Roe v. Wade Overturned: An Uncertain Future for Ethics in Reproductive Health
By Aleena Kuriakose
Introduction
On June 24, 2022, the Supreme Court overturned Roe v. Wade, signifying that women no longer hold a federal constitutional right to an abortion.
What is Roe v. Wade?
The history of the Roe v. Wade court case dates back to January 22, 1973 when the Supreme Court ruled that the Constitution of the United States generally protects a pregnant woman’s liberty to choose to have an abortion. However, a few days ago, the Supreme Court overturned the ruling, nearly four decades later, sparking outrage across the country and painting an uncertain picture of reproductive rights/health and ethics in medicine. Protests are rampaging across the nation with the prospect of states determining abortion rights unless Congress intervenes.
“Roe was egregiously wrong from the start…Its reasoning was exceptionally weak, and the decision has had damaging consequences. And far from bringing about a national settlement of the abortion issue, Roe and Casey have inflamed debate and deepened division" - Justice Samuel Alito
Already, many states have abortion bans in place and many have already outlawed abortions once the case was overturned.
What it Means for Physicians: Ethical Obligations vs. Following the Law
With the Supreme Court’s decision, physicians now face an overwhelming dilemma: their professional obligations will be in conflict with the state laws that forbid it.
In Texas, the 6-week abortion restriction makes it impossible for patients to know if they are pregnant early enough to receive a legal abortion. Because of this, doctors are faced with the hard, daily conversations with their patients of not being able to offer abortion — a safe and valid option — and thus going against their ethical obligations.
"It's very frightening and confusing for physicians and the whole team that cares for patients to know, what can we do, what is OK and what's not OK?"
says Dr. Lisa Harris, an ob-gyn and professor at the University of Michigan who joined a university task force last December to prepare for Roe to be overturned.
In medicine, in order for a medical practice to be considered ethical, it must respect the four medical pillars: autonomy, justice, beneficence, and non-maleficence.
Autonomy: respect for the patient’s right to self-determination
Justice: treating all patients equally and equitably
Beneficence: the duty to do “good” for the patient
Non-maleficence: the duty to not harm the patient
However, these ethical principles are in jeopardy with the new state regulations. Many physicians express their concern over potentially losing their license over exercising their moral duties for their patients.
One such physician — Dr. Louise King — firmly states,
“I can only help patients if I keep my license, so if you're a utilitarian, you'll say, 'Well, the greater good demands that I just comply with these laws because if we all get our licenses taken, there'll be nobody to care for anyone.”
As of now, the nation is at a tipping point. Abortion vocalists are making their voices heard, including the American Medical Association (AMA). The AMA's stance on the new decision is that it is a violation of human rights. Currently, on their official website, under the Code of Medical Ethics Opinion 4.2.7, it still states that the Principles of Medical Ethics of the AMA "do not prohibit a physician from performing an abortion in accordance with good medical practice and under circumstances that do not violate the law."
However, with new abortion bans in states as well as complete outlaws of abortion, physicians are unable to conduct a safe and legal abortion procedure in general. Obeying the law means sacrificing the moral obligations associated with being a licensed physician to serve their patients. But defying regulations and following ethical principles also means potential repeal of a physician's license.
References
https://www.npr.org/sections/health-shots/2022/06/24/1107316711/doctors-ethical-bind-abortion
https://www.ama-assn.org/delivering-care/ethics/abortion