EDAP Investigation Will Expose Deceptive Abortion Clinic Practices

With the assistance of Thomas Strahan, an attorney and the leading expert on the published literature regarding post-abortion injuries, we have compiled the following list of information that can be gathered for EDAP and used to develop a case for prosecution for illegal or deceptive business practices.

• It is important to gather up as much advertising and printed literature from each clinic as possible in order to identify any “false pretense” or “false promise” or statements which “create a likelihood of confusion or misunderstanding.”

For example, many abortion clinics say they offer “counseling,” when in fact they do not employ formally trained or licensed counselors. If the title “counselor” is used, it is likely to create a false impression that the counselor is trained to deal with the broad range of issues related to problem pregnancies and abortion. In this case, the representation that the clinic offers “counseling services” is false and misleading.

• Any broad or general claims, such as promises to improve the client’s “health,” should be identified. In fact, while there are a large number of risks associated with abortion, no health benefits have been yet been documented.
• Does the clinic give a false impression of being able to offer referrals? Do they operate a “referral service” which gives the impression of being independent but actually feeds women into a clinic owned by the owners of the “referral service?” Do they use more than one name for the same facility? Are they abusing corporate powers or exceeding their corporate charter?
• A clinic that offers general anesthesia or twilight sleep as a “consumer option” is vulnerable to the charge of placing business interests ahead of medical interests. The use of anesthetics is always associated with increased risks. When this is offered as an “option” for an extra charge rather than prescribed as a medical recommendation, it suggests that the clinic is more interested in selling “extras” than making good medical decisions. (If anesthesia was medically indicated, it would be prescribed for all similar patients, not sold as an “option.”)
• The handling of other financial transactions is also an area of vulnerability. Profiteering from the sale of drugs is contrary to state law. Withholding savings or credits, and the passing on of some business expenses may also be a violation of consumer rights. For example, does a clinic profit from the sale of fetal tissue for research or other purposes? If so, are they supplying a credit to the woman’s bill? Conversely, clinics affiliated with the National Abortion Federation must pay the NAF a fee for every abortion patient. Are these membership fees being charged to the patient?

Is the clinic charging for antibiotics, and if so, are they overcharging? (In some states, case law requires that savings for bulk purchases of pharmaceuticals must be passed on to the patient.) Similar overcharging may occur for birth control devices. Are they adding a charge for disposal of fetal remains? All billing practices may be subject to strict scrutiny.

• Are all payments to physicians and other staff properly reported to the Department of Revenue?
• Does the clinic provide the proper follow-up care which one would expect of a reputable medical facility? Are patients able to talk to a nurse if they are having problems, or just some lay person on an 800 number? (Though these staff persons may in theory be under the direction of a physician, this practice may amount to practicing medicine without a license.) Or are women simply passed off to other medical care providers for follow-up care?
• Are women being given the proper antibiotics as part of the standard charge for the abortion? Or are the antibiotics offered as another “option” rather than required as part of proper medical care?
• What portion of the clinic’s patients are referred to them by women’s regular doctors? If the clinic attracts most of its patients through advertising in the yellow pages, this would help to demonstrate that it is operated like a consumer business (and therefore, subject to consumer protection laws.)
• Is there any fee-splitting or kickbacks to outside physicians, family planning agencies, or others for referring patients to the clinic?
• Are pathological exams done by an independent lab? Is the lab in close proximity to the clinic, or in another state? Do they get reports back within 2 to 3 days (as is necessary to avoid dangers related to molar pregnancies, ectopic pregnancies, etc.), or is this just another sham? How do they screen for ectopic pregnancies prior to the abortion? Are they properly administering other tests, such as pregnancy tests and tests for venereal diseases? Are they overcharging for these tests?
• Do they offer free pregnancy tests in order to attract customers who will be “sold” an abortion? This practice smacks of a business rather than medical practice. Is offering free pregnancy tests, in effect, nothing more than a “loss leader” for attracting women who will be encouraged to pay for an abortion?
• Are the informed consent procedures designed to give full disclosure and ensure free consent, or are they only a facade intended to give the appearance of a legitimate medical practice?
• Does the abortion clinic obtain the name of the patient’s physician or obtain the patient’s medical records? Does the abortionist do a proper physical and psycho-social evaluation to identify known risk factors for post-abortion problems, or is abortion simply treated as a commodity available on request?

All other things being equal, the following characteristics identify abortion businesses that may be especially vulnerable to prosecution for illegal business activities:

(1) the cooperation is for-profit;

(2) the cooperation is owned by a lay person (meaning it is a business investment rather than a medical practice);

(3) the owner lives out of state (the clinic has only minimal oversight);

(4) the clinic employs itinerant abortionists;

(5) there is not a medical director on the premises at all times to handle complications;

and/or

(6) the clinic offers general anesthesia as an “option” to patients.

Originally published in The Post-Abortion Review 7(3) July-Sept. 1999. Copyright 1999 Elliot Institute.