Bucks Montgomery Physician Summer 2021 - 9

There has also previously been a legislative attempt to prohibit
prescription of medications to induce abortion in the
first trimester via telemedicine, forcing women to travel to a
physician's office or clinic to obtain the medication during a
pandemic, when this is not medically necessary.
Bills restricting access to safe, legal abortion are annually
introduced in PA. Kathy Rapp (R), chair of the House Health
committee of PA, recently held 2 days of biased hearings on
the issue, and one of the physicians who testified actually lied
about medical facts. He practices family medicine in a small
town near York, PA, and claimed he often reverses medical
abortions. He has no credentials in OB/GYN, does not practice
it, and ACOG has clearly stated there is no science to justify
this, nor that it is effective. Restrictive laws usually pass both
the PA House and Senate but are vetoed by Governor Wolf.
Since the election in 2018, there has not been a veto-proof
majority, therefore the partisan legislators have not been able
to override the veto. That could change after the 2021 Governor's
election. I wish to reassert that women cannot achieve
political equality unless we can control our reproductive
choices. Choice includes when, and if, to bear children, how
many children to have, and options in how we can take care of
them. Ideally, this should be done in context with equal rights
for men in that sphere. Ideally that should include access to,
and affordability of, effective contraception. In reality, that
is often not possible, and sometimes contraception
fails, even when used properly.
According to Federal Law, elective abortion
until viability is legal (Roe v. Wade, 1973) but
there are a few issues. First, many states have
passed, and continue to attempt to pass, legislation
to limit access to safe, legal abortion,
regardless of trimester. Many of these state
laws have been ruled against in state and/or
federal courts. However, the composition
of the Supreme Court of the United States
(SCOTUS) has changed. This means that,
regardless of precedent (stare decisis), these
restrictive statutes may now be upheld if
brought again to the Supreme Court,
and a serious attempt to overturn Roe v. Wade may succeed.
SCOTUS has recently given certiorari to a restrictive law in
Kentucky, which may be the chance foes of abortion rights
have been waiting for. Gov. Greg Abbott in Texas recently
signed a bill allowing citizens to sue physicians and other practitioners
that provide abortion.
Interestingly, federal legislation to give guaranteed equality to
the LGBTQ+ community has been criticized unless there is
some exemption for religious beliefs. Yet, there is no waiver for
women whose religious beliefs do not prohibit abortion! There
are tenets in Christian, Jewish, and Muslim communities that
do not share these beliefs about personhood or the morality
of abortion, and within each religious affiliation, there
are those who do, i.e., the Catholic Church, Orthodox Jews,
and Evangelical Christians. In addition, there are atheists or
non-religious individuals, who have other personal beliefs. Yet
with a medically safe procedure, religious rights of choice are
being violated. From a purely medical point of view, which I
believe appropriate for me to support as a physician, these laws
do not prevent abortion or in any way protect women. It is my
opinion, based on history, that more women will seek illegal
procedures or try unsafe, unproven methods to terminate their
own pregnancies. We experienced this before 1973, and the
consequences for women's and children's health are significant.
More women will die.
In PA, several restrictions were enacted in 1989 under Casey
v. Planned Parenthood. They include the requirements that
women sign a consent 24 hours before the actual procedure,
and the requirement for parental permission, even though
a pregnant teen is considered an emancipated minor for
other medical decisions! The provision of the law that was
struck down by SCOTUS required married women to obtain
permission from their husbands to terminate an unwanted
pregnancy. That was just too much for the first woman Justice,
Sandra Day O'Connor! Justice O'Connor also established the
principle of undue hardship to women if they cannot access
abortion due to statewide restrictions. This principle caused
several restrictive laws to be overturned by SCOTUS or denied
certiorari (SCOTUS will not take up the case and will let the
lower court ruling stand).
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BUCKS AND MONTGOMERY COUNTY MEDICAL SOCIETIES 7
Bucks Montgomery Physician Summer 2021

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