Joan Rivers died September 4 in New York City’s Mount Sinai Hospital after going into cardiac arrest following what most news outlets reported as “a routine surgical procedure” on her throat at an Upper East Side outpatient clinic. A week after the New York State Health Department began an investigation into the circumstances of her death, the New York Times reported that ear, nose, and throat specialist who was in the operating room when Rivers went into cardiac arrest “was not authorized to practice medicine in the clinic…. Under state and federal regulations, facilities like the clinic must review the credentials and qualifications of physicians and grant them privileges before permitting them to perform procedures. …. Neither the gastroenterologist nor the E.N.T. specialist has been accused of wrongdoing.” Within twenty-four hours, the medical director was cashiered.
Now, even though Joan Rivers was in a doctor’s office in Manhattan, which is literally roiling with physicians, and taken to one of America’s most renowned hospitals roughly eight blocks away, she died.
Now, let’s consider: if I were to give you a drug that, according to Britain’s National Health Service has “very common” side-effects of vomiting, nausea, diarrhea, and uterine cramps as well as “common” (i.e., “more than 1 in 100 people”) side-effects that include heavy vaginal bleeding and “infection or inflammation of the uterus or tummy—this may be fatal,” my guess is you would only want to use such powerful drugs only with a doctor physically present who can admit you to a hospital someplace within a reasonable proximity of where you are in case of complications. You might feel reassured in that viewpoint about a doctor needing to be there if you knew that the U.S. National Institute of Health itself recommends this drug “should be taken only in a clinic, medical office, or hospital under supervision of a qualified doctor.” You might reasonably think such medical supervision indicated if you knew that, just before it gave approval to the drug, the FDA was considering a number of protocols governing administration of the drug (e.g., requiring prescribers to have special training, to have certain follow-up surgical skills, and to have admitting privileges at a hospital within an hour’s drive of his practice). You might be surprised to learn that these protocols were subsequently watered down or dropped, in many peoples’ views, for political and ideological reasons.
If, in light of all this and knowing that a famous star could die from a much more routine outpatient procedure a couple blocks away from a major medical facility, you still thought that certain precautions are reasonable and prudent in the patient’s interests … you would be wrong. At least politically incorrect. Or at least you won’t get invited to the next Planned Parenthood dinner.
The drug we are talking about is mifepristone, one of two drugs used to perform chemically-induced abortions. Planned Parenthood has been doing abortions in Iowa by video conference using that drug. Yes, you read me right. The “doctor” can be several hundred miles away from the woman. After “examining” his patient by TV, he then presses a switch that 0pens a locked drawer from which the woman removes a package of mifepristone. She then goes off to take it and can come back in a few days. She should come back for follow up within two weeks to make sure her “do-it-yourself-abortion” worked, i.e., she is not still pregnant or suffering infection from incomplete abortion. They call it “telemedicine.”
The State of Iowa stepped in to try to stop “telemedicine.” Planned Parenthood has fought the Iowa Board of Medicine’s prohibitions, but Iowa District Court Judge Jeffrey Farrell on August 18 upheld the Board’s rule. Planned Parenthood remains on the warpath and will likely appeal.
When the FDA first allowed testing of RU-486 (the trade name for mifepristone) in 1994—in the middle of the Clinton Administration—an Iowa woman nearly died after losing between one-third and two-thirds of her blood after using the drug. Drugs that essentially induce hemorrhage and abortion are inherently dangerous.
But normal protocols for medical follow up—training, ultrasound equipment, admitting privileges, being “there” for your patient—cost money. As the Times reports, the clinic where Rivers began dying is required by “state and federal regulations” to grant privileges to those who do procedures there. But when Texas imposed a requirement on abortionists to have admitting privileges to a hospital somewhere within a thirty mile radius of the abortuary (even though they couldn’t save Rivers eight blocks away in Manhattan), the Abortion Establishment branded the requirement an unnecessary procedural hurdle and Wendy Davis launched her (in)famous political career with a filibuster of such “unreasonable” rules. Planned Parenthood argues that the restrictions are unnecessary and simply seek to limit abortion. In a world where the media is not a supine lapdog of the abortion industry, such self-interested claims would be rigorously examined: doesn’t Planned Parenthood actually have a vested corporate interest in laxer standards in order to maximize its business? What other reasons would there be for turning words on their head, e.g., substituting “reading the dosing information” for training, having “arrangements” with some other doctor in lieu of one’s own follow-up surgical ability, having ambiguous “access” to some medical facility rather concrete admitting privileges within an hour’s drive of where the doctor actually is?
Who is really perpetrating a “war on women?” The State of Iowa, which demands an abortionist at least be able to touch the woman from whom he will collect a fee? Or Planned Parenthood which is quite willing to mechanically put drugs into an unattended woman’s hands in a rural county which are death-dealing for her child and potentially death-dealing for her? (We will not talk about their hostility to the requirement for an ultrasound to establish the pregnancy and make the woman aware in truly informed consent of the state of her unborn child’s development at the stage she is considering aborting it).
One would think that when a woman has an abortion, her “doctor” at least would be there. But, as Gertrude Stein observed long ago in another context, at least in Planned Parenthood’s heartland, “there is no there there.”