life or law: healthcare in an abortion-ban era

a pro & con opinion essay on the current challenge healthcare providers face when approached with a duty to care and a duty to follow the law.

Jul 03, 2025

Section 1: The Background

With around 73 million induced abortions taking place worldwide every year, it is estimated that 45% of them are unsafe (World Health Organization, 2024). As abortion bans rise steadily in states following the overturning of Roe v. Wade, women are finding it difficult to access quality healthcare in times of emergencies. Some are denied care due to their state’s restrictive laws, others have to wait for tests and time to pass before being operated on, and many travel out of state to avoid criminalization. The consequences of inaccessibility to care pose great risks to maternal health (Center for Reproductive Rights, 2023). When a woman has no other option but to seek help in a dire situation, healthcare providers are faced with an ethical dilemma: the conflict between obeying state laws and providing the duty of care to a patient.

Three years post-ban, cases involving preventable maternal deaths are coming to light. A recent incident reviewed by Georgia’s maternal mortality committee showcases the ethical struggle dilemma of healthcare workers. In 2022, Amber Thurman, a 28-year-old medical assistant, was faced with complications after traveling to North Carolina for mifepristone pills. After being sent to a hospital, she was diagnosed with a septic abortion. The standard procedure was a dilation and cutterage (D&C), which was prohibited in Georgia. Overnight, her blood pressure dipped, she was at risk of bleeding out, and after more than 20 hours of delay the doctors operated. The D&C was performed, but Amber did not survive due to low blood flow. The maternal mortality committee recently deemed Amber’s death preventable, saying the hospital’s delay in performing the D&C had a large impact on her outcome (Surana, 2024).

Critical situations like Amber’s are becoming more prevalent as state bans tighten. Some healthcare providers are afraid to operate certain procedures given the ambiguous language of the law and possible punishments. Laws are established to be followed, ensuring justice is properly served. As citizens, doctors are not exempt from the law and could face legal consequences for performing procedures deemed illegal (Giubilini et al., 2023). However, within the medical field are professional standards of conduct that have guided the practice for centuries. Providers hold steadfast in the belief that patients are owed a duty of care under their medical obligations. Appendix A of the American Medical Association Principles of Medical Ethics defines the principle objective of the medical profession as rendering service to humanity with full respect, service, and devotion. In an emergency, he or she will render service to the best of their ability (Riddick Jr, 2003).

The complex relationship between legal obligations and duty of care to a patient creates a muddy perspective on healthcare emergencies that this essay seeks to clarify. In relation to ambiguous abortion laws, which place strong restrictions on a provider’s duty to care, there may be legal repercussions if a procedure is completed without meeting precise conditions (Fla. Stat. 390). However, the critical conditions of a patient can vary, making it difficult to apply the law. Failing to act in an effort to follow the law and seek out care only in severe circumstances could delay the possible saving of a life. This tension between life and law must be examined through an ethical lens, with a focus on analyzing legal implications and the professional expectations of a healthcare provider.

The landscape of the medical field is ever-changing as new powers arise and modern practices replace the old. While abortion may be legally banned, there will always remain a need for care. Patients will find ways to access pills or procedures, possibly in an illegal manner, that can result in an urgent call for help. In these moments when intervention is necessary, a doctor will be faced with an ethical dilemma and must consider what truly matters: the life on the operating table or the law in the books.

Section 2: Choosing Life

Healthcare professionals should act in accordance with medical standards rather than legal restrictions when facing an emergency that could lead to patient damages. Under torts law, medical professionals are held under a reasonably prudent person standard of care to protect life and prevent harm. The Restatement (Second) of Torts § 299A describes how “one who undertakes to render services in the practice of a profession or trade is required to exercise the skill and knowledge normally possessed by members of that profession.” (Restatement (Second) of Torts, 1965). By following the standards and skills normally possessed by members of the healthcare community, doctors can avoid medical malpractice suits and damages on behalf of the patient (Schechter, 2012).

