Posted on Jun 25, 2022
For doctors, abortion restrictions create an 'impossible choice' when providing care
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https://www.npr.org/sections/health-shots/2022/06/24/ [login to see] /doctors-ethical-bind-abortion
Now that the Supreme Court has overturned Roe v. Wade, medical ethics experts say many physicians will be caught in a bind: unable to fulfill their professional obligations to provide care to their pregnant patients because of state laws that forbid it.
Physicians take an oath to "do no harm" as part of their medical training. They learn about how to stay up to date, throughout their careers, on the best standards of care for treatment. And they learn about patient privacy and safety, and how patients should have a say in their care based on their values and lived experience.
"The goal is for a patient to make a decision for themselves about what's right," says Dr. Stephanie Mischell, a family physician in Dallas who is a fellow with Physicians for Reproductive Health.
But too often, Mischell says, the conversations she has with pregnant patients have less to do with their values and health and more to do with navigating a labyrinth of legal requirements. "There's a running list of different types of restrictions and bans that exist on abortion care, whether it's pre-viability bans, mandatory waiting periods, mandatory counseling, bans on telehealth – Texas really has all of them," she says.
Now that the Supreme Court has overturned Roe v. Wade, medical ethics experts say many physicians will be caught in a bind: unable to fulfill their professional obligations to provide care to their pregnant patients because of state laws that forbid it.
Physicians take an oath to "do no harm" as part of their medical training. They learn about how to stay up to date, throughout their careers, on the best standards of care for treatment. And they learn about patient privacy and safety, and how patients should have a say in their care based on their values and lived experience.
"The goal is for a patient to make a decision for themselves about what's right," says Dr. Stephanie Mischell, a family physician in Dallas who is a fellow with Physicians for Reproductive Health.
But too often, Mischell says, the conversations she has with pregnant patients have less to do with their values and health and more to do with navigating a labyrinth of legal requirements. "There's a running list of different types of restrictions and bans that exist on abortion care, whether it's pre-viability bans, mandatory waiting periods, mandatory counseling, bans on telehealth – Texas really has all of them," she says.
For doctors, abortion restrictions create an 'impossible choice' when providing care
Posted from npr.org
Medical
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Abortion
Posted 2 y ago
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PO1 William "Chip" Nagel
..."Former AMA president Dr. Gerald Harmon told NPR in early June that the AMA hasn't surveyed its 270,000 dues-paying doctors about abortion specifically — and he says individual physicians may have religious or conscience-based objections to abortions — but as an organization, the AMA is united in fighting excessive government intrusions into medical care.
"We speak with one voice against government – politicians and lawyers and judges – in the exam room, whether it's maternal fetal medicine, women's reproductive health, gender [identity] medical treatments," he said. "We need to be more outspoken and protect our ability to perform medically appropriate safe abortions and be able to teach that."
Not all physicians subscribe to this view, nor do they see physicians as having an ethical conflict when treating patients in places that restrict abortion. In fact, the American Association of Pro-Life Obstetricians and Gynecologists filed its own amicus brief to the court enumerating the risks of abortion and saying opposition among doctors is part of the medical tradition. "In declining to perform abortions, doctors are keeping with the longstanding tradition of their profession. Abortion has been deemed contrary to sound medicine for thousands of years," the brief reads.
But most medical groups and journals defend access to abortion as a legitimate and safe health care option, especially in recent weeks. "The fact is that if the US Supreme Court confirms its draft decision, women will die. The Justices who vote to strike down Roe will not succeed in ending abortion, they will only succeed in ending safe abortion. Alito and his supporters will have women's blood on their hands," the Lancet editorial board wrote in May.
King says physicians, hospitals and medical groups haven't always spoken "loudly enough" in defense of abortion. "I've always been outspoken, but I'm in the minority," she says. "Typically, hospitals are not vocal about providing abortion care because they don't want to invite controversy and protests on the street. That makes sense – we don't want to disrupt patient care," she says.
But the country has reached a tipping point, she argues. Abortion providers like her "should all be very proud of the care that we provide and very vocal about how we all believe it to be essential health care."
..."Former AMA president Dr. Gerald Harmon told NPR in early June that the AMA hasn't surveyed its 270,000 dues-paying doctors about abortion specifically — and he says individual physicians may have religious or conscience-based objections to abortions — but as an organization, the AMA is united in fighting excessive government intrusions into medical care.
"We speak with one voice against government – politicians and lawyers and judges – in the exam room, whether it's maternal fetal medicine, women's reproductive health, gender [identity] medical treatments," he said. "We need to be more outspoken and protect our ability to perform medically appropriate safe abortions and be able to teach that."
Not all physicians subscribe to this view, nor do they see physicians as having an ethical conflict when treating patients in places that restrict abortion. In fact, the American Association of Pro-Life Obstetricians and Gynecologists filed its own amicus brief to the court enumerating the risks of abortion and saying opposition among doctors is part of the medical tradition. "In declining to perform abortions, doctors are keeping with the longstanding tradition of their profession. Abortion has been deemed contrary to sound medicine for thousands of years," the brief reads.
But most medical groups and journals defend access to abortion as a legitimate and safe health care option, especially in recent weeks. "The fact is that if the US Supreme Court confirms its draft decision, women will die. The Justices who vote to strike down Roe will not succeed in ending abortion, they will only succeed in ending safe abortion. Alito and his supporters will have women's blood on their hands," the Lancet editorial board wrote in May.
King says physicians, hospitals and medical groups haven't always spoken "loudly enough" in defense of abortion. "I've always been outspoken, but I'm in the minority," she says. "Typically, hospitals are not vocal about providing abortion care because they don't want to invite controversy and protests on the street. That makes sense – we don't want to disrupt patient care," she says.
But the country has reached a tipping point, she argues. Abortion providers like her "should all be very proud of the care that we provide and very vocal about how we all believe it to be essential health care."
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