On The Pitt, Falsifying Medical Records, and Undermining Informed Consent to Champion Fake Abortion Narratives
How a new media drama gets so much wrong to make a stupid point
A commonly reported fear from critics of laws restricting abortion is doctors will be fearful to take lifesaving action out of concern the proper medical intervention will be erroneously perceived as an illegal abortion. Two articles from ProPublica (here and here) go so far as to blame laws restricting abortion for the deaths of two women, in one case explicitly stating without direct evidence that doctors feared to take lifesaving action because of Georgia laws. This trope has been bandied about again and again to great effect in an attempt to stoke the fears of the general public about the negative consequences of retracing abortion. However, the new medical drama The Pitt, available to stream on Max, offered a twist on how doctors might respond to working in states which explicitly restrict abortion under certain conditions, particularly restriction based how far along the pregnancy is. They can lie about the development of the unborn.
On Episodes 4 and 5, a 17-year-old patient and a woman we are initially led to believe is her mother return to the ER after missing an appointment with the doctor from the previous day for a medical abortion. The new physician, a senior resident, performs an examination and informs the attending Dr. Robinavitch, played by Noah Wylie of ER fame, that her exam produced different results from the doctor from the previous day. The fetus appears larger and more developed, the pregnancy appears slightly further along by more than week. The previous exams placed the age of the fetus at just over 10 weeks, and every new ultrasound measurement taken by Dr. Collins indicates the fetus is beyond 11 weeks of age and not eligible for a medical abortion. The conclusion? The doctor from the previous day intentionally reported the fetus as younger to make it possible to facilitate the medical abortion. Things get weirder as the attending offers the resident two options, use the other doctor’s measurements or do another round of exams and falsify the medical records to prescribe the medical abortion. The attending essentially orders the resident to commit a crime because, as he puts it, “she is 17, she deserves a life.” When Dr. Collins refuses to break the law, Dr. Robinavitch orders her to erase her results and make it looks as if she never saw the patient. He will examine her and falsify the medical records himself. What a hero.
To clarify, abortion is legal in Pennsylvania through the 23rd week. That makes the line about the girl deserving a life even more bizarre than it already is. She can’t have a life if she procures her abortion through some other means than a medical abortion? The writers of the show are justifying falsifying medical records based on HOW she gets an abortion versus whether she CAN get an abortion. At this point in the show, the urgency of the moment is built through withholding clarity on Pennsylvania’s abortion law giving the impression that draconian abortion laws will interfere with the life of a poor unfortunate soul who found themselves pregnant. The show runners manufacture a time sensitive crisis by obfuscating the Pennsylvania abortion laws, but it is not a crisis where doctors are confused about laws. The only three doctors involved in the case show enough familiarity with the law to work to actively circumvent it.
I have no idea which is more likely between these two scenarios, doctors being terrified into inaction by the complexity of abortion laws versus doctors lying and falsifying medical records to violate abortion laws of which they disapprove. Neither option casts medical professionals in a complimentary light, and neither portrayal reflects anything remotely like the medical professionals I have the pleasure of knowing. They tend to be supremely competent and accomplished individuals who lived focused and deliberate lives to achieve the highest levels of success in their studies. They don’t tend to be easily confused by the laws which govern their profession. Doctors hiding behind ignorance of the law to justify poor treatment of patients are not victims of pro-life laws. They are bad doctors.
The Pitt option is even worse. The idea that doctors would commit crimes by falsifying medical records or order other doctors to participate in falsifying medical records is horrifying. In addition to the base criminality, it undermines informed consent. A patient wants a medical abortion, and, in order to provide that to her the doctors lie about how far along her pregnancy is. The deception on The Pitt may appear to be only a small exaggeration, but it amounts to lying to a patient about her medical condition. The purpose of informed consent is for a doctor to communicate to the best of her ability the medical condition of the patient and explain how the treatment options will work to help improve the condition. Setting aside for a moment that pregnancy is NOT a medical condition but merely healthy human reproduction and a predictable and natural outcome of consensual sex, informed consent with any medical condition is not possible if the medical professionals are lying to patients to help them get what they want. Of course, they could include their patient in the lie, which would open the patient up to charges of collusion. How sold out to abortion do the writers of this show have to be to not understand how wildly dangerous this idea is? The heroic doctors swooping in, falsifying medical records and flouting state laws to make sure a 17-year-old gets her preferred method of abortion. Good grief, is that truly what these writers see as virtuous?
An attorney who specializes in medical malpractice made an interesting observation, they can always see when records have been changed or falsified. If something goes wrong and a lawsuit is filed, the lawyers will be looking hard for evidence of falsified medical records, and they will find them. No competent, responsible, or ethical doctor is going to do this. Which leads me back to what I wrote earlier about doctors afraid to offer medical care out of fear of prosecution. Just like them, the doctors who would break the law by falsifying medical records in order to break state laws on abortion all the while undermining informed consent aren’t abortion heroes. They are bad doctors.