Since the U.S. Supreme Court’s Dobbs decision overturning Roe v. Wade in 2022, physicians may find their professional obligations to care for patients in conflict with state laws restricting reproductive health care. For nearly 50 years, Roe v. Wade protected a pregnant person's right to terminate a pregnancy in the United States. But since Dobbs, state legislatures have adopted laws to govern abortion and reproductive care. A number of states ban or severely restrict abortion. This may hamper provision of urgent medical care even in cases of miscarriage and ectopic pregnancy. Cases have been reported of women dying for lack of needed care. In some states, laws requiring treatment of embryos or fetuses as persons may also challenge physicians’ ability to provide IVF and other infertility treatment.
With this shift in the legal landscape, physicians and other clinicians are left to grapple with laws that may create obstacles to necessary medical treatment. They worry that the tightening of abortion rules in some states will lead to more pregnancy-related deaths across the nation due to legal uncertainty. And people in marginalized groups are particularly at risk, according to researchers. Doctors are asking: When do professional ethics and personal conscience outweigh state prohibitions? Law has long permitted individual physicians to decline participation in abortion due to conscientious objection, but should law also protect physicians’ conscientious provision of needed reproductive health care?
We’ve assembled three experts on the frontlines of this difficult health care issue to discuss this conflict between law, ethics, and medicine. Join the Consortium on Law and Values in Health, Environment & the Life Sciences for this timely webinar!
The webinar is free and open to the public.
Supplemental Information
Resources
- American College of Obstetricians and Gynecologists, Committee Opinion No. 385: The Limits of Conscientious Refusal in Reproductive Medicine. Obstetrics & Gynecology 2007;110(5):1203-1208;doi:10.1097/01.AOG.0000291561.48203.27.
- American College of Obstetricians and Gynecologists' Committee on Health Care for Underserved Women, Abortion Training and Education, Committee Opinion 612. 2014 (reaffirmed 2022);612:1-5.
- AMA Code of Medical Ethics, AMA Principles of Medical Ethics. Last revised June 2001.
- AMA Code of Medical Ethics, Preface & Preamble.
- Berlinger N. Conscience Clauses, Health Care Providers, and Parents. Hastings Center 2023. Accessed Sept. 30, 2024.
- Blackwell S, Louis JM, Norton ME, Lappen JR, Pettker CM, Kaimal A, Landy U, Edelman A, Teal S, Landis R. Reproductive Services for Women at High Risk for Maternal Mortality: A Report of the Workshop of the Society for Maternal-Fetal Medicine, the American College of Obstetricians and Gynecologists, the Fellowship in Family Planning, and the Society of Family Planning. American Journal of Obstetrics & Gynecology 2020;222(4):B2-B18;doi:10.1016/j.ajog.2019.12.008.
- Challenges in the Provision of Lifesaving Care for Pregnant Patients Following the Overturn of Roe v. Wade: Proceedings of a Workshop - in Brief. National Academies Press Published proceedings of the National Academies of Sciences, Engineering, and Medicine webinar, 2023;doi:10.17226/27242.
- Fox D. The Abortion Double Bind. American Journal of Public Health 2023;113(10):1-18.
- Fox D. Medical Disobedience. Harvard Law Review 2023;136(4):1030-1111.
- Goodman JD. Abortion Ruling Keeps Texas Doctors Afraid of Prosecution, New York Times Dec. 13, 2023; updated Dec. 14, 2023.
- Gostin LO, Wetter S, Reingold RB. One Year After Dobbs – Vast Change to the Abortion Legal Landscape. JAMA Health Forum 2023;4(8):e233091;doi:10.1001/jamahealthforum.2023.3091.
- Louis JM, Menard MK, Gee RE. Racial and Ethnic Disparities in Maternal Morbidity and Mortality. Obstetrics & Gynecology 2015;125(3):690-694;doi:10.1097/AOG.0000000000000704.
- Lyerly AD, Waggoner MR. Another Consequence of Overturning Roe: Imperiling Progress on Clinical Research in Pregnancy. American Journal of Bioethics 2022;22(8):59-62;doi:10.1080/15265161.2022.2088894.
- Lyerly AD, Waggoner MR. Reproductive Intrusions: Evidence and Ethics. American Journal of Bioethics 2024;24(2):31-33;doi:10.1080/15265161.2023.2296420.
- Lyerly AD, Faden RR, Mello MM. Beneath the Sword of Damocles: Moral Obligations of Physicians in a Post-Dobbs Landscape. Hastings Center Report 2024;54(3):15-27;doi:10.1002/hast.1589.
- National Academies of Sciences, Engineering, and Medicine. After Roe: Challenges in the Provision of Lifesaving Care. A Webinar, June 29, 2023, webinar.
