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Speak Out Rheum: To Prescribe Is Humane (Unless You’re In Texas)

Raymond Scalettar, MD, DSc  |  Issue: November 2022  |  November 7, 2022

You have heard the argument that a fetus is a person entitled to all protections accorded any living being. But is it?

Arguments and counter-arguments come from politicians, the courts, religious leaders, medical specialists and other groups with vested interests in the answer and actions that follow. The heart of the conflict is the tension between maternal and fetal rights and what takes priority: protecting the health and, possibly, the life of a pregnant woman or the desire to save a fetus. Who is to make the decision—the woman or some external party claiming authority to do so?

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And what is a fetus, especially one that may not be viable? The argument is that it is a “baby” who should be given a chance to live, even at the literal expense of the mother’s life. But before the fetus is born is it—can it be—a living human being? If it first has to be born to live, then is a fetus a baby or only a possible baby?

You feel like you are back in your debate class in college, trying to convince your audience of the correctness of your position on the topic du jour: syllogisms.

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Pushing the academic and intellectual questions aside, you recall the battle being fought today had its genesis in a 1987 court-ordered Caesarean section on a woman dying of cancer who was 26 weeks pregnant. The baby died two hours after the operation, and the mother died two days later. The family sued and, in a 7–1, precedent-setting decision, the D.C. Court of Appeals ruled that a woman has the right to decide about medical treatment for herself and her fetus. It said that only in “rare and exceptional” cases would it be possible to override the mother’s wishes and acknowledged that “some may doubt that there could ever be a situation extraordinary or compelling enough to justify a massive intrusion into a person’s body, such as a Caesarean section, against that person’s will.”21

What Next?

While you prepare for deposition, you are despondent. You are accused of prescribing methotrexate to induce an abortion and know that Texas law makes performing an abortion a felony, punishable by up to life in prison. You also know that you are facing a huge fine because the law mandates the attorney general seek a civil penalty of not less than $100,000, plus attorney’s fees.

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Filed under:EthicsLegal UpdatesOpinionProfessional TopicsSpeak Out Rheum Tagged with:abortionMethotrexatepregnancySpeak Out Rheumatology

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