1
|
Pyle A, Adams SY, Cortezzo DE, Fry JT, Henner N, Laventhal N, Lin M, Sullivan K, Wraight CL. Navigating the post-Dobbs landscape: ethical considerations from a perinatal perspective. J Perinatol 2024; 44:628-634. [PMID: 38287137 DOI: 10.1038/s41372-024-01884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/08/2023] [Accepted: 01/15/2024] [Indexed: 01/31/2024]
Abstract
Restrictive abortion laws have impacts reaching far beyond the immediate sphere of reproductive health, with cascading effects on clinical and ethical aspects of neonatal care, as well as perinatal palliative care. These laws have the potential to alter how families and clinicians navigate prenatal and postnatal medical decisions after a complex fetal diagnosis is made. We present a hypothetical case to explore the nexus of abortion care and perinatal care of fetuses and infants with life-limiting conditions. We will highlight the potential impacts of limited abortion access on families anticipating the birth of these infants. We will also examine the legally and morally fraught gray zone of gestational viability where both abortion and resuscitation of live-born infants can potentially occur, per parental discretion. These scenarios are inexorably impacted by the rapidly changing legal landscape in the U.S., and highlight difficult ethical dilemmas which clinicians may increasingly need to navigate.
Collapse
Affiliation(s)
- Alaina Pyle
- Department of Pediatrics, Division of Neonatology, Connecticut Children's Medical Center, Hartford, CT, USA.
- University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Shannon Y Adams
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - DonnaMaria E Cortezzo
- Division of Neonatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Division of Pain and Palliative Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jessica T Fry
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Division of Palliative Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Natalia Henner
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Division of Palliative Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Naomi Laventhal
- Department of Pediatrics, Michigan Medicine-University of Michigan Medical School, Ann Arbor, MI, USA
| | - Matthew Lin
- Department of Pediatrics, Pediatric Palliative Care Team, Children's National Medical Center, Washington, DC, USA
| | - Kevin Sullivan
- Division of Neonatology, Nemours Children's Hospital - Delaware, Wilmington, DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - C Lydia Wraight
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| |
Collapse
|
2
|
Mannava SV, Brar A, Patwardhan U, Godfrey J, Berdan E, Gow K, Knod JL. Bridging the Knowledge Gap: A Toolkit on Reproductive Rights for Pediatric Surgeons in the Post-Dobbs Era. J Pediatr Surg 2024:S0022-3468(24)00181-7. [PMID: 38589273 DOI: 10.1016/j.jpedsurg.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The ripple effect of the Supreme Court ruling in Dobbs v. Jackson Women's Health Organization has impacted physicians and patients across numerous medical specialties. In pediatric surgery, the patient population ranges from fetus to the pregnant patient. There is a gap in the knowledge of pediatric surgeons regarding abortion laws and access. This project aims to bridge the gap by creating access to reliable resources which may be used to optimize patient care and support physicians. METHODS We collaborated with the Reproductive Health Coalition, co-founded by the American Medical Women's Association and Doctors for America, to curate a list of resources beneficial to pediatric surgeons. RESULTS We created a web-based toolkit with the purpose of providing easily accessible and reliable information on reproductive rights in the United States. We identified up-to-date resources on state-by-state abortion laws, legal resources, patient-centered information on obtaining abortion care, and resources for physicians interested in getting involved in advocacy. CONCLUSION Pediatric surgery rests at a critical juncture with respect to reproductive rights in the United States. Our toolkit enables users to understand the current climate and identify next steps to advocate for patients and physicians amidst a formidable legal environment. LEVEL OF EVIDENCE Level V.
Collapse
Affiliation(s)
- Sindhu V Mannava
- Indiana University School of Medicine, Department of Surgery, Indianapolis, IN, USA
| | - Amanpreet Brar
- University of Michigan, Department of Surgery, Ann Arbor, MI, USA
| | - Utsav Patwardhan
- Rady Children's Hospital San Diego, Division of Pediatric Surgery, San Diego, CA, USA
| | - Jodi Godfrey
- American Medical Women's Association, West Orange, NJ, USA
| | - Elizabeth Berdan
- Mary Bridge Children's Hospital, Department of General and Thoracic Surgery, Tacoma, WA, USA
| | - Kenneth Gow
- University of Washington School of Medicine, Division of Pediatric General and Thoracic Surgery, Seattle, WA, USA
| | - J Leslie Knod
- University of Connecticut School of Medicine, Department of Surgery and Pediatrics, 282 Washington Street, Hartford, CT 06106, USA.
| |
Collapse
|
3
|
Zhao J, Zahn A, Pang SC, Quang TS, Campbell J, Halkitis PN. Early national trends in non-abortion reproductive care access after Roe. Front Public Health 2024; 12:1309068. [PMID: 38525331 PMCID: PMC10957616 DOI: 10.3389/fpubh.2024.1309068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
Background Roe was overturned in 2022. No peer-reviewed evidence exists for the indirect spillover effects of overturning Roe on non-abortion reproductive care access for diverse patient populations. Methods National data were from 2013-2023 HHS Title X Directory, 2013-2020 CDC Artificial Reproductive Technologies (ART) Surveillance and 2021-2023 manual collection, and Guttmacher Institute. Outcome measures included numbers of ART clinics and Title X entities. Title X entities are those that receive federal funds to establish and operate voluntary family planning projects, especially for low-income patients. We reported pre-and post-Roe changes, associations between changes in measures and abortions, and characteristics of changed measures by region and political geography. Results Post-Roe America witnessed national declines of 1.03% in ART clinics and 18.34% in Title X entities, and average state decreases of 0.08 ART clinics (p < 0.05) and 18 Title X entities (p < 0.001). State-level ART clinic closures and abortion reductions had little association except for Texas, Oklahoma, Arizona, New York, and California. Plummets in Title X entities and abortions were positively associated: Reducing 100 abortions was associated with defunding two Title X entities (p < 0.05). The South experienced the largest losses of both, while 83.39% of lost Title X entities were in states that voted Republican in the 2020 presidential election, disproportionate to the 49.02% of states that voted Republican and the 42.52% of US population residing in these states. Conclusion We provide one of the first few evidence of spillover impacts of overturning Roe on non-abortion care access for diverse populations: low-income men and women, single parents by choice, and biologically and socially infertile patients. Early evidence warns of worsening challenges of inequities and calls for immediate policy actions.
Collapse
Affiliation(s)
- Junying Zhao
- Department of Health Administration and Policy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Aaron Zahn
- Department of Health Administration and Policy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | | | - Tony S. Quang
- Department of Radiation Oncology, Tibor Rubin VA Medical Center, Long Beach, CA, United States
| | - Janis Campbell
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Perry N. Halkitis
- Department of Biostatistics and Epidemiology, Rutgers University, Piscataway, NJ, United States
| |
Collapse
|
4
|
Gyuras HJ, Field MP, Thornton O, Bessett D, McGowan ML. The double-edged sword of abortion regulations: Decreasing training opportunities while increasing knowledge requirements. Med Educ Online 2023; 28:2145104. [PMID: 36373897 PMCID: PMC9668273 DOI: 10.1080/10872981.2022.2145104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 05/21/2023]
Abstract
PURPOSE The authors explore how abortion regulations in Ohio, an abortion-restrictive state in the USA, impact obstetrician-gynecologists' (OB/GYNs) training in reproductive healthcare and describe what OB/GYNs believe to be the broader impact of Ohio's regulations on skill-building, skills maintenance, and professional retention of reproductive healthcare providers in the state. Authors discuss how their findings foreshadow abortion training limitations in Ohio and other abortion-restrictive states now that abortion regulations have returned to the states. METHODS The authors conducted four semi-structured focus groups and five in-depth interviews between April 2019 and March 2020. Participants included OB/GYNs practicing obstetrics and gynecology in Ohio between 2010 and 2020. Thematic analysis was conducted using Atlas.ti. RESULTS Twenty attending physicians and 15 fellows and residents participated in the study. Participants discussed the impact of Ohio's written transfer agreement, gestational-limit, and abortion method and facility bans on training and skill-building opportunities. Participants felt that Ohio's strict abortion regulations 1) limit opportunities to observe and perform abortion procedures during training; 2) require learning the ever-changing legality of abortion provision; 3) limit the number of abortions OB/GYNs can provide, leading to the atrophy of their skills over time; and 4) may prevent prospective medical students and residents from choosing to study in Ohio and may lead to physician attrition from the state. CONCLUSION Prior to the reversal of federal protections for abortion in 2022, OB/GYNs in Ohio and other abortion-hostile states experienced barriers to training in abortion care. In returning abortion regulation to the states, access to training is likely to be increasingly restricted. This research demonstrates how abortion-restrictions hamper physicians' skills needed to care for patients, particularly in emergent situations. This puts patients at risk and places physicians in precarious ethical positions. Expanding protections and reducing restrictions on abortion will ensure OB/GYNs and trainees have the skills necessary to care for patients presenting for reproductive healthcare.
Collapse
Affiliation(s)
- Hillary J. Gyuras
- Gyuras Is a Research Associate, College of Public Health, the Ohio State University, Ohio, USA
- CONTACT Hillary J. Gyuras 60 Townshend Hall, 1885 Neil Ave. Mall, The Ohio State University, Columbus, OH 43212
| | - Meredith P. Field
- Division of Social Sciences, Alfred University, Alfred, New York, USA
| | - Olivia Thornton
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Massachusetts, USA
| | - Danielle Bessett
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michelle L. McGowan
- Biomedical Ethics Research Program, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
5
|
Fleck LM. Teaching Bioethics Today: Waking from Dogmatic Curricular Slumbers. Camb Q Healthc Ethics 2023:1-8. [PMID: 37941123 DOI: 10.1017/s0963180123000178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The Dobbs decision has precipitated renewed medical, political, and professional interest in the issue of abortion. Because this decision handed responsibility for regulation of abortion back to the states, and because the states are enacting or have enacted policies that tend to be very permissive or very restrictive, the result has been legal and professional confusion for physicians and their patients. Medical education cannot resolve either the legal or ethical issues regarding abortion. However, medical education must prepare future physicians for caring for patients seeking abortion-related services. Physicians must be prepared to interact appropriately (sensitively and with integrity) with patients or colleagues whose views on abortion differ significantly from their own. This essay describes our educational effort to achieve that objective. The motto that governed this exercise was "No Easy Answers."
