Supreme Court decisions have liberalized a woman's right to decide whether to obtain an abortion. Some state and local governments have tried to circumvent these decisions by enacting requirements designed to discourage abortions by, among other things, dictating to physicians an elaborate litany of specific information that must be communicated to a patient as a necessary precondition of her informed consent for an abortion. This article discusses the legal status of such requirements, their implications for the professional autonomy of physicians, and the role of the medical profession in challenging these restrictions, on its own behalf and in concert with its patients.
PIP: Focus in this discussion of abortion and informed consent requirements is on the legal status of such requirements, their implications for the professional autonomy of physicians, and the role of the medical profession in challenging these restrictions, on its own behalf as well as in concert with its patients. Some state and local governments have attempted to circumvent Supreme Court Decisions liberalizing a woman's right to decide whether to have an abortion by enacting requirements designed to discourage abortions. Among other things these requirements dictate to physicians an elaborate litany of specific information that must be communicated to a patient as a necessary precondition of her informed consent for an abortion. Among the explanations for the Supreme Court's recognition of the physician's essential role is its extensive consideration of medical data and practice. The judicial liberalization of accessibility to abortion may be directly traceable to progress in medical technology that reduces the health risks associated with the performance of an abortion. The opponents of the availability of abortion generally deplore medicine's contribution to the liberalization of abortion and the freedom afforded to physicians to counsel patients regarding abortion. They maintain that this converts physicians into "destroyers" of life. In an effort to narrow or circumvent judicial expansion of the availability of abortion, groups opposing abortion have directed political pressure toward enactment of restrictive national, state, or local legislation. Many of these laws contain provisions that seriously interfere with the physician's right to practice medicine in conformity with his/her best clinical judgment, by imposing unreasonable requirements in regard to the nature of informed consent necessary as a precondition for performing the abortion. A prototype of such legislation was enacted as a municipal ordinance by the Akron, Ohio City Council in 1978. The Akron regulation required that abortion be described to the pregnant woman as a "major surgical procedure" and mandated that she be warned of a variety of serious physical and mental complications that might result. Also, according to the regulation, the physician must give the woman a detailed description of the anatomic and physiologic characteristics of the fetus at the gestational age when the abortion is performed. On June 12, 1981 the United States Court of Appeals for the Sixth Circuit declared several provisions of the Akron ordinance to be unconstitutional and hence invalid. Serious challenges are ahead, for the courts have been less than unanimous in condemning laws that impinge upon medical practice.