How the SCOTUS abortion ruling could impact patient privacy

The June 2022 overturning of Roe v. Wade by the Supreme Court of the United States (SCOTUS) led to the removal of the federal right to an abortion.

But this decision could ultimately impact patient privacy, as the patient may no longer be at the forefront of the decision-making process (under the guidance of their physician), as reported in JAMA.^[]

The right to privacy—which includes medical confidentiality pertaining to use of contraceptives—could possibly be at risk, ultimately compromising your patients’ well-being.

Right to contraception in question

As a result of the SCOTUS decision, it’s now up to individual states to decide under which circumstances an individual can access abortion, which in some cases can be a life-saving procedure. Some states have already adopted laws completely banning abortion, many without exception for cases of incest or rape and some with exception for only saving the pregnant individual’s life.

According to a StatNews.com article, Justice Clarence Thomas stated in his opinion on Roe that in the future, the Court may wish to review other cases pertaining to the right to privacy, use of contraception, same-sex relations, and same-sex marriage.^[]

“[I]n future cases, we should reconsider all of this Court’s substantive due process precedents, including Griswold, Lawrence, and Obergefell,” Justice Thomas wrote, deeming these precedents “demonstrably erroneous” and in need of correction.

According to the JAMA article, a number of abortion restrictions across some states claim that fertilization marks the start of “personhood” or being an “unborn child.” Under this interpretation, contraceptives like Plan B (levonorgestrel, which is ingested within 72 hours of having unprotected sex) and intrauterine devices (IUDs) could pose a threat to the life of the unborn.

Justice Samuel Alito also spoke to the dangers of some contraceptives in 2003 case Burwell v. Hobby Lobby, claiming that a handful of FDA-approved birth control methods “may have the effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus.”

Meanwhile, some states have already begun referring to IUDs and emergency contraception as “abortifacients,” according to an article published by the New England Journal of Medicine.^[]

And if states declare that life starts at the point of fertilization, and thousands of frozen embryos are granted rights in these states, then both fertility centers and patients could bear a tremendous burden.

How states could impact patients’ well-being

Both Roe and Planned Parenthood of Southeastern Pennsylvania v. Casey (also overturned by the Supreme Court) offered protections grounded in the nature of the patient-clinician relationship.

Roe and Casey granted patients and clinicians the ability to center the patient’s values in the landscape of medical decision-making, according to the New England Journal of Medicine.

The overturning of Roe and Casey could threaten this foundation of the patient-clinician relationship and, subsequently, the well-being of patients.

This does not go unrecognized by respected medical organizations, or even President Biden. In a press release published just after Roe was repealed, AMA President Jake Resneck, Jr., MD said that the SCOTUS decision to overturn Roe represents “an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship, and a brazen violation of patients’ rights to evidence-based reproductive health services.”^[]

President Biden—whose opinion echoes similar sentiments—has signed an executive order to safeguard access to reproductive healthcare services, as reported by the White House.^[] This order protects access to several forms of contraception—including IUDs and emergency contraceptives—as well as family planning and counseling, among other reproductive healthcare rights.