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Crisis of Conscience in Post-Roe America  - PDF: https://lnkd.in/gc4uPUhK One might think that the issue of conscience in medicine is largely moot with the fall of Roe v. Wade. After all, it was the abortion right that prompted legislation to safeguard conscientious objectors. Now that abortion is banned in many conservative states,6 the issue might fade away. One would be mistaken. With the demise of Roe, the asymmetry in the law’s treatment of the consciences of willing and refusing providers will deepen, and conflicts multiply. In states with abortion bans, a large share of providers will effectively find themselves subject to the sorts of restrictions that Catholic and other refusing hospitals earlier imposed. Crises of conscience will develop beyond ob-gyn and emergency medicine in oncology, intensive care, dermatology, and so on. But unlike the response to Roe, the consciences of these providers will elicit little concern from state legislatures. Refusal laws, however, are expanding. Following the playbook successfully used for abortion, right-wing politicians are poised to authorize refusal of a wider range of services, likely to mean contraception, LGBTQ-affirming treatment, HIV prevention and treatment, and vaccination. These statutes will set up further collisions between the consciences of willing providers and the policies of refusing institutions. In the near term, blue states will not diverge as dramatically from red states as we imagine, due in no small part to laws authorizing refusal of abortion and other reproductive healthcare. Many states with relatively liberal abortion laws have allowed their healthcare markets to become dominated by refusing healthcare systems. Nationwide, hospitals with Catholic affiliation are 15.8% of the market but are more dominant (in the range of 30% and 40%) in many states—including Colorado, Oregon, Washington, and Wisconsin.7 Increasingly, physicians in group and private practice are employed by health systems that require them to abide by religious restrictions.8 After Dobbs v. Jackson Women’s Health Organization,11 the asymmetry may deepen. In restrictive states, Part III contends, the crisis of conscience for willing providers will increase, even as rights to refusal expand. Part IV identifies several possible complications for the legal framework governing conscience in medicine. It suggests that as refusal bills broaden, they may (unintentionally) shield providers committed to delivering at least some care. And as abortion bans grow more severe, hospitals once categorized as refusing may find themselves willing to perform life- and health-saving abortions. Part V turns to issues of conscience in those states seeking to safeguard abortion. It argues that the normalization of refusal and the reach of religious healthcare systems will erect major barriers to the expansion of reproductive healthcare in these states.

Supreme Court rejects challenge to mifepristone, a medication used in abortion https://ift.tt/Fcs6unQ An attempt to severely limit access to the abortion medication mifepristone has been unanimously rejected by the US Supreme Court. Two years after the court struck down the right to an abortion as a national guarantee, the ruling represents a significant victory for pro-choice advocates. The plaintiffs were a group of physicians and activists who opposed abortion, and the court ruled that they lacked standing to file a lawsuit. One of the two medications used in a medication abortion—which is now the most popular way to end pregnancies in the US—is mifepristone. The Alliance for Hippocratic Medicine, the plaintiffs, had maintained that the drug's government approval ought to be revoked. However, many of the court's seven justices were doubtful during the case's March arguments that any of the plaintiffs had experienced injury as a result of mifepristone's availability, which is required in order to have the legal standing to suit. The court said in their conclusion that while the plaintiffs "had sincere legal, moral, and ideological objections to elective abortion and to FDA's relaxed regulation," "they failed to demonstrate" any real harm. In June 2022, the Supreme Court reversed Roe v. Wade, therefore eliminating the legal right to an abortion. Since then, abortion rights have been restricted in 21 states, surpassing the threshold it established. Out of them, seventeen have declined the treatment at six weeks or less. The use of mail-order tablets for medication abortion has grown to be a popular and efficient way to get past such restrictions. The Food and Drug Administration (FDA) authorized the use of the two-drug combination in 2000 for usage up to 10 weeks of pregnancy. Misoprostol is given to the patient to empty the uterus after mifepristone is used to induce an abortion. Since 2016, the FDA has made the medication easier to get, let physicians to see patients virtually, and authorized prescriptions to be issued by mail. Both misoprostol and mifepristone are safe to use, according to the FDA, the American College of Obstetrics and Gynecologists (ACOG), and other major medical organizations, after 20 years of usage. According to US research, medication abortion is around 95% successful in terminating a pregnancy and only needs further medical monitoring less than 1% of the time. Latest news June 13, 2024 at 08:34PM

