what is the news: Doctors and pharmacists unite to raise concerns about opaque state laws that could interfere with patients’ access to medically necessary medications and hinder physicians and pharmacists from using their professional judgment.
Patients can “lose access to care and suffer irreparable harm” as “physicians, pharmacists and other healthcare professionals face a bewildering legal landscape due to unclear state laws, confusing language and unknown implementation by regulatory and enforcement agencies,” after a decision US Supreme Court in Dobbs vs Women’s Health Jackson This summer, says a joint statement by the AMA, the American Pharmacists Association, the American Society of Health System Pharmacists, and the National Association of Community Pharmacists.
Find out why there is a file Dobbs judgment An attack on reproductive health and safe medical practices.
Why is it important: Some members of these organizations and their patients have already reported that the uncertainty surrounding state policy is disrupting care as patients experience delays or denial of medically necessary medications.
For example, there are reports that:
- Legal counsel advised in some health systems and hospitals, which are tasked with reducing legal exposure, not to provide some drugs because they prioritize caution over access to drugs.
- Leaders in some organizations have removed emergency contraception — which are not an abortion factor — from the tools used in the care of sexual assault survivors because they believe the legal risk is too unclear.
- Some pharmacies have put in place policies that require pharmacists to refuse certain prescriptions unless they meet onerous new administrative procedures. For example, the pharmacist must confirm the patient’s diagnosis with the prescriber for each potential abortion, even if the drug has multiple uses.
Doctors and pharmacists are raising concerns because more than half of the states in the country have already, or are expected to, severely restrict patients’ access to abortion services. Many laws include language that prohibits the description and dispensing of “abortion-inducing drugs” or other similar terms.
The vague language of laws often makes it unclear whether health professionals are prohibited from prescribing or dispensing drugs only when the purpose of abortion is, or whether the drug is strictly prohibited regardless of the purpose of prescribing or dispensing it.
For example, methotrexate may be used off-label to terminate an intrauterine pregnancy. But it is often used as a first-line treatment for inflammatory diseases such as arthritis. Likewise, mifepristone can be used to terminate a pregnancy, but there are many other reasons a doctor may prescribe medication in a medical emergency, such as treating an ectopic pregnancy, preeclampsia, and conditions during labor and delivery. It can also be used to medically manage an abortion.
The joint statement of the AMA and pharmacy organizations calls for “clear guidance from state boards of medicine and pharmacy, agencies, and policy makers” that support the prescription and distribution of medically necessary drugs that could be called into question under the legal and regulatory model that Dobbs created.
“Without access to medicines that are proven to be safe and effective, the health of our patients is at risk. As clinicians and pharmacists, we view patient well-being as paramount and are deeply concerned about disruption to the continuity of care,” the joint statement says.
“We call on state policy makers to ensure through guidance, law or regulation that patient care is not disrupted and that physicians and pharmacists are free to continue the practice of medicine and pharmacy without fear of professional punishment or liability. We strongly urge medical and pharmacy boards, agencies and policy makers in state to act To help ensure our patients maintain continuity of care and our members clearly understand their legal and licensing obligations.”
Learn more: With abortion under attack, Doctors push to criminalize care. That includes in the courts, such as fighting a bid in Arizona Restoration of the Abortion Act of 1901 criminalizing medicine.
Also read how Doctors support continued access to medical abortion Nationwide, read about the AMA reproductive health certificate Before Congress from the President of the AMA Jack Resnick, MD.
Dr. Resnick was among the doctors cited in this article The New York Times material check Effect Dobbs decision about health care. Reporter Kate Zernick wrote of doctors who “say that criminalizing abortion is changing the way they treat women arriving in emergency rooms and on labor and delivery floors with desirable but complex pregnancies”.