Doctors have a code, a set of principles meant to guide their practice: Give care. Act justly. Respect patients. Do no harm. But for Texas doctors, especially obstetrician-gynecologists, following those seemingly straightforward principles has become a legal and ethical minefield.
Physicians are finding themselves torn between providing medically appropriate care and staying in compliance with the state’s draconian anti-abortion laws. The stakes couldn’t be higher: risking major fines and up to life in prison for doctors on one side, and on the other, often putting women’s lives at risk because of delays in care or refusals to provide formerly routine procedures. As a result, medical decisions regarding pregnancy complications now involve a host of new stakeholders—hospital administrators and lawyers—who may put questions of institutional risk above patient well-being.
Dr. Shanna Combs, an OB-GYN, waded into that minefield a few months ago while on her shift at a maternity care hospital in Fort Worth. Her patient, 19 weeks along in her first pregnancy, was in bad shape. Her water had broken prematurely, and she’d gone into labor much too early. By the time Combs got to her, she’d been laboring for 48 hours. Her child had a heartbeat but was several weeks away from being strong enough to survive outside the womb.
“Previously, we would call this an inevitable miscarriage or
