End-Of-Life Decisions and Pregnancy: Post-Dobbs Sanctioned Death Sentences
Thursday, October 12, 2023
4:00 PM – 5:15 PM ET
Location: Laurel CD (Fourth Floor)
All individuals, regardless of their pregnancy status, should be able to direct their end-of-life care. However, over half of the states in the U S endorse pregnancy clauses within their advanced directive regulations, invalidating the end-of-life decision-making of pregnant persons. Whilst pregnancy exclusion laws already impose several ethical implications on pregnant persons and their families, anti-abortion legislation will place further constraints on autonomy, injustice, and dignity violations of pregnant or potentially pregnant persons. Dobbs v. Jackson Women's Health Organization carries further implications for pregnant persons, their families, and physicians in states where abortion is now criminalized. It is likely that this legislation will exacerbate the need for advanced directives for pregnant persons following a speculative growth in pregnancies, resulting in a possible increase in pregnancy mortality rate and access to safe abortions. The ruling in Dobbs may result in further states adopting similar pregnancy exclusion laws, making it even harder for pregnant persons and their families to challenge restrictive advanced directive statutes. To protect this vulnerable population, several steps can be taken: (1) increasing awareness of exclusion laws; (2) encouraging persons to discuss their end-of-life preferences and complete advanced directives; (3) increasing research on how pregnant persons are affected by exclusions clauses; and (4) supporting legislation that allows pregnant persons’ advanced directives to remain legitimate regardless of their pregnancy status. In the shadow of Dobbs, we need to protect pregnant persons’ autonomy wherever possible.
Georgia Loutrianakis, MA – Institute for Bioethics & Health Humanities – University of Texas Medical Branch