of Informed Consent Legislation
So far in 2019, state legislation intending to limit access to abortions has skyrocketed. With a conservative Supreme Court and a Republican White House and Senate, anti-abortion activists see a “much better opportunity [...] than even a year ago” to limit abortion rights. The main types of laws being introduced in at least ten states are ‘heartbeat bills,’ which limit abortion after a heartbeat is detected, or after six weeks, as well as ‘trigger bills,’ which would immediately outlaw abortion should Roe v. Wade be overturned.
Abortion is perhaps the only medical procedure that remains a highly-politicized issue, with Republicans taking a strict anti-abortion stance and Democrats a strictly pro-choice one. But as of late, the GOP has arguably become out of touch with the American people in its “pro-life” intransigence. According to one poll conducted by NBC News and the Wall Street Journal, 54% of Americans believe Republicans are too extreme in their stances on abortion. By contrast, 41% believe Democrats are too extreme.
One under-discussed area of abortion legislation is ‘informed-consent’ laws. These laws, which have been implemented by at least 37 states, ostensibly aim to provide patients with the information they need to make an informed, consensual decision about whether or not to get an abortion. The laws include anything from 48 hour mandatory-waiting periods, abortion counseling, and sets of information doctors are required to offer or give to patients.
The information often comes in the form of an informed-consent abortion brochure, that describes the procedure, possible side effects, and the development of a fetus. The content of these brochures is also, very often, false.
In fact, according to a study that analyzed the ‘informed consent’ abortion pamphlets that 29 states require doctors provide to patients, a staggering 31% of the information in these pamphlets—which are supposed to provide factual information about a medical procedure—is medically inaccurate. In states like Kansas, that number climbs to 43.4%.
The falsehoods told to patients in these informed consent brochures come in various forms. Many warn about links between abortion and serious medical issues, such as heart disease, breast cancer, infertility, PTSD-- all claims considered baseless by major American medical associations. Other inaccuracies involve the use of misleading language to make the fetus appear more ‘babylike,’ and suggest that the fetus can feel pain, even though fetuses are incapable of feeling pain until at least 24 weeks into a pregnancy. Some states go so far as to tell the patient that getting an abortion is equivalent to ending a whole, unique life, which has also never been considered accurate from either a medical or legal standpoint.
Even beyond the 31% of information that is categorically inaccurate, much of the rest of information in informed-consent abortion pamphlets is irrelevant to those 90% of patients who get abortions in the first 13 weeks of pregnancy. Overwhelmingly often, warnings of the serious risks of abortion and the stages of fetal development only apply to those seeking late-term abortions—which account for less than 1% of total abortion procedures. This information inappropriately includes much more significant health risks, and a description of late-stage fetal development. Many brochures also include graphic pictures of the ‘unborn child.’
Whether you agree with the idea of abortion or not, it should be obvious that legally requiring doctors to lie to patients about a medical procedure is morally reprehensible. But doing so also violates the fundamental tenets of medical practice and patient-doctor trust. In 1978, Congress created a panel of experts to determine what is required for a patient to have ‘informed consent.’ As legislators told then-President Reagan in 1982, informed consent requires that a patient needs the “capacity to make decisions about their care,” that their participation must be “voluntary,” and that they must be provided “adequate, appropriate” information to make their choices.
However, as the Guttmacher Institute explains, abortion brochures supposedly designed to ensure a patient’s informed consent actually violate their right to said consent. The information provided to patients that is inaccurate violates their right to information about a medical procedure. The same is true for patients receiving an abortion in the first trimester who receive information that pertains only to late-term abortions; this information is not “germane,” or relevant, to the patient, Guttmacher explains.
Because these brochures actively mislead patients, they violate their right to informed consent. They also severely damage the trust between a doctor and their patient, thereby inhibiting an essential condition for the ethical practice of medicine. Doctors often, for example, must tell the patient a series of ‘facts’ about abortion risks that they then assert are scientifically invalid—a confusing and potentially traumatic situation for a patient making an already difficult decision.
When a patient loses the ability to give informed consent, they lose one of the essential rights of ethical modern medicine. No matter how you feel about abortion, it is clear that laws that aim to spread lies in the doctor’s office are immoral and must be struck down. In this case, objectivity in abortion informed-consent laws is not merely ‘politically correct’—it is an ethical imperative.
There are horror stories from around the world about what can happen when a patient loses the right to informed consent, such as a recent case in Argentina, where an eleven-year-old child requested an abortion after being raped by a family member. Rape is one of the few instances in which Argentina allows abortion. Even so, the hospital lied to the child, giving them pills the child was told were vitamins that were actually meant to hasten the development of the fetus. Because their right to informed consent was ignored, an eleven year old, still a child, is now a parent herself. We cannot allow similar cases of misinformation, and their devastating consequences, to occur here.
As the fight over abortion only continues to ramp up under a conservative White House, Supreme Court, and Senate, the need for medical accuracy has never been more important. In 2016, the Supreme Court ruled against Texas for its misleading abortion laws, including informed consent brochures—but that was under a much more liberal Court. In what is sure to be a contentious year (and 2020 election) on the subject of abortion, we must be able to put politics aside in favor of medical accuracy. Patient safety, consent, and the ethical practice of medicine depend on it.