Abortion, Conscientious Practice, Drug Testing in Pregnancy

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Abortion, Conscientious Practice, Drug Testing in
Pregnancy

• Karen Adams, MD
• Martin Donohoe, MD

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Conscientious Practice
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• Do providers have a medical or ethical
  responsibility to refer patients for legal,
  medically sound options that they are personally
  opposed to or unwilling to offer?

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• The advice of the health care provider is always
  very influential to patients making their
  decisions, because it is seen to be based on
  medical science.
• Given that a providers stance on abortion may be
  intrinsically more based on personal viewpoints
  of 'when life begins' as a belief rather than
  scientific fact, should a practitioner advise
  their patient of their personal stance and its
  influence on their decision before launching into
  the discussion of a patient's options?

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• Social policy and law recognize a fetus as having
  moral standing, hence the law that allows for
  charging a person responsible for the death of a
  pregnant women with two counts of homicide.
• Social policy and law also recognize potential.
  Namely, if you cause an injury that reduces the
  future potential of an individual, you are liable
  for damages. A fetus is obviously not capable of
  independent life till at least the 24th week of
  gestation but it has the potential for autonomy
  from the moment of conception.

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• Society and the law also provide protections for
  individuals without the ability to care for
  themselves or live independently,i.e. the
  mentally ill, individuals with physical or mental
  disability, the elderly and infirm, and patients
  medically determined incompetent.
• Is it reasonable to believe that a fetus might
  deserve the same protections society offers to
  individuals who can not see to their own
  interests?

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• The government has weighed in many times on what
  information government funded and independent
  providers must provide or must not provide.  Do
  you think that these provisions are a good thing?
• Is there a significant difference between this
  and standard of care practice which require the
  disclosure/discussion of certain facts and risks
  prior to any procedure?

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Barriers to Abortion
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Barriers to Abortion

• Epidemiology
• Legal point of viability
• Costs and coverage
• Limited availability of mifepristone

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• Legal barriers
• State/federal laws
• Parental notification laws
• TRAP laws
• Refusal clauses
• Fetal rights
• Partial birth abortion ban
• Biased counseling laws

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Barriers to Abortion

• Provider availability
• Harassment of patients and providers
• Pseudoscience and ideology over science
• Sex ed
• EC
• Effects of US policy on abortion worldwide

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Drug Testing in Pregnancy
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Drug Testing in Pregnancy

• Drug use in pregnancy
• Charleston Policy
• Potential solutions
• Related issues of privacy, drug use and testing,
  physicians as agents of the state, moral and
  legal dilemmas

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Contact Information

• Public Health and Social Justice Website
• http//www.phsj.org
• martindonohoe_at_phsj.org