A new law went into effect in South Dakota this past July that represents a serious infringement on the right of patients and their physicians to do what they think is best for the patient. The law concerns abortion, an incendiary topic. I’m not writing here to debate the rightness or wrongness of abortion; for one thing, in my experience such a discussion never changes anyone’s mind and often becomes vitriolic. Rather, I’m writing to bring attention to what I see as a precedent dangerous to good medical care.
The background to this law is that abortion opponents, stymied by several Supreme Court decisions, most notably Roe v. Wade, have over the years tried various roundabout techniques on the state level to limit severely or even prevent abortion. These measures take the form of making it more difficult for a woman to obtain an abortion. The South Dakota law follows this pattern.
The law mandates that the physician hand a woman seeking an abortion a lengthy written document. The precise language of this document is decreed by the state legislature, and the woman must sign each page of it. However you feel about abortion, the key problem here is that a legislative body is, in effect, practicing medicine. The language of the statement is not medical, it is political. Any reasonable person realizes that the principal intent of the law is to reduce (or even eliminate) the number of abortions in South Dakota.
My concern is that, if this practice is allowed, there is nothing to stop legislatures (or Congress) from passing similar laws about any medical situation they wish. From my perspective as a pediatric intensivist, I’m most concerned about intrusion into the wrenching end-of-life discussions all intensivists from time to time have with families, but in theory such laws could be about anything. Several constitutional scholars note that the law probably violates physicians’ first amendment rights to free speech.
You can read the precise language contained in the statement, as well as more about the controversy here.
Sachin on 