A few weeks ago, I had a conversation with the Democratic staff of the House Oversight and Government Reform Committee. They were looking for a medical student to testify at an upcoming hearing on contraception—would I be that student?
Ultimately, the
Committee chose to invite a student at Georgetown Law Center as their
witness—but neither of was given a chance to address the Committee. Chairman Darrell Issa refused to seat
Sandra Fluke because, in his view, the hearing was “not about reproductive
rights but instead about the administration’s actions.” The hearing was quite clearly a
reaction to the Obama Administration’s decision to require church-affiliated
organizations to provide insurance coverage for contraception. Ms. Fluke would have been the only
woman on the panel.
I suspect that,
even if I had been invited, I would not have had the opportunity to address
Congress. But if I had, here is what
I would have said:
Mr. Chairman,
Ranking Member Cummings, and Ladies and Gentlemen of the Committee—
It is a privilege to
sit here before you and be able to address you, the men and women who make up
the membership of this committee.
As I look beside me, however, it must be recognized that I am the sole
female on this panel—a collection of witnesses you have asked discuss access to
medication that is only prescribed to women.
If this hearing had
been called to discuss the issue of access to erectile dysfunction medication
and the panel here consisted solely of women, I would have also argued that
your decision was, at best, irrational.
My gender
notwithstanding, I hope to present two rational, evidence-based arguments in
support of our responsibility to assure that women have access to
contraception. There are other
arguments we could discuss, but these two highlight the absurdity of
obstructing the use of certain classes of safe, effective medications.
First, contraception
provides this country with measurable health and economic benefits that have
nothing to do with sexual activity.
Although they are called “oral contraceptive pills” (OCPs), synthetic estrogen
and progesterone are now among the most widely prescribed medications in America. Is that because more women are sexually
active? No. It is because these medications have
helped millions of women with a diverse array of medical concerns. They are now prescribed for acne, endometriosis,
polycystic ovarian syndrome, and as a means of protecting women who are
particularly at risk for certain diseases such as ovarian cancer. The health risks involved when access
to these drugs is blocked is very real.
For example, without OCPs a woman with polycystic ovarian syndrome is
exposed to unopposed estrogen, placing her at higher risk for endometrial
cancer.
Along these same
lines, from a public health standpoint, OCP prescriptions allow more women to
attend school and work without having to use previously used sick days for
debilitating premenstrual cramps. By
denying women diagnosed with dysmenorrhea (painful cramps) or menorrhagia
(excessively heavy blood flow) the option of birth control pills, we deny them
the current gold standard for treatment.
All evidence suggests that health care providers should use these tools
to treat female patients. In a
nation that has invested such a large portion of funding—about two percent of
our annual budget—towards medical research, it is unfortunate that some would
ignore this research-based conclusion.
Second, although we
may disagree as to the benefits of family planning, we should all recognize
that, in this country, it is a doctor’s obligation to present a patient with a
wide range of reasonable medical choices.
I recently completed
a rotation in the nursery of a nearby hospital whose policy is not to offer
contraceptives to women. As I was
discharging new mothers—most of whom were immigrants, or poor, or both, with little
idea of where to go and what to do after they and their newborns left our care—I
was not able to present them with a fair range of options.
Many studies have
shown that it is beneficial for women to use some sort of birth control for the
first year after delivery. Becoming
pregnant any sooner puts the mother, her current child, and the future infant
at risk for adverse health outcomes.
I struggled to bite my tongue as these mothers left without this important
medical advice—information that I freely and routinely provide to other
patients at other hospitals. How could this hospital, whose goal is
to provide the best healthcare to its patients, deny these women that
information?
Regardless of where
you stand religiously on the use of contraception, as medical students in the
year 2012, we are taught that it is our responsibility as healthcare
professionals to provide “patient centered care.” We have moved away from the paternalistic view of “doctor
knows all,” to presenting the evidence and options to patients in order to come
to healthcare decisions together as a team. Without presenting the full spectrum of available options,
we are reverting back to a paternalistic view that physicians (or politicians) “know”
what is best. That view, in
my opinion, is wrong.
-
Yonit
Lax
MD Candidate | Class of 2013
The George Washington University
School of Medicine and Health Sciences
The George Washington University
School of Medicine and Health Sciences
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| Photo Courtesy of Planned Parenthood: The Chosen Witnesses at the Hearing |
Wisdom of the Sages- Rosemary Sage Sweet Potatoes, Beets + Garlic
This is absolutely delicious, I make it often to accompany meals or as a snack for the week. The whole garlic roasted together melts in your mouth and the sage gives it a perfect edge.
Ingredients: ( 3- 4 servings)
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| Pre-cooking |
3 Beets cubed
6 Whole Cloves of garlic unpeeled
1 bunch of Sage
Handful of Rosemary
Olive Oil - just enough to coat
Instructions
1) Preheat Oven to 425
2) Line a baking dish with parchment paper
3) Mix together all ingredients
4) Bake for approx 45 minutes
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| Rosemary-Sage Sweet Potatoes Beets + Garlic (Sorry if they seem scarce, I may have picked at these before taking the picture....oops) |
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