The Massachusetts Medical Society
wishes to be recorded in strong support of key elements of House bill 3320 and
Senate Bill 1209, collectively referred to hereinafter as the ROE Act. This includes support for provisions in the ROE Act
relative to eliminating the requirement of parental consent, updating
terminology in the Massachusetts legal code to be rooted in medicine and
science, and ensuring safety net coverage for abortion. As a professional association of physicians and
medical students advocating to improve patient care, the Medical Society
supports policies that enhance and protect the
physician-patient relationship and preserve physicians’ ability to make
clinical decisions for the benefit of patients.
We believe these provisions in the ROE Act effectuate those goals.
The Massachusetts Medical Society has long
supported legislative approaches to health care issues that provide due
deference to medical judgment and due respect to the physician-patient
relationship, both within the context of abortion, and relative to clinical
care more broadly. Current Massachusetts
law contains antiquated, medically unnecessary provisions that tie the hands of
doctors and interfere with the physician-patient relationship, including a
statute that unduly regulates physicians’ ability to exercise medical judgment
to choose the most appropriate abortion procedure for a given patient. Our laws politicize the provision of a basic
component of healthcare, fundamentally stigmatizing abortion – and both the
people who seek it and those who provide it – and causing undue barriers and
delays to access care. The Medical
Society supports provisions of the ROE
Act that will align laws governing abortion, a valid medical procedure in the
continuum of reproductive health care, with those related to all other
pregnancy-related care, and modernize state law to conform with current medical
standards.
The Medical Society
believes that the only criteria needed to consent to abortion
should be pregnancy and medical decision-making capacity. As such, we support
eliminating mandatory parental consent and the judicial bypass process
teenagers must navigate to access safe, legal abortion. Under the ROE Act, the process for minors
accessing abortion would be aligned with the process for minors accessing all
other pregnancy-related care. By eliminating
parental consent requirements, the ROE Act ensures the small percentage of
young people who cannot turn to their parents when they experience an
unintended pregnancy will still be protected—without delaying their care or
causing them to leave the state to receive it. Timely access to medical care is especially
important for pregnant teenagers because of the significant medical, personal,
and social consequences of adolescent childbearing. Moreover, putting medically unnecessary
barriers in the way to care for young people often leads them to seek care out
of state, which could jeopardize their health and safety if they are unable to
obtain appropriate follow up care as medically indicated.[1]
The current process requiring a young person to navigate the
court system to obtain judicial authorization offers no support or protection
for young people, while often causing undue stress, anxiety, and fear. Under the ROE Act, a young person in need of care
would be supported by qualified medical professionals in the Commonwealth who offer non-directive, comprehensive options
counseling to all pregnant patients.
Medical providers are most apt to gauge young people’s medical
decision-making capacity and necessarily make that assessment in the process of
obtaining informed consent from patients.
Where judges lack specialized training in handling these sensitive
matters, medical providers are proficient and adept in recognizing abuse and coercion
and can connect young people to a network of support. Moreover, medical providers are mandated
reporters under state law and are obligated to report abuse or suspected abuse,
including sexual abuse, to the appropriate authorities.
Not only does the judicial bypass system not support young
people, it has harmful impacts. A recent
study of Massachusetts’ judicial bypass system published in the Journal of
Obstetrics & Gynecology showed that the judicial bypass process disproportionately
affects young people of color and young people of low socioeconomic status, reflective
of existing, pervasive inequities in access to health care. Requiring parental or judicial consent is
associated with delays in access for minors seeking abortion. The aforementioned study found that minors
who obtained parental consent experienced an average delay in access to care of
9 days, whereas those who obtained judicial consent experienced an average
delay of 15 days.[2] These unnecessary delays can have a
detrimental clinical impact, limiting patients’ care options by rendering them
ineligible for medication abortion, a nonsurgical option
only available to patients in the first 10 weeks of pregnancy. In fact, one-in-three minors from the study who
accessed abortion through the judicial bypass system lost access to medication
abortion. Delays
in access to reproductive health care make care more expensive and increase associated
risks of the procedure, ultimately failing to protect the best interests of the
patient.
The ROE Act also
removes medically unnecessary statutory provisions and inflammatory language
that were written to restrict abortion access and that do not reflect current
medical standards. The Medical Society supports provisions
of the ROE Act that will update pregnancy and abortion-related medical
terminology used in our legal codes to reflect the most recent scientific
evidence and knowledge, ensuring Massachusetts laws are rooted in medicine and
science.
Lastly, the Medical
Society supports codifying the state safety net program’s coverage of abortion
care. The current safety net program helps people with low incomes who are
ineligible for MassHealth coverage access pregnancy-related care. Access to health care is not equitable when it
is limited only to those who can afford it.
Enshrining this coverage into law will ensure that when it comes to
decisions about whether or not to end a pregnancy, a person has the health
coverage they need so they can genuinely access their
full range of options and make the medical decision that is right for them.
The Commonwealth should
pass legislation that will respect the rights of pregnant people and recognize
abortion as health care. For these
reasons, the Massachusetts Medical Society supports these critical elements of
the ROE Act.
[1]
New York and Vermont do not have a minimum age of consent required to access
abortion. In Connecticut, people under
the age of 16 are able to access abortion without parental consent
[2]
Janiak E, Fulcher IR, Cottrill AA, et al. Massachusettsʼ Parental Consent Law
and Procedural Timing Among Adolescents Undergoing Abortion. Obstetrics
& Gynecology. 2019;133(5):978-986. doi:10.1097/aog.0000000000003190.
