Physicians and medical student leaders from all corners of medicine have adopted policies critical to ensuring access to reproductive health care and preventing government interference in the practice of medicine.
The action came at the AMA’s 2022 midterm meeting, the first time the House of Delegates met since the U.S. Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Org (PDF). This court decision, along with subsequent state action, is an assault 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.
“As Dobbs decision, health care in the United States has been thrown into chaos, with life-and-death decisions left to hospital attorneys, patients needing care moved across state lines, and uncertainty about the future of access to reproductive health care,” said the president of AMA Jack Resneck Jr., Ph.D.
“The AMA strongly opposes government interference in the practice of medicine, especially for established, medically necessary treatments,” added Dr. Resneck, a practicing dermatologist and health policy expert in the San Francisco Bay Area. “Patients and doctors need assurances that they will not be charged with crimes for medically necessary treatment. Unfortunately, this is a post-Dobbs world we face now. The fact that medically necessary treatment can be criminalized speaks volumes for these flawed abortion laws.
“Physicians and other health care professionals must try to comply with vague, restrictive, complex and conflicting state laws that interfere with the practice of medicine,” noted Dr. Resneck. “These new policies will help the AMA continue our advocacy and protect physicians in the legislature and the courts.”
The AMA 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 doctors and patients are not held civilly or criminally liable in cases where pregnancy loss results from medically necessary care.
Recent changes in abortion laws have led to confusion, prompting payers, pharmacies and doctors’ offices to restrict the use of medically necessary treatments — even in states where abortion is legal. Pharmacists opposed filling the required drugs on the grounds that they could be misused to terminate a pregnancy and could face criminal charges.
Learn more in Dr. Resneck’s powerful AMA Leadership Perspectives column, “What I Told Congress About Reproductive Health.”
The AMA Principles of Medical Ethics have long recognized that when the letter of the law precludes urgently needed care, physicians should be free to act in accordance with their best professional judgment.
The House of Delegates amended the ethics guidelines to clarify this principle in the context of abortion, expressly allowing physicians to perform abortions in accordance with good medical practice.
“Caught between good medicine and bad law, doctors struggle to fulfill their ethical obligations to the health and well-being of patients while trying to come to terms with reckless government interference in the practice of medicine that endangers the health of our patients,” e -r , said Resnek.
“In exceptional circumstances, the profession’s ethical guidelines support physician behavior that is on the side of patient safety and health, recognizing that this may conflict with legal restrictions that limit access to abortion or reproductive care,” he said.
The action clarifies the AMA’s ethical guidelines on abortion and is consistent with established AMA policies opposing government interference in the patient-physician relationship as inconsistent with the proper exercise of professional judgment and the fiduciary duty of physicians to protect the welfare of patients.
Physicians and medical students also directed the AMA to provide support, including legal support as appropriate, and to develop policies, strategies, and resources to help physicians navigate between ethical obligations and legal requirements.
Check out the AMA Code of medical ethicsand read about Dr. Resneck’s speech at the opening session of the midterm meeting, in which he discussed empowering physicians to put patients first.
To ensure broad and equitable access to the abortion services required by the newly enacted 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 that simple,” said Dr. Resnek. “It is unrealistic to expect patients, especially those covered by Medicaid, to shoulder the cost of abortions. Our new policy is a roadmap for improving access and equity to ensure patients get the healthcare they need.
Visit AMA Advocacy in Action to learn more about what’s at stake in reproductive health advocacy and other advocacy priorities the AMA is actively working on.
Although the Accreditation Council for Graduate Medical Education (ACGME) requires access to abortion training for all OB/GYN residents, nearly 45% of accredited programs are in states that have or are likely to ban abortion. The newly adopted policy directs the AMA to ensure that medical students and residents maintain access to abortion education. Specifically, the AMA will advocate for the availability of abortion training and clinical exposure to medication and procedural abortions.
The AMA will also advocate for funding for institutions that provide clinical training in reproductive health services—including medication and procedural abortion—to medical students and resident and fellow physicians from other programs so that they can expand their capacity to admit physicians. out-of-state-in-training who seek that training.
Under the new policy, the AMA will maintain pathways for medical students and resident and fellow physicians to receive training in medication and procedural abortions elsewhere in the event that training is restricted or illegal at a home institution.
Before the Dobbs in a decision in June, the House of Delegates adopted a policy to reject the criminalization of caregiving.
Read on for other highlights from the 2022 AMA Midterm Meeting.