stopthatgirl7Oct 5, 2023

A Woman Was Denied Medication for Being of ‘Childbearing Age.’ She Just Sued the Hospital

Tara Rule says her doctor in upstate New York was “determined to protect a hypothetical fetus" instead of helping her treat debilitating pain.

https://jezebel.com/childbearing-age-medication-denied-lawsuit-1850899899

A Woman Was Denied Medication for Being of ‘Childbearing Age.’ She Just Sued the Hospital

Tara Rule says her doctor in upstate New York was “determined to protect a hypothetical fetus" instead of helping her treat debilitating pain.

Jezebel
Show threadFlowVoidOct 6, 2023
This sort of thing was common practice long before Dobbs. And it is usually motivated by a fear of getting sued over birth defects, especially if there is an alternative that is not teratogenic. And there almost always is an alternative.
Show threadSuddenlyBlowGreenOct 6, 2023
What birth defects would there be in this case?
Show threadFlowVoidOct 6, 2023

I don’t know, because the medication in question hasn’t been identified.

But in general, if a medication causes any birth defects (or, more often, miscarriages) in lab animals then it won’t be used at the equivalent dose in pregnancy. It would be unethical to try to find out what it does to a human fetus.

Show threadSuddenlyBlowGreenOct 6, 2023
So the woman was pregnant?
Show threadbranchOct 6, 2023

From the text in the original post, I assume she was not.

“determined to protect a hypothetical fetus"

Show threadFlowVoidOct 6, 2023
She’s not pregnant, but doctors try to avoid giving teratogenic drugs long-term to patients who might become pregnant while taking them.
Show threadLavaPlanetOct 6, 2023
Which is super not ok. You get that, right?
Show threadFlowVoidOct 7, 2023
No, I don’t get that. If a drug might result in birth defects, it should only be used as a last resort. And that’s not just me or some random NY docs saying it, it’s the WHO and European Medicines Agency
Statement on the risks associated with use of valproic acid (sodium valproate) in women and girls of childbearing potential

This safety statement is being issued to alert stakeholders to the revised guidance on the use of valproic acid (sodium valproate) for the treatment of epilepsy and bipolar disorder in women and girls of childbearing potential contained in addenda to the mhGAP intervention guide (mhGAP-IG) and mhGAP humanitarian intervention guide (mhGAP-HIG). The addenda have been issued in advance of an update to the mhGAP guideline for non-specialist health-care providers which is due to be released later this year, and was discussed at the meeting of the WHO Advisory Committee for the Safety of Medicinal products (ACSoMP) on 14 December 2022 [2022 December ACSoMP recommendations]. A safety statement has also been added to the Essential Medicines List (EML). Prescription of valproic acid (sodium valproate) for women and girls of childbearing potential:Valproic acid (sodium valproate) should not be prescribed to women and girls of childbearing potential because of the high risk of birth defects and developmental disorders in children exposed to valproic acid (sodium valproate) in the womb. In women and girls of childbearing potential, lamotrigine or levetiracetam should be offered as first line monotherapy for both generalized onset seizures and focal onset seizures.For women and girls of childbearing potential currently prescribed valproic acid (sodium valproate):Advice should be provided on use of effective contraception, without interruption, during the entire duration of treatment. Information must be provided on risks associated with valproic acid (sodium valproate) use during pregnancy, pregnancy prevention and refer for contraceptive advice if they are not using effective contraception.Individual circumstances should be evaluated in each case when choosing the contraception method and involving the woman in shared decision making.If a woman is planning to become pregnant, a person trained in the management of epilepsy/bipolar disorder in pregnant women should consider alternative treatment options. Women should be informed to consult their physician as soon as they are planning pregnancy and the need to urgently consult their physician in case of pregnancy.Every effort should be made to switch to appropriate alternative treatment prior to conception. If switching is not possible, the woman should receive further counselling regarding the risks of valproic acid (sodium valproate) for the unborn child to support her informed decision-making.A specialist should periodically review whether valproic acid (sodium valproate) is the most suitable treatment for the person.Contact for further information: [email protected]

Show threadLavaPlanetOct 7, 2023
Do you see the problematic thinking in that line of thinking, though? You are saying a woman can’t be trusted to use a medication if it might cause a birth defect. She can’t be trusted not to fall pregnant, she can’t be trusted to think for herself. She can’t be trusted to keep up with birth control. She can’t be trusted when she says she doesn’t want kids ever. What the first consideration is for, is the *possible child, foremost. Not the person, the actual patient. And you’re quoting American healthcare?
Show threadFlowVoidOct 7, 2023

I’m quoting the WHO and a European agency, neither are American health care. This is a universal approach taken by health care, which in general is concerned with outcomes. Which means acknowledging that no matter how often patients say “Trust me”, they know a certain number will have a bad outcome.

It’s the same reason why doctors increasingly urge their patients to not keep firearms at home. It’s not a matter of trust, it’s a matter of statistics.

Show threadLavaPlanetOct 7, 2023
Firearms and medication aren’t even slightly in the same ballpark. What you are arguing for is that all women of child baring age should never be allowed to mitigate their own risks. And the *potential possible for a fetus, has more consideration that the actual person. If you want to talk firearms. Firearms aren’t banned outright. This drug has been completely and utterly denied to a person because of the *potential to crate another human. So if you compare that to firearms, that’s like saying only women can’t be trusted with firearms, even if they have safe measures to keep them at home. Like a gun safe. I live in Australia, we have guns here, I can go and buy a gun, and there’s safety measures I have to abide by. That’s not what’s happening here. That’s not what you’re arguing. It’s problematic to assume that one gender is incapable of mitigating risks, at all. She can prevent herself getting pregnant while on the drug and says she’s child free, never wants kids. The potential for that to fail is still held in higher regard than the actual harm be caused an actual person, not an imaginary person that doesn’t exist (if you want to call a cluster of cells a person, spoiler it’s not). This would be like you going to the doctors and the doctor won’t give you medication to relieve agonising pain to the extent it commonly causes suicidality, and the doctor says, no you just have to suffer in this pain when nothing else is helping, because you might cause a pregnancy in a woman, and you tell he doctor you promise to use protection and that you’re gay and don’t even sleep with women, and he still doesn’t care, because the potential for damage to someone who doesn’t even exist is more important than you and your actual lived existence. There is a medical rule that has caused people who it applies to harm, and those people are speaking out. You aren’t able to imagine or consider their situation. This is an issue in the USA. So using medical advice from other sources doesn’t really apply. This is happening because of the medical issues in that region specifically, the banning of essential health care for women, which is having huge roll on effects.
Show threadFlowVoid

Doctors are expected to mitigate risks, too. Valproate-induced spina bifida is a real problem, it is caused by people who didn’t “mitigate their risks”, and doctors have a responsibility to prevent it when it won’t harm their patients.

Despite what patients often think, doctors are not drug dispensaries. It’s not their job - and never has been - to give patients whatever drugs they read about online. If there is a less risky drug that can treat the patient, they will prescribe that instead.

To take another example, vancomycin is an antibiotic of last resort. Bacteria have not yet developed widespread resistance to it, so it is reserved for patients who have antibiotic-resistant infections. The more it is used, the more likely bacteria will finally develop resistance to it.

Next time you get antibiotics, try telling your doctor “No, I want a vancomycin prescription”. You will be disappointed. They are going to give you what the think is best for you without incurring unnecessary risks

Oct 7, 2023 at 10:57pmWeb