- Pierson B. Federal Guidance on Life-Saving Abortions Puts Doctors in a Bind. Reuters July 21, 2022. Accessed Sept. 30, 2024.
- Reingold RB, Gostin LO, Goodwin MB. Legal Risks and Ethical Dilemmas for Clinicians in the Aftermath of Dobbs, JAMA Network 2022;328(17):1695-1696;doi:10.1001/jama.2022.18453.
- Society for Maternal-Fetal Medicine, Battarbee AN, Osmundson SS, McCarthy AM, Louis JM, SMFM Publication Committee. Society for Maternal-Fetal Medicine Consult Series #71: Management of Previable and Periviable Preterm Prelabor Rupture of Membranes. 2024;231(4):B2-B15;doi:10.1016/j.ajog.2024.07.016.
- Society for Maternal-Fetal Medicine, Lappen JR, Vricella LK, Andrews V, Christensen E, Heuser CC, Horvath S, Johnson CT, Louis JM, Luchowski AT, Norton ME, Sagaser KG, Srinivas SK, Werner E, Zahedi-Spung L, Blackwell S. Society for Maternal-Fetal Medicine Special Statement: Maternal-fetal medicine subspecialist survey on abortion training and service provision. American Journal of Obstetrics and Gynecology 2021;225(1):B2-B11;doi: 10.1016/j.ajog.2021.04.220.
- Texas Health & Safety Code, Performance of an Abortion. Chapter 170A. Effective August 25, 2022.
- Texas Supreme Court. Texas v. Zurawski. No. 23-0629. May 31, 2024.
- U.S. Department of Health & Human Services (DHHS), Conscience Protections and Religious Freedom. Last reviewed July 16, 2024.
Disclosures
It is the policy of the University of Minnesota to ensure balance, independence, objectivity, and scientific rigor in all of its sponsored educational activities. All participating faculty are required to disclose to the program audience any financial relationships related to the subject matter of this program. Disclosure information is reviewed in advance to manage and resolve any possible conflicts of interest. Specific disclosure information for each faculty member will be shared with the audience prior to the faculty’s presentation.
No speakers or moderators for this event have disclosures to report.
Speakers are:
Bio
Judette Louis, MD, MPH, is the James M. Ingram Professor and Chair for the Department of Obstetrics and Gynecology at the University of South Florida (USF) Morsani College of Medicine, where she serves as Division Chief and Fellowship Director of Maternal-Fetal Medicine. She also holds a faculty position in the USF College of Public Health, is Chief of the Tampa General Hospital Women's Institute, and is Past-President of the Society for Maternal-Fetal Medicine. Dr. Louis has authored more than 90 scientific articles and book chapters on reproductive medicine topics, including maternal morbidity and mortality, sleep and pregnancy, and health disparities in maternal-fetal medicine. As a leader on reproductive health care, she is frequently invited to speak nationally and presented in the workshop on “After Roe: Challenges in the Provision of Lifesaving Care: A Webinar” hosted by the National Academies’ Committee on Reproductive Health, Equity, and Society.
Bio
Dov Fox, JD, LLM, DPhil, is the Herzog Research Professor of Law at the University of San Diego, where he founded and directs the Center for Health Law Policy & Bioethics. Prof. Fox has written extensively on the issues raised by legal restrictions on reproductive health care. He has published more than 75 articles in leading journals of law, medicine, and public health. In 2023, he published an influential article on Medical Disobedience in the Harvard Law Review. His latest book, “Birth Rights and Wrongs: How Medicine and Technology are Remaking Reproduction and the Law,” was published by Oxford University Press.
Bio
Anne Drapkin Lyerly, MD, MA, is a Professor of Social Medicine and Research Professor in Obstetrics and Gynecology at the University of North Carolina (UNC), Chapel Hill, where she was also the first Associate Director for UNC’s Center for Bioethics. She previously served as Chair of the American College of Obstetricians and Gynecologists (ACOG) Committee on Ethics, and Co-Chair of the Program Committee for the American Society of Bioethics and Humanities (ASBH). Her research addresses socially and morally complex issues in reproductive medicine, including conscience in the provision of reproductive care. Dr. Lyerly has published extensively on these issues, including co-authoring Beneath the Sword of Damocles: Moral Obligations of Physicians in a Post-Dobbs Landscape in the Hastings Center Report.
Moderated By:
Bio
Professor Susan M. Wolf is a Regents Professor; McKnight Presidential Professor of Law, Medicine & Public Policy; Faegre Drinker Professor of Law; and Professor of Medicine at the University of Minnesota. She is Chair of the University’s Consortium on Law and Values in Health, Environment & the Life Sciences. She is an elected member of the National Academy of Medicine (NAM) and a Fellow of the American Association for the Advancement of Science (AAAS).