𝐓𝐎𝐃𝐀𝐘: The Supreme Court is hearing oral arguments in a case that could deny pregnant people emergency medical care and further upend abortion access across the country. 🔶 𝐖𝐡𝐚𝐭 𝐢𝐬 𝐭𝐡𝐞 𝐡𝐞𝐚𝐫𝐢𝐧𝐠 𝐚𝐛𝐨𝐮𝐭? This hearing is about the Emergency Medical Treatment and Labor Act, a.k.a. EMTALA, a federal law that requires hospitals receiving Medicare funding to provide “stabilizing treatment” to patients seeking care in emergency rooms. Now, anti-abortion extremists want to exclude pregnant people from this protection and force providers in states with abortion bans to turn away patients with life-threatening pregnancy-related complications. 🔶 𝐖𝐡𝐨 𝐚𝐫𝐞 𝐭𝐡𝐞 𝐩𝐥𝐚𝐲𝐞𝐫𝐬 𝐢𝐧 𝐭𝐡𝐞 𝐜𝐚𝐬𝐞? In this consolidated case, SCOTUS will be presiding over both Idaho v. United States and Moyle v. United States. Idaho and its legislature, including Speaker of the Idaho House Mike Moyle, are being represented in part by Alliance Defending Freedom, a religious, anti-abortion organization that’s famous for representing a baker who refused to make a cake celebrating a gay wedding. The US is being represented by the Dept. of Justice. 🔶 𝐖𝐡𝐚𝐭 𝐰𝐢𝐥𝐥 𝐭𝐡𝐞 𝐥𝐚𝐰𝐲𝐞𝐫𝐬 𝐚𝐫𝐠𝐮𝐞? The DOJ is arguing Idaho’s criminal abortion ban conflicts with EMTALA by banning all abortions unless necessary to save a pregnant person’s life. Without EMTALA’s protections, Idaho providers can’t offer stabilizing abortion care for dangerous pregnancy complications that put a patient’s health and future fertility at risk. The state’s lawyers are arguing that EMTALA should be interpreted only to prevent emergency rooms from turning away low-income patients. 🔶 𝐖𝐡𝐚𝐭 𝐝𝐨 𝐦𝐞𝐝𝐢𝐜𝐚𝐥 𝐩𝐫𝐨𝐯𝐢𝐝𝐞𝐫𝐬 𝐭𝐡𝐢𝐧𝐤? Several medical groups have sided with the Dept. of Justice, underscoring that providers must be able to give their patients the emergency abortion care without unnecessary interference. In a statement, the American Medical Association said withholding emergency care could mean that “pregnant patients will suffer and potentially die, or experience life-long complications.” 🔶𝐈𝐬 𝐭𝐡𝐢𝐬 𝐚 𝐛𝐢𝐠 𝐝𝐞𝐚𝐥? Yes. The US is already in a horrifying maternal mortality crisis, and the consequences of letting state abortion bans override EMTALA protections could be devastating for pregnant people in states with restrictive abortion laws. Moreover, medical providers fearing prosecution will continue to flee those states, as they have in Idaho, leaving people with little to no maternal health care. 🔶𝐍𝐨𝐰 𝐰𝐡𝐚𝐭? Now, we wait to see what happens at this April 24th hearing. While this decision should be easy—the Constitution says federal law “shall be the supreme Law of the Land”—SCOTUS could neutralize EMTALA’s protections. ➡️ Regardless of the outcome, we will not stop fighting until EVERYONE has access to the reproductive health care they need when they need it.

