WASHINGTON The U.S. Supreme Court's ruling last week that outlawed a certain abortion procedure could be a first step of greater government intrusion into private medical decisions, doctors said on Monday.
The ruling will also almost certainly intimidate doctors who provide any type of abortion services, according to a series of commentaries in the New England Journal of Medicine.
"With this decision the Supreme Court has sanctioned the intrusion of legislation into the day-to-day practice of medicine," Dr. Jeffrey Drazen, editor of the journal, said in one of the commentaries, to be published on May 24.
"Both health care providers and patients should be alarmed by the current degree of intrusion by our government into the practice of medicine and even more so by the apparent trajectory that it seems poised to follow in the near future," Drazen added.
On Wednesday, a closely divided U.S. Supreme Court upheld a nationwide ban on the abortion procedure, called partial-birth abortion by opponents, and intact dilation and extraction by doctors.
President George W. Bush signed the Partial-Birth Abortion Ban Act into law in 2003, and the court's decision was the first to uphold a federal ban on an abortion procedure since the landmark Roe v. Wade ruling in 1973 that legalized abortion.
"I am concerned. It is going to chill physicians who provide these services, and I am concerned that women who need and want them may have more difficulty obtaining them," said Dr. Michael Greene, a professor at Harvard Medical School and director of obstetrics at Massachusetts General Hospital in Boston.
"Lacking confidence in the judicial system, physicians may choose to avoid performing second-trimester surgical abortions, thus restricting access to them, perhaps even if the mother's life is in jeopardy," Greene wrote in his commentary.
Alta Charo, a professor of law and bioethics at the University of Wisconsin, said the law would only directly affect a handful of abortions -- with just 2,200 out of 1 million abortions in 2000 having been intact dilation and extraction procedures.
But they are done when physicians consider them medically necessary, she said. This is the first law that does not consider a woman's health, Charo said.
"We have already had lots of government intervention -- waiting periods, state-written informed consent documents," Charo said in a telephone interview.
"We have seen a long pattern of state intervention in abortion medical procedures."
She said the decision posed a threat to doctors who perform legal surgical abortions.