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Tuesday, October 3, 2023

The real threat to reproductive rights is your medical record

The recent Republican debate has thrust abortion rights back into the national spotlight. Several candidates, including former Vice President Mike Pence, said they would institute a federal abortion ban if elected. As a family physician, I find myself deeply troubled by this, as it threatens the privacy and wellbeing of the patients we vow to protect.

In my practice, I strive to uphold the principle of “do no harm.” But this foundational tenet of medicine becomes challenging to navigate when a woman’s right to make decisions about her own body is overshadowed by a mosaic of state legislations.

Consider, for a moment, the disparities in abortion legislation across the United States. States like Alabama and Georgia have garnered national attention for passing highly restrictive abortion laws. Alabama’s legislation, in particular, stands out as one of the strictest in the nation, criminalizing the procedure with very few exceptions, such as when the mother’s life is in jeopardy or if the fetus has a lethal anomaly. Contrast this with states like New York and California, which have taken proactive measures to protect and even expand reproductive rights.

This stark divergence in state legislations means that a procedure deemed medically necessary and entirely legal in one state could lead to criminal charges in another.

With all the progress around national health data sharing, medical records are no longer confined within state borders. HIPAA permits medical records to be exchanged without patient consent when physicians have a treatment purpose for that data. Records are frequently shared across state lines, especially when patients relocate or seek specialized care in another state.

With the current patchwork of reproductive care laws, a woman’s medical history, which should remain a private matter between her and her health care providers, could inadvertently become a tool for incrimination.

It’s not beyond the realm of possibility for a woman who has undergone a legal medical procedure in New York to later face legal challenges in Alabama simply because her medical records indicate she had an abortion. This potential scenario underscores the inherent dangers of allowing health care to become a political pawn.

If the Republican candidates’ stance on reproductive rights, as showcased in the debate, translates into national policy, the ramifications could be profound and far-reaching. We could find ourselves in a nation where women’s rights and health care provisions vary so drastically from one state to another that it becomes a logistical and ethical nightmare. Such inconsistency not only erodes the very essence of medical ethics but also places women in an incredibly vulnerable position, especially when their medical records become accessible across state boundaries.

Furthermore, the emotional and psychological toll on women cannot be understated. The fear of potential legal repercussions, combined with the stigma often associated with abortion, can lead to significant mental health challenges. Women may be deterred from seeking essential medical care or be hesitant to share their full medical history with healthcare providers, further jeopardizing their overall health. As someone who’s played a role in standing up national data sharing networks across the U.S., I feel strongly that shared data should be used to enhance patient understanding and outcomes — not put women, or any patient, at risk.

The discourse on abortion rights during the Republican debate serves as a stark and urgent reminder of the complexities and challenges surrounding reproductive health in the United States. I implore our political leaders to prioritize evidence-based care, patient autonomy, and the sanctity of the doctor-patient relationship over divisive politics. The health, rights and dignity of women across our nation deserve nothing less.

Steven Lane, MD, MPH, is chief medical officer of Health Gorilla.c

Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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