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The Los Angeles Times (LA Times) last week ran an article under this headline: “Doctors fear California law aimed at COVID-19 misinformation could do more harm than good.”
On the surface, this seems like a long-awaited, albeit meager, acknowledgment from mainstream journalism of the devastating harm that will result from penalizing dissenting opinions from those who are qualified to speak on such matters.
If it sounds too good to be true, you would be right.
Although a handful of physicians commented for the article on the potential danger of this legislation, the LA Times eventually landed squarely in defense of this unprecedented invasion of the doctor-patient relationship by an authority that mindlessly supports one version of “the facts.”
Some doctors are concerned about ‘chilling effect’
The LA Times quoted several physicians, including Dr. Eric Widera, a professor of geriatric medicine at the University of California, San Francisco (UCSF), who said, “What was misinformation one day is the current scientific thinking another day.”
Dr. Monica Gandhi, an infectious disease specialist at UCSF, said, “I am concerned this bill will not take into account how quickly information changes in COVID-19.”
Even Dr. Leana Wen, an emergency physician and health policy “expert” at George Washington University — notorious for her record of scathing attacks on anyone who eschewed the experimental inoculation — said it would be easy to imagine a similar law being used to suppress factual medical information.
“We should be very concerned about the chilling effect on medical practice and scientific discourse — and look out for copycat legislation from other states on other issues (i.e. reproductive care) that use politics in an attempt to censor physicians,” Wen said in an email.
In other words, censoring physicians about reproductive care could only be politically motivated and dangerous because medical facts would be suppressed, according to Wen — whereas censoring physicians who disagree with the COVID-19 narrative is acceptable because such a position could not be factually based.
The LA Times article explained that the new California law targeted conversations between doctors and their patients and would “not cover, for example, any fringe claims that a COVID-19 skeptic with a medical degree might air on social media or at a public rally. An attempt to limit a physician’s public pontifications would probably not survive a 1st Amendment challenge in court, a legislative analysis of the bill found.”
That’s reassuring. We want to enact only those laws that would “probably” not override the First Amendment, right?
Of note, the “fringe claims” link in the LA Times article cites an article by PolitiFact from more than two years ago attacking Dr. Simone Gold for advocating for early COVID-19 treatment with hydroxychloroquine. More on this below.
Governor had concerns but signed anyway
In his signing statement, California Gov. Gavin Newsom acknowledged that he was “concerned about the chilling effect other potential laws may have on physicians and surgeons who need to be able to effectively talk to their patients about the risks and benefits of treatments for a disease that appeared in just the last few years.”
But if he was so concerned about laws that affect conversations between doctors and their patients why did he sign this bill?
Did he at least allow for an open debate between physicians in California about this unprecedented incursion into what has always been a sacred and private space of the ailing and the healer?
Newsom continues in his statement:
“I am signing this bill because it is narrowly tailored to apply only to those egregious instances in which a licensee is acting with malicious intent or clearly deviating from the required standard of care while interacting directly with a patient under their care.”
Would you care to define “egregious,” Governor? How exactly will “malicious intent” be adjudicated? If the bill is “narrowly tailored,” where are these terms defined?
As physicians, we are well aware of the “standard of care” and how difficult it is to define given the myriad of disease states and their combinations, patients’ unique histories and emerging therapies and expert opinions that are subject to change.
We are also well aware of our commitment to do no harm — “Primum non nocere.” That is what is first, as the Latin “Primum” signifies. That is required. “Standard of care” is not.
Standard of care is a consensus opinion that evolves and can sometimes be interpreted in more than one way at any time depending on which “expert” you choose to consult.
“Required standard of care” is either redundant or meaningless depending on the circumstances.
That’s excusable, Governor. You are not a physician. We do not expect you to understand the nuances of the ethical commitment we have to our patients and the art of medicine. Neither do we expect you to understand how to dissect a medical study, interpret data, weigh evidence or even be a doctor.
Yet doctors in California can now rely upon you to dictate which information can be shared with their patients.
As a physician it is beyond insulting to me to know that any government would think it necessary to create additional legislation to prosecute physicians with “malicious intent.”
