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Abortion, Conscientious
Practice, Drug Testing in
Pregnancy
Karen Adams, MD
Martin Donohoe, MD
Conscientious Practice

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?


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 provider’s 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?

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.

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?

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?
Barriers to Abortion
Barriers to Abortion




Epidemiology
Legal point of viability
Costs and coverage
Limited availability of mifepristone

Legal barriers







State/federal laws
Parental notification laws
TRAP laws
Refusal clauses
“Fetal rights”
“Partial birth abortion” ban
Biased counseling laws
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
Drug Testing in Pregnancy
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
Contact Information
Public Health and Social Justice
Website
http://www.phsj.org
[email protected]