Tarasoff v. Regents of the University of California is a landmark case in torts law concerning the conflict between care and law. While not highlighting abortion specifically, its ruling showcases how duty of care can take precedence even in instances of restriction. In Tarasoff, the plaintiff’s parents claimed that psychiatrists at Cowell Memorial Hospital at the University of California had a duty to warn their daughter of death threats made by their patient, Prosenjit Poddar. The psychiatrists, because of legal restrictions concerning patient confidentiality, asserted they had no duty of care to a third party. After Tatiana Tarasoff’s death, the jury contended that the defendants owed a duty to exercise reasonable care to her (Tarasoff, 1976). Following the thought process of this precedent, the duty of care requires patient’s lives to be examined in a way that avoids harm, regardless of the law in place. By following this duty in abortion emergencies, professionals adhere to their standards and protect themselves against liabilities.

Ignoring the duty of care can lead to preventable deaths and health complications in vulnerable communities. Maternal mortality rates are significantly higher in regard to black women in the United States. It is estimated that in the U.S., the abortion rate among black individuals is 27.1 per 1,000 compared to 10 per 1,000 for white individuals. With these communities living in states with some of the most restrictive abortion policies, an even more dangerous threat is made as they are 2-4 times more likely to experience maternal mortality than white individuals (Kheyfets et al., 2024). The legal restrictions increase the barrier between providers and patients who may not be able to afford care due to travel expenses and utilize unsafe methods to abort.

With the overturning of Roe, there is a lack of abortion education and training for providers. 17% of medical schools in the U.S. do not formally teach abortion, and there was a 10.5% decrease in OBGYN applicants compared to previous application cycles in 2022-2023 (Orgera et al., 2023). With the expertise of obstetrical care declining, there are heightened impacts on marginalized communities that may be in isolated rural regions. These areas already lack the resources necessary to care. With no skills to treat a patient in an emergency, doctors will succumb to the legal restrictions rather than fight for a patient they have limited ability to treat. If doctors adhere to the duty of care over legal impositions by educating themselves on abortion care, they can mitigate disparities in maternal mortalities.

Healthcare providers should prioritize patient autonomy and the fundamental right to receive medical treatment in emergencies. Patient autonomy is one of the most sacred rights protected by the common law in the Fourteenth Amendment of the Constitution. In healthcare, it involves recognizing the right of a patient to make their own decisions (Pozgar, 2014). If doctors do not prioritize autonomy, a patient is denied a right they should be guaranteed. This is enforced further by the Patient Self-Determination Act of 1990, which ensures patients are informed of their rights to accept or refuse medical care. Both autonomy and this act highlight the constitutional right to make healthcare decisions (Pozgar, 2014). The laws prohibiting abortion contradict the laws that give rights to a patient, especially in emergencies when abortion care is necessary for the life of a mother. It brings to question the issue of trust in healthcare providers. If patients cannot be guaranteed safety in a time of peril, they may feel uncomfortable to turn to hospitals to provide care. By prioritizing the patient’s autonomy and duty of care, doctors honor the fundamental rights of humans.

The Emergency Medical Treatment and Active Labor Act (EMTALA) enforces emergency care regardless of restrictions. EMTALA was passed by Congress in 1986 to provide standardized regulatory rights in response to medical emergencies in the United States. The act requires emergency rooms to provide stabilizing treatment to patients who come in with an emergency medical condition. One of the definitions of an emergency medical condition is “placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy” (42 U.S.C. § 1395dd, 1986). The Supreme Court has not affirmed a pregnant woman’s right to emergency care post-Roe, which has left it to the hands of the states.

