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The Third Person in the Room.

Mara Buchbinder

    The Hastings Center Report
    |April 17, 2025
    PubMed
    Summary

    Abortion bans create an imaginary "third person" in the exam room, negatively impacting the patient-physician relationship for obstetrician-gynecologists. This barrier hinders care and trust in states with strict abortion laws.

    Area of Science:

    • Medical Ethics
    • Reproductive Health Law
    • Patient-Physician Relationship Dynamics

    Background:

    • The Supreme Court's Dobbs v. Jackson Women's Health Organization decision has led to near-total abortion bans in several U.S. states.
    • Media coverage often focuses on direct patient harm from denied abortion care.
    • Subtler impacts on the patient-physician relationship remain less explored.

    Purpose of the Study:

    • To explore the perceived impact of abortion bans on the clinical encounter from the perspective of obstetrician-gynecologists.
    • To understand how legal restrictions on abortion influence the patient-physician dynamic.

    Main Methods:

    • Qualitative commentary reflecting on interviews with general obstetrician-gynecologists.
    • Analysis of physicians' experiences in states with near-total abortion bans.
    Keywords:
    Dobbsabortionclinical counselingclinical ethicspatient‐physician relationship

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    Main Results:

    • Physicians described an intangible "third person" present during clinical encounters.
    • This "third person" symbolizes the intrusive nature of abortion bans in medical decision-making.
    • The presence of this "third person" creates a barrier and disrupts the therapeutic relationship.

    Conclusions:

    • Post-Dobbs abortion bans introduce a figurative "third person" into the patient-physician relationship.
    • This intrusion erodes trust and complicates the delivery of obstetric and gynecologic care.
    • Addressing these impacts is crucial for maintaining effective patient-physician communication and care.