Indiana PPAN and Indiana ACLU Chapters Oppose Informed Consent
The Hysterectomy Educational Resources and Services (HERS) Foundation, a non-profit international women’s health education organization, held its 28th annual conference in New York City on Saturday, April 24, 2010. The focus of the conference—hysterectomy informed consent legislation—recently drew opposing comments from representatives of two non-profit groups.
Congresswoman Carolyn B. Maloney (D-NY), an ardent women’s rights advocate, delivered the Keynote Address at the conference. State Representative Bruce Borders (R-IN), who recently proposed hysterectomy informed consent legislation in the form of House Bill 1366, addressed what voters can do to help bring about meaningful legislation to counteract the more than 621,000 hysterectomies performed each year on women in the U.S. who are not provided with information that is required for informed consent.
For nearly three decades, the HERS Foundation has been asking the question, who would deny women the anatomical facts that are requisite to hysterectomy informed consent? When this question was posed in an Indiana House of Representatives hearing, the Indiana Hospital Association and a gynecologist who claimed to represent the American College of Obstetrics and Gynecology (ACOG) voiced opposition to HB1366. As did Planned Parenthood Action Network (PPAN) of Indiana and Indiana ACLU.
Planned Parenthood has long opposed video consent legislation, such as the one currently in place in Utah.[1] And in a missive PPAN of Indiana recently sent to its followers, they said of HB1366, “Thank you to all of our supporters who spoke out against this incredibly unjust and unnecessary bill.”[2] The HERS Foundation and other supporters of the bill welcome a public dialogue with representatives of PPAN to discuss their perception of how educating women about the anatomical facts of a life-altering surgery is “unjust and unnecessary” and the HERS position that informed consent is both just and necessary.
Indiana ACLU board member Joan Laskowski claimed that HB1366 “compromises dignity and autonomy protected by reproductive liberty.”[3] HERS also seeks a public dialogue with Indiana ACLU representatives who support Laskowski’s position that informed consent “compromises” rather than ensures dignity, autonomy, and liberty. In his book Patient Autonomy and the Ethics of Responsibility (MIT Press, 2005), Alfred I. Tauber unwaveringly states that informed consent supports autonomy and preserves dignity. I attempted to speak with Laskowski regarding her stance on a woman’s right to information required for informed consent. She restated her opinion and then ended the phone call, denying me the opportunity to speak.
HERS Foundation supporters include women and men from all political parties and from both sides of the abortion debate. Hysterectomy and abortion are about very different issues that should not be confused. Hysterectomy limits “reproductive liberty” in women who would choose to have children. Informed consent guarantees liberty and autonomy.
Hysterectomy is the surgical removal of the uterus, a hormone-responsive reproductive sex organ. Removal of the uterus impacts every cell in a woman’s body. Information about the consequences of the surgery is every woman’s right to know, prior to being told to sign a hysterectomy consent form.
Women scheduled for hysterectomies who watch HERS’ 12-minute video Female Anatomy: the Functions of the Female Organs report to HERS that they canceled their surgeries. Approximately 29% of medical expenditures are surgery-related, and hysterectomy is the most commonly performed non-obstetric surgery performed in the U.S.[4]
Hysterectomy represents more than $17B a year to the medical industry. If hysterectomies that are not life saving cease to be performed, hospitals and gynecologists will no longer benefit from more than half a million medically unwarranted hysterectomies performed each year. But the question remains unanswered why the Indiana representatives of two venerated non-profit organizations have mounted opposition to informed consent.
At issue here is medical ethics. Just as well-informed voters are at the heart of the American political system, no woman can be said to have provided consent without full, accurate information about the alternatives to and consequences of removal of her female organs prior to hysterectomy.
Politicians from both sides of the aisle have stepped forward in support of the HERS Foundation’s mandate to put information about the consequences of hysterectomy into informed consent. Borders, whose talk at the HERS conference was titled "Your Vote is Mightier than the Lobbyist's Dollar,” expressed surprise that two organizations one would expect to be natural allies of his bill not only did not support it but voiced opposition to it.
[1] Utah Criminal Code, Title 76, Offenses Against the Family, Section 305.5 Requirements for printed materials and informational video, http://le.utah.gov/~code/TITLE76/htm/76_07_030505.htm
[2] Planned Parenthood Indiana, “IGA Update,” email, February 9, 2010.
[3] Joan Laskowski, VP Legislation, ACLU - IN Board Member, “Legislation Update At Mid-Session,” http://www.aclu-in.org/2010_general_assembly_at_midsession.
[4] Muñoz, Eric; Muñoz, William III; Wise, Leslie, “National and Surgical Health Care Expenditures, 2005-2025,” Annals of Surgery, February 2010, pp 195-200.
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