A trio from the OUWB community successfully published a commentary in a major clinical journal dealing with a topic set to be imminently addressed by the U.S. Supreme Court.

“Why Hospitals Must Provide Abortions in Pregnancy Emergencies” was co-authored by Abram Brummett, Ph.D., assistant professor, Department of Foundational Medical Studies, Riya Chhabra, and Deepali Tailor — both rising M3s. It was published in the Annals of Internal Medicine.

The commentary essentially suggests that based on public reason, a strong moral argument exists in states that otherwise prohibit abortion for requiring emergency abortion when the physical health — or even life — of an adult patient is at risk. Other commentaries on the subject primarily have focused on the legal aspects of the case.

Brummett says now is the time for commentaries like the one he and the students wrote as it’s a topic that the U.S. Supreme Court is likely to rule on at any moment.

“To have a paper published in a journal like this is a success,” says Brummett. 

The issue

Following the U.S. Supreme Court ruling in Dobbs v Jackson Women’s Health Organization, the U.S. Department of Health and Human Services (DHHS) clarified that the Emergency Medical Treatment and Labor Act (EMTALA) prohibits state law from banning abortions in the context of a pregnancy emergency.

The act primarily applies to hospitals that receive federal funding and have emergency departments, which means most U.S. hospitals. EMTALA mandates emergency medical care for all persons, regardless of finances or insurance.

In court, however, Texas and Idaho have challenged the legal authority of EMTALA. The case has made it to the U.S. Supreme Court, where justices are expected to soon issue a final ruling. (Early reports indicate the court has ruled in favor of allowing abortions in emergency situations.)

Brummett says that so far, most commentaries on the issue have focused on the legal aspects of the case — specifically, on the topic of federal law vs. state.

The piece penned by Brummett and the two students, however, centers on articulating a public reason-based moral justification for emergency abortions. Rather than arguments using religious reasons, public reason requires arguments to be based on shared reasons. 

“We all agree that a 22-year-old pregnant patient who could die as the result of a pregnancy emergency is really bad,” he says. “We don’t all agree that a 12-day-old embryo being terminated as the result of a pregnancy emergency is bad in the same way.”

The commentary clearly spells out who may benefit from reading it.

“Our analysis may be of use to clinicians who wish to advocate for either maintaining the EMTALA requirement or, if the requirement is overturned, enacting life and health exceptions to abortion bans at the state level (both exceptions are not currently active in all states),” wrote the co-authors.

The student co-authors say they have similar motivations for being involved.

“We just really want to start a conversation with people, regardless of where they fall on the spectrum of the issue, so that a place can be found where we can all work together and find solutions,” says Chhabra.

As future physicians, Tailor says it’s especially important to be aware of such issues that seem to be in flux.

“We could end up practicing anywhere and meeting people from all walks of life,” she says. “Being able to have open conversations and communicate effectively about these types of issues is important.” 

‘A grand slam’

As part of OUWB’s Medical Humanities and Clinical Bioethics curriculum, Brummett teaches seminars that address specific topics like conscientious objection.

In one of the seminars, Chhabra and Tailor teamed up on a paper that would ultimately form the basis of the published commentary. Brummett says he read the paper, thought it was “really interesting,” and worth developing for publication.

After the trio put many hours of work into research and writing for the piece, they sought publication in what Brummett called “a major clinical journal.”

“That’s always a grand slam for our students’ careers,” he says. “This will be something they present at conferences, can talk about during residency interviews, and so on.”

Having a piece published in a journal like Annals of Internal Medicine was a first for the two students who served on the 2023-24 executive board for OUWB’s American Medical Association chapter.

“We worked on a lot of policies that were centered around women’s health, and this is very much in that same area,” says Tailor.

“It was a good experience,” says Chhabra. “It’s very exciting and I feel very grateful that our paper was accepted.”

And even though the medical students have plenty of other responsibilities, both say the project was worth taking on.

“It stems from being passionate about it and wanting to be involved in advocacy,” says Chhabra.

Tailor expressed similar feelings.

“Whenever I’m passionate about something, I try to make time for it,” she says. “Plus, this is such an important issue not just in Michigan, but all over the United States…wherever we end up practicing as physicians, we’ll be able to be advocates for those in the communities we serve.”

For more information, contact Andrew Dietderich, senior marketing specialist, OUWB, at [email protected].

To request an interview, visit the OUWB Communications & Marketing webpage.

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