Collapse
Affiliation(s)
- Leonard M Fleck
- Center for Bioethics and Social Justice, College of Human Medicine, Michigan State University, East Lansing, MIUSA
| |
Collapse
|
6
|
Woodcock AL, Carter G, Baayd J, Turok DK, Turk J, Sanders JN, Pangasa M, Gawron LM, Kaiser JE. Effects of the Dobbs v Jackson Women's Health Organization Decision on Obstetrics and Gynecology Graduating Residents' Practice Plans. Obstet Gynecol 2023; 142:1105-1111. [PMID: 37769302 DOI: 10.1097/aog.0000000000005383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/03/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE To explore the association of the Dobbs v Jackson Women's Health Organization ( Dobbs ) decision on future practice locations of graduating obstetrics and gynecology residents. METHODS This is a mixed-methods survey study of obstetrics and gynecology residents graduating from sites with Ryan Program abortion training programs (109 sites) between March 8, 2023, and April 25, 2023. We conducted both univariate and multivariable logistic regression analyses to identify factors that were associated with post- Dobbs change in career plans, particularly location. We also performed a thematic analysis using responses to the survey's optional, open-ended prompt, "Please describe how the Dobbs v Jackson Women's Health Organization decision impacted your professional plans." RESULTS Of an estimated 724 residents graduating from residencies with Ryan Program abortion training programs, 349 participated in the survey (48.2% response rate); 17.6% of residents indicated that the Dobbs decision changed the location of intended future practice or fellowship plans. Residents who before the Dobbs decision intended to practice in abortion-restrictive states were eight times more likely to change their practice plans than those who planned to practice in protected states before the Dobbs decision (odds ratio 8.52, 95% CI 3.81-21.0). In a thematic analysis of open-ended responses, 90 residents wrote responses related to "not living in a state with abortion restrictions." Of residents pursuing fellowship, 36 indicated that they did not rank or ranked lower programs in restrictive states. CONCLUSION These findings demonstrate reduced desire of residents in obstetrics and gynecology to practice or pursue fellowship in restrictive states after residency. This reduction in obstetrics and gynecology workforce could significantly exacerbate maternity care deserts.
Collapse
Affiliation(s)
- Alexandra L Woodcock
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah; and Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Bixby Center for Global Reproductive Health, San Francisco, California
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Jungels A, Demers L, Ford E, Stevens BK, Sabatello M, Dasgupta S. Project Inclusive Genetics: Protecting reproductive autonomy from bias via prenatal patient-centered counseling. HGG Adv 2023; 4:100228. [PMID: 37646012 PMCID: PMC10461018 DOI: 10.1016/j.xhgg.2023.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/25/2023] [Indexed: 09/01/2023] Open
Abstract
Clinician bias negatively impacts the healthcare received by marginalized communities. In this study, we explored factors that influence clinician and trainee bias against individuals with intellectual disabilities and its impact on clinical judgment in prenatal genetic testing settings. Specifically, we examined bias toward a fetus with a higher chance of developing a disability. We compared genetics specialists with their non-expert counterparts. This web-based study included clinical vignettes, implicit association tests (IATs), and an educational module. 595 participants were recruited via their institution or professional society. We conducted statistical analyses, including regression models controlling for key demographic characteristics, to analyze recommendation patterns and degree of change after the module. Genetics expertise strongly correlated with appropriate testing recommendation when the patient would not consider pregnancy termination (r = 1.784 pre-module, r = 1.502 post-module, p < 0.01). Factors that influenced pre-module recommendation to test include increased age (r = -0.029, p < 0.05), high religiosity (r = 0.525, p < 0.05), and participant personal preference against testing (r = 1.112, p < 0.01). Responses among participants without genetics expertise improved after the educational module (Z = -4.435, p < 0.01). 42% of non-experts who answered inappropriately changed their answer to match guidelines after the module. Individual bias, along with structural and institutional bias, permeates family planning encounters and significantly decreases quality of care. We demonstrate here that anti-bias training is effective, particularly for non-expert providers, and it can improve the care provided to individuals with intellectual disability. Evidence-based training such as this one can help providers make appropriate genetic counseling recommendations.
Collapse
Affiliation(s)
- Apolline Jungels
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Lindsay Demers
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston MA, USA
| | - Eric Ford
- Independent Scholar, Brooklyn, NY, USA
| | - Blair K. Stevens
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Maya Sabatello
- Center for Precision Medicine and Genomics, Department of Medicine, and Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Shoumita Dasgupta
- Department of Medicine, Biomedical Genetics Section, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| |
Collapse
|
8
|
Tancioco V, Pancholi R, Schechter-Perkins E, Drainoni ML, White K. Emergency department staff perspectives on caring for patients experiencing early pregnancy loss (Boston, Massachusetts 2021). Contraception 2023; 125:110091. [PMID: 37331465 DOI: 10.1016/j.contraception.2023.110091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/28/2023] [Accepted: 06/04/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVES A preimplementation study to examine the context of, and barriers and facilitators to, providing early pregnancy loss care in one emergency department (ED), to inform implementation strategies to improve ED-based early pregnancy loss care. STUDY DESIGN We recruited a purposive sample of participants and conducted semistructured individual qualitative interviews focused on caring for patients experiencing pregnancy loss in the ED until saturation was reached. For analysis, we used framework coding and directed content analysis. RESULTS Participant roles in the ED included administrators (N = 5), attending physicians (N = 5), resident physicians (N = 5), and registered nurses (N = 5). Most (70%, N = 14) participants identified as female. Primary themes included (1) caring for early pregnancy loss patients is challenging and uncomfortable, (2) inability to provide compassionate early pregnancy loss care causes moral injury, and (3) stigma influences early pregnancy loss care. Participants explained that early pregnancy loss is challenging due to added pressure, patient expectations, and gaps in knowledge. They reported barriers to providing compassionate care that are out of their control, such as systematic workflows, limited physical space, and insufficient time and expressed that these barriers lead to moral injury. Participants also reflected on how early pregnancy loss and abortion stigma affect patient care. CONCLUSIONS Caring for patients experiencing early pregnancy loss in the ED requires unique considerations. ED staff recognize this and desire more early pregnancy loss education, clearer early pregnancy loss tools and protocols, and early pregnancy loss-specific workflows. With concrete needs identified, an implementation plan to improve ED-based early pregnancy loss care can be created, which is important now more than ever, due to the impending influx in the ED for early pregnancy loss care after the Dobbs decision. IMPLICATIONS Since the Dobbs decision, patients are self-managing abortions and/or seeking out-of-state abortion care. Without access to follow-up, more patients are presenting to the ED with early pregnancy loss. By demonstrating the unique challenges emergency medicine clinicians face, this study can support initiatives to improve ED-based early pregnancy loss care.
Collapse
Affiliation(s)
- Virginia Tancioco
- Obstetrics and Gynecology, Boston University/Boston Medical Center, Boston, MA, United States.
| | - Rushina Pancholi
- Obstetrics and Gynecology, Boston Medical Center, Boston, MA United States.
| | | | - Mari-Lynn Drainoni
- Sections of Infectious Diseases, Department of Medicine, Boston University/Boston Medical Center, Boston, MA, United States; Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, United States.
| | - Katharine White
- Obstetrics and Gynecology, Boston University/Boston Medical Center, Boston, MA, United States.
| |
Collapse
|
9
|
Clayton EW, Tritell AM, Thorogood AM. Avoiding Liability and Other Legal Land Mines in the Evolving Genomics Landscape. Annu Rev Genomics Hum Genet 2023; 24:333-346. [PMID: 36630592 DOI: 10.1146/annurev-genom-100722-021725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This article reviews evolving legal implications for clinicians and researchers as genomics is used more widely in both the clinic and in translational research, reflecting rapid changes in scientific knowledge as well as the surrounding cultural and political environment. Professionals will face new and changing duties to make or act upon a genetic diagnosis, address direct-to-consumer genetic testing in patient care, consider the health implications of results for patients' family members, and recontact patients when test results change over time. Professional duties in reproductive genetic testing will need to be recalibrated in response to disruptive changes to reproductive rights in the United States. We also review the debate over who controls the flow of genetic information and who is responsible for its protection, considering the globally influential European Union General Data Protection Regulation and the rapidly evolving data privacy law landscape of the United States.
Collapse
Affiliation(s)
- Ellen Wright Clayton
- Department of Pediatrics and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
- School of Law, Vanderbilt University, Nashville, Tennessee, USA;
| | - Alex M Tritell
- School of Law, Vanderbilt University, Nashville, Tennessee, USA;
| | | |
Collapse
|
10
|
Henrich JB, Schwarz EB, McClintock AH, Rusiecki J, Casas RS, Kwolek DG. Position Paper: SGIM Sex- and Gender-Based Women's Health Core Competencies. J Gen Intern Med 2023; 38:2407-2411. [PMID: 37079185 PMCID: PMC10117249 DOI: 10.1007/s11606-023-08170-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/10/2023] [Indexed: 04/21/2023]
Abstract
Women's health care has evolved significantly since it was first acknowledged as an integral part of internal medicine training more than two decades ago. To update and clarify core competencies in sex- and gender-based women's health for general internists, the Society of General Internal Medicine (SGIM) Women and Medicine Commission prepared the following Position Paper, approved by the SGIM council in 2023. Competencies were developed using several sources, including the 2021 Accreditation Council for Graduate Medical Education Program Requirements for Internal Medicine and the 2023 American Board of Internal Medicine Certification Examination Blueprint. These competencies are relevant to the care of patients who identify as women, as well as gender-diverse individuals to whom these principles apply. They align with pivotal advances in women's health and acknowledge the changing context of patients' lives, reaffirming the role of general internal medicine physicians in providing comprehensive care to women.