Some of us may be misinformed, negligent or less than competent.
But a physician practicing with malicious intent is a monster.
There probably are a few out there, as I have recently come to accept. But are there really so many monsters in California that necessitate this kind of statute?
Perhaps you don’t know how to spot them, Governor.
Do you really believe that the physicians who disagree with the Centers for Disease Control and Prevention (CDC) guidelines are acting maliciously?
Is it possible that there is a legitimate counterposition to what our agencies of public health are decreeing?
If there were a valid opposing view, how would you know?
What constitutes ‘misinformation?’
From the LA Times article:
“By making the prohibition against COVID-19 lies unambiguously clear, the new law will strengthen a medical board’s hand if a physician who has been sanctioned tries to challenge that decision, said state Sen. Richard Pan (D-Sacramento), a pediatrician and co-author of the measure.”
Excellent! It’s about time the medical board finally got some help dealing with doctors who even try to challenge their decisions. That will certainly be good for medicine.
In private discussions with my physician colleagues over the years we often lament how little power our medical board has in controlling our opinions and the way we practice — despite the thousands of dollars we pay every few years to maintain our licensure.
It’s also wonderful to know that the prohibition against the lies is now unambiguous, but what constitutes a lie? Doesn’t that have to be unambiguous too?
As Pan explained to the LA Times:
“The code is there to protect patients. Its authors wrote it with the most glaring examples in mind, such as Dr. Simone Gold, the Beverly Hills physician who founded the anti-vaccine group America’s Frontline Doctors. Gold has promoted debunked COVID-19 treatments such as the anti-malarial drug hydroxychloroquine and has spread outlandish claims about vaccine safety.”
Pan was not asked to refute the 266 separate studies that demonstrate an overall benefit of the drug hydroxychloroquine. This would be necessary in order to claim that the drug has been debunked.
Perhaps he was referring to the multinational, peer-reviewed study of hydroxychloroquine published in The Lancet in May 2020. Did he know it was retracted two weeks later due to data corruption, among other things?
What are the outlandish claims about vaccine safety, and who, besides Gold, is making them?
Is Pan referring to the CDC, a branch of the U.S. Department of Health and Human Services (HHS)?
The CDC claims, “Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in US history” — despite knowing for more than a year that of 10.1 million V-safe enrollees, 1 in 7 sought medical attention after getting the jab.
Claiming that the COVID-19 vaccines are under “the most intense safety monitoring in US history” while quietly amassing hundreds of thousands of reports from vaccine recipients without performing any analysis is pretty outlandish, wouldn’t you say?
Or is he saying that the 31,300 deaths following COVID-19 vaccines reported to the Vaccine Adverse Event Reporting System (VAERS) have all been falsified?
VAERS, incidentally, is also a system developed by the HHS. Is the HHS spreading misinformation by allowing VAERS to continue capturing adverse event data?
Please help us identify who the culprits are in this, Dr. Pan. Is it the CDC or the HHS? One of them is clearly lying.
It gets even more confusing
CA Assembly Bill No. 2098 states in section 1b:
“The Legislature finds and declares all of the following:
“(b) Data from the federal Centers for Disease Control and Prevention (CDC) shows that unvaccinated individuals are at a risk of dying from COVID-19 that is 11 times greater than those who are fully vaccinated.”
11 times greater? That’s not what the CDC says:
Why is your legislature inaccurately “declaring” CDC findings, Dr. Pan? How would the new law regard a physician who misrepresents CDC data like the California legislature is doing?
If I were a physician in California, what should I tell my patients about the risk of dying from COVID-19 if they remained unvaccinated?
If I repeated what the state of California “declares and finds,” would I have to answer to the Medical Board of California for spreading misinformation because it contradicts the CDC?
If I chose to repeat what California “declares and finds” — knowing that it contradicts the CDC, because I wanted to avoid any reprimand from the board — would that be considered malicious intent?
Or would I be “clearly deviating from the required standard of care”? Both? Neither?
We look forward to seeing how well the state of California will be served by your new law that eliminates a lot of the “ambiguity” we have been dealing with.
