q and a/ethical healthcare after roe-The New Yorker
source-https://www.newyorker.com/news/q-and-a/ethical-health-care-after-roe
title & author-Ethical Health Care After Roe
Can physicians meet their obligations to patients when abortion is criminalized?
By Isaac Chotiner
July 8, 2022
snip-"...I spoke to Louise Perkins King, a surgeon and bioethicist at Harvard, and the vice-chair of the ethics committee at the American College of Obstetricians and Gynecologists (acog). Her work focusses on the ethical obligations and quandaries faced by medical professionals; the Court’s decision raises significant questions about how doctors who support abortion rights should approach their responsibilities to patients and the law going forward. During our conversation, which has been edited for length and clarity, we discussed how bioethicists think about abortion, how the medical community should approach its own members who are opposed to abortion, and whether it’s ever appropriate for doctors to break the law."
snip-"Does the decision to strike down Roe v. Wade change the ethical obligations of doctors in the United States?
It doesn’t change our ethical obligations; it makes them more challenging, because to meet our ethical obligations, to provide abortion—which is health care—in some states physicians will be facing criminal and financial penalties. And, from a utilitarian standpoint, if you meet your ethical obligations and ignore the law and risk those criminal and financial penalties, it may be that you’re then no longer available to treat other patients. Figuring out how to thread that needle is difficult, as is figuring out when you can legally treat women who are pregnant, if they’re facing various emergencies, because it is very difficult to know what you can and cannot do."
snip-" You broached something earlier that I want to come back to. A doctor may choose not to follow an unethical or immoral law. One of the problems with not following laws, even if they’re bad laws, is that they create all these other second- and third-order utilitarian consequences that can be really, really problematic—which is why, broadly speaking, people should not evaluate every single law every second of the day and just broadly follow the law. I think that’s what most ethicists would say."
snip-" The laws in various states are all slightly different, but, at the end of the day, they’re going to put doctors in a position of deciding when a woman is sick enough for them to intervene, and that’s incredibly difficult to figure out. Sepsis, for example, proceeds very slowly until it doesn’t, and then it kills. That’s the story that happened with Savita Halappanavar in Ireland. The law moves very slowly in its clarification process, through things happening, cases going forward, and then courts deciding whether something was legal or not legal. In the moment, when you’re sitting in front of someone who may be dying, and you’re being told that it might be illegal to help them, that’s not a moment when you can rely on the law to give you guidance
A physician faced with somebody in exactly Savita’s situation of sepsis—but with electrical activity [in the fetus] and not being able to proceed forward with the termination that would save her life—might go through with that procedure and then, if they’re prosecuted, go through years of the legal process, of trying to figure out if they’ve broken the law or not. During that time, they might not be able to provide care meaningfully to other patients because they’re consumed with defending themselves in court."
much more there.