Taking information from @ThatsNotRight on IG: Women are dying from Republican abortion bans! If GOP pundits continue to push out voters rights and increase representation across legislative lines, they are threatening for worsening outcomes and even greater punishment for people trying to help and clinicians just trying to do their jobs. The most restrictive state laws, are wiring as intended- They pit doctors’ fears of prosecution against their patients’ health needs, requiring providers to make sure their patient was inarguably on the brink of death or facing “irreversible” harm when they intervened with procedures like a D&C. “They would feel the need to wait for a higher blood pressure, wait for a higher fever — really got to justify this one — bleed a little bit more,” Dr. Melissa Kottke, an OB-GYN at Emory University School of Medicine warned lawmakers in 2019 during one of the hearings over Georgia’s ban. The availability of D&Cs (classified as a form of abortion under the reversals DESPITE BEING CONDUCTED WHEN THE FETUS IS ALREADY DEAD/ NON-VIABLE) for both abortions and routine miscarriage care helped save lives after the 1973 Supreme Court ruling in Roe v. Wade, studies show, reducing the rate of maternal deaths for women of color by up to 40% the first year after abortion became legal. But since abortion was banned or restricted in 22 states over the past two years, women in serious danger have been turned away from emergency rooms and told that they needed to be in more peril before doctors could help. Some have been forced to continue high-risk pregnancies that threatened their lives. Those whose pregnancies weren’t even viable have been told they could return when they were “crashing.” A short, SAMPLE list of KNOWN Women who have died: Amber Thurman, Georgia, sepsis death from doctors delaying D&C Candi Miller, Georgia, sepsis death from inability to obtain D&C Anya Cook lost half her blood before doctors would treat her in Florida Jaci Statton, Oklahoma, told to wait in her car until she was "crashing" Christina Zielke bled out in Ohio before receiving treatment Blair Nelson, Texas, fertilization compromised from delayed treatment Allie Phillips, Tennessee, forced to carry a dead fetus and risked septic shock Unnamed, Texas, miscarried in hospital lobby after refused treatment Kyleigh Thurman, Texas, ectopic pregnancy ignored until fallopian tube ruptured Kelsie Norris-De La Cruz, Texas, ectopic pregnancy ignored, required removal of fallopian tube These are only a fraction from GOP barbaric bans!

*A CALL FOR ANTI CAMPAIGN AGAINST ABORTION OR SAFE MOTHERHOOD BILL. Today the country is anticipating to legalized abortion or safe motherhood as they describe, not knowing it's after mat. For over decades, Sierra Leone has been recording alarming cases on abortion, which results to the death of many victims with brighter ambitious for the future. There death results due to lack of trained doctors to do the operation safely. Record had proven that unsafe abortion are a major contributor to the high maternal deaths rate in Sierra Leone. It is evidenced that women who undergo unsafe abortion often face severe health issues, including heavy bleeding, infections, and damage to internal organs. These complications can be life- threatening and required extensive medical attention to victims involved. Moreover, considering the economic impact pose a critical challenge for unsafe abortions.The cost of medical supplies, personnel, and extended hospital stays for post - abortion care are very substantial in nature and reflect negatively to victims at risk. Most of these women who suffer from complications may be unable to work or attend school or university, leading to economic losses for themselves and their families.Take a look at the sad story of a seventeen years old Amina who, bright and ambitious to become a lawyer with determination to finish her education despite the hurdles of challenges she faced. However, her life was took an unexpected turn when she discovered that she was pregnant. Fearful of stigma and impact on her future, Amina felt she had no choice but to seek an abortion. Unfortunately on the process she lost her life . . Fellow Sierra Leoneans, what's the different between Abortion and Safe motherhood? Are they not the same? Abortion itself is surrounded with social and psychological effects, most times women who seek abortion often face social stigma and discrimination, which leads to isolation and mental health issues - and can also be traumatic, depression and full of anxiety. As the nation is crying for such a bill to be abolish, we are calling on United Nations population Fund (UNFPA), UNICEF, PLAN INTERNATIONAL, SAVE THE CHILDREN SIERRA LEONE and more, your role and support towards women's and children's health has been a vital one. Allowing the enactment of such a bill it would create more room for your organization to spend much finance on abortion case, as organizations join us to register an anti campaign against abortion or safe motherhood before legalizing it. As citizens, we are very assertive that our so called politicians are very eager to have this abortion bill into effect, without considering it's impact after. Giving a pathway to this ugly bill into law, our young girls and women would become dropout and create high rate of prostitution without fear. ✈️ By Patrick Matthew Sellu 🍃Nation Oversee For better future.

