By MIKE MAGEE
In case you had been making an attempt to overlook, the primary Presidential Debate is that this week.
Query: Would Wholesome Ladies Create a Wholesome Democracy?
When he assumed the function because the AMA’s 178th president on June 13, 2023, Jesse M. Ehrenfeld, MD, MPH centered on inequities in well being care as a high precedence for his yr in workplace. In a memorable opening that day in Chicago, the Wisconsin anesthesiologist shared a private mission with 700 AMA delegates centered on his then 4 yr previous son. Ethan was born 10 weeks untimely at 2 lbs 7 oz.
“Watching my son cling to life, I used to be struck by the painful actuality that, regardless that I used to be a doctor and now, a father, neither I, nor my husband, might donate blood just because we’re homosexual. Discriminatory insurance policies—insurance policies rooted in stigma, not science—barred us from doing probably the most humane of acts, donating our blood.”
Dr. Ehrenfeld used that story as a leaping off level to share his priorities as their new President. He pledged that day to hunt justice and fairness, highlighting:
“Black girls are at the least 3 times as seemingly as white girls to die because of their being pregnant.
“Black males are 50% extra prone to die following elective surgical procedure.
“LGBTQ+ teenagers and younger adults endure increased charges of psychological well being challenges that usually go undiagnosed.”
He additionally warned, within the shadow of the Dobbs determination on June 24, 2022, of “… discouraging tendencies associated to well being outcomes—maternal mortality charges within the U.S. are greater than double these of different well-resourced nations, as an example—and have gotten extra prevalent.”
However when it got here to the politics of reproductive well being entry, he selected his phrases fastidiously and took a quieter tone with the viewers of politically savvy medical doctors from crimson and blue states.
“Sure facets of the nation’s political local weather have grow to be dangerously polarized. Politicians and judges are making choices about well being care previously reserved for sufferers and physicians and sufferers…” he stated.
This assertion, coming one yr after Dobbs, clearly didn’t mirror, in depth, the phrases of his predecessor, Jack Resneck Jr.,MD, who wrote on the day of the choice, “The American Medical Affiliation is deeply disturbed by the U.S. Supreme Court docket’s determination to overturn almost a half century of precedent defending sufferers’ proper to crucial reproductive well being care…In alignment with our long-held place that the early termination of a being pregnant is a medical matter between the affected person and doctor, topic solely to the doctor’s medical judgment and the affected person’s knowledgeable consent, the AMA condemns the excessive court docket’s interpretation on this case.”
That sentiment was strengthened by the nation’s 25,000 OBGYNs, 60% of whom are girls. Their affiliation (ACOG) wrote, “Right this moment’s determination is a direct blow to bodily autonomy, reproductive well being, affected person security, and well being fairness in the USA. Reversing the constitutional safety for secure, authorized abortion established by the Supreme Court docket almost 50 years in the past exposes pregnant individuals to arbitrary state-based restrictions, laws, and bans that may go away many individuals unable to entry wanted medical care.”
Statements on behalf of the American Nurses Affiliation, and the organizational arms for each physicians associates (PAs) and nurse practitioners (NPs) had been equally forthright.
There are 4.2 million nurses, over 1 million medical doctors, and over 1/2 million PAs and NPs within the US. And because the newest US Census Report headlined, “Your well being care is in girls’s arms. Ladies maintain 76% of all well being care jobs.” This contains 90% of all nursing positions, 66% of PAs, and 55% of all present Medical Faculty slots.
Not surprisingly, as girls numbers have risen, conventional oaths for the caring professions have mirrored altering priorities. For instance, the ladies majority 2022 getting into class of Penn State’s School of Drugs for the primary time gave high billing of their skilled oath to sufferers, to not the gods: “By all that I maintain highest, I promise my sufferers competence, integrity, candor, private dedication to their greatest curiosity, compassion, and absolute discretion, and confidentiality throughout the regulation.”
Seven years earlier, the American Nurses Affiliation (ANA), created a proper Code of Ethics, which largely supplanted the 1893 Nightingale Pledge, with a 4 pillared Code which celebrated Autonomy (affected person self-determination), Beneficence (kindness and charity), Justice,(equity) and Nonmaleficence (do no hurt), as anchors to Nursing’s 9 Provisions (or Pledges) that decide to: compassion and respect, patient-focus, advocacy, energetic determination making, self-health, moral setting, scholarly pursuit, collaborative teamwork, skilled integrity and social justice.
Throughout Dr. Ehrenfeld’s one-year tenure following the Dobbs determination girls’s entry to well being care deteriorated in crimson state after crimson state, a degree mirrored in clear losses for Republicans on statewide initiatives supporting abortion entry from Kansas to Kentucky, and Vermont to Michigan. However because the Kaiser Household Basis reported this yr, “As of April 2024, 14 states have applied abortion bans, 11 states have positioned gestational limits on abortion between 6 and 22 weeks…” Add to this that 1 in 5 present OB residents say they’ve determined to steer away from restrictive crimson states after they pursue apply alternatives on commencement.
And nonetheless, crimson states embracing MAGA’s marriage to White Nationalists appear to have doubled down on every little thing from proscribing entry to remedy abortion and contraception, to ebook banning, to limiting LBGTQ+ rights and selling prayer in public colleges within the hopes of attaining a Christian Nationalist society.
Which brings us to the quick approaching 2024 Presidential debate. Ladies’s reproductive autonomy might be effectively represented. It’s arguably the premier fairness and justice situation earlier than us, central to each America’s sufferers and their caring well being professionals. However let’s not overlook it’s also central to the well being of our democracy.
John J. Patrick PhD, in his ebook Understanding Democracy, lists the beliefs of democracy to incorporate “civility, honesty, charity, compassion, braveness, loyalty, patriotism, and self restraint.”
What different type of authorities is there that so intently aligns with the aspirational pledges and oaths of our medical doctors, nurses, and physique politic?
Mike Magee MD is a Medical Historian and common contributor to THCB. He’s the writer of CODE BLUE: Inside America’s Medical Industrial Advanced.
