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Personal Perspective| Volume 5, ISSUE 3, 100855, March 2023

The urgent need for physician-led abortion advocacy

  • Maria Phillis
    Correspondence
    Corresponding author: Maria Phillis, MD, JD.
    Affiliations
    Division of Maternal Fetal Medicine, Department of Reproductive Biology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH (Drs Phillis, Hackney, and Malhotra)

    Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH (Dr Phillis)
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  • David N. Hackney
    Affiliations
    Division of Maternal Fetal Medicine, Department of Reproductive Biology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH (Drs Phillis, Hackney, and Malhotra)
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  • Tani Malhotra
    Affiliations
    Division of Maternal Fetal Medicine, Department of Reproductive Biology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH (Drs Phillis, Hackney, and Malhotra)
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Published:December 28, 2022DOI:https://doi.org/10.1016/j.ajogmf.2022.100855
      When the Supreme Court of the United States decided Dobbs v. Jackson, it overruled Roe v. Wade and the decades of legal protections that physicians and patients have relied upon in making pregnancy decisions, including but not limited to abortion care. Abortion access has been limited before Dobbs, but the new legal landscape substantially limits patient access to abortion care by greatly curtailing legal provision of these services in many states, restricting physicians’ ability to provide legal abortion care through confusing, inconsistent, and burdensome legal requirements, and by upending decades of reliable standards and leaving physicians and lawyers guessing about possible future court decision.
      Medical societies and healthcare organizations over the last 50 years since Roe have largely been silent in the face of attacks to abortion rights. Their silence left a void in which politicians and legislators without an understanding of abortion care promoted their own ideology and political interest at the expense of patient access to abortion care, patient autonomy, the physician–patient relationship, and physician autonomy.
      Physicians have an ethical duty to organize and advocate. Abortion legislation exemplifies the impact of unjust policies limiting our ability to provide patients with autonomy over their medical decision-making and interfering in the provision of evidence-based care, and in some cases preventing us from upholding our oath to do no harm. We must regain control of the examination room from political ideologies so that we can provide equitable, patient-centered, evidence-based, autonomous healthcare to our patients.

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      References

      1. Dobbs v. Jackson Women's Health Organization, 597 U.S. _____ (2022). Available at https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf. Accessed October 1. 2022.

      2. Roe v. Wade, 410 U.S. 113 (1973) Available at: https://supreme.justia.com/cases/federal/us/410/113/. Accessed October 1, 2022.

      3. Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 (1992), Available at: https://supreme.justia.com/cases/federal/us/505/833/. Accessed October 1, 2022.

      4. State bans on abortion throughout pregnancy. 2022. Available at:https://www.guttmacher.org/state-policy/explore/state-policies-later-abortions. Guttmacher Institute. Accessed October 19, 2022.

      5. Hoyert DL. Maternal mortality rates in the United States, 2020. Health E-Stats. National Center for Health Statistics. 2022. Available at:https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm. Accessed October 1, 2022.

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