By Tegan Clarke
On June 24, 2022, the US Supreme Court issued its 6-3 decision in Dobbs,1 the culmination of more than three decades of attacks on reproductive freedom and the steady erosion of a woman’s* right to an abortion. In a potentially crippling blow to the so-called right to privacy, the Court pried open the door to every clinic, hospital, and exam room in the country and invited lawmakers inside. The state has inserted itself as a party and decision-maker in conversations previously held in confidence between a woman and her physician. It no longer seems inconceivable that the state could envision a role for itself in her conversations with her physician about her birth control, who her sexual partners are, the sex acts she engages in, or her access to any other care targeted by regressive activists. The extent to which a state might regulate any medical care with this power is not limited by its social acceptability.
No matter one’s position on abortion itself, all physicians should be wary of the implications of this decision for their own practice. The same authority that a state uses to ban abortions could likewise be used to ban addiction treatment, gender affirming care, PREP, or any other procedure or treatment that some concerned citizen might seek an injunction for. Since Casey, physicians have allowed the state to put words into our mouths, compelling us to “counsel” women with misleading and even outright false information about the decision they have chosen to make.2 Now, the treatment options that we may offer our patients may be artificially limited based on nothing more than the city or state in which we practice–or, perhaps more salient, whether our patient has the time and resources to travel, potentially hundreds of miles, for that treatment. None of these are positive developments in the practice of evidence-based medicine. They are fundamentally opposed to the principles that we hold dear in the profession.
Autonomy is a pillar of modern medicine. An adult woman of decisional capacity has the sole authority to consent to her medical care in all but very limited circumstances.3 The notion that we would deny her medical control of her own body is beyond shameful. As physicians, we would not tolerate a romantic partner or father or neighbor or any other person to veto a mentally competent woman’s decisions on contraception, sterilization, or abortion. Likewise, we must not tolerate the state stepping into that role. Let’s make our voices heard. Let’s make our voices heard.
* The author would like to acknowledge that while in this piece the term “woman” is used, the right to sexual and reproductive health is not limited to any one gender, and not every person with the capacity for pregnancy identifies as a woman.
- Dobbs v. Jackson Women’s Health Organization, No. 19-1392, 597U.S. (2022)
- Planned Parenthood v. Casey, 505 U.S. 833, 881-87 (1992)
- Zürcher T, Elger B, Trachsel M. The notion of free will and its ethical relevance for decision-making capacity. BMC Med Ethics. 2019;20(1):31. Published 2019 May 8. doi:10.1186/s12910-019-0371-0
Tegan Clarke is a medical student at the University of New Mexico.