Collapse
Affiliation(s)
| | | | | | | | - Rachel S Casas
- Penn State Milton S. Hershey Medical Center, Hershey, USA
| | | |
Collapse
|
11
|
Barnes-Davis ME, Cortezzo DE. The patient/physician relationship in a post-Roe world: a neonatologist viewpoint. J Perinatol 2023; 43:968-972. [PMID: 36528653 PMCID: PMC10325948 DOI: 10.1038/s41372-022-01583-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
The Supreme Court ruling in Dobbs v. Jackson Women's Health Organization has far-reaching implications that go beyond the practice of obstetrics and gynecology. The ruling and subsequent laws and bills impact many specialties and have implications for healthcare as a whole. The rapidly changing medicolegal landscape has significant bearings on and implications for the fields of neonatology and pediatrics. These rulings have an impact on the patient-physician relationship and a shared decision-making approach to care. Furthermore, there are significant sequelae of forced birth and resuscitation. This review provides a clinically relevant update of the current medicolegal landscape and applications to the practice of neonatology.
Collapse
Affiliation(s)
- Maria E Barnes-Davis
- Division of Neonatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, USA, OH.
| | - DonnaMaria E Cortezzo
- Division of Neonatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Pain and Palliative Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
12
|
Affiliation(s)
| | - Rieham Owda
- Department of Obstetrics and Gynecology, and
| | | | - Kathleen Collins
- Medical Science Training Program
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| |
Collapse
|
13
|
Cortezzo DE, Vawter-Lee M, Shoaib A, Venkatesan C. Role of palliative care in fetal neurological consultations: Guiding through uncertainty and hope. Front Pediatr 2023; 11:1205543. [PMID: 37334218 PMCID: PMC10272582 DOI: 10.3389/fped.2023.1205543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023] Open
Abstract
Fetal neurology is a rapidly evolving and expanding field. Discussions about diagnosis, prognosis, treatment options, and goals of care often begin in the antenatal period. However, there are inherent challenges to fetal counseling of neurological diagnoses due to limitations of fetal imaging, prognostic uncertainty, and variability in neurodevelopmental outcomes. In the midst of uncertainty, families are challenged with preparing a care plan for their baby while simultaneously experiencing profound grief. The paradigms of perinatal palliative care can assist with the grieving process and help frame diagnostic testing and complex decision-making within the context of a family's spiritual, cultural, and social belief system. This ultimately leads to a shared decision-making process and value driven medical care. While perinatal palliative care programs have expanded, many families faced with such diagnoses never meet with a palliative care team prior to delivery. Moreover, there is significant variability in the availability of palliative care services throughout the country. Using an illustrative vignette of a patient with a prenatally diagnosed encephalocele, this review aims to provide a basic framework of perinatal palliative care for fetal neurology diagnoses that emphasizes 1) importance of clear, consistent, and transparent communication among all subspecialists and families, 2) creation of a palliative care birth plan, 3) importance of consistent care providers and longitudinal points of contact prenatally and post-delivery, 4) close communication between the prenatal and post-natal providers to allow for optimal continuity of care, and 5) recognize that information, care plans, and goals of care often evolve over time.
Collapse
Affiliation(s)
- DonnaMaria E. Cortezzo
- Cincinnati Children's Hospital Medical Center, Division of Neonatal and Pulmonary Biology, Cincinnati, OH, United States
- Cincinnati Children's Hospital Medical Center, Division of Pain and Palliative Medicine, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Marissa Vawter-Lee
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Cincinnati Children's Hospital Medical Center, Division of Neurology, Cincinnati, OH, United States
| | - Abdullah Shoaib
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Cincinnati Children's Hospital Medical Center, Division of Neurology, Cincinnati, OH, United States
| | - Charu Venkatesan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Cincinnati Children's Hospital Medical Center, Division of Neurology, Cincinnati, OH, United States
| |
Collapse
|
14
|
Grimes CL, Halder G, Beckham AJ, Kim-Fine S, Rogers R, Iglesia C. Anticipated Impact of Dobbs v Jackson Women's Health Organization on Training of Residents in Obstetrics and Gynecology: A Qualitative Analysis. J Grad Med Educ 2023; 15:339-347. [PMID: 37363665 PMCID: PMC10286908 DOI: 10.4300/jgme-d-22-00885.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/06/2023] [Accepted: 04/14/2023] [Indexed: 06/28/2023] Open
Abstract
Background On June 24, 2022, the Supreme Court of the United States in the case of Dobbs v Jackson Women's Health Organization ended constitutional protection for abortion, thus severely restricting access to reproductive health care for millions of individuals. Concerns have arisen about the potential impact on medical students, residents, and fellows training in restricted areas and the effect on gynecologic training and the future provision of competent comprehensive women's health care in the United States. Objective To qualitatively explore the anticipated impacts of the Dobbs ruling on training in obstetrics and gynecology (OB/GYN). Methods A participatory action research approach employing methods of qualitative analysis was used. Trainees and leaders in national OB/GYN professional and academic organizations with missions related to clinical care and training of medical students, residents, and fellows in OB/GYN participated. Two focus groups were held via Zoom in July 2022. Using an iterative process, transcripts underwent coding by 2 independent researchers to identify categories and common themes. Themes were organized into categories and subcategories. An additional reviewer resolved discrepancies. Results Twenty-six OB/GYN leaders/stakeholders representing 14 OB/GYN societies along with 4 trainees participated. Eight thematic categories were identified: competency, provision of reproductive health care, residency selection, inequity in training, alternative training, law-based vs evidence-based medicine, morality and ethics, and uncertainty about next steps. Conclusions This qualitative study of leaders and learners in OB/GYN identified 8 themes of potential impacts of the Dobbs ruling on current and future training in OB/GYN.
Collapse
Affiliation(s)
- Cara L. Grimes
- Cara L. Grimes, MD, MAS, is Associate Professor of Obstetrics and Gynecology (OB/GYN) and Urology, and Associate Chair of Research in OB/GYN, New York Medical College
| | - Gabriela Halder
- Gabriela Halder, MD, MPH, is Assistant Professor of OB/GYN, University of Texas Medical Branch
| | - A. Jenna Beckham
- A. Jenna Beckham, MD, MSPH, is Assistant Professor of OB/GYN, WakeMed Health and Hospitals
| | - Shunaha Kim-Fine
- Shunaha Kim-Fine, MD, MS, is Clinical Associate Professor of OB/GYN, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca Rogers
- Rebecca Rogers, MD, is Professor of OB/GYN, Albany Medical Center
| | - Cheryl Iglesia
- Cheryl Iglesia, MD, FACOG, is President, Society of Gynecologic Surgeons (on behalf of the Society for Gynecologic Surgeons Collaborative Research in Pelvic Surgery Consortium)
| |
Collapse
|
15
|
Geisler HC, Safford HC, Mitchell MJ. Rational Design of Nanomedicine for Placental Disorders: Birthing a New Era in Women's Reproductive Health. Small 2023:e2300852. [PMID: 37191231 PMCID: PMC10651803 DOI: 10.1002/smll.202300852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/16/2023] [Indexed: 05/17/2023]
Abstract
The placenta is a transient organ that forms during pregnancy and acts as a biological barrier, mediating exchange between maternal and fetal circulation. Placental disorders, such as preeclampsia, fetal growth restriction, placenta accreta spectrum, and gestational trophoblastic disease, originate in dysfunctional placental development during pregnancy and can lead to severe complications for both the mother and fetus. Unfortunately, treatment options for these disorders are severely lacking. Challenges in designing therapeutics for use during pregnancy involve selectively delivering payloads to the placenta while protecting the fetus from potential toxic side effects. Nanomedicine holds great promise in overcoming these barriers; the versatile and modular nature of nanocarriers, including prolonged circulation times, intracellular delivery, and organ-specific targeting, can control how therapeutics interact with the placenta. In this review, nanomedicine strategies are discussed to treat and diagnose placental disorders with an emphasis on understanding the unique pathophysiology behind each of these diseases. Finally, prior study of the pathophysiologic mechanisms underlying these placental disorders has revealed novel disease targets. These targets are highlighted here to motivate the rational design of precision nanocarriers to improve therapeutic options for placental disorders.
Collapse
Affiliation(s)
- Hannah C. Geisler
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Hannah C. Safford
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Michael J. Mitchell
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Penn Institute for RNA Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19014, USA
- Institute for Regenerative Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| |
Collapse
|
16
|
Pagoto SL, Palmer L, Horwitz-Willis N. The Next Infodemic: Abortion Misinformation. J Med Internet Res 2023; 25:e42582. [PMID: 37140975 DOI: 10.2196/42582] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/16/2023] [Accepted: 03/08/2023] [Indexed: 05/05/2023] Open
Abstract
The World Health Organization (WHO) defines an infodemic as the proliferation of false or misleading information that leads to confusion, mistrust in health authorities, and the rejection of public health recommendations. The devastating impacts of an infodemic on public health were felt during the COVID-19 pandemic. We are now on the precipice of another infodemic, this one regarding abortion. On June 24, 2022, the Supreme Court of the United States (SCOTUS) decision in Dobbs v. Jackson Women's Health Organization resulted in the reversal of Roe v. Wade, which had protected a woman's right to have an abortion for nearly 50 years. The reversal of Roe v. Wade has given way to an abortion infodemic that is being exacerbated by a confusing and rapidly changing legislative landscape, the proliferation of abortion disinformants on the web, lax efforts by social media companies to abate abortion misinformation, and proposed legislation that threatens to prohibit the distribution of evidence-based abortion information. The abortion infodemic threatens to worsen the detrimental effects of the Roe v. Wade reversal on maternal morbidity and mortality. It also comes with unique barriers to traditional abatement efforts. In this piece, we lay out these challenges and urgently call for a public health research agenda on the abortion infodemic to stimulate the development of evidence-based public health efforts to mitigate the impact of misinformation on the increased maternal morbidity and mortality that is expected to result from abortion restrictions, particularly among marginalized populations.
