Opinion: Abortion ruling will force doctors to choose between Hippocratic oath and court warrant

We are committed to serving patients to the best of our abilities, putting their well-being first, maintaining their confidentiality and avoiding harm to them. The seriousness of our oaths moved us deeply.

Being a doctor is different from being a business executive, salesperson or politician – we are committed to a very high moral code. That’s not to say someone in another line of work can’t do the same, but for doctors it’s part of the job description.

The oath, a version of which was written some 2,000 years ago, remains our traditional moral compass, our North Star, deeply embedded within us to guide us when faced with conflicting demands – those struggles in the middle of the night. with sick patients when we would rather just go home and sleep.

It’s what allows countless patients to trust us and allows us, as strangers, to heal their bodies and hear their deepest secrets, whether it’s sexual activity, illicit drug use or mental health. We also learn and dedicate ourselves to more recently recognized activities bioethical principlessuch as respect for the rights and autonomy of patients, and justice and the protection of vulnerable groups.
But the Supreme Court decision to overturn Roe v. Wade is now forcing doctors to wrestle with violating those principles because of a court warrant that most Americans, according to a recent CNN pollto oppose.

It should be noted that patients discuss potential abortions not only with OB-GYNs but also with internists, psychiatrists, and others in the medical field. As a psychiatrist and researcher, I have spoken to women about the abortion decisions they have faced. I am fortunate to work in New York, a state that will undoubtedly preserve the right to abortion, but many of my medical colleagues in other states are terrified and deeply troubled by the court’s opinion. With the fall of Roe, doctors must now face the troubling decision between following the law or the Hippocratic oath.

States already vary widely on whether, when, and under what circumstances a woman can have an abortion. sixteen states, including Washington, DC, have laws that protect the right to abortion. Another one 13 have so-called trigger bans in place that would take effect in Roe’s absence, according to the Guttmacher Institute, a research organization that supports abortion rights. And nine additional states have restrictions on abortion that could be reinstated in light of the Supreme Court’s decision.
In Michigan, for example, Roe has almost 50 years replaced a 1931 law which prohibits nearly all abortions unless they are “necessary to preserve the life” of a patient. Last month, a judge handed down a preliminary injunction block the law while a decision in a lawsuit for Planned Parenthood – which argues the 1931 law violates the state Constitution – is still pending.
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Roe being overthrown, the situation in Michigan shows how my colleagues in various states can be forced to face dilemmas about how to interpret restrictive abortion laws — and what the risk of death, for example, must be in order to be able to intervene. Similar questions now arise for doctors in Arkansas, which only allows abortion to save a woman’s life in “a medical emergency”.

I try to put myself in the shoes of colleagues in states where abortion will be banned or severely restricted and I can imagine the immense pressure these doctors are currently under.

In some states, laws will prohibit doctors not only from performing abortions, but also from “aiding and abetting” them in any way. The term help and encouragement is, perhaps intentionally, terribly vague; these doctors could be sued if they tell a pregnant woman who does not wish to have children that she can travel to another state for the procedure. Texas law encourages individuals to sue abortion providers and anyone aiding and abetting such a procedure. The reward for chatter is up to $10,000.
These laws could actually to deploy themselves across state lines if a patient from, say, Texas seeks an abortion from a provider in a state where abortion is legal. A handful of states have recently begun passing laws to protect their doctors from such lawsuits. This month, New York Governor Kathy Hochul sign the New York Freedom From Interference With Reproductive Health Advocacy and Travel Exercise Act, allowing New York doctors to fight back in abortion lawsuits. Connecticut passed a similar law, and California and New Jersey are also planning to legislate.
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But in the vast majority of states, darkness prevails and doctors are worried.

States across the country are expected to enact similar protections, but whether they will and how this patchwork of varying state laws will play out is uncertain.

Unsurprisingly, in states with restrictive abortion laws, my fellow OB-GYNs talk about moving. Medical students tell me they don’t want to train in states where they can’t talk about abortion. Far fewer interns from our country’s top medical schools who want to provide reproductive health care are likely to want to move to those states, which will only hurt the quality of care there.

Now that Roe is overthrown, we are forced to tread the slippery slope of the question of which elements of bodily autonomy should be restricted in certain states, and this question presents physicians with an extremely long list of potential conflicts between respect state laws and acting in the best interests of their patients. I implore state legislatures and governors to keep this in mind when considering laws that will impede quality health care for the citizens of their state.

Covid-19 has already overwhelmed doctors with an unprecedented level of emotional distress. Repeal of Roe c. Wade will, for many, add to already high stress levels.

We must all recognize these broader harms to society as well as the negative impact this decision will have on doctors, hospitals, our healthcare system and patients, whether they support abortion or not. An understanding of these dangers can help state and national policymakers as well as voters carefully reconsider whether to support banning abortion.

Overthrow Roe v. Wade doesn’t just hurt women who seek abortions, it hurts all of us.


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