The AMA stands by the principle: Reproductive care is health care

Leaders of physicians and medical students from all walks of medicine have adopted key policies to ensure access to reproductive health care and prevent government interference in the practice of medicine.

The actions took place during the 2022 AMA interim meeting, the first time the House of Delegates has met since the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Care Organization (PDF). This court ruling, and subsequent actions at the state level, represent an attack on reproductive health and safe medical practice.

At the meeting, delegates adopted policies opposing the criminalization of pregnancy loss resulting from medically necessary care, supporting expanded access to abortion care and more.

” Since Dobbs decision, health care in the United States has been thrown into chaos, with life or death decisions being left to hospital lawyers, patients needing care crossing state lines and uncertainty over the future of access to reproductive health care,” said the AMA President. Jack Resneck Jr., MD.

“The AMA strongly opposes government interference in the practice of medicine, especially for well-established medically necessary treatments,” added Dr. Resneck, a practicing dermatologist and health care policy expert from the region. of San Francisco Bay. “Patients and doctors need assurances that they will not be charged with crimes for medically necessary treatment. Unfortunately, it’s the after-Dobbs world we now face. The fact that medically necessary treatment can be criminalized speaks volumes about these flawed abortion laws.

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“Physicians and other medical professionals must attempt to comply with vague, restrictive, complex, and conflicting state laws that interfere with the practice of medicine,” Dr. Resneck noted. “These new policies will help the AMA continue its advocacy and defend doctors before legislatures and courts.”

WADA will oppose criminal charges against patients or physicians when pregnancy loss results from medically necessary treatment for cancer and other illnesses. The AMA will also advocate that physicians and patients not be held civilly or criminally liable in cases where pregnancy loss results from medically necessary care.

Recent changes in abortion laws have caused confusion that has prompted payers, pharmacies and medical practices to restrict the use of medically necessary treatments, even in states where abortion is legal. Pharmacists have resisted refilling needed drugs on the grounds that they could be used off-label for pregnancy termination and could face criminal charges.

Learn more in Dr. Resneck’s powerful AMA Leadership Viewpoints column, “What I Told Congress About Reproductive Health.”

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The AMA’s Principles of Medical Ethics have long recognized that where the letter of the law excludes urgent care, physicians must be given the latitude to act in accordance with their best professional judgment.

The House of Delegates amended the Ethical Guidelines to clarify this principle in the context of abortion, expressly allowing doctors to perform abortions in accordance with good medical practice.

“Caught between good medicine and bad law, physicians struggle to fulfill their ethical duties to the health and well-being of patients, while trying to comply with reckless government interference in the practice of medicine that is dangerous to the health of our patients,” said Dr. Resneck.

“In extraordinary circumstances, the profession’s ethical guidelines support the conduct of physicians who side with the safety and health of their patients, recognizing that this may conflict with legal constraints that limit access to abortion or reproductive care,” he said.

The action clarifies the AMA’s ethical guidelines on abortion and aligns with established AMA policies opposing government intrusion into patient-physician relationships as contrary to the proper exercise of the professional judgment and the fiduciary duty of physicians to protect the welfare of patients.

Physicians and medical students also asked the AMA to provide support, including legal support where needed, and to develop policies, strategies and resources to help physicians navigate duties. ethical and legal requirements.

Discover the WADA Code of medical ethicsand read Dr. Resneck’s speech at the opening session of the interim meeting where he discussed empowering physicians to put patients first.

To ensure broad and equitable access to abortion services required by the recently adopted policy, the AMA will advocate for public health programs and private insurers to cover these services. The AMA will also urge lawmakers to codify legal protections for doctors who provide abortion services.

“Reproductive care is health care. It’s as simple as that,” Dr. Resneck said. “To expect patients, especially those covered by Medicaid, to bear the cost of abortion services is unrealistic. Our new policy is a roadmap for improving access and equity to ensure patients get the health care they need.

Visit AMA Advocacy in Action to learn more about reproductive health protection issues and other advocacy priorities that AMA is actively working on.

Although the Accreditation Council for Higher Medical Education (ACGME) requires access to abortion education for all obstetrics and gynecology residents, nearly 45% of accredited programs are in states that prohibit or are likely to prohibit abortion. The recently adopted policy directs the AMA to ensure that medical students and residents retain access to abortion education. Specifically, the AMA will advocate for the availability of abortion education and clinical exposure to medication and procedural abortion.

The AMA will also advocate for funding of institutions that provide clinical training in reproductive health services – including medications and procedural abortion – to medical students and medical residents and colleagues from other programs so that they can expand their ability to accept doctors from out of state. in training who seek this training.

Under the new policy, the AMA will support pathways for medical students and medical residents and colleagues to obtain medication and procedural abortion training at another location in the event that such training is limited or illegal in a home institution.

In front of Dobbs ruling in June, the House of Delegates passed a policy to push back against the criminalization of care.

Check out other highlights from the 2022 AMA Interim Meeting.