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Abortion policies at the bedside: incorporating an ethical framework in the analysis and development of abortion legislation
  1. Alicia E Hersey1,
  2. Jai-Me Potter-Rutledge2,
  3. Benjamin P Brown1
  1. 1 Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
  2. 2 Brown University School of Public Health, Providence, Rhode Island, USA
  1. Correspondence to Dr. Alicia E Hersey, Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA; alicia_hersey{at}


About 6% of women in the world live in countries that ban all abortions, and 34% in countries that only allow abortion to preserve maternal life or health. In the USA, over the last decades—even before Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion—various states have sought to restrict abortion access. Often times, this legislation has been advanced based on legislators’ personal moral values. At the bedside, in contrast, provision of abortion care should adhere to the normative principles of medical ethics and reproductive justice, centreing patients and their individual reproductive intentions and desires. Abortion regulations, through their influence on patients and providers, may facilitate or impede such ethical care at the bedside. In this paper, we present a framework to model how abortion legislation should fit into the patient–provider relationship and to clarify the dynamics by which legislation may affect healthcare encounters. Our proposed framework serves as a tool to analyse the ethical impact of abortion regulations. We propose a model for assessing abortion policies based not on legislators’ or advocates’ individual moral claims, but on the shared, normative framework of clinical medical ethics. Through contrasting case studies, we demonstrate how a robust normative ethical framework can recentre patients and their reproductive needs. Our model is one way to account for—and safeguard—patients’ diverse viewpoints and needs in the development of abortion policy, and it can serve to ground narratives for advocacy by healthcare workers and their professional organisations.

  • Abortion - Induced
  • Policy
  • Ethics- Medical

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  • Contributors AH conceptualised the project idea, performed the literature reviewed, drafted and revised the manuscript. AH is the guarantor of the manuscript. J-MP-R contributed to edits and feedback. BPB contributed to the conceptualisation and editing of the manuscript and approved the final draft of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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