![]() Sometimes, against all recommendations and indications, a patient will refuse treatment. Sometimes we will have to set aside our personal opinions to do what is right by the patient. This principle underscores the agreement we all make upon entrance into medical school. Health care relies on a fiduciary relationship: We must always place the patient's interests before our own. Wade is a sentencing especially for low-income patients of color: to either face the dangerous gamut of unwanted childbirth, or the unregulated market of self-sought abortions.įinally, we reach beneficence, the ethical principle to do the good and right thing. It merely forces them to occur later, as patients seek care elsewhere or in unsafe, self-sought manners. Studies show that restricting abortion does not decrease the number of abortions performed. By limiting abortion access, these inequities will continue to disproportionately affect Black communities. has the highest maternal mortality rate among developed countries in the world, driven by a disparity in care and outcomes for Black patients. Justice is intimately wound up in this argument. Denying a patient the care they need is an assault on their autonomy. Even in the stickier questions around continuing treatment for a terminal illness or end-of-life care, we are taught to adhere to the gold standard of following the patient's wishes. These are choices we as individuals make about our own bodies that others must honor. A person can, if faced with a massive bleed and fully informed of the consequences, refuse a lifesaving blood transfusion. Anyone can get their ears pierced or choose to donate a kidney. In medicine, we recognize the right an individual has to make decisions regarding their own body. The principle of autonomy is both simple and complex. Nonmaleficence refers to living patients - and their decision about their health is the only one that matters. ![]() ![]() Spontaneous abortion is normal and common - an estimated 1 in 4 pregnancies results in miscarriage. In reality, fertilization is not a guarantee of life, even without medical intervention. The phrase "do no harm," has often been co-opted by anti-abortion activists claiming to act in the interests of an underdeveloped fetus. It may pose an immediate threat to the pregnant person's health, it may burden them with cost and commitment they are not equipped to withstand, it may pose too great a psychological toll to carry a pregnancy to term. ![]() There are myriad reasons someone may wish to discontinue a pregnancy. Forced birth threatens the lives of patients. The principle of nonmaleficence, or to do no harm, should be straightforward. Wade would make it illegal in many states to practice ethical medicine. The threat to the right to abortion promises to tear that framework apart. If we are working in the best interests of our patients and granting them the autonomy they deserve, we are on the right side of the law. Generally, the law protects providers and patients who operate under these principles. Throughout our first year of medical school, we discuss ethical principles in medicine, often portrayed as four pillars: nonmaleficence, autonomy, justice and beneficence. For more information about our efforts to continually expand the range of views we publish, see /opinion/newvoices. Opinion editor's note: This article, part of our New Voices collection, was written by a first-time contributor to Star Tribune Opinion. ![]()
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