AMA House of Delegates

AMA meeting: Texting while driving, trans fats on hit list

Delegates said bans on both practices would promote safety and protect patients.

By Damon Adams — Posted Dec. 1, 2008

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In a move to keep the public healthy, the AMA is supporting bans on artificial trans fats in food and text messaging while driving.

At its Interim Meeting in November, the House of Delegates voted to support state and federal legislation that bans use of artificial trans fats by the nation's restaurants and bakeries. Delegates said trans fats are one of the most dangerous fats, and eating foods containing them increases the risk for heart disease by raising LDL and lowering HDL.

"Really, the issue is health and helping Americans make healthy choices. It's more of a prevention," said Mary Anne McCaffree, MD, a pediatrician in Oklahoma City and a member of the AMA Board of Trustees.

California and some cities such as New York prohibit the use of trans fats in restaurants and bakeries. The AMA had existing policy that urged reduced use of trans fats and encouraged replacing such fats with healthier fats and oils.

Dr. McCaffree said using healthier options, such as extra virgin olive oil, could prevent 30,000 to 100,000 premature deaths each year. She said bans on artificial trans fats could be extended to packaged foods in vending machines.

But some delegates at the meeting opposed the directive, likening it to legislating behavior and saying it goes too far in telling people what not to do.

"We haven't banned cigarettes. We're going to ban trans fats?" said S. Jay Jayasankar, MD, a delegate for the American Academy of Orthopaedic Surgeons.

New policy against text messaging

Delegates also called for the AMA to advocate for state legislation prohibiting use of handheld devices to send text messages while driving.

"We have among our teenagers a generation of 'text-aholics.' It is worse than being drunk," said AMA Trustee Peter W. Carmel, MD, a pediatric neurosurgeon in Newark, N.J.

Supporters of the measure cited research indicating the practice causes a 400% increase in time spent with eyes off the road. They also noted federal investigators said the engineer of a California train was text messaging seconds before the train crashed in September, killing 25 people.

According to the AMA, texting while driving has been banned by the District of Columbia and seven states -- Alaska, California, Connecticut, Louisiana, Minnesota, New Jersey and Washington.

"Drivers who are texting are more likely to miss a red light," said Arvind Goyal, MD, MPH, a delegate for the American Assn. of Public Health Physicians. "This is a risk to other people on the street."

Christie Morgan, an alternate delegate for the Massachusetts Medical Society, said she saw a young mother brought to the emergency department after being struck by a car. The woman had been text messaging as she walked into traffic. She died.

"It's certainly an emerging health issue," said Morgan, a fourth-year medical student at Boston University School of Medicine. "We're trying to protect the public and our patients."

Chicago emergency physician Neil Winston, MD, said a colleague lost a friend who died while text messaging behind the wheel.

"It's something that I felt was very timely for us to move forward on," said Dr. Winston, a delegate for the Illinois State Medical Society. "If you've actually got your eyes locked away from the road, that's a prescription for disaster."

The new policy also encourages physicians to educate patients about the health risks of text messaging while driving. Dr. Carmel said he talks to his young patients about health risks such as smoking cigarettes. "Now I'll also tell them about texting."

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ADDITIONAL INFORMATION

Meeting notes: Legislative actions

Issue: Medicare administrative contractors sometimes take months to enroll or re-enroll physicians. Meanwhile, these physicians receive no pay for treating Medicare patients.
Proposed action: Seek legislation requiring MACs to process physician Medicare applications within 30 days or suffer fines and penalties. The legislation should also direct MACs to provide appropriate feedback to physicians on the enrollment process. [ Adopted ]

Issue: Doctors could be held liable for adverse events from drugs and medical devices that have Food and Drug Administration approval.
Proposed action: Support state and federal legislative efforts to grant physicians who appropriately use FDA-approved drugs and medical devices the same level of liability protections for adverse events as awarded manufacturers. [ Adopted ]

Issue: There is no national entity to evaluate medical treatments against each other.
Action: Support a call by the AMA Council on Medical Service for a national research body to do comparative-effectiveness research. [ Adopted ]

Issue: Medical research and use of marijuana is stymied by its classification as a Schedule I drug and by criminal prosecutions of patients and physicians.
Proposed action: Support reclassification and urge law enforcement authorities to cease prosecutions of doctors and patients complying with state medical marijuana laws. [ Referred for study ]

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