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Rough Draft: Legal and ethical issues regarding Roe V. Wade overturn Dennise Sutton West Coast University HA 500: Legal and Ethical Issues in Health Care Management Susan Vellek October 15 th , 2023

Rough Draft: Legal and ethical issues regarding Roe V. Wade overturn Overturning Roe v. Wade has elicited apprehension as to legal perspectives, ethical concerns, and interprofessional issues that may arise in modern times regarding abortion. In this case, the court ruled that the right to privacy, as inferred from the 14th Amendment, safeguarded abortion as a fundamental right. Even so, the government maintained the authority to regulate or limit access to abortion based on the stage of pregnancy. The Dobbs v. Jackson Women's Health Organization case, ruled by the Supreme Court, reversed the federal security of access to abortion determined in the Roe v. Wade case. This ruling poses a threat to the physical and psychological well-being of numerous expectant individuals and their families. Furthermore, it carries significant implications for medical education and will fundamentally alter the knowledge, abilities, and quality of care that will be provided by future medical practitioners. Under Dobbs , 70.77% of the 129,295 US medical students will have their training restricted by state laws: 66,088 (51.11%) in states with highly restrictive abortion bans and 25,412 (19.65%) in states with a mix of restrictions and protections. Only 37,795 (29.23%) medical students will train in protected states. (Traub et al., 2022) The Roe case has traditionally been perceived by the public as primarily addressing the issue of abortion. However, considering the recent Dobbs decision, concerns have arisen regarding the broader implications of Roe on other non-abortion rights. The decision of whether to have a child and the timing of such a decision is a deeply personal matter that is made by the woman or person capable of becoming pregnant, in consultation with their trusted medical provider, as well as their spouses or partners, as they see fit. For the past five decades, this decision has afforded women and individuals capable of becoming pregnant the autonomy to determine the fate of their own bodies. Although they may still have some access to the

necessary healthcare, it is likely that there will be forthcoming restrictions in the months and years ahead, as individual states gain the authority to determine which healthcare services and procedures are permissible. Ethics refers to the boundaries and regulations that individuals choose to abide by, which are frequently influenced by their surroundings and traditions. These principles and moral standards serve as a compass for our conduct and determine whether we are deemed virtuous or immoral. In the healthcare industry, ethics assume a pivotal role in guaranteeing that healthcare professionals make well-informed decisions while administering treatment to patients and clients. This guarantees that the highest quality of care is provided, irrespective of cultural disparities, and that all patients receive equal treatment. Legality and ethics both consist of the practice of setting a form of standards/rules that we are required to abide by in society. It is common in the healthcare industry that the two may conflict with one another; Meaning, the legal duties of a healthcare professional may become incongruous with their ethical values at some point in time. There is often considerable overlap in the conduct governed by morality and that governed by law. Laws are created to set boundaries for societal behavior. They are enforced to ensure that the expected behavior happens. (Pozgar, 2020, 4). Kirchner article “Legal challenges for family physicians” illuminate on legal issues and challenges that are currently taking places due to the overturn of Roe V. Wade. Kirchner shares with the audience that The Supreme Court ruled that there is no constitutional protection for abortion, overturning the precedents established in Roe v Wade and Planned Parenthood v Casey and enabling states to restrict or ban abortion with preexisting laws or new legislation. Kirchner argues that the Dobbs ruling has led to confusion about abortion rights, risks, information dissemination, and funding for reproductive health care, causing a public health crisis. She supports her argument with

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statistics that state health policy analysts predict 26 states will ban abortion, with many unenforceable laws remaining active after the 1973 Roe v Wade decision. In all, she expands on how it has become a struggle for physicians to harmonize the law when their medical expertise’s and moral values. There are numerous ethical concerns that are to arise out of the overturn, including a significant increase in the maternal mortality rate in the United States. It is already well- established that the United States faces challenges with women dying from complications related to pregnancy at a rate nearly four times higher than that of other countries. Overturning, there will be sizable spikes in the populations of people belonging to ethnic minorities. The alterations in the legislation would make the fulfillment of moral obligations more arduous. In many instances, healthcare providers may be required to provide an abortion to a patient to meet their ethical obligations, which could potentially subject them to criminal and financial penalties in certain states. Determining how to fulfill ethical obligations while also upholding the law will now be a complex task, as it is exceedingly difficult to ascertain the permissible actions when treating pregnant women facing various emergencies. Ethics plays a pivotal role in the healthcare industry, enabling professionals to effectively communicate with patients and their families. Establishing a code of ethics fosters an environment of compassionate care that benefits patients, their loved ones, and healthcare providers alike. The practice of establishing standards or rules that must be followed in society is common to both legality and ethics. In the healthcare industry, conflicts may arise between these two concepts, as the legal obligations of healthcare professionals may at times be inconsistent with their ethical values. There is often a significant overlap between the behaviors governed by morality and those governed by law. Laws are created to set boundaries for societal behavior.

