Curious Bioethics Round-Up - March 13-17, 2023
Abortion, Maternal Mortality, Gender Affirming Care, and on Being Wrong
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In today’s curated collection, you’ll find:
Bioethics in the News: abortion pills, another year of worsening maternal mortality, more attacks on gender-affirming care
What I’m Reading: Doula Angela Tatum Malloy; a long-form read on being wrong
Educational Opportunities: Embodied social justice, ProPublic abortion event
Bioethics in the News
The two main news stories I’m sharing this week are on medication abortion and maternal mortality. People who have the luxury of believing that pregnancy is no big deal have no idea what they are talking about.
Abortion Pills
There are two significant abortion pill cases in the news this week:
A federal case in Texas is likely to impact national access to mifepristone
Wyoming Governor signs statewide ban on mifepristone
Texas
In case you aren’t aware of mifepristone, it’s been available since 2000 and is the most commonly used medication for abortion. It’s incredibly safe - way safer than an over-the-counter medication like Tylenol.
In Amarillo, Texas, U.S. District Judge Matthew Kacsmaryk is considering banning access to the abortion pill, mifepristone, nationwide. This is not terribly surprising since Trump appointed the Christian rights crusader to have the ability to rule on cases just like this.
Behind the lawsuit? An anti-abortion group called the Texas-based Alliance for Hippocratic Medicine. Why did they file their case against the FDA in Amarillo’s federal courthouse? Because Kacsmaryk hears 95% of all cases.
His rulings read like an alt-right conservative parody account, but the dude is serious. And he has been handed way too much power.
Wyoming
Late on Friday, Wyoming Republican Governor Mark Gordon placed the first statewide ban on abortion medications (mifepristone and misoprostol). The use of mifepristone is de facto banned in all the states that ban or severely restrict abortion, but this law specifically prohibits medication.
The law states it is “unlawful to prescribe, dispense, distribute, sell or use any drug for the purpose of procuring or performing an abortion.” The ban takes effect on July 1, 2023.
Both of these stories show how attacks on abortion have nothing to do with safety. They are partisan attacks on public health.
Speaking of public health, let’s move on to pregnancy-related deaths in America…
Maternal Mortality
A new report on maternal mortality rates released by the Centers for Disease Control and Prevention shows an alarming increase in maternal mortality, especially for Black women.
In 2021, the maternal mortality rate for Black women was 69.9 deaths per 100,000 live births. White women died at a rate of 26.6 per 100,000 live births. That means Black women who give birth are 2.6 times as likely to die as white people who give birth.
This increased risk of death is not due to some inherent condition of Black women. It’s racism. Racism and sexism are deeply embedded not only in the practice of medicine but throughout society.
While the COVID-19 pandemic can be pointed to for 2020 and 2021 data, the U.S. was already doing a poor job caring for pregnant and postpartum people. As a result, overall maternal mortality for all Americans is abysmal - around three times worse than in other high-income countries.
Gender-Affirming Care
Thursday was a very bad day for transgender kids.
Florida
The Florida Board of Medicine enacted a rule banning any new patients from receiving gender-affirming care. Patients already recieving care may continue, but cannot access surgical procedures. The Board of Osteopathic Medicine will pass an identical ban at the end of the month.
Kentucky
Kentucky banned gender-affirming care on Thursday. Not only did the state ban providing care to new patients, they require doctors to set a schedule to de-transition patients already receiving medication therapy.
As a pediatric anesthesiologist who routinely cares for trans kids, these two decisions make me heartsick, but more than that, they make me scared. Despite the claims that these decisions are to protect kids - they don’t. The way to care for trans kids - to improve their mental health so they can grow up to be adults - is by honoring who they are and ensuring they have access to safe care, supported by the evidence.
What I’m Reading This Week
Angela Tatum Malloy
Angela Tatum Malloy is a Louisiana doula selected as a USA TODAY’s Women of the Year for her work improving the health of Black mothers and infants.
“Black doulas play an effective role in saving the lives of Black women from preventable conditions,” she said. "We're able to be that bridge between the mother and the provider so that there's better communication."
Read about her incredible work and approach to care here: Meet the Fayetteville doula fighting to improve Black maternal health, infant mortality rates
The Value of Being Wrong
As a strongly opinionated person, I have spent many years assessing how to assess my own beliefs - how did I get them? Why did I keep them? Is the evidence there or am I clinging to something else?
I have been an avid reader of Maria Popova’s The Marginalian (formerly Brain Pickings) and love her scientific humanities approach to literature. She writes the most beautiful journeys through old library books you never knew you wish you’d read.
This week’ long-form tribute is The Value of Being Wrong: Lewis Thomas on Generative Mistakes.
We are at our human finest, dancing with our minds, when there are more choices than two. Sometimes there are ten, even twenty different ways to go, all but one bound to be wrong, and the richness of selection in such situations can lift us onto totally new ground. This process is called exploration and is based on human fallibility. If we had only a single center in our brains, capable of responding only when a correct decision was to be made, instead of the jumble of different, credulous, easily conned clusters of neurons that provide for being flung off into blind alleys, up trees, down dead ends, out into blue sky, along wrong turnings, around bends, we could only stay the way we are today, stuck fast.
- Lewis Thomas
Educational Opportunities
Embodied Social Justice Certificate Program
A one-of-a-kind, 3-month certificate program committed to collective liberation, increasing awareness and unlearning of oppressive social structures, and repairing belonging. I discovered this on the fabulous
CTZNWELL newsletter (definitely worth a subscription - Kerri's resources are incredible every single week).
3-Month Online Certificate Program, April 3 - June 30, 2023
Learn more and enroll here.
ProPublica Post-Roe: Today’s Abortion Landscape
This event was rescheduled to next Tuesday, March 21 - sign up here for access. I’ll be working in an operating room, but look forward to catching the recording after.
That’s it!
As always, thanks for being curious!
Hit reply and let me know what ethics issues you are most curious about this week—I’d love to hear from you!
See you next week!
Be Well & Be Curious,
Alyssa
