CHEST Guidelines-The-Impact-of--em-Dobbs-v-Jackson--em--on-Future-C

The-Impact-of--em-Dobbs-v-Jackson--em--on-Future-C

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The Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, which reshaped abortion policies in the U.S., has had significant implications for critical care fellows, according to a 2023 cross-sectional survey. Conducted by the American Thoracic Society’s Women in Critical Care Interest Group, the survey sought to explore the decision's impact on 1,164 invited critical care fellows, receiving 265 responses (22.8% response rate).<br /><br />Most survey respondents (89.4%) opposed the Dobbs ruling, with 38.9% expressing concerns about how it impacts care for critically ill obstetric patients. About 14.3% of fellows noted that state legislation was affecting their doctor-patient relationships, and 27.9% were worried about the legal implications of performing medically necessary abortions. The fellows' responses highlighted unanimous discomfort with the ruling's potential constraints on providing adequate care to obstetric patients.<br /><br />The survey also revealed potential regional shifts in workforce distribution, as the Dobbs decision influenced fellows' future residence and work choices, specifically impacting decisions regarding geographical work location (57.7%) and the health systems they would join (62.3%). The impact was more significant for female fellows regarding their choice of work and living regions, with statistical significance observed for residence region (P = .01) and work region (P = .02).<br /><br />This study suggests that restrictive abortion policies, as exacerbated by the Dobbs ruling, might lead to critical care physician shortages in states with tougher regulations, potentially worsening disparities in maternal mortality and access to intensive care. To mitigate the negative repercussions on the critical care workforce, especially concerning obstetric patients, strategic interventions are deemed necessary. However, the research acknowledges limitations such as biases and the sensitivity of the topic affecting response rates.

Keywords

Dobbs v. Jackson

abortion policies

critical care fellows

American Thoracic Society

obstetric patients

workforce distribution

regional shifts

maternal mortality

physician shortages

restrictive legislation