Idaho and Moyle, et al. v. United States is a recent case appealed to the U.S. Supreme Court by politicians who wanted to set EMTALA aside and put doctors in jail for providing abortion care in emergencies. This has heightened the worry of providers who do not want to face the risk of state prosecution. Yet the sword is double-edged. Even if providers adhere to state abortion bans and deny care in emergencies, the act of denial could put them at risk for federal sanctions in violation of EMTALA (Idaho and Moyle, et al., 2024). Due to the principles of providing this care regardless of barriers, physicians should uphold their duty to the patient.

Section 3: Choosing Law

Following the law ensures that patients are provided with standard and consistent healthcare. Laws play a fundamental role in establishing objective guidelines for citizens, especially professionals who have patients' lives in their hands. Healthcare compliance is the continuous process of adhering to local, state, and federal healthcare laws to prohibit fraud or abuse in the healthcare industry (Nelson, 2022). Regulating healthcare will ensure priority of patient safety, cost-effectiveness, and access to care (Pozgar, 2014). Ignoring the law and providing inconsistent medical practices and healthcare compliance removes the objectivity of patient care.

Healthcare compliance has led to the regulation of several facets of patient care. An example is the Health Insurance Portability and Accountability Act (HIPAA). HIPAA was enacted in 1996 to provide a clear mandate to protect patient medical information from intrusion by third parties uninvolved in their care (Polzar, 2014). In a case example from the U.S. Department of Health and Human Services, a hospital employee failed to meet the minimum necessary requirements when leaving a telephone message to a patient’s family regarding her treatment plan. New procedures were implemented, directing future employees on what type of confidential information could be given in a voicemail to prevent HIPAA violations (U.S. Department of Health and Human Services, 2008). This case highlights how subjective decision-making can disrupt legal protocols in the healthcare field. Regarding reproductive healthcare and emergency treatment, strict adherence to the law would ensure there is no subjectivity and patients are provided consistent care.

Adhering to the law will protect the life of an unborn child. When the Supreme Court ruled on Dobbs v. Jackson Women’s Health Organization in 2022, states were allowed to enforce laws protecting fetal life (Dobbs, 2022). The Unborn Victims of Violence Act of 2004, also known as Laci and Conner’s Law, created a separate offense for killing or injuring an unborn child. It defines the term ‘unborn child’ as “a child in utero, a member of the species homo sapiens, at any state of development, who is carried in the womb” (H.R. 1997, 2004). Since the reversal of Roe, 38 states have established fetal homicide laws for pregnancy loss (Pregnancy Justice, 2023). These laws have implications for healthcare providers, adding a new duty of care: the unborn child.

Healthcare practitioners are not only balancing the life of a mother but of an unborn child as well. This unborn child, now a second patient, is owed justice of the law. Pemberton v. Tallahassee Memorial Regional Center is an example of case law establishing precedent for fetal rights. In Pemberton, the plaintiff made arrangements to deliver her baby through vaginal birth at home, not wanting a cesarean. After over a day of labor and fluid complications, she went to the emergency room, where the board-certified obstetricians determined that a cesarean was medically necessary. A judge went to the hospital and ordered Ms. Pemberton to stay, as a vaginal birth would pose a substantial risk of uterine rupture and kill the baby (Pemberton, 1999). This case exemplifies that by adhering to the laws, healthcare providers can protect unborn children who deserve to be treated as patients in need of care.

If laws are bypassed in certain circumstances, precedent may be set for laws to be disregarded in other circumstances. The legal system was built upon the foundation of integrity. The public places trust in the system and in return, the system upholds justice and safety. When healthcare providers bypass the legal system, other providers can follow suit and eventually dismantle the foundation of the law and its integrity. This follows the argument of the slippery slope. In a slipper slope argument, one insists that a course of action will lead to a chain reaction resulting in an undesirable end (Texas State University, 2019). An example would be that if one’s friend was late to coffee, one might assume that friend would be late for the rest of their future coffee visits. In the application of healthcare, there are many slippery slope arguments, such as legalizing marijuana. Opponents to legalization claim that it is a slippery slope that could potentially lead to the legalization of other drugs like cocaine and heroin, as well as widespread recreational use (Texas State University, 2019).

