March 17, 2012

Extreme Healthcare: Erectile Dysfunction

In response to the various anti-contraception bills circulating across the land, a state senator in Ohio has proposed legislation that would require men desiring a prescription for ED drugs to undergo a series of extreme and potentially embarrassing steps before being allowed to purchase the drug.  Essentially, the bill would require men to ‘take their medicine’ before they could take their medicine.  

Here are the proposed requirements:  an affidavit signed by at least one sexual partner certifying the erectile dysfunction; an assessment by an approved sex therapist to determine that the dysfunction is truly erectile, not psychological; a stress test ensuring the patient is healthy enough for sexual activity;a signature certifying the patient was informed of the risks of the medicine; awritten statement from the doctor on the necessity and reason for the drug; a repeat stress test every 90 days to ensure continued good cardiac health; outpatient counseling sessions within 90 days of the initial prescription ; and maintenance of all written documentation in the patient’s medical records for not less than seven years.

I appreciate that there is no requirement to pay for erectile dysfunction drugs in group health insurance benefit packages, as was the plan for contraceptives.  But since most plans do cover these drugs, I’m concerned that the Ohio approach doesn’t go far enough.  

It may address the medical issues, but it doesn’t get to the heart of the moral issues which are apparently integral to health care decision-making.  I would make the following suggestions:

·         The signed documents in the initial requirements must be kept on file with the state government for at least seven years, not just held in the patient's medical record.

·         A photo of the men receiving the prescription must be updated and filed with the state each time the prescription is refilled.

·         ED drugs would only be available to men who are married to women of child-bearing age with no reproductive health issues.

·         The women would not be allowed to use any medical or barrier method of birth control during the man’s course of treatment with the drug.  An attestation to this effect would need to be signed by both the husband and the wife, under penalty of perjury.

·         An attestation of reproductive health from the wife’s gynecologist must be signed and kept on file by the state. This document would require renewal each time the prescription was refilled. Should the woman's health change such that she was no longer able to conceive a child, the ED prescription would immediately be voided and any unused medication returned for disposal.

·         The wives of the men seeking the prescription must also sign a document, with renewal every refill, indicating continued consent to their husband receiving the ED prescription.

·         The men must only use the drug when contemplating sexual intercourse with their wives.  Any other use of the drug would be subject to criminal penalties. A signed notice of understanding of this requirement must also be kept on file.

·         Physicians must maintain and file with the state, at least quarterly, a list of all patients receiving ED medications.

Oh, one more thing.  The couples have to video themselves, and we get to watch.