Collapse
Affiliation(s)
- Sherry L Pagoto
- UConn Center for mHealth and Social Media, UConn Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Lindsay Palmer
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Nate Horwitz-Willis
- Planned Parenthood Advocacy Fund of Massachusetts, Boston, MA, United States
| |
Collapse
|
17
|
Feld H, Elswick A, Goodin A, Fallin-Bennett A. Partnering with recovery community centers to build recovery capital by improving access to reproductive health. J Nurs Scholarsh 2023; 55:692-700. [PMID: 36345125 DOI: 10.1111/jnu.12836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/19/2022] [Accepted: 10/08/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND People with substance use disorders (SUD), especially opioid use disorder (OUD) have the highest rates of unintended pregnancies (80-95%) and report unmet reproductive health needs. Women of childbearing age have some of the highest death rates from opioids and are notably rising the most rapidly, and when pregnancy does occur overdose is one of the leading causes of maternal mortality. There are numerous gender-based health disparities and social determinants of health shaped by the distribution of power and privilege that influence the risk trajectories of people who can get pregnant or are pregnant with a substance use disorder (SUD). PURPOSE The purpose of this paper is to describe how reproductive health is essential to recovery and building recovery capital for people who can get pregnant, (1) introduce a pilot implementation science study working with trained peer support coaches to promote reproductive autonomy in the community, and (2) make policy and advocacy recommendations relevant to the new reproductive health landscape in the United States. We will also describe the adaptation and feasibility of the initial pilot study where we partnered with a recovery community center to train peer recovery coaches to provide low barrier resources (contraception, pregnancy tests and prenatal vitamins) and referrals to health care. METHODS This initiative is the merging of best practices in recovery and community-based global reproductive health, to empower people with SUD who can get pregnant in an implementation science framework. The pilot study will last 3 months in each city and aims to (1) assess and describe the effectiveness of the training of local peer recovery coaches on the link between recovery capital and reproductive health, and (2) assess the feasibility, acceptability, appropriateness, scalability, sustainability, and uptake and reach of low barrier reproductive health resources (pregnancy tests, prenatal vitamins, and emergency contraception). In this paper we are only reporting the initial findings regarding adaptation and feasibility. FINDINGS Informed by qualitative interviews with stakeholders and participants, the method of contraception was adapted from injectable to emergency to meet the needs and context of the community with SUD. Early outcomes such as uptake and acceptability indicate that this is a feasible model with peer recovery coaches and recovery community centers, with the greatest uptake of emergency contraception and pregnancy tests. CONCLUSION Considering recent policies limiting access to reproductive health, innovative community-based solutions are needed to engage and empower people who can get pregnant or are pregnant while in active drug use and in recovery. Providing low barrier reproductive health items by people with lived experience with SUD can serve as a valuable harm reduction model and improve recovery capital. CLINICAL RELEVANCE This is the first study to propose a methodology and context to implement a community-based study merging best practices in recovery with those in reproductive health with the potential to improve recovery capital and maternal/child health trajectories for people with SUD.
Collapse
Affiliation(s)
- Hartley Feld
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Alex Elswick
- Family Sciences, University of Kentucky, Lexington, Kentucky, USA
- Voices of Hope, Lexington, Kentucky, USA
| | - Amie Goodin
- Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, Florida, USA
| | - Amanda Fallin-Bennett
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
- Voices of Hope, Lexington, Kentucky, USA
| |
Collapse
|
18
|
Gupta S, Perry B, Simon K. Trends in Abortion- and Contraception-Related Internet Searches After the US Supreme Court Overturned Constitutional Abortion Rights: How Much Do State Laws Matter? JAMA Health Forum 2023; 4:e230518. [PMID: 37115538 PMCID: PMC10148201 DOI: 10.1001/jamahealthforum.2023.0518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Importance The US Supreme Court ruling in Dobbs v Jackson Women's Health Organization on June 24, 2022, revealed immediate and distinct differences between states regarding abortion legality. Whether the ruling was associated with population-level changes in seeking information on reproductive health care-related information is unknown. Objective To determine whether the US Supreme Court ruling on Dobbs v Jackson Women's Health Organization was associated with increased information seeking for reproductive health care access in the states with immediately effective (trigger and pre-Roe) abortion laws vs other states. Design, Setting, and Participants This was a retrospective cross-sectional study of nationwide real-time internet search data by state-week from January 1, 2021, through July 16, 2022. Difference-in-difference event study estimates were used to evaluate abortion- and contraception-related internet searches after the Supreme Court draft majority decision was leaked on May 2, 2022, and the final ruling was issued on June 24, 2022, in states immediately affected vs other states. Data analyses were performed from July 18 to January 14, 2022. Exposures The Supreme Court's draft majority decision leaked on May 2, 2022, and the final ruling on Dobbs v Jackson Women's Health Organization on June 24, 2022. Preexisting state trigger laws and pre-Roe bans that became effective immediately when Roe was overturned by the decision on Dobbs. Main Outcomes and Measures Number of searches per 10 million Google queries in a state-week for terms related to abortion or contraception. Results Searches for abortion-related terms increased from 16 302 to 75 746 per 10 million searches per state-week during the weeks before vs after the May 2, 2022, leak of the draft majority decision in states with trigger laws or abortion bans. This was a 42% (95% CI, 24%-59%) higher increase than in states with laws that protect abortion access. Searches for contraception also increased from 56 055 to 82 133 searches per state-week after the ruling in the states with abortion bans, 25% (95% CI, 13%-36%) higher than the increase in states protecting abortion access. Conclusions and Relevance The findings of this retrospective cross-sectional study suggest that changes in internet searching for terms related to reproductive health care can capture immediate population-level changes in information-seeking behavior regarding reproductive health care access. These data are critical for shaping health policy discussions.
Collapse
Affiliation(s)
- Sumedha Gupta
- Department of Economics, Indiana University, Indianapolis
| | - Brea Perry
- Department of Sociology, Indiana University, Bloomington
| | - Kosali Simon
- O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington
- National Bureau of Economic Research, Cambridge, Massachusetts
| |
Collapse
|
19
|
LANTZ PAULAM, MICHELMORE KATHERINE, MONIZ MICHELLEH, MMEJE OKEOMA, AXINN WILLIAMG, SPECTOR‐BAGDADY KAYTE. Abortion Policy in the United States: The New Legal Landscape and Its Threats to Health and Socioeconomic Well-Being. Milbank Q 2023; 101:283-301. [PMID: 36960973 PMCID: PMC10126955 DOI: 10.1111/1468-0009.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/06/2023] [Indexed: 03/25/2023] Open
Abstract
Policy Points The historic 2022 Supreme Court Dobbs v Jackson Women's Health Organization decision has created a new public policy landscape in the United States that will restrict access to legal and safe abortion for a significant proportion of the population. Policies restricting access to abortion bring with them significant threats and harms to health by delaying or denying essential evidence-based medical care and increasing the risks for adverse maternal and infant outcomes, including death. Restrictive abortion policies will increase the number of children born into and living in poverty, increase the number of families experiencing serious financial instability and hardship, increase racial inequities in socioeconomic security, and put significant additional pressure on under-resourced social welfare systems.
Collapse
Affiliation(s)
| | | | - MICHELLE H. MONIZ
- University of Michigan
- Michigan Medicine Department of Obstetrics and Gynecology
| | - OKEOMA MMEJE
- University of Michigan
- Michigan Medicine Department of Obstetrics and Gynecology
| | | | | |
Collapse
|
20
|
Spence RA, Hinyard LJ, Jagsi R, Jimenez RB, Lopez AM, Chavez-MacGregor M, Spector-Bagdady K, Rosenberg AR. ASCO Ethical Guidance for the US Oncology Community Where Reproductive Health Care Is Limited by Law. J Clin Oncol 2023; 41:2852-2858. [PMID: 36989462 DOI: 10.1200/jco.23.00174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
The decision in Dobbs v Jackson Women's Health Organization overturned federal protections for abortion rights, making way for states to enact abortion bans with or without exceptions for the health or life of the pregnant patient. Patient care across many areas of medicine including oncology continues to be affected. Although the change in the legal landscape is widely felt, the core ethical considerations for physicians do not change because of restrictions on the practice of medicine. ASCO offers this guidance to assist US oncologists and institutions who must balance limitations with established ethical duties. This paper articulates principles for cancer care and pregnancy, offers a framework for ethical reflection and action for oncologists who care for pregnant patients, and makes recommendations for individual and institutional action to support evidence-based, patient-centered care in the United States where abortion is illegal or access is limited.
Collapse
Affiliation(s)
| | - Leslie J Hinyard
- Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine, St Louis, MO
| | - Reshma Jagsi
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA
| | - Rachel B Jimenez
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ana Maria Lopez
- Medical Oncology and Integrative Medicine and Nutritional Sciences, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Mariana Chavez-MacGregor
- Departments of Breast Medical Oncology and Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kayte Spector-Bagdady
- Department of Obstetrics and Gynecology, Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI
| | - Abby R Rosenberg
- Department of Pediatrics, Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA
| |
Collapse
|
21
|
Schreiber CA, Khabele D, Gehrig PA. The Dobbs v Jackson Women's Health Organization Supreme Court Decision-Concerns, Challenges, and Consequences for Health Care. JAMA Surg 2023; 158:229-230. [PMID: 36318215 DOI: 10.1001/jamasurg.2022.5714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This Viewpoint discusses potential consequences that the US Supreme Court ruling in Dobbs v Jackson Women’s Health Organization may have for patient outcomes, public health, training and legal challenges for health care professionals, and the patient-practitioner relationship.
