By Katie Gu
The American Medical Association (AMA) recently adopted new policies aimed at protecting access to reproductive health care and reducing government interference in medical practice. As the nation’s most prominent professional medical association, the AMA’s unified stance brings a stronger physician-led voice in reproductive health care advocacy in the aftermath of Dobbs v. Jackson Women’s Health Care Organization.
Convening nearly 200 medical societies within the U.S., the AMA is the nation’s largest association for physicians and medical students. By “representing physicians with a unified voice in courts and legislative bodies,” the organization advances policies that help improve the practice of medicine and public health. The AMA is governed by a House of Delegates (HOD), in addition to executive management and a board of trustees. As the legislative and policy-making body of the AMA, the HOD identifies pressing health policy issues impacting patients and physicians.
In November, the AMA HOD convened for the first time since Dobbs at the 2022 Interim Meeting. The Meeting addressed the clinical challenges of navigating the post-Dobbs landscape of abortion laws. As announced by AMA President Dr. Jack Resneck Jr., MD, the AMA has now adopted key policies to combat the “vague, restrictive, complex and conflicting state laws that interfere in the practice of medicine” in the context of reproductive care. These policies were also informed by critical perspectives from the 14-member delegation in attendance from the American College of Obstetricians and Gynecologists (ACOG).
The AMA’s newly-adopted policies take a multi-pronged approach towards advancing its principle that reproductive care is health care. The policies fall under three primary categories: 1) opposing government intervention in the patient-physician relationship and criminal charges against doctors for providing medically-necessary abortions; 2) advocating for abortion protections and physician resources; 3) ensuring access to abortion training for obstetrics and gynecology residents.
First, the AMA updated its Principles of Medical Ethics to clarify that government intrusion into the patient-physician relationships is “contrary to the appropriate exercise of professional judgment and physicians’ fiduciary obligation to protect patients’ well-being.” Specifically, the updated AMA Ethical Guidelines expressly permit physicians to perform abortions in keeping with good medical practice.
States have now imposed new reporting requirements on physicians to document and/or disclose health data of patients seeking abortion care. Law enforcement can now obtain easy access to sensitive health data through a subpoena or court order. While the Health Insurance Portability and Accountability Act (HIPAA) usually prohibits physicians from disclosing identifiable health information, the law creates an exception that permits, but does not require, physicians to disclose such data for law enforcement purposes. As a result, physicians are now caught in a patchwork of obligations created under state law, HIPAA, medical ethics, and professional duties and obligations. The AMA’s new policies signal the association’s efforts to provide assurances and protections for physicians providing and patients receiving medically necessary treatments.
Amid the uncertain future of access to reproductive care, the AMA has signaled a strong commitment to “oppose governmental interference in the practice of medicine, especially for well-established, medically necessary treatments,” said Dr. Resneck. To that end, the AMA has pledged to provide legal support to physicians and medical students navigating the fault lines between ethical duties and post-Dobbs legal requirements. The association also has urged lawmakers to codify legal protections for physicians providing abortion services.
Further, the AMA’s new policies aim to protect both abortion coverage and training. The AMA plans to engage public and private insurers, public health programs, and lawmakers to ensure access to medically necessary reproductive care. As 45% of accredited graduate medical programs are in states that have either already banned abortion or are likely to do so, the AMA has pledged to support continued access to abortion training. In states with abortion bans, the AMA will support opportunities for medical students and residents to pursue medication and procedural abortion training at another institution. To support hospitals and academic centers accepting out-of-state trainees, the AMA plans to advocate for additional funding for clinical training on reproductive health care.
Historically, the AMA has played a pivotal role in abortion’s legality. In 1859, the association adopted an official anti-abortion policy, lending support to movements to criminalize abortion. In 2022, the AMA is now fighting against the criminalization of reproductive care. The association’s newly-adopted policies add necessary momentum to the future of physician-led advocacy in the aftermath of Dobbs.