Curious Bioethics, April 2-8, 2023
Abortion pills, trans athletes, Black Health & Science Comms
Hey there, Curious Human!
In today’s curated collection, you’ll find:
Bioethics in the News: contradicting abortion pill cases, wins for transgender athletes
What I’m Reading: Bioethicist Keisha Ray’s Black Health, The Truelove poem
Educational Opportunities: Science communication and masking, discussion with physician-writer Ricard Nuila, MD
Bioethics in the News
Texas and Washington Abortion Rulings
On Friday, two courts made opposing rulings on access to mifepristone: one removing Food and Drug Administration (FDA) approval and one calling to expand access. Mifepristone has been approved for 23 years and used safely by millions of patients.
In Texas, Matthew Kacsmaryk suspended the US FDA’s approval of mifepristone - a safe and effective drug used for medication abortion. This would impose a nationwide injunction on accessing the medication. (I wrote to you about the Texas case a few weeks ago.) It is unprecedented for a judge to override the FDA’s drug approval. No judge should have this much authority. We should expect that if this ruling is allowed to stand, birth control and emergency contraception will be attacked next. Beyond that, any partisan judge can prevent patient access to any drug, regardless of expert analysis of a medication’s safety.
But in Washington State, 17 Democratic attorneys general have argued that the FDA has been too restrictive with mifepristone access. Judge Tomas Rice issued a preliminary injunction telling the FDA not to take “any action to remove mifepristone from the market or otherwise cause the drug to become less available.”
Grace Haley wrote a great summary of the two lawsuits at
:
The quote below is from
's The Anti-Abortion Movement Will Sacrifice Anything to Control Women:But the big takeaway from the radical and unprecedented decision to ban Mifepristone is this: The anti-abortion movement has always been an anti-democratic and authoritarian movement, and that authoritarianism has taken over the Republican Party and the far-right judiciary. This decision was not about life or women’s health or drug regulation or even the law (it really, really wasn’t about the law). It was a simple assertion of dominance, a clear statement that the right will stop at absolutely nothing – including the outer bounds of American law – to force women into compliance.
More States Ban Gender-Affirming Medical and Social Care
Indiana and Idaho join the hatred bandwagon and ban access to gender-affirming care for children. These states continue to promote and capitalize on a false narrative that gender-affirming care is limited to surgery (it’s not) and that surgeries are done with little to no oversight. As a gender-affirming care provider, these false assertions fill me with rage. The vast majority of gender-affirming care is social care and reducing stigma. The people who suffer from these blanket restrictions are kids, who need our love and support to be themselves.
These restrictions attack clinicians’ ability to provide care, no matter the scientific and clinical evidence.
West Virginia Can’t Prevent Trans Athletes from Competing
12-year-old middle schooler Becky Pepper-Johnson will be allowed to run on her school’s track team. The Supreme Court will not allow West Virginia to ban transgender athletes from participating in public school sports. This is an important win against anti-trans bans across the country.
If, like me, you haven’t heard much about this case, it’s because it was on the emergency docket (also referred to as the shadow docket). The case was decided without a full briefing or argument. Conservative Justices Samuel Alito and Clarence Thomas dissented, which should surprise no one. I’m relieved they were the only two dissenters.
Title IX Update to Prevent Brand Bans against Trans Athletes
In a related case, the U.S. Education Department proposed changes to Title IX, which prevents sex-based discrimination in federally funded education programs. This would further protect transgender students from discrimination. You can read the DOE’s fact sheet here.
The proposed regulation would be in the Title IX regulations at section 106.41(b)(2):
If a recipient adopts or applies sex-related criteria that would limit or deny a student's eligibility to participate on a male or female team consistent with their gender identity, such criteria must, for each sport, level of competition, and grade or education level: (i) be substantially related to the achievement of an important educational objective, and (ii) minimize harms to students whose opportunity to participate on a male or female team consistent with their gender identity would be limited or denied.
One thing I’ll be keeping a look out for is how this will impact students who do not identify as either gender, in a world built on a binary classification system.
What I’m Reading This Week
Black Health: The Social, Political, and Cultural Determinants of Black People's Health
My friend Keisha Ray’s new book is out on Black health. I’ve cheered her on for the last few years while she was writing the book. I know her determination to write a text that was accessible rather than high-brow academic speak. So I haven’t started reading this yet, but I am eagerly awaiting the copy I ordered!
Why do American Black people generally have worse health than American White people? To answer this question, Black Health dispels any notion that Black people have inferior bodies that are inherently susceptible to disease. This is simply false racial science used to justify White supremacy and Black inferiority. A genuine investigation into the status of Black people's health requires us to acknowledge that race has always been a powerful social category that gives access to the resources we need for health and wellbeing to some people, while withholding them from other people. - Oxford University Press
Written in an engaging and accessible style
Highlights the lived experience of Black people and the relations between their health and institutions
Provides study questions in each chapter to engage readers
Discusses how Covid-19 shone a light on existing inequalities in health in America
You can order it from Oxford University Press or Amazon.
The Truelove: Poet and Philosopher David Whyte on Reaching Beyond Our Limiting Beliefs About the Love We Deserve
You can read David Whyte’s whole poem and Maria Popover’s magical way of tying together the stories we tell ourselves of what we are worthy and unworthy of, on The Marginalian.
While this love poem is most obviously about romantic love, I can’t help but read it and think of my own relationship with medicine, bioethics, and cyclic burnout. To take on a life of meaning, to live life to the fullest, there are many sacrifices. It is a privilege to be able to show love for other humans through care. And yet, we’re trying to do this in a system designed with entirely different motives, and it can feel like drowning to have so little ability to overcome systemic inequity. I often imagine what it would take to walk across this healthcare territory to something better, safer, and more loving of our fellow humans.
so that when
we finally step out of the boat
toward them, we find
everything holds
us, and everything confirms
our courage, and if you wanted
to drown you could,
but you don’t
because finally
after all this struggle
and all these years
you simply don’t want to
any more
you’ve simply had enough
of drowning
and you want to live and you
want to love and you will
walk across any territory
and any darkness
however fluid and however
dangerous to take the
one hand you know
belongs in yours.
~David Whyte
Educational Opportunities
Why Is There Confusion About Whether Masks Prevent COVID-19? Public Perceptions, Misperceptions and the Messaging of Science
Columbia Bioethics has a free public webinar on masking and science communication.
WHEN: Thursday, April 27, 6:15 pm–7:45 pm EDT ( 3:15 - 4:45pm PDT)
WHERE: Online —> Register Here.
Author Discussion with Ricardo Nuila, MD
University of Colorado’s Center for Bioethics and Humanities is hosting a conversation with physician-writer Ricardo Nuila about his debut novel, The People’s Hospital.
Where does one go without health insurance, when turned away by hospitals, clinics, and doctors? In The People’s Hospital, physician Ricardo Nuila’s stunning debut, we follow the lives of five uninsured Houstonians as their struggle for survival leads them to a hospital where insurance comes second to genuine care.
WHEN: May 4, 2023, 12:00 PM - 01:00 PM MDT (10:00 -11:00 AM PDT)
WHERE: Online —> Register Here.
That’s it!
As always, thanks for being curious!
Hit reply and let me know what ethics issues you are most curious about this week—I’d love to hear from you!
See you next week!
Be Well & Be Curious,
Alyssa