Collapse
Affiliation(s)
- Courtney A Schreiber
- Division of Family Planning, Penn Medicine Pregnancy Early Access Center, University of Pennsylvania, Philadelphia
| | - Dineo Khabele
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Paola A Gehrig
- Department of Obstetrics and Gynecology, University of Virginia, Charlottesville
| |
Collapse
|
22
|
Miller M, Lindley AR, West JD, Thayer EK, Godfrey EM. Does lower use of academic affiliation by university faculty in top U.S. newspapers contribute to misinformation about abortion? J Commun Healthc 2023; 16:7-20. [PMID: 36919808 DOI: 10.1080/17538068.2022.2150166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND University faculty are considered trusted sources of information to disseminate accurate information to the public that abortion is a common, safe and necessary medical health care service. However, misinformation persists about abortion's alleged dangers, commonality, and medical necessity. METHODS Systematic review of popular media articles related to abortion, gun control (an equally controversial topic), and cigarette use (a more neutral topic) published in top U.S. newspapers between January 2015 and July 2020 using bivariate analysis and logistic regression to compare disclosure of university affiliation among experts in each topic area. RESULTS We included 41 abortion, 102 gun control, and 130 smoking articles, which consisted of 304 distinct media mentions of university-affiliated faculty. Articles with smoking and gun control faculty experts had statistically more affiliations mentioned (90%, n = 195 and 88%, n = 159, respectively) than abortion faculty experts (77%, n = 54) (p = 0.02). The probability of faculty disclosing university affiliation was similar between smoking and gun control (p = 0.73), but between smoking and abortion was significantly less (Ave Marginal Effects - 0.13, p = 0.02). CONCLUSIONS Fewer faculty members disclose their university affiliation in top U.S. newspapers when discussing abortion. Lack of academic disclosure may paradoxically make these faculty appear less 'legitimate.' This leads to misinformation, branding abortion as a 'choice,' suggesting it is an unessential medical service. With the recent U.S. Supreme Court landmark decision, Dobbs v. Jackson Women's Health Organization, and subsequent banning of abortion in many U.S. states, faculty will probably be even less likely to disclose their university affiliation in the media than in the past.
Collapse
Affiliation(s)
- Madison Miller
- Medical Student, University of Washington School of Medicine, Seattle, WA, USA
| | - Alexa R Lindley
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Jevin D West
- Information School, Co-Founder of the Center for an Informed Public, University of Washington, Seattle, WA, USA
| | - Erin K Thayer
- Department of Family Medicine, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Emily M Godfrey
- Departments of Family Medicine and Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
| |
Collapse
|
23
|
Stotland NL. Abortion: Perspectives from an APA Past-President. Psychodyn Psychiatry 2023; 51:1-5. [PMID: 36867185 DOI: 10.1521/pdps.2023.51.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The United States Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, eliminating the national right to abortion, poses challenges to psychiatrists and patients. Abortion laws now vary widely from state to state and are constantly changing and being challenged. The laws affect both patients and health care professionals; some prohibit not only the performance of abortion but efforts to inform and assist patients seeking abortion. Patients may become pregnant during and/or because of episodes of clinical depression, mania, or psychosis, and recognize that their current circumstances will not allow them to become adequate parents. Some laws allowing abortion to protect a woman's life or health explicitly exclude mental health risks; many prohibit transfer of a patient to a permissive venue. Psychiatrists working with patients contemplating abortion can convey the scientific evidence that abortion does not cause mental illness and help them identify and work through their own beliefs, values, and likely responses to the decision. Psychiatrists will also have to decide whether medical ethics or state laws will govern their own professional behavior.
Collapse
Affiliation(s)
- Nada L Stotland
- Served as the 135th President of the American Psychiatric Association
| |
Collapse
|
24
|
Oumano M, Dibble E. Antiabortion laws and reproductive health information in nuclear medicine. Clin Imaging 2023; 95:62-64. [PMID: 36621068 DOI: 10.1016/j.clinimag.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/09/2022] [Accepted: 12/20/2022] [Indexed: 01/03/2023]
Abstract
The Supreme Court of the United States (SCOTUS) decision on Dobbs v Jackson Women's Health Organization overturned a 49-year-old federal recognition of abortion rights and drastically altered a long-established risk-benefit analysis for pregnant or potentially pregnant patients in nuclear medicine. In this current legal landscape, the collection/documentation of reproductive health information (RHI) must be reduced and, in our brief communication, we outline how to do just that.
Collapse
Affiliation(s)
- Michael Oumano
- Department of Medicine and Biological Sciences, Brown University, Providence, RI 02912, USA; Department of Medical Physics and Radiation Safety, Rhode Island Hospital, Providence, RI 02903, USA; Landauer Medical Physics, 2 Science Road, Glenwood, IL 60425, USA.
| | - Elizabeth Dibble
- Warren Alpert Medical School of Brown University/Rhode Island Hospital Department of Diagnostic Imaging, Providence, RI, USA
| |
Collapse
|
25
|
Stein RA, Katz A, Chervenak FA. The far-reaching impact of abortion bans: reproductive care and beyond. EUR J CONTRACEP REPR 2023; 28:23-27. [PMID: 36369860 DOI: 10.1080/13625187.2022.2140008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
On 24 June 2022, the US Supreme Court overturned Roe v. Wade, a 49-year-old precedent that provided federal constitutional protection for abortions up to the point of foetal viability, returning jurisdiction to the individual states. Restrictions that came into effect automatically in several states, and are anticipated in others, will severely limit access to abortions in approximately half of the US. Even though every state allows for exceptions to the abortion bans, in some instances these exceptions can be used to preserve the health of a pregnant patient, while in other instances, only to preserve their life. The vague and confusing nature of the abortion ban exceptions threatens to compromise the standard of care for patients with pregnancy complications that are distinct from abortions, such as nonviable pregnancies, miscarriages, and ectopic pregnancies. Additionally, we envision challenges for the treatment of women with certain autoimmune conditions, pregnant cancer patients, and patients contemplating preimplantation genetic diagnosis as part of assisted reproductive technologies. The abortion ban exceptions will impact and interfere with the medical care of pregnant and non-pregnant patient populations alike and are poised to create a medical and public health crisis unlike any other one from the recent past.
Collapse
Affiliation(s)
- Richard A Stein
- Department of Chemical and Biomolecular Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| | - Adi Katz
- Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Department of Obstetrics and Gynecology, Lenox Hill Hospital, New York, NY, USA
| | - Frank A Chervenak
- Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Department of Obstetrics and Gynecology, Lenox Hill Hospital, New York, NY, USA
| |
Collapse
|
26
|
Jacobs JW, Fabbri S, Woo JS, Booth GS. Overturning Roe v. Wade: Medical and Legal Impacts on Blood Transfusion in the Obstetric Population. J Womens Health (Larchmt) 2023; 32:129-131. [PMID: 36576800 DOI: 10.1089/jwh.2022.0441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Jeremy W Jacobs
- Division of Transfusion Medicine, Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Stefka Fabbri
- Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, Colorado, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
27
|
Gamboa Bernal GA. Derogada la sentencia Roe vs. Wade. pers bioet 2023. [DOI: 10.5294/pebi.2022.26.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Después de casi medio siglo fue derogada la sentencia del caso Roe vs. Wade por la Corte Suprema de los Estados Unidos, lo que puede suponer el fin del aborto en ese país. Se mencionan algunos antecedentes, hitos históricos, arreglos y el contexto de la situación que desembocó en la sentencia mediante la cual se estableció el derecho constitucional al aborto (Roe vs. Wade), se mantuvo la decisión tomada (Planned Parenthood vs. Casey) y finalmente cómo se revocaron las sentencias anteriores (Dobbs vs. Organización de Salud Femenina Jackson). Se concluye, desde una perspectiva biojurídica, que se corrigió un fallo no solo controvertido en su aplicación, sino sobre todo en su génesis, donde queda claro que el aborto no es un derecho constitucional y que los organismos judiciales no son competentes para regular sobre esa materia y sobre otras análogas. Desde el punto de vista bioético, es un fallo revocatorio histórico, que rectificó una de las mayores injusticias contemporáneas, que puso por encima la autonomía individual sobre el hecho biológico incontrovertible de una nueva vida humana y el cuidado que demanda su dignidad ontológica: Roe vs. Wade costó la vida a millones de embriones, en los Estados Unidos y en el resto del mundo.
Collapse
|
28
|
Fleck LM. The Dobbs Decision: Can It Be Justified by Public Reason? Camb Q Healthc Ethics 2023;:1-13. [PMID: 36683585 DOI: 10.1017/S0963180122000822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
John Rawls has held up as a model of public reason the U.S. Supreme Court. I argue that the Dobbs Court is justifiably criticized for failing to respect public reason. First, the entire opinion is governed by an originalist ideological logic almost entirely incongruent with public reason in a liberal, pluralistic, democratic society. Second, Alito's emphasis on "ordered liberty" seems completely at odds with the "disordered liberty" regarding abortion already evident among the states. Third, describing the embryo/fetus from conception until birth as an "unborn human being" begs the question of the legal status of the embryo/fetus, as if an obiter dictum settled the matter. Fourth, Alito accuses the Roe court of failing to exercise judicial restraint, although Alito argued to overturn Roe in its entirety. In brief, the Dobbs opinion is an illiberal, disingenuous, ideological swamp that swallows up public reason and the reproductive rights of women.
Collapse
|
29
|
Fleck LM. Abortion and "Zombie" Laws: Who Is Accountable? Camb Q Healthc Ethics 2023;:1-2. [PMID: 36683576 DOI: 10.1017/S0963180122000810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
30
|
Espey E, Haider S, Stone J, Gyamfi-Bannerman C, Steinauer J. Now is the time to stand up for reproductive justice and abortion access. Am J Obstet Gynecol 2023; 228:48-52. [PMID: 36008167 DOI: 10.1016/j.ajog.2022.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/08/2022] [Accepted: 07/18/2022] [Indexed: 01/26/2023]
Abstract
The ongoing assault on abortion care in the United States culminating in the Supreme Court decision that overturned Roe v Wade calls for concerted national action to address the major gaps in care and training that will ensue. We write this call to action to our community of obstetrician-gynecologists to prioritize advocacy for access to abortion care. Professional health organizations understand the importance of access to contraception and abortion care as the foundation for reproductive health, autonomy, and empowerment. As restrictions proliferate, patients are encountering significant challenges in accessing care; all in our community who provide obstetrical and gynecologic care need to step up to ensure adequate and equitable patient care and provider training. In this Clinical Opinion, we outline current professional organization evidence-based support for comprehensive reproductive health care including abortion care, without interference by politics, strategies to proactively prevent further restrictions, and actions to mitigate the harm that will be caused by further restrictions to abortion care. We must all speak up, be visible in our support, and take any and every opportunity to advocate for abortion care as an integral part of comprehensive reproductive medical care.
