1. Abortion, Conscientious Practice, Drug Testing in Pregnancy Karen Adams, MD Martin Donohoe, MD

2. Conscientious Practice

3. Do providers have a medical or ethical responsibility to refer patients for legal, medically sound options that they are personally opposed to or unwilling to offer? Do providers have a medical or ethical responsibility to refer patients for legal, medically sound options that they are personally opposed to or unwilling to offer?

4. The advice of the health care provider is always very influential to patients making their decisions, because it is seen to be based on medical science. The advice of the health care provider is always very influential to patients making their decisions, because it is seen to be based on medical science. Given that a provider’s stance on abortion may be intrinsically more based on personal viewpoints of 'when life begins' as a belief rather than scientific fact, should a practitioner advise their patient of their personal stance and its influence on their decision before launching into the discussion of a patient's options? Given that a provider’s stance on abortion may be intrinsically more based on personal viewpoints of 'when life begins' as a belief rather than scientific fact, should a practitioner advise their patient of their personal stance and its influence on their decision before launching into the discussion of a patient's options?

5. Social policy and law recognize a fetus as having moral standing, hence the law that allows for charging a person responsible for the death of a pregnant women with two counts of homicide. Social policy and law recognize a fetus as having moral standing, hence the law that allows for charging a person responsible for the death of a pregnant women with two counts of homicide. Social policy and law also recognize potential. Namely, if you cause an injury that reduces the future potential of an individual, you are liable for damages. A fetus is obviously not capable of independent life till at least the 24th week of gestation but it has the potential for autonomy from the moment of conception. Social policy and law also recognize potential. Namely, if you cause an injury that reduces the future potential of an individual, you are liable for damages. A fetus is obviously not capable of independent life till at least the 24th week of gestation but it has the potential for autonomy from the moment of conception.

6. Society and the law also provide protections for individuals without the ability to care for themselves or live independently,i.e. the mentally ill, individuals with physical or mental disability, the elderly and infirm, and patients medically determined incompetent. Society and the law also provide protections for individuals without the ability to care for themselves or live independently,i.e. the mentally ill, individuals with physical or mental disability, the elderly and infirm, and patients medically determined incompetent. Is it reasonable to believe that a fetus might deserve the same protections society offers to individuals who can not see to their own interests? Is it reasonable to believe that a fetus might deserve the same protections society offers to individuals who can not see to their own interests?

7. The government has weighed in many times on what information government funded and independent providers must provide or must not provide. Do you think that these provisions are a good thing? The government has weighed in many times on what information government funded and independent providers must provide or must not provide. Do you think that these provisions are a good thing? Is there a significant difference between this and standard of care practice which require the disclosure/discussion of certain facts and risks prior to any procedure? Is there a significant difference between this and standard of care practice which require the disclosure/discussion of certain facts and risks prior to any procedure?

8. Barriers to Abortion

9. Epidemiology Epidemiology Legal point of viability Legal point of viability Costs and coverage Costs and coverage Limited availability of mifepristone Limited availability of mifepristone

10. Legal barriers Legal barriers State/federal laws State/federal laws Parental notification laws Parental notification laws TRAP laws TRAP laws Refusal clauses Refusal clauses “Fetal rights” “Fetal rights” “Partial birth abortion” ban “Partial birth abortion” ban Biased counseling laws Biased counseling laws

11. Barriers to Abortion Provider availability Provider availability Harassment of patients and providers Harassment of patients and providers Pseudoscience and ideology over science Pseudoscience and ideology over science Sex ed Sex ed EC EC Effects of US policy on abortion worldwide Effects of US policy on abortion worldwide

12. Drug Testing in Pregnancy

13. Drug use in pregnancy Drug use in pregnancy Charleston Policy Charleston Policy Potential solutions Potential solutions Related issues of privacy, drug use and testing, physicians as agents of the state, moral and legal dilemmas Related issues of privacy, drug use and testing, physicians as agents of the state, moral and legal dilemmas

14. Contact Information Public Health and Social Justice Website http://www.phsj.org martindonohoe@phsj.org