Daily Rounds: Criminalizing Bad Moms; Health Payment Bill Coming; No Botox For Migraines; Malpractice Reconsiderd

The Criminalization Of Bad Mothers (The New York Times) — "You might not expect a rural Alabama mother with a felony conviction to have in her corner a national army of feminists, civil libertarians and gynecologists, but Kimbrough’s case has attracted the interest of groups like Planned Parenthood, the A.C.L.U. and the American Congress of Obstetricians and Gynecologists, who all maintain that her conviction sets a dangerous precedent. Emma Ketteringham, the director of legal advocacy at the National Advocates for Pregnant Women, a New York-based reproductive-justice group, has been following Kimbrough’s case closely. She has drafted “friend of the court” briefs for Kimbrough signed by groups like the National Organization for Women-Alabama and the American Medical Association. She argues that applying Alabama’s chemical-endangerment law to pregnant women “violates constitutional guarantees of liberty, privacy, equality, due process and freedom from cruel and unusual punishment.” In effect, she says, under Alabama’s chemical-endangerment law, pregnant women have become “a special class of people that should be treated differently from every other citizen.” And, she says, the law violates pregnant women’s constitutional rights to equal protection under the law. Ketteringham also recruited two prominent Alabama lawyers, Jake Watson and Brian M. White, to take Kimbrough’s case pro bono. “I love babies, too, but I don’t like locking up their mamas,” Watson told me."

Health Payment Bill On Move (State House News Service, via The Boston Herald) — "A long-awaited health care system overhaul is finally on the move. Fourteen months after Gov. Deval Patrick filed a proposal on the issue, Senate President Therese Murray said Wednesday she expects the Senate to take action in mid-May on a bill making major changes to the way health care is delivered and paid for in Massachusetts...The bill, with multi-billion-dollar implications for an industry that also ranks as Massachusetts largest employer, has been sitting idle in the Legislature’s Health Care Financing Committee since Patrick filed it in February 2011. On Wednesday, the committee decided to discharge Patrick’s bill unchanged and send it to the Senate budget committee, a step that signals the bill is nearing consideration in the full Senate."

Botox Treatment Not So Effective For Migraine Headache Relief (Time Heathland) — "But now a new review of the research suggests that Botox (onabotulinumtoxin A) actually has minimal headache benefit. Dr. Jeffrey Jackson, professor of medicine at the Medical College of Wisconsin, reported on Tuesday in the Journal of the American Medical Association on a review of 31 trials investigating Botox’s effectiveness in reducing migraine and chronic tension headache symptoms. Studies comparing Botox to placebo showed a slight decrease in the number of migraine headaches per month among Botox users, but no difference between patients when it came to chronic tension headaches. In trials that compared Botox to other headache treatments, there was no statistically significant difference in the number of headaches patients reported each month. “I was surprised that the [migraine] benefit was so minimal,” says Jackson. “I was also surprised that Botox doesn’t work to relieve tension headaches.”

At A Conference On Avoidable Care, Experts Say Malpractice Not The Central Issue (The Boston Globe) — '"Malpractice is “such an unimportant element of what is going on,” said Dr. Jerome Hoffman, professor of emergency medicine at the University California, Los Angeles, and the University of Southern California, after a panel of experts spoke about what drove doctors to provide unnecessary care. Amitabh Chandra, an economist and professor of public policy at the Harvard Kennedy School, argued that the practice of defensive medicine — ordering tests and procedures to avoid lawsuits — was not a significant driver. Each year, the United States spends about $56 billion on medical liability, he said, including a total of $10 billion on payments to injured patients and administrative costs. The rest, about $46 billion, is attributable to “doing more than we should because we want to reduce the threat of litigation,” Chandra said.'