By Tom Quiner
An Iowa City doctor responded forcefully to my essay which appeared in the Des Moines Register last Friday.
Here is Dr. Robert Ashman’s letter which appeared in the morning’s Des Moines Register:
Tom Quiner’s piece from Aug. 2 urging the Iowa Board of Medicine to prohibit telemedicine abortions attempts to mislead and frighten.
He begins with the story of an unfortunate patient who died after an abortion, but hers was not a telemedicine abortion. Neither did his extensive quote from the Food and Drug Administration physician listing potential abortion complications refer to telemedicine abortions. His title “Webcam Abortions Have Nothing to do with Health” is mistaken, unless the health of women is to be ignored.
In fact, the attempt to ban them is motivated not by the desire to improve health but to prevent women who have decided to end an unwanted pregnancy from finding a safe, affordable method.
I won’t review the extensive published evidence that the telemedicine abortion procedure performed in Iowa since 2000 is as safe and effective as alternative methods, and as satisfactory as judged by 97 percent of patients. The most frequent complication is bleeding requiring additional treatment, which affects about one in 5,000 patients, the same risk as if the doctor were present.
This safety record depends critically on restricting the procedure to intrauterine pregnancies in the first nine weeks, when the embryo is small, as established by ultrasound. Quiner tugs at our heartstrings by confusing the 9-week embryo with a “person,” a “child” and a “dead baby” to be expelled into the toilet. But embryo, fetus and child are meaningful distinctions if you understand human development.
The Board of Medicine cannot outlaw telemedicine abortions without violating the Hippocratic Oath they took when they became doctors, which contains the phrase “first do no harm” to your patient.
The justification for this claim is that the time from conception to taking RU486 is the most important risk factor for abortion complications. Patients who choose the telemedicine version typically live in remote areas or are financially challenged. Thus, unless the board can find a substitute procedure suitable for this population without delaying the abortion, they will be harming the patient.
Some on the board may respond, “But the embryo is my patient.” And the woman is not?
— Dr. Robert Ashman, Iowa City