TEnding the federal right to abortion in the US would have profound and damaging impacts on medical education, the freedom to practice medicine and the ability of patients to seek medical advice without fear of prosecution, doctors and legal experts said. .
The warnings come as a leaked draft opinion from the supreme court and the accompanying report from politician shows that a majority of the justices voted to overturn Roe v Wade, a landmark decision that has protected the federal right to abortion for nearly 50 years.
If the court’s opinion does not change substantially from the leaked draft, at least 26 states would be certain or likely to ban abortion. Until the court issues a final decision, expected in June, Roe prevents states hostile to abortion from banning the procedure before the fetus can survive outside the womb.
“If this decision ends up being similar to what [was leaked]this will substantially affect abortion care, obstetric care and health care in general,” said Dr. Nisha Verma, Darney-Landy Fellow at the American College of Obstetricians and Gynecologists.
Such a decision would represent a seismic shift in the American health care landscape, with devastating consequences for health care, education, and the doctor-patient relationship.
“It really starts with the doctors, because taking down Roe will have a serious chilling effect,” said Lindsay Lewis, co-author of a National Association of Criminal Defense Lawyers report that studied the possible criminal effects of taking down Roe, and a member of the meeting. from the same organization.
Abortion restrictions are now more likely to contain extremely limited life-saving exemptions for pregnant people, harsh criminal penalties for providers, and lack exemptions for rape and incest.
That puts doctors in the position of trying to interpret legislation that is often extremely narrow. In a recent example, an abortion ban in Oklahoma makes performing an abortion a crime punishable by up to 10 years in prison. Additionally, medical exemptions for the procedure are extremely limited.
An abortion can be legally performed only if the medical emergency “cannot be remedied by delivery of the child.” “Medical emergency” is strictly defined as a threat to a person’s life “from a physical disorder, physical illness, or physical injury, including a life-threatening physical condition caused by or arising from the pregnancy itself.” .
Functionally, these restrictions on medical exemptions have made the new abortion bans much stricter than even some that existed before Roe, when some states allowed women to seek authorization for an abortion from state boards. hospitals on the basis of psychological crises.
“Basically over the last decade, or a little bit over the last decade, these exceptions have just become so narrow that they’re functionally unusable,” said Elizabeth Nash, an expert on state abortion restrictions at the Guttmacher Institute, a rights research organization. reproductive. “There are very few people who meet these definitions.”
In another example, if Roe falls, doctors who perform abortions against state law in Alabama could face up to 99 years in prison.
“This has the potential to change the doctor-patient relationship,” Lewis said. Physicians may not feel comfortable advising women that they can go to another state for an abortion, while women may feel uncomfortable speaking openly about their considerations.
Additionally, tough crime laws passed in the nearly 50 years since Roe was decided mean that some enthusiastic prosecutors could charge doctors, and a host of others, with aiding and abetting, conspiring or abetting in crime-related crimes. the end of a pregnancy. .
Abortion bans would also have a dramatic impact on medical education, particularly obstetrics and gynecology residents, who must learn about routine abortion care as part of their training.
“Largely due to the politicization of obstetric care and abortion, the public sees them as two very different and separate things,” when, in fact, “pregnancy management and termination are very interconnected,” said Dr. Kavita Vinekar, Assistant Professor at the University. from Los Angeles California School of Medicine and a member of Physicians for Reproductive Health. “Many of the skills we use in obstetrics are directly related to the training we receive in abortion care.”
AN study co-authored by Vinekar found that nearly half (44%) of OB/GYN residents, or about 2,600 residents, will attend programs in states that could ban abortion training.
Some programs have already pioneered efforts to help residents of Texas, which banned six-week abortions in September 2021, travel to states where it is legal. But it is not simple or easy.
“I’m trying to think of ways to help, so there aren’t huge training and education gaps in our workforce, but I’m also very nervous about it,” said study co-author Dr. Jody Steinauer, director of the program. Ryan residency and training at the Bixby Center for Global Reproductive Health at the University of California, San Francisco.
Additionally, Steinauer said she worries that labor shortages threaten pregnant people in states where abortion is banned, because few doctors will want to practice under threat of prosecution, unable to provide safe, evidence-based care.
“The emotional distress factor alone would be enough for people not to want to practice in these states,” Steinauer said.
Existing abortion restrictions, even in Roe’s position, mean pregnant people can seek abortion care far from where they live. Verma has seen patients come to Georgia from Alabama and Tennessee, which have more restrictions. However, the threat of prosecution may pose a threat.
“In far too many of these cases,” a person who was prosecuted “has been brought to the attention of law enforcement by someone they sought medical attention from,” said Jill Adams, executive director of If/When/How, a reproductive organization. legal group of rights.
Although anti-abortion lawmakers often argue that they exempt women from punitive statutes, laws conferring rights on fetuses have already resulted in prosecutions. Those criminal penalties are likely to be expanded if Roe falls.
That was probably the case for Lizelle Herrera, a Texas woman who was charged with murder for a “self-induced abortion”. Charges were later dropped: abortion is legal because Roe is still the law of the land, but historians warn the case is a warning of things to come. There is no requirement for health care providers to report pregnant people to law enforcement for self-managed abortions, which are legal.
“At a time when we’re trying to end mass incarceration, we’re going to see a lot more women, a lot more people of color, a lot more poor people, these are the people we see getting abortions, being charged with crimes and just going to jail. for exercising what was once their right to determine what to do with their own bodies when it comes to pregnancy,” Lewis said.
Reference-www.theguardian.com