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The case of a 10-year-old Ohio rape sufferer who sought an abortion in Indiana simply after the US Supreme Court overturned Roe v. Wade final yr turned a serious flashpoint within the political debate. On Thursday, her physician was reprimanded and fined for discussing the case — and physicians fear that it’ll have a chilling impact on any sort of affected person advocacy that conflicts with the political agenda of state lawmakers.
The Indiana medical board discovered that Caitlin Bernard, an OB-GYN, violated affected person privateness legal guidelines in publicly disclosing that she had carried out the abortion with out the consent of the affected person or their dad and mom, although she by no means named the affected person and solely offered a normal define of the case, as docs sometimes do when performing well being advocacy. She will probably be fined $3,000 and issued a letter of reprimand, however will probably be allowed to maintain her medical license.
It’s the results of Indiana Republican Attorney General Todd Rokita, who’s operating for reelection in 2024, submitting a grievance towards Bernard final yr, additionally claiming that she was unfit to follow as a result of she had not stayed “abreast of current professional theory or practice.” Bernard’s lawyer beforehand characterised the grievance as an try to intimidate abortion suppliers.
The incontrovertible fact that Bernard is dealing with skilled penalties suggests that there’s a authorized grey space when speaking about sufferers in an advocacy context, even past the topic of abortion, that’s ripe for exploitation by political actors. Dr. Tracey Wilkinson, a professor of pediatrics at Indiana University School of Medicine who attended Bernard’s listening to earlier than the medical board Thursday, instructed Vox there was a protracted debate as as to whether Bernard had disclosed identifiable details about the affected person and witnesses who argued on the contrary.
She mentioned her colleagues across the nation have been “shocked and devastated” by the final word resolution, which confirmed that “politicization can really prevent us from being able to do our job.”
“All of us have an ethical duty to do advocacy,” Wilkinson mentioned. “This got so far because this was about abortion, but we’ve now set the precedent and opened the floodgates to any clinician doing their job and having their medical license put on the line.”
What occurred within the Indiana case
The 10-year-old affected person sought an abortion from Bernard in Indiana simply days after Roe fell final June as a result of she couldn’t get hold of one in her house state. Ohio had a set off ban prohibiting abortions after six weeks of being pregnant, earlier than most individuals know they’re pregnant, and he or she had been pregnant for six weeks and three days. (That ban has since been placed on maintain by the courts, however may go into impact once more.)
The story, initially reported by the Indianapolis Star, went viral. President Joe Biden talked about the case in remarks on the White House final July: “Ten years old — 10 years old! — raped, six weeks pregnant, already traumatized, was forced to travel to another state.” News retailers, nonetheless, questioned whether or not the case was actual, provided that the Star had relied on Bernard’s account alone. Right-wing politicians, together with South Dakota Gov. Kristi Noem, known as it “#FakeNews.”
The story was confirmed when 27-year-old Gerson Fuentes was charged in Franklin County, Ohio, after confessing to raping the woman on no less than two events. He later pleaded not responsible to the fees. His trial will proceed in July.
How docs have struggled to navigate the authorized panorama post-Roe
Bernard’s case earlier than the medical licensing board was uncommon as a result of it turned a entrance within the nationwide political battle over abortion. Rarely if ever does a state’s high prosecutor get entangled in medical licensing board hearings, and so they typically concern instances the place there’s a dangerous affected person final result, which didn’t occur right here.
“The outcome of the care that Dr. Bernard gave was exactly what she always does, which was compassionate, comprehensive health care,” Wilkinson mentioned.
Rather, the case involved her violations of pointers of the Health Insurance Portability and Accountability Act, often called HIPAA, which particularly mandates that identifiers corresponding to identify, date of delivery, and tackle be protected, but in addition prohibits the disclosure of any distinctive identifier. Bernard solely disclosed the age of the woman and her state of residence, however her listening to targeted on whether or not that would have been thought of identifiable data. Her employer, Indiana University Health, concluded final yr that she had not dedicated a HIPAA violation, however the medical board discovered the alternative.
The resolution to punish Bernard has left physicians throughout the nation “afraid of getting in the crosshairs of politicians in their state and feeling that they could be next,” she mentioned. That applies within the context of abortion, but in addition in relation to bans on gender-affirming look after trans children.
It’s exacerbating anxieties that physicians have been already feeling when it comes to navigating the patchwork of legal guidelines throughout the US post-Roe, a lot of which embody very restricted exceptions to abortion bans that in follow discourage docs from administering medically essential care. And that makes it all of the harder for docs to carry out their obligation to advocate for change past the partitions of the medical system.
“I do a lot of advocacy. And I’m not going to stop as a result of this hearing,” Wilkinson mentioned. “But that’s why this is such a dangerous precedent.”