If prediction becomes reality, healthcare providers could potentially dismantle the entire legal precedent of abortion laws. One bypass becomes another, one quick emergency surgery turns into ten, and soon enough there is no one abiding by the system. Not only is the authority of abortion laws weakened, but the trust of the public in the legal system is eroded. Public trust in the system is imperative for social order. Without trust, people may refuse to accept the authority of the law, and illegal procedures could multiply all over the country (Issue 2, 2024). By complying with the law, healthcare practitioners set the standard for care that patients could trust.

Choosing the law will decrease doctors' liability and legal consequences for providing illegal care. When faced with severe abortion bans, healthcare practitioners may be subject to legal repercussions that could land them in jail. According to a 2023 survey, 61% of OBGYNS who practice in abortion ban states report concerns about legal-making decisions with emergency care (Frederiksen et. al, 2023). As of 2025, 11 states impose criminal penalties on clinicians who violate bans, with minimum sentences imposed. In Alabama, violating the total ban is a Class A felony with a minimum sentence of ten years in prison; Tennessee places violations in the aggravated assault category; Indiana groups it with involuntary manslaughter (Felix, Sobel, & Salganicoff, 2025). If healthcare providers prioritize the law, they can avoid jail time and potential medical malpractice liabilities, ensuring the system remains in compliance.

Ethical Considerations

The consequential theory of ethics emphasizes the potential outcomes in medical emergencies rather than the actions of healthcare providers. A consequentialist considers that in a scenario, the action that will produce a good result will be the morally right act (Pozgar, 2014). This ethical theory applies to the restrictive nature of abortion bans. Applying its principle, a provider should take action, regardless of whether it is legal, if the action will produce the best outcome. A doctor should provide a D&C if the mother’s life will be saved; a doctor should not deny a patient if she is at risk of sepsis infection. In 2023, 18-year-old Nevaeh Crain passed away after three emergency visits, none of which addressed the fetal demise of her six-month pregnancy. Texas abortion bans at the time threatened doctors with prison if they intervened in a way that would end a fetal heartbeat. While including exceptions for life-threatening conditions, there was fear in providers on how to apply the law (Presser & Surana, 2024). If consequential ethics were applied to this situation, the morally right decision would have been to operate on her sepsis infection before her organs failed.

The ethical principle of beneficence calls into question the commitment of healthcare providers in light of abortion ban care. Beneficence is doing good, preventing harm, and taking actions that will benefit the patient while under care (Pozgar, 2014). If a woman needs a procedure in a medical emergency, the doctor should take action that will benefit the mother, if adhering to beneficence standards. Yet this principle can come into direct conflict with abortion ban laws that prevent a procedure from taking place. Beneficence can also be applied to both a mother and an unborn fetus, which raises a bioethical dilemma on which action will benefit which life. The Deontological Code of the Spanish Medical Association states “human embryo(s) must be treated in accordance with the same ethical guidelines…as applied to all other patients” (Leon Correa, 2013). Therefore beneficence not only applies to situations involving constricting abortion laws but also in the determination of who receives the patient benefit: the mother or the unborn fetus.

As physicians take risk when faced with the law, courage remains a virtue that aids in their decision-making. Without courage, there is no risk taken on behalf of the doctor. In the context of abortion bans, healthcare providers are faced daily with emergencies in which the presence of courage could save or destroy a life. Doctors are responding in these emergencies with a new kind of practice: hesitant medicine. Not only are they hesitant and lack courage to provide care, but they put the well-being of their patients at stake. The lack of clarity and presence of ambiguity in abortion law has led many doctors to abandon courage in favor of defensive medicine. Some providers have even left their state to find ways to practice outside of legal restrictions, abandoning the virtue of courage (Lilly, Newman, & Bjork-James, 2024).

