Phillis Maria, Hackney David N, Malhotra Tani
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).
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).
Am J Obstet Gynecol MFM. 2023 Mar;5(3):100855. doi: 10.1016/j.ajogmf.2022.100855. Epub 2022 Dec 29.
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.
当美国最高法院对多布斯诉杰克逊案做出裁决时，它推翻了罗诉韦德案以及医生和患者在做出与怀孕相关决定（包括但不限于堕胎护理）时所依赖的数十年法律保护。在多布斯案之前，堕胎的可及性就已受到限制，但新的法律格局通过大幅削减许多州对这些服务的合法提供、通过令人困惑、不一致且繁琐的法律要求限制医生提供合法堕胎护理的能力，以及通过颠覆数十年的可靠标准并让医生和律师对未来可能的法院判决进行猜测，极大地限制了患者获得堕胎护理的机会。自罗诉韦德案以来的过去50年里，医学协会和医疗保健组织在面对堕胎权受到的攻击时大多保持沉默。他们的沉默留下了一个空白，在这个空白中，不了解堕胎护理的政客和立法者以牺牲患者获得堕胎护理的机会、患者自主权、医患关系和医生自主权为代价，推行他们自己的意识形态和政治利益。医生有组织起来并进行倡导的道德责任。堕胎立法体现了不公正政策的影响，这些政策限制了我们为患者提供医疗决策自主权的能力，干扰了循证护理的提供，在某些情况下还阻止我们履行不伤害的誓言。我们必须从政治意识形态手中夺回检查室的控制权，以便能够为患者提供公平、以患者为中心、循证且自主的医疗保健服务。
