Conscientious Malpractice

Anti-abortion doctor group argued in court for the ability to refuse care to ER patients like Amber Thurman

It's difficult to grapple with the tragic news of the abortion ban-related death of a healthy 28 year-old medical assistant, nursing student hopeful, and mother of a small child. Amber Nicole Thurman died a preventable death from delayed medical care. Amber had experienced a rare, treatable complication after using medication to end her pregnancy; she needed antibiotics and a simple, minutes-long procedure that's frequently used to complete miscarriages by removing any remaining tissue (placenta, etc.) that hasn't been fully expelled from the body. Before six Republican-appointed Supreme Court justices overturned Roe v. Wade allowing abortion bans to take effect in Republican-controlled states, Amber would have been promptly treated. Instead, under Georgia’s abortion ban, doctors delayed the simple, minutes-long procedure until it was too late.

Back in 2019, during one of the legislative hearings over Georgia’s ban, medical experts warned that this would happen. “[Doctors] would feel the need to wait for a higher blood pressure, wait for a higher fever — really got to justify this one — bleed a little bit more,” Dr. Melissa Kottke, an OB-GYN at Emory, told lawmakers at the time.

Amber's last words to her mother were, “Promise me you’ll take care of my son.”

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At least one other woman has died because of Georgia’s abortion ban: Candi Miller, a 41 year-old wife and mother of three who suffered from lupus. Doctors had told Candi that a another pregnancy could kill her.

Both women's cases “add[] to mounting evidence that exceptions to abortion bans do not, as billed, protect the ‘life of the mother.’”¹

Their tragic deaths “also underscore[] the reality that abortion bans have not actually led to a decrease in abortions. But for people like [Amber and Candi], they have increased the degree of difficulty and risk.”²

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Helen Lewis, a staff writer at The Atlantic, reflected, “I read the story of Amber Nicole Thurman’s death with a kind of cold rage. This did not need to happen. Without Dobbs, it would not have happened. And it will keep happening.”³

What perhaps makes Amber's needless death under Georgia’s abortion ban even more chilling is the ugly reality that Amber is exactly the kind of patient that a group of activist “pro-life” doctors wish to freely refuse to treat. 

On March 26, 2024, the Supreme Court heard oral arguments in Alliance for Hippocratic Medicine v. FDA, a case disguised as a dispute over drug safety. As I pointed out a few days before oral arguments, “In reality, the plaintiffs’ professed saccharine devotion to and cloying concern for the safety of women and girls are merely an advantageous façade.”

In the written lawsuit and emphasized at oral arguments before the court, anti-abortion ER doctors argued that, because they personally object to abortion, they “oppose being forced” to treat patients who, like Amber, chose to terminate their pregnancies and experience the rare, treatable complication that Amber experienced. Even though the anti-abortion doctors acknowledge in the lawsuit that there is no way for them to know whether a miscarriage is natural or induced - because the symptoms are identical - they nevertheless don't want to treat these patients who come to them for help, because removing placental tissue will, the anti-abortion doctors contend, make them “complicit” in a patient’s choice to which they are personally opposed. 

[Excerpt of the Supreme Court arguments in the image below.]

The anti-abortion doctors’ primary argument in the lawsuit is that, because some patients who take mifepristone might experience complications, then “some of those patients might then seek care from an emergency room in a hospital where one of the [anti-abortion] doctors or a member of the [anti-abortion] plaintiff organizations is working. That doctor might then have to care for this patient, and might discover that the mifepristone did not successfully terminate the patient’s pregnancy. This anti-abortion doctor might then have to complete the abortion or otherwise provide care” which the doctor doesn't want to provide simply because the doctor is personally opposed to the choice the patient made to end her pregnancy.⁴

For these “pro-life” doctors, some patients’ lives don't deserve saving— lives like Amber's.

And because there's no way for doctors to medically distinguish between spontaneous or induced miscarriages, anyone experiencing a miscarriage could be suspected of making a choice that an anti-abortion ER doctor is personally opposed to and subsequently be subject to a refusal of care by the anti-abortion ER physician— at that physician's discretion.

No matter how they spin it. wanting to deny emergency medical care to certain patients because they don't like those patients’ choices, real or perceived, will never be pro life. It's faux-life. It's pro-death.

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Republicans’ abortion bans continue to inflict cruel and unnecessary suffering. “In Texas, a woman whose water broke at 18 weeks—far too early for her baby to survive outside the womb—was unable to get an abortion until she became septic. She spent three days in the ICU, and one of her fallopian tubes permanently closed from scarring. In Tennessee, a woman lost four pints of blood delivering her dead fetus in a hospital’s holding area. In Oklahoma, a bleeding woman with a nonviable pregnancy was turned away from three separate hospitals. One said she could wait in the parking lot until her condition became life-threatening.”⁵

Yet, anti-abortion doctors and their lobbying groups like American Association of Pro-Life OBGYNs (AAPLOG) continue to defend these laws for “protecting life.” Whose life?

Meanwhile, families are left to mourn. “The sting of [Amber] Thurman’s death remains extremely raw to her loved ones, who feel her absence most deeply as they watch her son grow taller and lose teeth and start school years without her. They focus on surrounding him with love but know nothing can replace his mother.”

“Something has gone terribly wrong in America when people who define themselves as pro-life have sentenced a small boy to go to bed tonight, and every night, without his mother.”⁶

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1. Surana, K. (2024b, September 18). Candi Miller died afraid to seek care amid Georgia’s abortion ban. ProPublica. https://www.propublica.org/article/candi-miller-abortion-ban-death-georgia

2. Surana, K. (2024b, September 18). Candi Miller died afraid to seek care amid Georgia’s abortion ban. ProPublica. https://www.propublica.org/article/candi-miller-abortion-ban-death-georgia

3. Lewis, H. (2024, September 18). The women killed by the dobbs decision. The Atlantic. https://www.theatlantic.com/ideas/archive/2024/09/women-killed-dobbs-decision-abortion/679921/

4. Millhiser, I. (2024, March 21). The Supreme Court’s abortion pills case, explained. Vox. https://www.vox.com/scotus/2024/3/21/24105984/supreme-court-mifepristone-abortion-pills-fda-alliance-hippocratic-medicine

5. Zhang, S. (2024, September 12). “that’s something that you won’t recover from as a doctor.” The Atlantic. https://www.theatlantic.com/magazine/archive/2024/10/abortion-ban-idaho-ob-gyn-maternity-care/679567/

6. Lewis, H. (2024, September 18). The women killed by the dobbs decision. The Atlantic. https://www.theatlantic.com/ideas/archive/2024/09/women-killed-dobbs-decision-abortion/679921/