More than two years after the US supreme court overturned Roe v Wade, state abortion bans are forcing doctors to provide substandard medical care, new research released Monday shows. The study describes how one woman, whose water broke too early on her pregnancy, ended up in the ICU with severe sepsis because she could not get an abortion to end her doomed pregnancy. Her story is one of dozens of narratives collected by the research group Advancing New Standards in Reproductive Health, which is housed at the University of California, San Francisco. Another woman’s liver transplant was canceled because doctors discovered that she was pregnant – even though the pregnancy was unwanted. Yet another was forced to give birth to a baby with anencephaly, a severe and fatal fetal anomaly. By the time the baby was handed over to the mother, the baby’s skin had turned from pink to navy. “The scream and wailing she let out once she saw the baby was soul-crushing and enough to break everyone in the room,” a medical student recounted to researchers. “The mother kept screaming ‘Why, God?’ in Spanish over and over, but this was not a problem up to the divine, but rather a completely man-made problem.” Advancing New Standards in Reproductive Health first started collecting narratives from doctors about their post-Roe experiences in August 2022, shortly after Roe fell in the supreme court case Dobbs v Jackson Women’s Health Organization. The group published a preliminary report of their findings in May 2023; they have collected a total of 86 narratives. “One question that we had was: were the changes that we were seeing initially related to the initial shock of the Dobbs decisions and the laws that then went into effect? Would clinical protocols adjust and healthcare providers figure out how to provide high-quality care? Would these poor-quality cases disappear?” said Dr Daniel Grossman, the lead author on the study. “These cases are continuing to happen.” Since Roe’s demise, more than a dozen states have totally banned abortion. Every state with a ban on the books technically allows abortions in cases of medical emergencies, but the exact details of what constitutes an “emergency” can differ from state to state. Doctors across the country have said that exceptions in abortion bans are worded so vaguely and confusingly that they are unworkable in practice. Ideally, if doctors realize a patient is careening towards a medical emergency, they act as swiftly as possible. Abortion bans, doctors have said, force them to wait to act until patients are on the brink of death. https://lnkd.in/ghTyC6eS

When you hear someone downplay the impact of the overturning of Roe vs. Wade, or minimize its impact by saying, “Don’t worry — they just kicked it back to the States,” I hope you will stop and consider just how dehumanizing and dismissive those sentiments are. One of the most destructive aspects of abortion bans is that lawmakers or extremist advocates are consistently attempting to intellectualize or make abstract the circumstances in which a woman would need life saving care. The intention here is to push anti-choice legislation that restricts women’s bodily autonomy, all while floating the idea that when autonomy is physically being restricted, it’s women who are hysterically overstating the consequences of this shift in policy. As recently as this week, John McEntee, a Trump ally and former Director of the White House Presidential Personnel Office, took to social media to claim that women who were ‘bleeding out in parking lots’ were making it up and that these instances were not real. In fact, he challenged people to give him real examples — a move that backfired when countless women came to TikTok to discuss their D&C procedures being denied & share their harrowing life & death complications. And last night, ProPublica published a story detailing the death of Amber Nicole Thurman, a 28-year old medical assistant and aspiring nurse, who lost her life because of the 2022 draconian anti-abortion law that went into effect in Georgia. Here in Georgia, Black women are already three times more likely to die from pregnancy-related complications than white women. Amber, who died waiting for 20 hours to receive medical assistance that was deemed readily available at an Atlanta hospital, is now another horrific addition to this disgraceful chapter in American and Georgian history. There’s no other way to say this: Amber Nicole Thurman’s death was entirely preventable. And because medical officials denied care based on the state’s criminalization of intervention, her six year old son is now without his mother. As ProPublica points out, “the availability of D&Cs for both abortions and routine miscarriage care helped save lives after the 1973 Supreme Court ruling in Roe v. Wade, studies show, reducing the rate of maternal deaths for women of color by up to 40% the first year after abortion became legal.” I’ve spent many years in the health care sector — and in particular, fighting for women’s rights to more equitable care. Delaying medical care for reproductive emergencies and life saving procedures is a death sentence. Donald Trump installed three Supreme Court Justices to make “kicking it back to the states” a reality — and he even proudly says that states passing these draconian laws is “a beautiful thing to watch.” Read the ProPublica piece & remember Amber’s story — & the story of so many other women who need our voices, & more importantly, our votes. https://lnkd.in/esRxeME4 #Women

