Individuals seeking abortion must be afforded privacy, dignity, respect, and support

Individuals seeking abortion must be afforded privacy, dignity, respect, and support

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“Freedom cannot be achieved unless women have been emancipated from all kinds of oppression.”- Nelson Mandela

The Supreme Court of the United States (SCOTUS) reverses its own constitutional precedents on rare occasions. Between 1789 to 2020, there were 25,544 Supreme Court opinions and judgments after oral arguments, and the court reversed only 145 times.

The court has changed its mind only when it thought past precedent was unworkable or no longer viable, or it got it wrong in the past, or by changing social conditions.  Examples of reversal of decision indicate Supreme Court’s practice of law keeping abreast with evolving science.

For example, in Stanford v. Kentucky, 492 U.S. 361 (1989), the court sanctioned the imposition of the death penalty on offenders who were at least 16 years of age at the time of the crime; however, in Roper v. Simmons, 543 U.S. 551 (2005), the court held that it is unconstitutional to impose capital punishment for crimes committed while under the age of 18, citing a body of sociological and scientific research that showed that juveniles have a lack of maturity and sense of responsibility compared to adults.

Likewise, in Penry v. Lynaugh, 492 U.S. 302 (1989), the court sanctioned the death penalty for intellectually disabled offenders and then in Atkins v. Virginia, 536 U.S. 304 (2002), the court ruled that executing people with intellectual disability violated the Eighth Amendment‘s ban on cruel and unusual punishment, noting that although the intellectually disabled can know the difference between right and wrong, deficits in their adaptive functioning means that they have a lesser ability to learn from experience, engage in logical reasoning, and understand the reactions of others.

However, the SCOTUS’ recent holding in Dobbs v. Jackson Women’s Health Organization, eliminating a constitutional right to an abortion, which saw reversal of Roe v. Wade, indicates a divorce between the evidence-based practice of law and the evidence-based practice of medicine.

Various medical organizations, including the American Medical Association (AMA), the American College of Obstetricians and Gynecologists (ACOG), and the American Psychiatric Association (APA) recognize the right to privacy and freedom of choice when it comes to a female making decisions regarding pregnancy.

The AMA recognizes that health care, including reproductive health services like contraception and abortion, is a human right, opposes limitations on access to evidence-based reproductive health services, including fertility treatments, contraception and abortion and any effort to undermine the basic medical principle that clinical assessments, such as viability of the pregnancy and safety of the pregnant person, are determinations to be made only by health care professionals with their patients, and supports shared decision-making between patients and their physicians regarding reproductive health.

The ACOG advocates to improve access to full-spectrum reproductive services, to integrate abortion as a component of mainstream medical care, and to oppose and overturn efforts restricting access to abortion.  The ACOG also supports every person’s right to decide whether to have children, the number and spacing of children, and to have the information, education, and access to health services to make these decisions.

Individuals seeking abortion must be afforded privacy, dignity, respect, and support, and should be able to make their medical decisions without undue interference by outside parties.  The APA has held the position for decades that abortion is a medical procedure for which physicians should respect the patient’s right to freedom of choice.

Further, APA opposes all constitutional amendments, legislation, and regulations curtailing family planning and abortion services to any segment of the population.

Laws restricting women’s access to safe and legal abortion services does not result in fewer abortions, instead, it compels women to risk their lives and health by seeking out unsafe abortion care.  Large longitudinal and international studies have found that obtaining a wanted abortion is not detrimental to mental health.  On the contrary, research shows people who are denied abortions have worse physical and mental health, as well as worse economic outcomes than those who seek and receive them.

Besides the physical and mental health benefits, safe and legal abortion has also shown to have financial benefits.  Women of nearly all races and ethnicities face higher rates of poverty than their male counterparts.  Three out of four women who receive an abortion are considered poor or low income.

In a brief to the SCOTUS, one hundred fifty-four economists wrote that access to legal abortion has led to women attaining higher levels of education and professional occupation and lower rates of children in poverty.  Poverty is a strong reinforcing factor in the accumulation of adverse childhood experiences (ACEs) and subsequent toxic stress correlated with unfavorable health outcomes in adulthood.

The SCOTUS proclaiming that the constitution does not confer right to an abortion, threatens the progress we have collectively made as a society.  A female’s right to freedom of choice related to pregnancy has been hijacked by the Dobbs’ ruling.  The ruling seems much more in sync with the gender apartheid promoted by the Taliban.

It makes me wonder whether our society solely encapsulates elimination of the gender pay gap as the only criteria defining gender parity.  As per the new law, the two most important people, that is the patient and the physician will be on lowermost end of the totem pole.

With the USSC making decisions pertaining to sexual activity between consenting adults, such as in Bowers v. Hardwick, 478 U.S. 186 (1986) and its reversal in Lawrence v. Texas539 U.S. 558 (2003), upholding the constitutionality of sodomy laws, it would be interesting to see what ruling the court comes up with, if presented with a case related to sexual or gender equality.

1973 was a pivotal year, both from a female’s reproductive rights and sexual orientation standpoint.  During that year, the USSC ruled in Roe v. Wade and the APA made a diagnostic revision which marked the beginning of the end of organized medicine’s official participation in the social stigmatization of homosexuality.  Similar shifts gradually took place in the international mental health community as well and in 1990, the World Health Organization removed homosexuality per se from the International Classification of Diseases.

Time only will tell whether the SCOTUS will make decisions compatible with the evolving standards of decency that mark the progress of a maturing society, akin to what it does in capital cases, when cases concerning sexual or gender equality come before it.

About The Author

Shobhit Negi MD

shobhitnegi@yahoo.com

Shobhit Negi, MD is a board certified child and adolescent, adult, and forensic psychiatrist from Baltimore.

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