Should anyone present know of any reason that this couple should not be joined in holy matrimony, speak now or forever hold your peace.” Book of Common Prayer, Church of England, 1549
Last evening Trump rose from the ashes and declared it was time to “Make America Great and Glorious Again” (MAGAGA).
This past week, five days after the Midterm elections, AMA President, Jack Resnick, Jr., MD, raised his voice from the podium at the AMA Interim Meeting in Hawaii with the AMA’s own version of a call to action:
“But make no mistake, when politicians insert themselves in our exam rooms to interfere with the patient-physician relationship, when they politicize deeply personal health decisions, or criminalize evidence-based care, we will not back down…I never imagined colleagues would find themselves tracking down hospital attorneys before performing urgent abortions, when minutes count … asking if a 30% chance of maternal death, or impending renal failure, meet the criteria for the states exemptions … or whether they must wait a while longer, until their pregnant patient gets even sicker…Enough is enough. We cannot allow physicians or our patients to become pawns in these lies.”
Over a year ago, they had signaled awareness that attacks on Roe v. Wade might fundamentally challenge patient autonomy and the sanctity of the patient-physician relationship. On September 21, 2021, the AMA with 25 other medical organizations filed an amicus brief in opposition to the restrictive Mississippi abortion law, Dobbs v. Jackson Women’s Health Organization. And on October 12, 2021, 19 medical societies, with the AMA in the lead, filed an amicus brief in U.S. v. Texas, the abortion vigilante law signed by Gov. Greg Abbott.
Over the past year, the AMA had ample warning that the situation was spinning out of control. On June 27, 2022, I wrote: “My concern today, despite the strong messaging from Chicago, is that the AMA and its membership have not fully absorbed that this is a ‘mission-critical’ moment in the organization’s history… The strong words, without actions to back them up will permanently seal the AMA’s fate, and challenge Medicine’s status as a ‘profession.’”
I was reacting to the AMA’s statement three days earlier, on release of the Dobbs decision, which labeled the decision “an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship…the AMA condemns the high court’s interpretation in this case. We will always have physicians’ backs and defend the practice of medicine, we will fight to protect the patient-physician relationship.”
At the time, I recommended that the AMA mobilize and orchestrate their Federation state and specialty societies to pursue acts of “physician ‘civil disobedience’ where appropriate to protect the health and well being of all women, regardless of age, race, sexual identity, religion, or economic status.”
This warning came six months after I highlighted Charles Dickens words in a “Tale of Two Cities” – “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, …” – as a way to dramatize that we too are a “tale of two cities” as this map of the United States, color coded for regressive legislation and tactics to disenfranchise women and children, people of color, the poor and the vulnerable, well illustrates.
On November 8, 2022, the AMA site posted a section titled “Advocacy in action: Protecting reproductive health.” But a constructive critic would be justified in suggesting that the plan is tall on “advocacy”, but short on “action.”
What does “action” look like? In Part 2 of this piece, I’ll provide examples from Michigan, Kansas, Kentucky, and Washington.