They are enforced to ensure that the expected behavior happens. (Pozgar, 2020, 4). It is the responsibility of everyone to adhere to their own ethical and moral principles. Healthcare ethics are of utmost importance, as workers must be able to identify healthcare dilemmas and make sound judgments and decisions while complying with applicable laws. It is essential for these professionals to feel regulated and guided in their practices to ensure competence and integrity. Physicians are guided by regulations pertaining to medical ethics, which serve to safeguard them from legal repercussions. In certain instances, it may become imperative to contravene these ethical principles to safeguard the public or as mandated by a court of law. Additionally, these principles aid in the resolution of ethical quandaries and conflicts. The difficulty arises when it comes to ethical decision-making in the medical world due to there being a “fine line dividing the good from the bad or the evil and in situations when there is a difference of opinion on what is morally permissible and what is not. Undoubtedly, in our society, the good and the evil exist side by side.” (Juneja, n.d.). The intricate correlation between attitudes towards abortion and the Roe v. Wade ruling is evident, however, recent surveys have provided distinct and conclusive findings. In William Galston article “Roe v. Was overturn despite public opinion” he states between 25% and 35% of Americans think that abortion should always be legal, 10% to 15% think it should never be legal, and the remaining 50% to 65% are split between those who think that it should be mostly legal with some exceptions and mostly illegal but with exceptions. Abortions should be allowed in cases where the life or health of the mother is at risk, the fetus has serious birth defects that would result in a shortened or non-existent lifespan, or if the pregnancy is due to rape or incest. According to a majority of the public, abortion should be allowed . In contrast, there is a majority of opposition to abortion when a married woman does not wish to have additional children, a

unmarried woman is unwilling to marry the father, or a family's financial situation renders it impossible to provide for another child. Nonetheless, there exists a dearth of agreement among Americans concerning the admissibility of terminating pregnancies in cases where the offspring would be delivered with substantial physical or mental impairments, albeit not necessarily ones that pose a threat to life. Where Interprofessional-ism is concerned, Interprofessional education refers to the process of learning where two or more professions, including students, residents, and healthcare professionals, acquire knowledge from, about, and alongside each other. This approach fosters successful collaboration and enhances patient outcomes. Health professions students from diverse fields are equipped with the necessary skills through interprofessional education to function effectively in a cooperative, team-oriented environment and provide exceptional patient- and population-centered care. Interprofessional teams enhance patient care, reduce costs, shorten hospital stays, and reduce medical errors. When health professionals work together as a cohesive team, communicate efficiently, and understand each other's roles and responsibilities, patients receive safer and higher-quality care. Where the Dobbs v. Jackson case is concerned, Dobbs impairs medical students’ ability to learn and provide safe, evidence-based clinical care to patients. Medical school teaches us pathophysiology, anatomy, and ethical clinical decision making, equipping us with a foundation to provide factual, ethical counselling for patients to make decisions about their own health. In addition to unintended pregnancy, abortion is medically indicated for pregnancy complications including placental abruption, infection, ectopic pregnancy, and eclampsia. The same medications and surgical techniques utilized for abortion also treat obstetric complications; students without abortion training will be limited in the skills necessary to manage these. Rates and severity of complications from unsafe abortion attempts

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will increase where abortion access is limited, and physicians in these regions will not be trained in their treatment. Without adequate education, long-term quality of reproductive healthcare in the U.S. will deteriorate. (Traub et al., 2022) Medical schools have a responsibility to provide comprehensive education to their students on all aspects of healthcare, including the topic of abortion. The lack of such an education can result in the dissemination of misconceptions and misunderstandings concerning individuals who seek abortion services. If students are unable to witness abortion procedures, inaccurate beliefs regarding the practice may propagate, thereby intensifying the marginalization of those who choose abortion to enhance their well-being. As a result, this can lead to the emergence of polarized discourse, which poses a significant disadvantage to a field that relies heavily on collaborative and team-centered care. Abortion is essentially a medical procedure that should be available to patients as a choice during shared decision-making discussions with their healthcare providers. However, legislative interference has hindered this right. Medical education must include instruction on abortion if it is to equip aspiring doctors with the knowledge and abilities, they will need to uphold the dignity of the relationship between patients and physicians, make clinical recommendations that are medically accurate, and manage every aspect of necessary healthcare. It is imperative that educators and students collaborate to ensure that abortion courses are developed by all medical institutions to diminish the potential adverse consequences for patients seeking dependable and impartial pregnancy-related care in the wake of the Dobbs V. Jackson Women’s Health Organization case.

References Giubilini, A., Schuklenk, U., Minerva, F., & Savulescu, J. (2023). Conscientious commitment, professional obligations and abortion provision after the reversal of roe v wade. Journal of Medical Ethics, (20230208): Jme-2022-108731. https://doi.org/10.1136/jme-2022- 108731 Juneja, P. (n.d.). Difficulties in Ethical Decision Making. MSG Management Study Guide. https://www.managementstudyguide.com/difficulties-in-ethical-decision-making.htm Kirchner, E. (2023). Legal challenges for family physicians in the post-roe v wade era. American Family Physician, 107(4), 344–347. Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). Burlington, MA: Jones & Bartlett Learning. Traub, A., Mermin-Bunnell, K., Pareek, P., Williams, S., Connell, N., & Kawwass, J. (2022, July 20). The implications of overturning. The LANCET . https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(22)00151-X/fulltext

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