Nicole Xu for NPR
Since Roe v. Wade was overturned, 13 states have banned abortion except in the case of a medical emergency or serious health risk for the pregnant patient. But deciding what cases qualify for a medical exception can be a difficult judgement call for doctors.
News reports and court affidavits have documented how health care workers sometimes deny women abortion procedures in emergency situations – including NPR’s story of a woman who was initially not treated for her miscarriage at an Ohio ER, though she’d been bleeding profusely for hours.
In Missouri, hospital doctors told a woman whose water broke at 18 weeks that “current Missouri law supersedes our medical judgment” and so she could not receive an abortion procedure even though she was at risk of infection, according to a report in the Springfield News-Leader.
That hospital is now under investigation for violating a federal law that requires doctors to treat and stabilize patients during a medical emergency.
And a survey by the Texas Policy Evaluation Project found clinicians sometimes avoided standard abortion procedures, opting instead for “hysterotomy, a surgical incision into the uterus, because it might not be construed as an abortion.”
“That’s just nuts,” Dr. Matthew Wynia says. He’s a physician who directs the Center for Bioethics and Humanities at the University of Colorado. “[A hysterotomy is] much more dangerous, much more risky – the woman may never have another pregnancy now because you’re trying to avoid being accused of having conducted an abortion.”
Reports like these prompted Wynia to publish an editorial in the New England Journal of Medicine in September, calling for physicians and leading medical institutions to take a stand against these laws through “professional civil disobedience.” The way he sees it, no doctor should opt to do a procedure that may harm their patient – or delay or deny care – because of the fear of prosecution.
“I have seen some very disturbing quotes from health professionals essentially saying, ‘Look, it’s the law. We have to live within the law,'” he says. “If the law is wrong and causing you to be involved in harming patients, you do not have to live [within] that law.”
These issues have raised a growing debate in medicine about what to do in the face of laws that many doctors feel force them into ethical quandaries.
Medical organizations raise the issue
At the American Medical Association’s November meeting, president Dr. Jack Resneck gave an address to the organization’s legislative body, and recounted how doctors around the country have run into difficulty practicing medicine in states that ban abortion.
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