Spring 2024

Mary Harmed, J.D., and Ingrid Skop, M.D., in this article, correct misleading statements in a recent Obstetrics & Gynecology article. No state has an abortion law that is a total ban on abortion. Every state law permits abortion when necessary to save a mother’s life. Texas law does not require an “imminent” risk and allows a doctor to use his “reasonable medical judgment” to determine if an abortion is necessary to prevent a “risk” of maternal death. Similarly, Idaho allows a doctor to use his “good faith medical judgment” to determine when to intervene, without need for “immediacy.”

Ingrid Skop, M.D., et al., in this article, discusses the implications of the U.S. FDA permanently removing the in-person prescribing requirements that previously safeguarded the use of mifepristone/misoprostol medical abortions, allowing prescribing through telemedicine or on-line ordering and distribution through the mail and pharmacies, without standard pre-abortion testing. This will increase the risk of complications due to failure to adequately determine the gestational age or rule out ectopic pregnancy by ultrasound or physical exam, failure to perform labs to document whether RhoGAM is indicated, and failure to obtain appropriate informed consent to prevent unwanted abortions, among other concerns. The FDA justified this action by referencing flawed studies with significantly undercounted complications. The details of these study deficiencies are examined in this article.

In this article, Olena Korolchuk et al. examines state regulation of medical care quality post-COVID and during martial law in Ukraine, identifying areas for improvement. It emphasizes state roles in healthcare standardization, continuous feedback monitoring, and studying patient satisfaction. Interrelationships among Ukraine’s state regulation mechanisms are determined, highlighting the need to enhance tools such as criteria and quality indicators for medical care assurance. The authors utilize various scientific methods, including analysis, synthesis, induction, and deduction, as well as historical and legal, formal legal, and comparative legal methods to examine the state regulation of ensuring the quality of medical care during martial law in Ukraine. The article considers the interrelationships of mechanisms and instruments of state regulation of quality assurance of medical care in Ukraine. It concludes that the state should enhance medical care quality regulation, drawing on international experiences from the EU and the USA and adapting best practices to national circumstances. The resilience of the healthcare system depends on effective quality assurance, ensuring preparedness, stability, and ongoing improvement prospects.

In this article, Elena Kiselyova et al. surveys the peculiarities of international standards in the field of health care and medical services, as well as the prospects of their implementation in Ukraine. Leading re- search methods are general and special research methods, including meth- ods of logic, analysis, comparison. The results outline recommendations for the use of international standards in the field of health care and medical services in Ukraine and summarizes the legal framework. The significance is reflected in that this study can serve as a basis for outlining future chang- es in legislation on the functioning of the health care system and imple- mentation of world practices in health care. Within the framework of this study, it systematizes the main international and European documents that reflect the main international standards in the field of health care and medical services as ratified in Ukraine.

In this article, Paul Benjamin Linton, Esq., examines the implications of the Alabama Supreme Court decision in LePage v. Center for Reproductive Medicine, which held that the parents of human embryos that were negligently destroyed at a fertility clinic could bring an action for damages under the State’s wrongful death statute. Although the Alabama legislature promptly enacted a law essentially overturning the state supreme court’s decision, concerns have been raised that the court’s decision might influence courts in other States to interpret their wrongful death statutes, or possibly even their fetal homicide statutes, to apply in similar circumstances, thereby threatening the availability of in vitro fertilization (IVF) technology. This article addresses those concerns.

In this article, David Reardon analyzes a Danish study of monthly and tri-monthly rates of first-time psychiatric contact following first induced abortions reported higher rates compared to first live births but similar rates compared to nine months pre-abortion. The researchers in that study con- cluded abortion has no independent effect on mental health; and any differ- ences between psychiatric contacts after abortion and delivery are entirely attributable to pre-existing mental health differences. But these conclusions are inconsistent with similar studies that used longer time frames. Reardon’s re-analysis reveals that the Danish data is consistent with the larger body of both record-based and survey-based studies when viewed over periods of ob- servation of at least nine months. Longer periods of observation are necessary to capture both anniversary reactions and the exhaustion of coping mecha- nisms which may delay observation of post-abortion effects.