Later this month, the U.S. Supreme Court will engage in oral arguments in the case U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine.
A ruling in favor of Alliance for Hippocratic Medicine, an organization of anti-abortion activists backed by the Christian right-wing lobbying group Alliance Defending Freedom, could result in eliminating access to mifepristone, one of the two drugs used in the recommended medication abortion regimen. Specifically, it would restrict telehealth access to mifepristone, in a time when telehealth abortions are growing in popularity even in abortion ban states. It would also prohibit the option to receive it by mail, and shorten the timeframe which it could be used in pregnancy from 10 to 7 weeks. This won’t just impact those living in states where abortions are nearly or completely banned, but those living in states where abortion care remains legal.
As the nation once again gears up to witness reproductive rights debates among the highest court, doctors tell Salon it’s time for the public debate to be centered around how restricting access to abortion care is limiting patient autonomy. It’s problematic in and of itself that post-Dobbs women across the country have had to prove themselves “worthy” to have access to abortions, a situation that will only be exacerbated if the U.S. Supreme Court limits access to mifepristone.
“Patients should not need to prostrate themselves to the courts, to hospital ethics boards, to the media to prove their worthiness to access health care,” Dr. Amelia Huntsberger, who previously worked as an obstetrician-gynecologist in Idaho, and relocated to Oregon, told Salon. “I'm so grateful for the patients who have done this because their stories matter and are moving the dial, but I'm outraged that they have had to expose themselves in these ways.”
There is a reason, Huntsberger said, that healthcare privacy laws exist.
Want more health and science stories in your inbox? Subscribe to Salon's weekly newsletter Lab Notes.
“HIPAA wouldn't exist if there wasn't general agreement that a patient's health care decisions and records are private and warrant protection,” she added.
“I'm so grateful for the patients who have done this because their stories matter and are moving the dial, but I'm outraged that they have had to expose themselves in these ways.”
As Huntsberger said, since the U.S. Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade, which provided Americans with a constitutional right to access abortion, women across the country have had to beg for access to abortion care in very public ways. Last year, a Texas woman named Kate Cox made headlines when she asked a trial court for permission to terminate her unviable pregnancy. Initially her request was granted, but quickly the permission was rescinded. Eventually, she was forced to travel out of state to terminate her pregnancy.
Texas has banned abortions after six weeks of pregnancy. While there’s an exception for threats to the mother’s life, her situation — which was a fatal genetic abnormality in her fetus that would kill it in utero or shortly after birth — wasn’t deemed worthy enough. Several women in Texas are currently part of a lawsuit suing the state saying they were unable to access the care they needed for their pregnancies.
Currently, 14 states have enacted abortion bans since Dobbs. A few of these states have “exceptions," such as for rape or incest, but some require stipulations such as victims must first report the rape to law enforcement. But medical providers say these exceptions conflict with a patient’s basic right to make decisions about their medical care.
“We shouldn't need to say, ‘even in a situation of rape or incest or an exception for the health of the mother.’ It's unnecessary,” Dr. Jen Ashton, a board certified OB/GYN and chief medical correspondent for Good Morning America, told Salon. “Every woman's situation is different, and every woman is entitled to patient autonomy.”
Patient autonomy is a key principle in medicine that recognizes the rights of patients to make their own healthcare decisions. This is precisely why many people call what’s happening with abortion care access in the U.S. a “human rights crisis.”
“Every woman's situation is different, and every woman is entitled to patient autonomy.”
In a report published by Human Rights Watch in April 2023, the organization said that by overturning constitutional protection for access to abortion, the U.S. was “in violation of its obligations under international law.”
“These human rights obligations include, but are not limited to, the rights to: life; health; privacy; liberty and security of person; to be free from torture and other cruel, inhuman, or degrading treatment or punishment; freedom of thought, conscience, and religion or belief; equality and non-discrimination; and to seek, receive, and impart information,” the organization stated.
Ashton added that in the U.S., especially when it comes to healthcare, there is a tendency in the U.S. to “make everything a competition.” This frequently applies to determining which situation is more important in terms of needing an abortion.
“As an OBGYN, it's not for me to pass judgment on any patient and the decision they make for themselves,” Ashton said. “It's my job to educate them and to inform them of their medical options and their facts, that's it.”
Dr. Alison Edelman, professor and OB/GYN at Oregon Health and Science University, told Salon she agrees abortion restrictions are a “human rights violation.” She added there are many reasons a person might need access to abortion care, and the reasoning behind it should never influence whether a person can access it.
We need your help to stay independent
According to a 2013 study that analyzed the reasons people seek abortions in the U.S., 40 percent of people mentioned a financial reason; more than one-third cited reasons relating to timing. Another 31 percent of the study’s participants said they didn’t have a stable relationship with their partner. In discussions around abortion, Edelman said, there is often a stronger focus on the “good abortion,” where an abortion is needed because of a terrible situation versus say the reason could simply be wrong timing. The “good abortion story,” as in the medically necessary kind, can bring people into the conversation at a “different level,” Edelman said.
“But people need to be able to choose the right healthcare for themselves and people have a reason that is important to them, and that's true of any healthcare management decision,” she said. “To make that decision for somebody else, it restricts their autonomy.”
As far as how the country can stop deeming one abortion more “worthy” than another, Edelman said when it comes to policy change, people need to make an impact by voting.
“The challenge right now is these laws have nothing to do with healthcare, it’s a social agenda,” she said,'' she said. “It's going to take everybody getting out and voting to make the change happen; it’s going to be incredibly important to make our voices be heard.”
Shares