Protecting patient rights and public health

Sept. 17, 2022  |  By John R. Brumsted, M.D. 

As a health care safety net provider for more than 1 million people in two states, the UVM Health Network exists to serve the needs of our patients. So when the essential right of patients to make decisions about their health care is jeopardized, we have an obligation to speak up. This is one of those times.

The U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization – and the subsequent move by politicians in many states to curb or eliminate access to safe abortion services – undermines health care access for millions of people. This impact falls disproportionately on those who already faced long-standing health care inequities and systemic or socioeconomic barriers to health and wellness. Access to reproductive health care – previously a constitutional right – is now in large part determined by geography, politics and privilege.

This is not how health care should work. The UVM Health Network stands in support of preserving access to the full range of reproductive health care, including abortion services. We support the right of patients to make decisions, with their health care provider, for themselves and their families. As a longtime physician focusing on women’s and family health care, I’ve seen first-hand how personal and difficult these decisions can be: They come down to individual circumstance at specific points in time. I’m proud that our health system is here to serve patients as they make these decisions.

With political rhetoric ramping up, I want to provide facts and context on this issue as it relates to our network. First, it’s important to note that our patients asked us for complete reproductive care, and we responded by providing those services. We offer high-quality reproductive health care, including services and education related to contraception; preconception care and planning; infertility; assisted reproductive care (including in vitro fertilization); pregnancy; abortion; and adoption – in whatever way is appropriate based on a person’s unique clinical circumstances. 

We believe decisions about reproductive health, including abortion, are a private matter between patient and provider. The frequent invocation of “late-term abortion” in public debate ignores the fact that abortion late in pregnancy is extremely rare (both in Vermont and nationally) and almost always results from a combination of dire medical need and intense social stressors. In rare situations when abortion is considered later in pregnancy, we follow a careful decision-making process that includes required consultation with clinical ethics leaders and our chief medical officer. We strive to provide thoughtful and compassionate care in those circumstances.

I also want to note that we have strengthened our policies that allow members of our staff and students who are learning in our institutions to opt out of certain procedures due to moral objection. That includes abortion.

I applaud recent actions by leaders in Vermont and New York to incorporate reproductive health care rights into state law. This November, Vermont voters will consider a constitutional amendment declaring that “personal reproductive autonomy is central to the liberty and dignity to determine one’s own life course.” This is an important step to further ensure that these critical health care services remain accessible.

In the run-up to Vermont’s constitutional vote, we’re likely to see an intensification of divisive rhetoric. But at this moment, we must focus on the fundamental right of patients to make their health care decisions – and the consequences to patients, families, communities and public health when that right is taken away.

John R. Brumsted, M.D., is president and CEO of UVM Health Network and an obstetrician-gynecologist.