Integrity challenges the code to which a healthcare provider should commit: one in pursuance of the law or one in the patient's interest. Integrity means reliably doing the right thing with a steadfast adherence to consistency (Pozgar, 2014). This virtue encourages physicians to prioritize the patient, as well as their autonomy. Organizations such as the American College of Obstetricians and Gynecologists (ACOG) showcase great integrity in light of legal restrictions. The ACOG recognizes comprehensive reproductive health care services as essential, with prohibitions jeopardizing safety (ACOG, 2015). Its advocation for policies ensuring decisions are made for the patient and not for the law shows a commitment to medical integrity.

Choosing a Side

After a thorough analysis and research of the legal implications and professional obligations of doctors in post-abortion ban care, I firmly align with the pro position. I believe that healthcare providers have a duty of care to a patient in times of emergency, which should take priority over any laws restricting care. While this may be controversial as it opens doors for precedent to unravel and other rules to be disobeyed, at the end of the day the patient is owed a duty which should be protected at all costs.

In Section 2: Choosing Life, I described four arguments supporting the pro perspective. The first emphasized the duty of care that professionals in a medical field have when treating patients (Restatement (Second) of Torts, 1965). While the law may place restrictions on the efforts of healthcare providers to perform their job, the physician has a duty to act according to any professional in the field. For example, if most physicians would order a D&C in an emergency abortion, a physician will be held to those standards. I also explored the negative effects that following the law could have on marginalized communities. These rural communities are already disproportionally affected by maternal mortality (Kheyfets et al., 2024). The laws are deterring OBGYNs from practicing in these regions, leading to a lack of abortion care knowledge. By ignoring the law and choosing the duty of care to the patient, these communities have a better chance at accessing quality abortion care in emergency situations. Patient autonomy is an important ethical principle in health law. It advocates for patients having full decision-making and control over their body when presented with options for healthcare. Doctors have a duty to uphold this principle in order to avoid eroding the medical system Americans have grown to trust in. This, as well as EMTALA which provides patients with emergency healthcare, are foundations in the system that have precedent over the legal restrictions imposed post Dobbs.

Section 3: Choosing Law advocated for the legal restrictions on emergency care. While providing good arguments, a lot are more nuanced and too particular to override the principles of care owed to a patient. For example, some argue that choosing the law will decrease a physician’s liability when engaging in illegal medical acts. While this may be true, many physicians are not always given harsh sentences in court due to conflicts with EMTALA. The Idaho Supreme Court ruled that emergency physicians could not be prosecuted under the abortion law if the pregnant patient’s life is endangered because the law conflicts with EMTALA (Balch, 2023).

Section 4: Ethical Considerations detailed four ethical frameworks that can support the pro side. Consequential ethics describes how outcomes in medical situations should be prioritized over the actual actions of healthcare providers. It considers that the action that produces a good result will be the morally right act, even if illegal. If performing an emergency abortion will save a mother’s life, the physician’s actions should not be considered illegal since it is producing the best outcome. In addition to consequential ethics, the virtue of courage is also present. I believe the virtue of courage is an unspoken response to the battle of law and life. Courage aids one in taking risk. Without courage, healthcare providers cannot overcome the legal system that is currently cloudy and subject to misinterpretation, subjecting many pregnant women to preventable deaths. If a woman has to worry about her safety in an emergency, she has no trust in the doctors who are there to give her the best outcome.

While laws governing abortion care are restrictive and limit many actions by providers around the country, it does not mean emergency deaths are validated. A woman should not be worrying that her doctor will be prioritizing law over her life. There will always remain a code of ethics governing professionals. These ethics make a promise to each patient who walks through the hospital doors. By following ethics and protecting patients, the physicians no longer need to cower in fear of legal implications. They can stand with integrity and continue to uphold the ethical foundations our healthcare system was built upon.

wallflower musings

Discussion about this post