POST-ABORTION EMERGENCY DEPARTMENT ETHICS: POST-ROE v.WADE
Supporting, not reporting: emergency department ethics in a post-Roe eraby Katie Watson, Maureen Paul, Susan Yanow, Jay Baruch New England Journal of Medicine 2022;387:10, 8 September 2022 DOI: 10.1056/NEJMp2209312 A woman in Texas went to an emergency department (ED) for help. Seeking reassurance about symptoms she was having, she shared intimate details about her life with health care workers she had never met and had a pelvic exam. In response, hospital staff reportedly called the authorities. A grand jury indicted the patient for murder for allegedly self-managing an abortion, and on April 7, 2022, she was arrested and jailed. The ethical and legal obligations related to confidentiality, privacy, and duty of care that ED staff embrace apply to patients who have had, or attempted to have, an abortion — which we believe is especially urgent to affirm, now that the right to abortion is no longer protected by Roe v. Wade. Between 2000 and 2020, there were at least 61 instances of people being arrested or criminally investigated for allegedly self-managing an abortion or helping someone else do so, according to a report from the organization If/When/How. One third of these cases were brought to law enforcement’s attention by health care providers. This article asks: How can we prevent EDs, which are the health care safety net for underserved and marginalized people in the United States, from becoming a dragnet? And in the rare situations in which ethical duties conflict with the law, what should ED clinicians do?