Dual Loyalty | Reproductive Justice

Abortion is health care, and abortion rights are human rights that must be guaranteed without discrimination. The right to reproductive autonomy and health is essential for individuals to survive, thrive, and live with dignity.  

Despite a clear trend of growing recognition of abortion rights in laws around the world, sexual and reproductive rights remain under attack in many places. Where countries criminalize abortion, they are effectively criminalizing pregnancy and subjecting pregnant individuals and their health care providers to risks of surveillance, harassment, arrests, and incarceration.  

In the United States, the Supreme Court’s rollback of the right to abortion in June 2022 has led to widespread violations of human rights. These impacts have been disproportionately felt by Black, indigenous, and low-income and rural women, who already face significant criminalization and discrimination in accessing health care.  On March 2, 2023, PHR and more than 190 organizations and individuals, including health practitioners and human rights experts, sent a letter to United Nations experts in response to the United States Supreme Court decision that repealed the constitutional right to abortion. Read the press release here.

The right to reproductive autonomy and health is essential for individuals to survive, thrive, and live with dignity.  

Resources 

Criminalized Care: How Louisiana’s Abortion Bans Endanger Patients and Clinicians

In March 2024 PHR and partners published Criminalized Care: How Louisiana’s Abortion Bans Endanger Patients and Clinicians documenting how Louisiana has been one of the most aggressive U.S. states in enacting and enforcing legal bans on abortion since the Dobbs ruling in June 2022. Our new report shows that Louisiana’s abortion bans deny basic human rights, violate federal law meant to protect patients, disregard evidence-based medical standards, and cause serious public health harm. The report was jointly published by Lift Louisiana, Physicians for Human Rights, Reproductive Health Impact, and the Center for Reproductive Rights.

In Clinicians’ Own Words: How Abortion Bans Impede Emergency Medical Treatment for Pregnant Patients in Idaho

In March 2024, PHR published In Clinicians’ Own Words: How Abortion Bans Impede Emergency Medical Treatment for Pregnant Patients in Idaho, a fact-finding brief documenting how Idaho’s abortion bans have impeded the provision of care required under the Emergency Medical Treatment & Labor Act (EMTALA). The brief recounts interviews with nine physicians who describe delays in pregnant Idahoans receiving the recommended standard of care, including, in some cases, as a result of the necessity of being transferred to out-of-state facilities, which resulted in increased morbidity among these patients.

Accessing Emergency Obstetrics Information as a Prospective Prenatal Patient in Post-Roe Oklahoma

In April 2023 PHR and partners published No One Could Say: Accessing Emergency Obstetrics Information as a Prospective Prenatal Patient in Post-Roe Oklahoma which highlights how the state’s abortion bans fuel confusion about clinicians’ ability to provide abortion care to save a pregnant patient’s life during obstetric emergencies without punishment. The report – the first study of its kind – was jointly published by Physicians for Human Rights (PHR), Oklahoma Call for Reproductive Justice (OCRJ), and the Center for Reproductive Rights (CRR).

Our Approach  

PHR works in solidarity with reproductive justice and rights partners around the United States in building a stronger, more inclusive, and human rights-based framework for abortion rights. We undertake research into the harms of criminalization of abortion in the United States on pregnant individuals, health care workers, and communities. PHR works to empower clinicians and advocates to speak out against the human rights violations occurring under these draconian laws. 

Dual Loyalty 

The criminalization of abortion creates a world where health care workers are being called upon to deviate from established medical standards, contravene medical ethics, and contribute directly to violations of their patients’ human rights. In the face of abortion restrictions, clinicians find themselves in the untenable situation of choosing between following anti-abortion laws or fulfilling their medical ethics to deliver impartial, evidence-based health care.  

This predicament is known as dual loyalty: a situation where clinicians find their obligations to their patients in direct conflict with their obligations to a third party, whether a state, health system, employer, or other entity that holds authority over them. All too often, such situations call on providers to violate patients’ human rights by violating bodily autonomy, denying necessary health care, or causing pain and suffering. 

In March 2024, PHR filed an amicus curiae brief in Idaho v. United States documenting how Idaho’s abortion ban dangerously overrides U.S. government protections in the Emergency Medical Treatment & Labor Act (EMTALA), which requires that health facilities offer stabilizing treatment – including pregnancy termination – when clinically indicated to preserve the health of a pregnant patient. Read the press release here.

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