A Failed Line of Communication?

Emily Wang discusses the disconnect between science, medicine, law, and politics in the context of abortion legislation, highlighting the communication failures and complexities that arise when political interests overshadow medical expertise and scientific evidence.

Our Huang summer kicked off with a raw and urgent reminder of the consequences when science, medicine, law, and politics misalign. While we so desperately want science to be as simple as verifying the facts and following what’s right, today’s seminar on “Privacy and Obstetrical Care in the post-Dobbs World” by Professor Jolynn Dellinger, Dr. Bev Gray, and Dr. Jonas Swartz reminded me that our reality is unfortunately not so simple. As science and medicine interface with law and politics, the narrative of what’s right, healthy, or safe tangles and frays. Over the last eleven months, states have been rolling out restrictive anti-abortion legislation. Our current political landscape reflects a world where some travel hundreds of miles to receive abortion care, where many doctors must turn away desperate patients, where many patients are fed misleading or wrong information.

Communication emerged as a recurring theme throughout our conversation. Professor Dellinger explained that often, abortion legislation is written and passed without ever consulting medical experts. Instead, legislation is discussed behind closed doors with only a few key interest groups present. In fact, Professor Dellinger explained that for North Carolina’s recent 12-week abortion ban, many of the bill’s sponsors didn’t even know about its details until the day of the vote. Although abortion care directly implicates health and well-being, many of the laws deciding abortion access instead derive from concerns of politics and reelection. The issue of communication between the legal and medical communities is further complicated through definitional differences, political interests, and a sidelining of scientific evidence.

“…abortion legislation is written and passed without ever consulting medical experts. Instead, legislation is discussed behind closed doors with only a few key interest groups present.”

Every bill starts by defining key terms. In the case of abortion, already, at the top of the page, the medical and legal communities diverge. Whereas politicians might use the term “abortion” to refer to medical and surgical termination of a pregnancy, Dr. Swartz explained that in medicine, “abortion” also encompasses miscarriages, otherwise known as a spontaneous abortion. This misalignment of vocabularies between medicine and policy crucially complicates the process of navigating new abortion legislation. Instead of focusing on providing the best possible care, doctors must devote their energy toward combing through pages and pages of legislation to determine the legality of that care.

More broadly, the definition-level conflict reflects a question of which values, principles, and knowledge we use to inform healthcare legislation. While the medical term may derive from science and medical ethics, the corresponding legal term may derive from politics and legal philosophy. As it stands, the legislation that determines whether someone can access abortion care appears to draw more from politics than it does from science.

Additionally, the lack of discourse between medical experts and policymakers often results in arbitrary policymaking. Many anti-abortion advocates champion a 72-hour pre-procedure consultation, claiming that the appointment will provide patients the opportunity to change their minds. Nevertheless, studies suggest that most patients arrive at an abortion clinic having already made up their minds. Thus, the consultation is not only unproductive but also creates an additional barrier to abortion care. In another example, Dr. Gray and Dr. Swartz explained that a 6-week abortion ban is a near complete abortion ban as many people don’t even learn that they’re pregnant until week 5 or 6.

Moreover, in the instances where Dr. Gray, Dr. Swartz, and their colleagues were consulted by lawmakers, they felt as though their words were used against them. While the doctors endeavored to clarify terms and explain medical concepts, they were extremely distraught to realize after the fact that their explanations were twisted to justify tighter abortion restrictions and anti-abortion narratives.

As if “following the science” wasn’t already difficult, Professor Dellinger and Drs. Gray and Swartz further highlighted how challenging it may be to even broach the topic between doctors and lawmakers. Crucially, it’s not a question of politicians not being able to talk to doctors. Instead, it’s an issue of politicians strategically avoiding conversations with doctors because they know the discussion may not be what they want to hear. Our panelists’ palpable frustration further indicates that there may not be an easy solution. This issue of abortion policy may be one that doesn’t close with a satisfying conclusion, and as much as I yearn to end this reflection with a tidy proposal for next steps, I realize that this may be an instance in which I must simply sit for a while and appreciate the gravity and complexity of the issue at hand.

 


Emily Wang, Huang Fellow ’26

Vivian AppleEmily Wang is a first-year undergraduate from Cary, North Carolina pursuing a major in chemistry and a minor in Asian American Diaspora Studies.