Momentous developments on abortion, guns, and Americans’ health

abortionbanstates-300x205Congress has passed a modest gun control law for the first time in three decades. The breakthrough, compromise measure, quickly signed by President Biden, not only provides for background checks for would-be weapons buyers younger than 21 and a push for states to pass laws to take guns away from the dangerous, it also provides a rare boost of tens of millions of dollars for desperately needed mental health services across the country.

kidshealthanniecasey-300x155But at the same time, the U.S. Supreme Court has upended New York’s long-standing restrictions on concealed weapons and the justices threw out a half century of established precedent in reversing Roe v. Wade.

In a blink, women’s reproductive health and their rights suffered a damaging blow, with medical experts, including the American Medical Association, the American College of Physicians, and the editors of the New England Journal of Medicine, condemning the high court’s allowing states to ban abortion, notably without allowing for exceptions for rape, incest, or when mothers’ lives are imperiled.

civilwarsecession63-300x182Justice Clarence Thomas, now the court’s senior jurist, also made clear in his writing in the Dobbs v. Jackson case, that he rejects the legal thinking — and now precedents — that Americans enjoy a right to privacy inferred from and rooted in the Constitution.

He targeted decisions, based in Roe’s privacy argument, legal scholars say, that have expanded and protected individuals’ rights to intimate relations of their own choosing in private (Lawrence),  use of contraceptives (Griswold), and the right to gay marriage (Obergefell). Thomas notably did not attack another pillar of high court privacy matters — the right for couples to marry across races.

The high court rulings brought tens of thousands of protestors into streets across the country, demonstrators expressing anger and alarm at what advocates saw as a reversal and assault on the lives of women and couples, gay and straight.

Almost instantly, the justices have riven a nation already grappling with deep political divides. Half the country will allow abortions, while the other half will not (see map, top right). The maps show a disturbing picture — of the poor health outcomes of children’s health in swaths of the country (middle, right) and echoing the historic divide of the Civil War (bottom map, above). As the Commonwealth Fund, which studies health care issues in nonpartisan, independent fashion, put it ever so politely in a stark online posting: “States with Strictest Abortion Laws Have Weakest Maternal and Child Health Outcomes.”

Other commentators will provide deeper dives into the political, social, legal, and medical-scientific takeaways from the late June developments on guns and abortion, including the imbalances between popular opinion on these issues (in support of abortion rights and tougher restrictions on guns) and opposite political and judicial outcomes. It is hard to ignore in a democratic society how views of a minority, especially in the extreme, can hold sway over a majority.

As a former president wisely has opined, however, elections matter. Votes matter. Consequential elections loom — this fall, in 2024, and beyond. Those who want a say in this country do so powerfully at the ballot box. Statehouses have become vital electoral battlegrounds as much as what happens in Washington, D.C.

In the District of Columbia, voter registration information is available by clicking here. Those in Maryland can find such information by clicking here. And in Virginia, the 411 is accessible by clicking here.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to afford and access safe, efficient, and excellent health care. This has become an ordeal due to the skyrocketing cost, complexity, and uncertainty of therapies and prescription medications, too many of which prove to be dangerous and bankrupting drugs.

After battling through a lethal coronavirus pandemic and the horrors of repeated, mass outbreaks of gun violence, did the nation and our health care system need the shock of black-robed justices, a number of them notably new to their roles, veering into such disruptive matters as gun control and abortion? Women already experience too much mistreatment in our medical system. Abortion is a wrenching, deeply personal, and private decision, and the courts, politicians, lawmakers, and advocates had spent decades seeking democratic compromises.

The Dobbs decision has created what one news organization described as medical “chaos.” Doctors, clinics, and hospitals in many states will now confront thorny criminal and civil issues when providing medical care to women with reproductive concerns, including ectopic pregnancies and miscarriages. Women’s health will suffer, studies suggest. Experts also are expressing concern about how blanket abortion bans will affect fertility care and research, as well as facilities and experts that provide such services.

As for the high court’s embrace of Second Amendment rights, do the justices themselves — after one of their members was threatened at his home by a heavily armed individual — not grasp how nightmarish the gun violence situation has become in this country? How did the high court majority ignore the slaughters in Uvalde, Texas, Buffalo, N.Y. — and even on the streets of the nation’s capital?

We have much work to do to improve the safety and quality of our health and our lives, all of us not running to extremes but finding the middle ground together on difficult issues like abortion and gun control.

Illustration credits: top map, Washington Post/Guttmacher Institute,  middle map, Annie E. Casey Foundation Kids Count Databook, bottom map, via Commons Media.
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