Consulting lawyers a new norm for some emergency physicians post Roe

In states with strict abortion bans, physicians are consulting lawyers to help determine whether an abortion is legally justified when patients arrive at emergency rooms with severe pregnancy complications, The New York Times reported Sept. 10.

Abortion was considered the standard of care in certain medical situations during the 50 years of Roe v. Wade. Now, state laws — some of which come with years of prison time if violated —  are generally vague and confusing to navigate in places where the procedure is criminalized. This has placed the onus on healthcare providers to "think like lawyers" and decide whether a condition is life-threatening enough to proceed with an abortion. 

When patients arrive at the ER with ectopic pregnancies, miscarriages or hemorrhaghing, emergency physicians in states with abortion bans must now consider key legal questions such as, "Do we wait until the fetus is definitely dead, or is mostly dead good enough?'" Alison Haddock, MD, emergency physician in Houston and chair of the board of the American College of Emergency Physicians, told the Times. "If they're telling us to wait for the condition to be fully emergent, how much bleeding is too much?"

"A lot of us go into emergency medicine because of the imperative to take care of every patient — the person without housing and a CEO — and we're really proud of that ethical obligation to say, 'Here's the patient in front of me and I'm going to do everything I can for them,'" she said. 

Now, "We're no longer basing our judgment on the clinical needs of a woman, we're basing it on what we understand the legal situation to be," Dr. Haddock said. "Having to consult a lawyer in an emergent situation is a whole new ballgame." 

Some hospitals are now organizing task forces to help physicians comply with their state laws and specify which emergencies and complications justify an aboriton, the Times reports. A task force at an Arizona hospital recommends having a lawyer on call so physicians can consult them when needed, and some Texas hospitals have adopted policies that require one or two additional physicians to review the decision before procedding with an abortion. 

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