Collapse
Affiliation(s)
- Eve Espey
- Department of Obstetrics & Gynecology, School of Medicine, The University of New Mexico, Albuquerque, NM.
| | | | | | | | | |
Collapse
|
31
|
Arvisais-Anhalt S, Ravi A, Weia B, Aarts J, Ahmad HB, Araj E, Bauml JA, Benham-Hutchins M, Boyd AD, Brecht-Doscher A, Butler-Henderson K, Butte AJ, Cardilo AB, Chilukuri N, Cho MK, Cohen JK, Craven CK, Crusco S, Dadabhoy F, Dash D, DeBolt C, Elkin PL, Fayanju OA, Fochtmann LJ, Graham JV, Hanna JJ, Hersh W, Hofford MR, Hron JD, Huang SS, Jackson BR, Kaplan B, Kelly W, Ko K, Koppel R, Kurapati N, Labbad G, Lee JJ, Lehmann CU, Leitner S, Liao ZC, Medford RJ, Melnick ER, Muniyappa AN, Murray SG, Neinstein AB, Nichols-Johnson V, Novak LL, Ogan WS, Ozeran L, Pageler NM, Pandita D, Perumbeti A, Petersen C, Pierce L, Puttagunta R, Ramaswamy P, Rogers KM, Rosenbloom ST, Ryan A, Saleh S, Sarabu C, Schreiber R, Shaw KA, Sim I, Sirintrapun SJ, Solomonides A, Spector JD, Starren JB, Stoffel M, Subbian V, Swanson K, Tomes A, Trang K, Unertl KM, Weon JL, Whooley MA, Wiley K, Williamson DFK, Winkelstein P, Wong J, Xie J, Yarahuan JKW, Yung N, Zera C, Ratanawongsa N, Sadasivaiah S. Paging the Clinical Informatics Community: Respond STAT to Dobbs v. Jackson's Women's Health Organization. Appl Clin Inform 2023; 14:164-171. [PMID: 36535703 PMCID: PMC9977563 DOI: 10.1055/a-2000-7590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Simone Arvisais-Anhalt
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, United States
| | - Akshay Ravi
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Benjamin Weia
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Jos Aarts
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hasan B. Ahmad
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
| | - Ellen Araj
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Julie A. Bauml
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Marge Benham-Hutchins
- College of Nursing and Health Science, Texas A&M University, Corpus Christi, Corpus Christi, Texas, United States
| | - Andrew D. Boyd
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, Illinois, United States
| | - Aimee Brecht-Doscher
- Department of Obstetrics and Gynecology, Ventura County Healthcare Agency, Ventura, California, United States
| | | | - Atul J. Butte
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, California, United States
| | - Anthony B. Cardilo
- Department of Emergency Medicine, NYU Langone Health, New York, New York, United States
| | - Nymisha Chilukuri
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - Mildred K. Cho
- Departments of Medicine and Pediatrics, Stanford University School of Medicine, Stanford, California, United States
- Stanford Center for Biomedical Ethics, Stanford University, Stanford, California, United States
| | - Jenny K. Cohen
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Catherine K. Craven
- Division of Clinical Research Informatics, Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio, Texas, United States
| | - Salvatore Crusco
- The Feinstein Institutes for Medical Research, Northwell Health, New Hyde Park, New York, United States
| | - Farah Dadabhoy
- Department of Emergency Medicine, Mass General Brigham, Boston, Massachusetts, United States
| | - Dev Dash
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Claire DeBolt
- Department of Pulmonary Critical Care, University of Virginia, Charlottesville, Virginia, United States
- Department of Clinical Informatics, University of Virginia, Charlottesville, Virginia, United States
| | - Peter L. Elkin
- Department of Biomedical Informatics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, United States
| | - Oluseyi A. Fayanju
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Laura J. Fochtmann
- Department of Psychiatry, Stony Brook University, Stony Brook, New York, United States
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, United States
| | | | - John J. Hanna
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - William Hersh
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
| | - Mackenzie R. Hofford
- Division of General Medicine, Department of Medicine, Washington University in St. Louis, St Louis, Missouri, United States
| | - Jonathan D. Hron
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Sean S. Huang
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Brian R. Jackson
- Department of Pathology, University of Utah, Salt Lake City, Utah, United States
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, United States
| | - Bonnie Kaplan
- Bioethics Center, Information Society Project, Solomon Center for Health Care Policy, Yale University Center for Medical Informatics, New Haven, Connecticut, United States
| | - William Kelly
- Department of Biomedical Informatics, University at Buffalo, Buffalo, New York, United States
| | - Kyungmin Ko
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, United States
- Department of Pathology, Texas Children's Hospital, Houston, Texas, United States
| | - Ross Koppel
- Department of Medical informatics, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Department of Medical informatics, University at Buffalo, Buffalo, New York, United States
| | - Nikhil Kurapati
- Department of Family Medicine Soin Medical Center, Kettering Health, Dayton, Ohio
| | - Gabriel Labbad
- Enterprise Information Systems, Cedars Sinai, Los Angeles, California, United States
| | - Julie J. Lee
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - Christoph U. Lehmann
- Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Stefano Leitner
- Department of Hospital Medicine, University of California San Francisco, San Francisco, California, United States
| | | | - Richard J. Medford
- Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Edward R. Melnick
- Department of Emergency Medicine and Biostatistics (Health Informatics), Yale School of Medicine, New Haven, Connecticut, United States
| | - Anoop N. Muniyappa
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Sara G. Murray
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Aaron Barak Neinstein
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Victoria Nichols-Johnson
- Department of OB/Gyn (Emerita), Southern Illinois University School of Medicine, Springfield, Illinois, United States
| | - Laurie Lovett Novak
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - William Scott Ogan
- Division of Bioinformatics, Department of Medicine, University of California San Diego Health, La Jolla, California, United States
| | - Larry Ozeran
- Clinical Informatics, Inc., Yuba City, California, United States
| | - Natalie M. Pageler
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - Deepti Pandita
- Department of Medicine, Hennepin HealthCare, Minneapolis, Minnesota, United States
| | - Ajay Perumbeti
- University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, United States
| | - Carolyn Petersen
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, United States
| | - Logan Pierce
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Raghuveer Puttagunta
- Department of Internal Medicine, Geisinger Health, Danville, Pennsylvania, United States
| | - Priya Ramaswamy
- Department of Anesthesiology and Critical Care, University of California San Francisco, San Francisco, California, United States
| | - Kendall M. Rogers
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, United States
| | - S Trent Rosenbloom
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Angela Ryan
- Australasian Institute of Digital Health, Sydney, New South Wales, Australia
| | - Sameh Saleh
- Department of Biomedical and Health Informatics/Department of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Chethan Sarabu
- Department of Information Services, Penn State Health, Hershey, Pennsylvania, United States
| | - Richard Schreiber
- Department of Information Services, Penn State Health, Hershey, Pennsylvania, United States
- Department of Medicine, Penn State Health, Hershey, Pennsylvania, United States
| | - Kate A. Shaw
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, United States
| | - Ida Sim
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
- University of California San Francisco University of California Berkeley Joint Program in Computational Precision Health, University of California San Francisco and University of California Berkeley, San Francisco, California, United States
| | - S Joseph Sirintrapun
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, United States
| | - Anthony Solomonides
- Research Institute, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Jacob D. Spector
- Information Services Department, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Justin B. Starren
- Division of Health and Biomedical Informatics, Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Michelle Stoffel
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Vignesh Subbian
- College of Engineering, The University of Arizona, Tucson, Arizona, United States
| | - Karl Swanson
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Adrian Tomes
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Karen Trang
- Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Kim M. Unertl
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Jenny L. Weon
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Mary A. Whooley
- Departments of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States
- San Francisco Veterans Affairs Healthcare System, San Francisco, California, United States
| | - Kevin Wiley
- Department of Healthcare Leadership and Management, Medical University of South Carolina, Columbia, South Carolina, United States
| | - Drew F. K. Williamson
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Peter Winkelstein
- Institute for Healthcare Informatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States
| | - Jenson Wong
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, United States
| | - James Xie
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Julia K. W. Yarahuan
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Nathan Yung
- Department of Hospital Medicine, University of California San Diego Health, La Jolla, California, United States
| | - Chloe Zera
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
| | - Neda Ratanawongsa
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco Center for Vulnerable Populations, San Francisco, California, United States
| | - Shobha Sadasivaiah
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| |
Collapse
|
32
|
Avnoon N. Time for women-centred gynaecology. Nat Rev Urol 2022; 19:689-690. [PMID: 36085514 DOI: 10.1038/s41585-022-00656-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Netta Avnoon
- Department of Sociology and Anthropology, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
33
|
Casas RS, Horvath SK, Schwarz EB, Bachorik AE, Chuang CC. Managing Undesired Pregnancy After Dobbs. J Gen Intern Med 2022; 37:4272-4275. [PMID: 36220947 PMCID: PMC9553298 DOI: 10.1007/s11606-022-07833-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/26/2022] [Indexed: 01/04/2023]
Abstract
Although both medication abortion (MAB) and aspiration procedures are safe and effective, the Supreme Court decision in Dobbs v. Jackson Women's Health Organization removed federal protection of access to abortion services. Abortion access is now illegal or severely limited in many states, leading to delays in abortion care for patients in all states. In this rapidly evolving landscape, primary care physicians (PCPs) must be familiar with laws surrounding abortion care in their own and neighboring states. PCPs must also be prepared to expedite abortion care by sharing resources, obtaining testing when needed, and counseling patients about expected outcomes following abortion.
