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美国的生殖健康政策:美国医师协会政策简报

Reproductive Health Policy in the United States: An American College of Physicians Policy Brief.

作者信息

Serchen Josh, Erickson Shari, Hilden David

机构信息

American College of Physicians, Washington, DC (J.S., S.E.).

Hennepin Healthcare, Minneapolis, Minnesota (D.H.).

出版信息

Ann Intern Med. 2023 Mar;176(3):364-366. doi: 10.7326/M22-3316. Epub 2023 Feb 28.

Abstract

The legal landscape around access to reproductive health care services was substantially altered after the Supreme Court decision in In the aftermath of the decision, some state governments have begun to impose stringent restrictions and complete bans on the provision of abortion, whereas others have sought to protect and expand access. Some have gone as far as imposing criminal and civil penalties on physicians and other clinicians who provide evidence-based, clinically indicated reproductive health care services and information that is guided by biomedical ethics and provided in the best interest of the patient's health and well-being. In several states, lawmakers have attempted and successfully used new approaches to enforcing and achieving these prohibitions, including prohibitions on crossing state lines to obtain abortion care, prohibitions on the mailing of medication abortion, and the authorization of third-party civil lawsuits. In this policy brief, the American College of Physicians (ACP) updates and expands on its previous public policy positions on abortion from its 2018 policy paper, "Women's Health Policy in the United States," to reflect this new reality. The College also offers policymakers and payers recommendations to promote equitable access to reproductive health care services and safeguard maternal health. ACP reaffirms its opposition to undue and unnecessary governmental interference in the patient-physician relationship that criminalizes the provision of health care made in the physician's clinical judgment and based on clinical evidence and the standard of care.

摘要

最高法院做出该项裁决后,围绕获得生殖保健服务的法律格局发生了重大变化。裁决做出后,一些州政府开始对堕胎服务实施严格限制并全面禁止,而其他一些州则寻求保护并扩大堕胎服务的可及性。一些州甚至对提供循证、临床指征明确的生殖保健服务以及依据生物医学伦理、符合患者健康和福祉最佳利益提供信息的医生及其他临床医生施加刑事和民事处罚。在几个州,立法者尝试并成功采用了新方法来执行和实现这些禁令,包括禁止跨州获取堕胎护理、禁止邮寄药物流产药物以及授权第三方提起民事诉讼。在本政策简报中,美国医师协会(ACP)更新并扩展了其2018年政策文件《美国的女性健康政策》中关于堕胎的先前公共政策立场,以反映这一新现实。该协会还向政策制定者和支付方提出建议,以促进公平获得生殖保健服务并保障孕产妇健康。ACP重申其反对政府对医患关系进行不当和不必要的干涉,这种干涉将基于医生临床判断、临床证据和医疗标准提供的医疗保健定为犯罪行为。

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