SGEM Xtra: You Don’t Own Me – Post Roe Emergency Medicine

Date: January 22, 2022 Reference: Samuels-Kalow M et al. Post-Roe Emergency Medicine: Policy, clinical, training, and individual implications for emergency clinicians. AEM Dec 2022 Guest Skeptic: Dr. Michelle Lin is an emergency physician and health services researcher whose goal is to transform acute care delivery to best meet the needs of those who experience the greatest barriers to accessing health care. This is an SGEM Xtra episode. The ruling of the US Supreme Court on June 24, 2022 in Dobbs v Jackson Women’s Health Organization overturned Roe v Wade and allowed individual US states to determine their own restrictions on abortion. There was a recent tweet about allyship and advocacy by an orthopaedic surgeon, Dr. Simon Fleming. He encouraged people to shut up and listen. To amplify other voices and transfer your privilege. I interpreted that to mean, at times, men should talk less and listen more. Dr. Kirsty Challen This is one of those times. Therefore, Dr. Kirsty Challen will be hosting this SGEM Xtra episode. Academic Emergency Medicine published a special contribution in December 2022 exploring the implications of this for providers of emergency healthcare. This episode was recorded one day after the 50th Anniversary of the Roe v Wade on January 22, 1973.  Although the SGEM is based in Canada and Dr. Challen is British we felt this was an issue of such importance that we wanted to invite the authors to discuss it further with us. TRIGGER WARNING: AS A WARNING TO THOSE LISTENING TO THE PODCAST OR READING THE BLOG POST, THERE MAY BE SOME THINGS DISCUSSED ABOUT ABORTION THAT COULD BE UPSETTING. THE SGEM IS FREE AND OPEN ACCESS TRYING TO CUT THE KNOWLEDGE TRANSLATION DOWN TO LESS THAN ONE YEAR. IT IS INTENDED FOR CLINICIANS PROVIDING CARE TO EMERGENCY PATIENTS, SO THEY GET THE BEST CARE, BASED ON THE BEST EVIDENCE. SOME OF THE ABORTION MATERIAL WE ARE GOING TO BE TALKING ABOUT ON THE SHOW COULD TRIGGER SOME STRONG EMOTIONS. IF YOU ARE FEELING UPSET BY THE CONTENT, THEN PLEASE STOP LISTENING OR READING. THERE WILL BE RESOURCES LISTED AT THE END OF THE BLOG FOR THOSE LOOKING FOR ASSISTANCE. QUESTIONS FOR DR. MICHELLE LIN Dr. Michelle Lin was asked several questions about the implications of the Dobbs v Jackson Women’s Health Organization decision. Please listen to the SGEM Xtra podcast on iTunes to hear her answers and for more details. Dr. Michelle Lin Why does Emergency Medicine need to know? After all, we aren’t abortion providers, or even Obstetrician/Gynaecologists. The paper talks about the unequal implications of this decision – surely the law is the law everywhere? Can you tell us more? What are the legal implications for Emergency Physicians caring for patients who may be miscarrying spontaneously, have an ectopic pregnancy, or present with the complications of an abortion which is illegal in that state? You said something specifically about documentation as well? And what about the pregnant or potentially pregnant Emergency Physician? Is this going to impact on us as a workforce too? You’ve mentioned that one of the policy actions for emergency physicians could be to use EMTALA to pre-empt state restrictions. Can you explain how that would work practically for those of us outside the US who don’t have an EMTALA-like system? Is there anything else you would like to say about this issue? The SGEM will be back next episode doing a structured critical appraisal of a recent publication. Trying to cut the knowledge translation window down from over ten years to less than one year using the power of social media. So, patients get the best care, based upon the best evidence. REMEMBER TO BE SKEPTICAL OF ANYTHING YOU LEARN, EVEN IF YOU HEARD IT ON THE SKEPTICS’ GUIDE TO EMERGENCY MEDICINE. Additional Resources: College of Family Physicians of Canada (CFPC) Abortion National Health Services (NHS) Abortions