Collapse
Affiliation(s)
- Rachel S Casas
- Division of General Internal Medicine, Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, USA.
| | - Sarah K Horvath
- Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, USA
| | - Eleanor Bimla Schwarz
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco at Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, USA
| | - Alexandra E Bachorik
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, USA
| | - Cynthia C Chuang
- Division of General Internal Medicine, Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, USA
| |
Collapse
|
34
|
Samuels-Kalow ME, Agrawal P, Rodriguez G, Zeidan A, Love JS, Monette D, Lin M, Cooper RJ, Madsen TE, Dobiesz V. Post-Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians. Acad Emerg Med 2022; 29:1414-1421. [PMID: 36268814 PMCID: PMC9772035 DOI: 10.1111/acem.14609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/27/2022] [Accepted: 10/18/2022] [Indexed: 12/24/2022]
Abstract
In June 2022, the United States Supreme Court decision Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade, removing almost 50 years of precedent and enabling the imposition of a wide range of state-level restrictions on abortion access. Historical data from the United States and internationally demonstrate that the removal of safe abortion options will increase complications and the health risks to pregnant patients. Because the emergency department is a critical access point for reproductive health care, emergency clinicians must be prepared for the policy, clinical, educational, and legal implications of this change. The goal of this paper, therefore, is to describe the impact of the reversal of Roe v. Wade on health equity and reproductive justice, the provision of emergency care education and training, and the specific legal and reproductive consequences for emergency clinicians. Finally, we conclude with specific recommended policy and advocacy responses for emergency medicine clinicians.
Collapse
Affiliation(s)
- Margaret E Samuels-Kalow
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Pooja Agrawal
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Giovanni Rodriguez
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy Zeidan
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jennifer S Love
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Derek Monette
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michelle Lin
- Department of Emergency Medicine, Stanford University, Palo Alto, California, USA
| | - Richelle J Cooper
- Department of Emergency Medicine, University of California Los Angeles, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Tracy E Madsen
- Department of Emergency Medicine, Alpert Medial School of Brown University, Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Valerie Dobiesz
- Department of Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
35
|
Buchbinder M, Mishtal J, Singer EO, Wendland CL. Society for Medical Anthropology Statement on Supreme Court Dobbs v. Jackson Women's Health Organization Decision. Med Anthropol Q 2022; 36:433-441. [PMID: 36433774 PMCID: PMC10098746 DOI: 10.1111/maq.12741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This statement summarizes key findings from anthropological and related scholarship on the harmful consequences of inadequate abortion access, leading the Society for Medical Anthropology to register profound concern about the recent Supreme Court decision in Dobbs v. Jackson. After circulation to SMA members for input, a finalized version passed a membership vote by an overwhelming margin. This statement complements one produced by the Council for Anthropology and Reproduction, available here.
Collapse
Affiliation(s)
- Mara Buchbinder
- University of North Carolina at Chapel Hill, Department of Social Medicine
| | - Joanna Mishtal
- University of Central Florida, Department of Anthropology
| | | | - Claire L Wendland
- University of Wisconsin-Madison, Departments of Anthropology and Obstetrics and Gynecology
| |
Collapse
|
36
|
Weinmann AS. One degree of separation: urgent questions surrounding new USA laws in women's healthcare. Trends Immunol 2022; 43:851-854. [PMID: 36182546 DOI: 10.1016/j.it.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 01/12/2023]
Abstract
The criminalization of women's healthcare in many USA states has created uncertainty about women's access to evidence-based medical care and will affect the physical, mental, and emotional health and well-being of women. This article is intended to start a discussion on this complex topic in the immunology community.
Collapse
Affiliation(s)
- Amy S Weinmann
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA.
| |
Collapse
|
37
|
Muacevic A, Adler JR. Effects and Proposed Countermeasures of Abortion Bans and Restrictions on People With Uteruses and Society. Cureus 2022; 14:e29906. [PMID: 36348848 PMCID: PMC9632542 DOI: 10.7759/cureus.29906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
With the recent overturning of Roe V. Wade by the Supreme Court, access to abortions in many regions across the United States will become very limited as laws regarding fetal termination will be determined by state legislators rather than on a federal level. This article highlights the effects of Roe V. Wade's abolishment on individuals that can get pregnant, how unwanted pregnancies will affect society in general, and reasonable steps forward following the ban. We conducted an electronic search using PubMed, Google, and Google Scholar. The search was retrospective, and the preliminary results focused on articles about the rationale behind pregnancy termination and the overall effects of abortion and the ban. Review papers, original papers, and newspaper articles were eligible for use. Sample size and region of publication were not exclusionary criteria. Each author independently reviewed and extracted data to write up each assigned section, and group collaborations occurred to create the final draft. Out of the 93 resources reviewed, 32 sources were deemed eligible and used in this article. These resources included 23 journal articles, eight websites, and one book.. The data gathered showed that while abortions have many potential complications even when performed under regulated conditions, taking away the choice of those with a uterus is also not without consequence. The economic, familial, and societal implications should be considered moving forward as safety nets will need to be implemented for people with uterus and children involved.
Collapse
|
38
|
Wall LL. The Ghost of Savita Halappanavar Comes to America. Obstet Gynecol 2022; Publish Ahead of Print. [DOI: 10.1097/aog.0000000000004979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022]
|
39
|
Niemczyk NA, Arrington LA, Avery MD. Navigating the Changing Abortion Landscape: Implications for Midwives and Midwifery Practice. J Midwifery Womens Health 2022; 67:541-543. [DOI: 10.1111/jmwh.13411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/05/2022]
|
40
|
Coen-Sanchez K, Ebenso B, El-Mowafi IM, Berghs M, Idriss-Wheeler D, Yaya S. Repercussions of overturning Roe v. Wade for women across systems and beyond borders. Reprod Health 2022; 19:184. [PMID: 36002861 PMCID: PMC9404636 DOI: 10.1186/s12978-022-01490-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
June 24th, 2022, a day that will be etched in today and future generations’ textbooks as a historic day, the United States of America revoked the constitutional right to seek safe abortion care. Overturning Roe v Wade allowed the divided individual states to independently decide the legal parameters regarding abortion care. A decision that disproportionately effects the reproductive lives of women residing on the land of America. Given the systemic impacts of racism, neoliberalism and white supremacy, it is the Black, racialized and poor women who suffer terrible repercussions. In this commentary the authors begin by discussing the historical biopolitical perspective, colonial systems and longstanding impacts on racialized women’s bodies in America. The discussion transitions to the implications of geopolitics at play nationally and cascading impacts globally, focusing on humanitarian and emergency settings. Using a medical humanities perspective, authors highlight the collision between politics and reproductive health policy and its implications on social determinants of health, such as women’s education, employment, housing, racial and gender equity and wellbeing. Long standing advocates, community leaders and healers, leading scientists, birth attendants, doctors, nurses, allied health professionals/providers and humanitarian workers – and many others - are reminded and live the weight of the continuous battle of population control, stemming from the oppressive history of control and exploitation.
Collapse
Affiliation(s)
- Karine Coen-Sanchez
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, Canada
| | - Bassey Ebenso
- Leeds Institute Health Sciences, University of Leeds, Leeds, UK
| | | | - Maria Berghs
- Unit for the Social Study of Thalassaemia and Sickle Cell, School of Allied Health Sciences, De Montfort University, Leicester, UK
| | - Dina Idriss-Wheeler
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
| |
Collapse
|
41
|
Shuman AG, Aapro MS, Anderson B, Arbour K, Barata PC, Bardia A, Bruera E, Chabner BA, Chen H, Choy E, Conte P, Curigliano G, Dizon D, O’Reilly E, Tito Fojo A, Gelderblom H, Graubert TA, Gurtler JS, Hall E, Hirsch FR, Idbaih A, Ilson DH, Kelley M, La Vecchia C, Ludwig H, Moy B, Muss H, Opdam F, Pentz RD, Posner MR, Ross JS, Sacher A, Senan S, Soto-Perez-de-Celis E, Tanabe KK, Vermorken JB, Wehrenberg-Klee E, Bates SE. Supporting Patients with Cancer after Dobbs v. Jackson Women's Health Organization. Oncologist 2022; 27:oyac165. [PMID: 35962750 PMCID: PMC9438903 DOI: 10.1093/oncolo/oyac165] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 11/14/2022] Open
Abstract
In the context of cancer, whether or not to choose pregnancy termination represents a difficult and multifaceted decision. In this editorial, members of The Oncologist editorial team attempt to contextualize the potential implications of the recent Supreme Court decision in Dobbs v. Jackson Women’s Health Organizationfor patients with cancer.