Delayed and Denied: How Florida’s Six-Week Abortion Ban Criminalizes Medical Care - PHR 9’24 🧐🧐New, important Report from Physicians for Human Rights September ‘24 about the consequences of Florida’s new post-Dobbs Supreme Court decision abortion bans on the health of & denials of healthcare for women & the changing reductions of needed reproductive care & and clinicians for that care “ In June 2022, the U.S. Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization overturned the federal constitutional right to abortion.[1] In July 2022, Florida enacted a ban on abortion care after 15 weeks of gestation from the first day of a pregnant person’s last menstrual period, with only limited exceptions.[2] Two years later, in April 2024 the Florida Supreme Court followed suit and overturned decades of precedent that the Florida Constitution’s Privacy Clause protects the right to abortion. This judgment cleared the way for a new, far more restrictive six-week abortion ban to take effect on May 1, 2024.[3] This ban shifted the legal limit for abortion from 15 weeks to six weeks from the first day of a pregnant person’s last menstrual period and included only very narrow exceptions that differed from those in the 15-week ban. The penalties for those who violate the ban are severe, including imprisonment, fines, and loss of medical licenses.[4] On the same day that the Florida Supreme Court revoked state constitutional protection of abortion rights, however, it also allowed a proposed amendment that would enshrine abortion rights into Florida’s Constitution to be included on the state’s November 2024 ballot for voters’ consideration. “ “Florida’s extreme abortion ban has created an unworkable legal landscape that endangers both patients and clinicians. The ban violates individual reproductive freedom, leads to preventable suffering, and compels clinicians to deviate from established standards of care and medical ethics. These denials constitute violations of Floridians’ fundamental rights, including their human rights to life, health, privacy, freedom from torture and cruelty, and equality.” ….” https://lnkd.in/g6t8CaQb

What Trump abortion ban has done to American Women. In August 2022, Amber Nicole Thurman, a 28 year old healthy medical assistant and single mother to a 6-year old boy lived in the state of Georgia, discovered she was 9-weeks pregnant with twins soon after the U.S. Supreme Court overturned Roe v. Wade, that erupted into massive abortion bans and restrictions in now 22 states in this country. The state of Georgia, passed a new law "LIFE Act" that took effect on July 20, 2022, that made Dilation and Curettage (D&C, a procedure to remove tissue from the uterus after an abortion or miscarriage, a felony offense. Amber made the decision to terminate the pregnancy to preserve her family stability, who had recently moved into a gated apartment complex with a plan to enroll in nursing school. Based on Georgia state abortion ban, she sought the medical abortion care in North Carolina clinic. Amber failed to appear on time for the clinic appointment, but instead was given Mifepristone and Misoprostol which is the standard treatment plan for inducing an abortion. In August, Amber developed vomiting and heavy bleeding, and was transported to a Georgia hospital where she was found to have retained products of conception. She developed severe sepsis and still did not receive a D&C. After 17 hours, she condition has deteriorated and was taken to the operating room to perform the D&C. Amber's condition progressed into disseminated intravascular coagulation (DIC), a rare blood clotting disorder. In an effort to save Amber's life, the surgeon performed a Hysterectomy that ended in cardiac arrest. Although the new law "LIFE Act" permits medical exceptions, this law language is too vague that caused confusion around the exceptions which led to delay in critical life-saving healthcare for this young woman. Georgia federal judge, afterward blocked the updated abortion law, however, Georgia state Supreme Court ruled in support of the abortion law. "The law allows abortion up to 20 weeks of pregnancy in cases of rape and incest and if one is necessary to prevent a patient's death or substantial physical impairment of a major bodily function." #VoteHarrisWalz2024 #VoteBlueAcrossTheBallot #VoteWomenReproductiveRights #StopTrumpVanceProject2025

☠️Texas is the 8th largest global economy - and it's not safe to be pregnant there. That means it's not safe if you are a pregnant employee (of any company) who works in the state, if you are pregnant traveling there for work or attending a conference (hello SXSW) and has a chilling effect on the willingness of healthcare providers to want to be in the state (across all specialties, not just OB/GYN). This is a business issue and not one easily solved by offering more benefits to workers -- although more accessible, inclusive benefits for part time and contract workers is an ongoing, unmet need -- OR by pretending this isn't happening and isn't dire. #DontBanEqualty #reproductivehealth #CSR McPherson Strategies Kate Bahn Rhonda Vonshay Sharpe Economic Policy Institute Shampaigne Graves