The Occasional Perspective - 7/6/22

Thoughts in the Moment…

Upending Health Care – Among all of the issues facing health care, the U.S. Supreme Court added to the list by eliminating a 50-year standing policy established in 1973 through the federal right to abortion. The policy was upended by the Supreme Court’s ruling stating that the prior long-standing policy was an error. It’s clear that this historic decision is going to have major consequences across the healthcare community. In case you missed it, here are some of the perspectives issued by various healthcare organizations, companies, and government officials in response the change in law related to abortion access.

  • American Hospital Association: "We expect that today's decision will have practical impacts on hospitals and health systems, including on healthcare provided across state lines, EMTALA obligations, maternal healthcare, the clinician-patient relationship, medical education and access to care for individuals regardless of socioeconomic status. We are committed to helping our member hospitals and health systems navigate the evolving landscape consistent with AHA's mission of advancing the health of all individuals and communities." (news release)
  • American Medical Association: "The American Medical Association is deeply disturbed by the U.S. Supreme Court's decision to overturn nearly a half century of precedent protecting patients' right to critical reproductive healthcare—representing an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship, and a brazen violation of patients' rights to evidence-based reproductive health services. States that end legal abortion will not end abortion—they will end safe abortion, risking devastating consequences, including patients' lives. …We will always have physicians' backs and defend the practice of medicine, we will fight to protect the patient-physician relationship, and we will oppose any law or regulation that compromises or criminalizes patient access to safe, evidence-based medical care, including abortion. As the health of millions of patients hangs in the balance, this is a fight we will not give up." (news release) kudos to Jack Resneck, Jr., AMA President
  • American Nurses Association: "Nurses have an ethical obligation to safeguard the right to privacy for individuals, families and communities, allowing for decision making that is based on full information without coercion. As the largest group of healthcare professionals, nurses have for decades assisted their patients with weighing the benefits, burdens and available options, including the choice of no treatment, when discussing sexual health issues and pregnancy. ANA firmly believes that no nurse should be subject to punitive or judicial processes for upholding their ethical obligations to their patients and profession." (news release)
  • Federation of American Hospitals: "FAH members remain committed to providing the best possible care to every patient who comes through our doors, while at the same time complying with state and local laws and regulations." (news release) hmmmmm…
  • America's Essential Hospitals: "This decision could inspire policies that result in an uneven distribution of providers across states, greater disparities in maternal health, and conflicts between state and federal laws. For example, providers might face concerns about how to reconcile state restrictions with their obligations under federal law to stabilize and treat emergency department patients. A chilling effect on physician training and shortages of obstetrician-gynecologists in some states also could follow this ruling. We urge policymakers to carefully consider their actions in the wake of this ruling and reject policies that would restrict healthcare access, undercut medical decision-making, and put patient care and health at risk." (news release) good thoughts for action…
  • American College of Obstetricians and Gynecologists: "Today's decision is a direct blow to bodily autonomy, reproductive health, patient safety and health equity in the United States. Reversing the constitutional protection for safe, legal abortion established by the Supreme Court nearly 50 years ago exposes pregnant people to arbitrary, state-based restrictions, regulations and bans that will leave many people unable to access needed medical care. The restrictions put forth are not based on science nor medicine; they allow unrelated third parties to make decisions that rightfully and ethically should be made only by individuals and their physicians. ACOG condemns this devastating decision, which will allow state governments to prevent women from living with autonomy over their bodies and their decisions." – Dr. Iffath Hoskins, president (news release)
  • National Nurses United: "Registered nurses understand that abortion is a basic healthcare service, and as a union of healthcare providers dedicated to advocating for the best interests of our patients, National Nurses United opposes any efforts to restrict our patients' control and choices over their own healthcare and their own bodies. The basic tenets of ethical medical care dictate that patients should enjoy autonomy, self-determination and dignity over their bodies, their lives, and the healthcare they receive. Singling out this exception, the right to end a pregnancy, that targets only people with reproductive capacity, is not only bad health policy, it is immoral, discriminatory, misogynist, violent, unacceptable and violates the nursing ethics we nurses pledge to uphold." (news release) – if it’s not obvious already, I agree!!
  • National League for Nursing: "With multiple states poised to legislate to eliminate or severely restrict abortion access and potentially hold abortion providers criminally liable, the result will inevitably be a patchwork of laws that will disproportionately negatively impact people of color and those on the economic margins of society, including rural Americans who already travel great distances for medical care." (news release)
  • ServiceEmployees International Union: "As a direct result of this ruling, more women will be forced to choose between paying their rent or traveling long distances to receive safe abortion care. Working women are already struggling in poverty-wage jobs without paid leave and many are also shouldering the caregiving responsibilities for their families, typically unpaid. This radical decision will impact all of us, especially those who already face barriers to accessing healthcare because of structural racism, sexism and corporate greed. Without the ability to determine whether and when to have children, essential workers serving their communities as child care providers, home care workers, healthcare workers, janitors and fast food workers can't hope to join the middle class." (news release)

And, If That Was Not Enough – In a separate – but, equally significant health care issue – the U.S. Supreme Court struck down by a vote of 6 – 3 the century old State of New York limits on who may carry guns in public. The majority opinion was issued by Justice Clarence Thomas which stated that the constitutionality of restrictions is historically “settled” in certain “sensitive places” such as legislatures, courtrooms and polling locations, and that “modern regulations” may “prohibit” the carry of firearms in “new” places. However, an across-the-board prohibition is not an acceptable public policy. Therefore, the states will be required to create a list of “sensitive” places where guns may not be carried. At the same time, the majority opinion did not provide any guidance although during the oral arguments, a number of justices asked questions about areas like public transportationcrowded venuesuniversity campuses or where alcohol is served. Justice Brett Kavanaugh and Chief Justice John Roberts in a concurring opinion noted that states could still enact rigorous requirements for public carry permits such as stringent background, mental health record reviews and requirements for completion of training courses.

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