Collapse
Affiliation(s)
| | - Matti S Aapro
- Multidisciplinary Oncology Institute (IMO), Clinique de Genolier, Genolier, Switzerland
| | | | | | | | | | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston TX, USA
| | | | - Herbert Chen
- University of Alabama-Birmingham, Birmingham, AL, USA
| | - Edwin Choy
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Don Dizon
- Brown University, Lifespan Hospital, Providence, RI, USA
| | | | | | | | | | | | - Evan Hall
- University of Washington, Seattle, WA, USA
| | | | - Ahmed Idbaih
- Hôpitaux Universitaires La Pitié-Salpêtrière, Paris, France
| | - David H Ilson
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Heinz Ludwig
- Wilhelminen Cancer Research Institute, ViennaAustria
| | - Beverly Moy
- Massachusetts General Hospital, Boston, MA, USA
| | - Hyman Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Frans Opdam
- Leiden University Medical Centre, Leiden, The Netherlands
| | - Rebecca D Pentz
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | | | | | | | - Suresh Senan
- VU University Medical Center, Amsterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
42
|
Mosley EA, Ayala S, Jah Z, Hailstorks T, Dixon Diallo D, Hernandez N, Jackson K, Hairston I, Hall KS. Community-led research for reproductive justice: Exploring the SisterLove Georgia Medication Abortion project. Front Glob Womens Health 2022; 3:969182. [PMID: 36033920 PMCID: PMC9412101 DOI: 10.3389/fgwh.2022.969182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/26/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction While reproductive injustice indicators are improving globally, they are worsening in the United States particularly for Black and other marginalized communities. Eugenics and obstetric violence against low-income and communities of color create well-founded distrust of sexual and reproductive health (SRH). Transformational, reparative ways of conducting SRH research are needed. Proposed principles of community-led research for reproductive justice Drawing on our collective experience as reproductive justice leaders, SRH researchers, and clinicians, we propose the following principles of community-led research for reproductive justice: 1) Center the marginalized community members most affected by SRH inequities as leaders of research; 2) Facilitate equitable, collaborative partnership through all phases of SRH research; 3) Honor multiple ways of knowing (experiential, cultural, empirical) for knowledge justice and cross-directional learning across the team; 4) Build on strengths (not deficits) within the community; 5) Implement the tenets of reproductive justice including structural-level analysis and the human rights framework; 6) Prioritize disseminating useful findings to community members first then to other audiences; 7) Take action to address social and reproductive injustices. SisterLove's community-led georgia medication abortion project We offer the community-led Georgia Medication Abortion (GAMA) Project by reproductive justice organization SisterLove from 2018-2022 as a case study to demonstrate these principles along with the strengths and challenges of reproductive justice research. Discussion Community-led reproductive justice research offers innovative and transformational methods for truly advancing SRH in an era of increasing policy restrictions and decreasing access to care. Yet existing funding, research administrative, and publishing systems will require structural change.
Collapse
Affiliation(s)
- Elizabeth A. Mosley
- Center for Reproductive Health Research in the Southeast (RISE), Emory University School of Public Health, Atlanta, GA, United States,*Correspondence: Elizabeth A. Mosley
| | | | - Zainab Jah
- SisterLove, Inc., Atlanta, GA, United States,National Birth Equity Collaborative, Washington, DC, United States
| | - Tiffany Hailstorks
- Center for Reproductive Health Research in the Southeast (RISE), Emory University School of Public Health, Atlanta, GA, United States,Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | | | - Natalie Hernandez
- Center for Maternal Health Equity, Morehouse School of Medicine, Atlanta, GA, United States
| | | | | | - Kelli S. Hall
- Center for Reproductive Health Research in the Southeast (RISE), Emory University School of Public Health, Atlanta, GA, United States,Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
| |
Collapse
|
43
|
Evans SB, Blitzblau RC, Chapman CH, Chollet-Lipscomb C, Deville C, Ford E, Gibbs IC, Howell K, Peters GW, Ponce SB, Seldon C, Spector-Bagdady K, Tarbell N, Terezakis S, Vyfhius MAL, Wright J, Zietman A, Jagsi R. Restricted Access to Abortion, the Dobbs Ruling, and Radiation Oncology: Standing United Against Reproductive Injustice. Int J Radiat Oncol Biol Phys 2022; 114:385-389. [PMID: 35963470 DOI: 10.1016/j.ijrobp.2022.07.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Suzanne B Evans
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut.
| | - Rachel C Blitzblau
- Department of Radiation Oncology, Duke University, Durham, North Carolina; Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington
| | | | | | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eric Ford
- Department of Radiation Oncology, University Of Washington, Seattle, Washington
| | - Iris C Gibbs
- Stanford Medicine, School of Medicine, Stanford Cancer Institute, Stanford University, Stanford, California
| | - Krisha Howell
- Department of Radiation Oncology, Fox Chase Cancer Center, Temple Health, Philadelphia, Pennsylvania
| | - Gabrielle W Peters
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Sara Beltrán Ponce
- Medical College of Wisconsin Department of Radiation Oncology, Milwaukee, Wisconsin
| | - Crystal Seldon
- Department of Radiation Oncology, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - Kayte Spector-Bagdady
- Center for Bioethics & Social Sciences in Medicine and the Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Nancy Tarbell
- Department of Radiation Oncology, Harvard Medical School and Mass General Hospital, Boston, Massachusetts
| | - Stephanie Terezakis
- University of Minnesota, Department of Radiation Oncology, Minneapolis, Minnesota
| | - Melissa A L Vyfhius
- University of Maryland School of Medicine, Chesapeake Oncology and Hematology Associates, Department of Radiation Oncology, Glen Burnie, Maryland
| | - Jean Wright
- Department of Radiation Oncology, University Of Washington, Seattle, Washington
| | - Anthony Zietman
- Department of Radiation Oncology, Harvard Medical School and Mass General Hospital, Boston, Massachusetts
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, Michigan
| |
Collapse
|
44
|
Affiliation(s)
- Whitney Arey
- From the Texas Policy Evaluation Project, Population Research Center (W.A., K.L., A.B., K.W.), the Department of Women's Health, Dell Medical School (L.H.), the Steve Hicks School of Social Work (K.W.), and the Department of Sociology (K.W.), University of Texas at Austin, Austin, the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston (A.B.), and the Pegasus Health Justice Center, Dallas (G.M.)
| | - Klaira Lerma
- From the Texas Policy Evaluation Project, Population Research Center (W.A., K.L., A.B., K.W.), the Department of Women's Health, Dell Medical School (L.H.), the Steve Hicks School of Social Work (K.W.), and the Department of Sociology (K.W.), University of Texas at Austin, Austin, the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston (A.B.), and the Pegasus Health Justice Center, Dallas (G.M.)
| | - Anitra Beasley
- From the Texas Policy Evaluation Project, Population Research Center (W.A., K.L., A.B., K.W.), the Department of Women's Health, Dell Medical School (L.H.), the Steve Hicks School of Social Work (K.W.), and the Department of Sociology (K.W.), University of Texas at Austin, Austin, the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston (A.B.), and the Pegasus Health Justice Center, Dallas (G.M.)
| | - Lorie Harper
- From the Texas Policy Evaluation Project, Population Research Center (W.A., K.L., A.B., K.W.), the Department of Women's Health, Dell Medical School (L.H.), the Steve Hicks School of Social Work (K.W.), and the Department of Sociology (K.W.), University of Texas at Austin, Austin, the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston (A.B.), and the Pegasus Health Justice Center, Dallas (G.M.)
| | - Ghazaleh Moayedi
- From the Texas Policy Evaluation Project, Population Research Center (W.A., K.L., A.B., K.W.), the Department of Women's Health, Dell Medical School (L.H.), the Steve Hicks School of Social Work (K.W.), and the Department of Sociology (K.W.), University of Texas at Austin, Austin, the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston (A.B.), and the Pegasus Health Justice Center, Dallas (G.M.)
| | - Kari White
- From the Texas Policy Evaluation Project, Population Research Center (W.A., K.L., A.B., K.W.), the Department of Women's Health, Dell Medical School (L.H.), the Steve Hicks School of Social Work (K.W.), and the Department of Sociology (K.W.), University of Texas at Austin, Austin, the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston (A.B.), and the Pegasus Health Justice Center, Dallas (G.M.)
| |
Collapse
|
45
|
Gilbert AL. Why I Will Not Boycott Complex Family Planning Board Certification. Obstet Gynecol 2022; 140:141-142. [DOI: 10.1097/aog.0000000000004881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
46
|
Traub AM, Mermin-Bunnell K, Pareek P, Williams S, Connell NB, Kawwass JF, Cwiak C. The implications of overturning Roe v. Wade on medical education and future physicians. Lancet Reg Health Am 2022; 14:100334. [PMID: 36777391 PMCID: PMC9904004 DOI: 10.1016/j.lana.2022.100334] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Ariana M. Traub
- Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA,Corresponding author.
| | | | - Priyasha Pareek
- Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Sonya Williams
- Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Natalie B. Connell
- Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Jennifer F. Kawwass
- Emory Reproductive Center, Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, 550 Peachtree St. NE, Atlanta, GA 30308, USA
| | - Carrie Cwiak
- Division of Family Planning, Department of Gynecology and Obstetrics, Emory University School of Medicine, 550 Peachtree St. NE, Atlanta, GA 30308, USA
| |
Collapse
|
47
|
Abstract
The Supreme Court removed a federal right to abortion access in June 2022. This returned the legality of abortion to each of the 50 states. This will have a profound impact on the provision of prenatal care in general and prenatal genetic screening and testing.
Collapse
Affiliation(s)
- Megan A Allyse
- Program in Biomedical Ethics and Department of Obstetrics and Gynecology, Mayo Clinic, Jacksonville, FL, USA.
| | - Marsha Michie
- Department of Bioethics, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
48
|
Landau R, Burgart AM, Sutton CD. Loss of access to legal abortion in America: history, implications, and action items for anesthesiologists. Anaesth Crit Care Pain Med 2022; 41:101125. [PMID: 35803575 DOI: 10.1016/j.accpm.2022.101125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Ruth Landau
- Virginia Apgar Professor of Anesthesiology, Department of Anesthesiology, Columbia University Irving Medical Center, New York, New York, USA.
| | - Alyssa M Burgart
- Clinical Associate Professor, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford Center for Biomedical Ethics, Stanford University School of Medicine, California, USA
| | - Caitlin D Sutton
- Assistant Professor in Anesthesiology, Department of Pediatric Anesthesiology, Perioperative, and Pain Medicine, Division of Maternal-Fetal Anesthesia, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
49
|
Affiliation(s)
- Anna Kheyfets
- MOTHER Lab, Tufts University School of Medicine, Boston, MA 02111, USA.
| | - Brenna Miller
- MOTHER Lab, Tufts University School of Medicine, Boston, MA 02111, USA
| | | |
Collapse
|
50
|
Nambiar A, Patel S, Santiago-Munoz P, Spong CY, Nelson DB. Maternal morbidity and fetal outcomes among pregnant women at 22 weeks’ gestation or less with complications in two Texas hospitals after legislation on abortion. Am J Obstet Gynecol 2022; 227:648-650.e1. [DOI: 10.1016/j.ajog.2022.06.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022]
|