Oklahoma House Ignores its Doctor in Abortion Debate
By Tim Talley
The Associated Press
April 6, 2007
As the Oklahoma Legislature's only physician, Rep. Doug Cox is often sought out for counsel and advice on matters of public health.
But Cox's colleagues in the state House have largely ignored him and other medical professionals as they debate proposed anti-abortion regulations that, among other things, would bar state hospitals, clinics and workers from performing abortions at state expense unless the mother's life is threatened.
Cox and other doctors believe the measure, overwhelmingly passed by the House and awaiting final passage in the Senate, will drive a wedge between them and their pregnant patients and cut off treatment for women with troubled pregnancies who are uninsured or underinsured.
"I consider myself to be pro-life. But I want to be pro-life with compassion," said Cox, R-Grove, an emergency medicine physician at Integris Grove General Hospital who said he has delivered hundreds of babies and never performed an abortion.
The discord has reopened legislative debate on the emotional subject of abortion. In the past two years, lawmakers have approved a variety of caveats and restrictions to the procedure made legal by the U.S. Supreme Court's 1973 Roe v. Wade decision.
Among them are laws that require parental consent before a girl under 18 can get an abortion and informed consent for women considering an abortion. Not until this year have physicians mounted organized opposition.
A group of doctors met with Gov. Brad Henry Thursday afternoon to discuss their concerns and urge him to veto the legislation should it reach his desk. Paul Sund, Henry's communications director, said the governor has made no decision.
Supporters believe the physicians' concerns are unfounded. While the measure prohibits the use of state resources to encourage or perform an abortion, it would not stop a doctor from discussing it as an option, said Tony Lauinger, chairman of Oklahomans for Life and vice president of the National Right to Life Committee.
"There's a world of difference between discussing options and encouraging a woman to have an abortion," Lauinger said.
But some obstetricians and gynecologists believe the bill's language is subject to interpretation and that it could prohibit them from mentioning termination as an option for pregnant women or accepting payment for their services from Medicaid, a federal health care program for the indigent that is partly supported with state tax dollars.
"This is an overly restrictive bill," said Dr. Dana Stone of Lakeside Women's Hospital in Oklahoma City. "It's legislative intrusion into medical decision making."
"We have effectively eliminated our learning centers as a referral source," Cox said. Women with complicated pregnancies are often referred to hospitals affiliated with state-funded medical schools.
Lauinger said the bill will not affect Medicaid payments because of an exception that allows the use of state funds "to the extent required for continued participation in a federal program."
Cox, chairman of the House Public Health Committee, offered amendments he said would resolve physicians' concerns and authorize medically qualified abortions under certain medical conditions to protect a woman's health. But they were tabled or simply not heard.
"There's no compassion in this bill in these rare cases," said Cox, who has practiced medicine for 26 years and was Oklahoma's Family Physician of the Year last year. "Medicine is not always black and white. There's lots of gray areas. This handcuffs the doctors in dealing with the gray areas."
Cox and other doctors said debate on the bill is being driven by politics instead of patient welfare. Although he heads the Public Health Committee, the bill was assigned to a different committee where a group of doctors who hoped to address their concerns were not allowed to speak.
"I would have certainly allowed the physician experts to speak," Cox said.
Stone was among the group.
"I was really disappointed," Stone said. "I've always thought that, even when I didn't agree with what they did, they had people's best interests at heart.
"They had people there that could have given them some insight and they chose not to hear those people," she said.
Supporters, including nearly all of Cox's Republican colleagues in the House, said the bill is not about whether abortions can be performed but who will pay for them.
"Many people have very, very heartfelt opinions about this," said House Speaker Pro Tem Gus Blackwell, R-Goodwell. "We're just saying we're not going to allow taxpayer funding to pay for this."
Lauinger said the anti-abortion measure has wide support among state lawmakers as well as voters. It is also supported by U.S. Sen. Tom Coburn, R-Okla., a Muskogee physician who has delivered more than 3,000 babies.
"We think that the state of Oklahoma is a pro-life state and that the relatively small number of doctors who have voiced opposition are not representative of the people of Oklahoma or the medical community at large," Lauinger said.
Cox's viewpoint is endorsed by the Oklahoma State Medical Association and the Oklahoma Osteopathic Association, which urged lawmakers to vote against the bill.
"Doctors are ethically bound to discuss all options of treatment with patients," said Dr. Jack Beller, head of the OSMA's council on state legislation. "This will prevent physicians from even discussing the option of an otherwise legal treatment with the patient."
Not all Oklahoma physicians agree. Dr. Robert Aikman, an obstetrician-gynecologist in Tulsa, said nothing in the bill will prevent a doctor from discussing abortion with patients.
"You're always under an obligation to discuss what a person's options are," he said. Aikman, who said he performed abortions in Canada and the United States before stopping for intellectual and spiritual reasons, said he now believes an obstetrician has two patients a pregnant woman and an unborn child.
"Our public policy should be to protect both mother and child, not to pit one against the other," he said.
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