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It's Official: SCOTUS Strikes Down Roe v. Wade

— Opinion ends constitutional protection for abortion, returns rights to the states

MedpageToday
A photo of pro-choice and pro-life protestors in front of the US Supreme Court building in Washington, DC.

WASHINGTON -- The Roe v. Wade, the 1973 landmark decision establishing the right to abortion.

"We hold that Roe and Casey must be overruled," wrote Justice Samuel Alito, in a majority opinion issued as part of a 6-3 decision in the case of . Alito was joined by Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett.

The Dobbs case revolved around a law passed in Mississippi that outlaws abortions after 15 weeks' gestation, which is several weeks before the fetus is considered viable. At issue in the case was whether all pre-viability laws against abortion are unconstitutional. The plaintiffs in the case sought to overturn Roe, which legalized abortion up to the point of fetal viability, generally considered to be at 22 to 24 weeks.

"Roe was egregiously wrong from the start," the decision continued. "Its reasoning was exceptionally weak, and the decision has had damaging consequences. And far from bringing about a national settlement of the abortion issue, Roe and Casey [, the Supreme Court case decided in 1992 in favor of upholding Roe] have enflamed debate and deepened division."

The Dobbs majority opinion issued on Friday states: "The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision, including the one on which the defenders of Roe and Casey now chiefly rely -- the Due Process Clause of the Fourteenth Amendment." states that no state shall "deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws."

Chief Justice John Roberts, Jr. agreed with the majority, but filed a concurring opinion stating that he would have taken a "more measured course," without completely overruling the right to abortion.

A dissenting opinion, authored by the Court's three liberal members -- Justices Stephen Breyer, Sonia Sotomayor, and Elena Kagan -- stated that the justices dissented with sorrow, "for this Court, but more, for the many millions of American women who have today lost a fundamental constitutional protection."

"Whatever the exact scope of the coming laws, one result of today's decision is certain: the curtailment of women's rights, and of their status as free and equal citizens," the dissenting justices stated.

The final decision ends constitutional protection for abortion, returning rights to state legislatures. Two dozen states are very likely to ban abortion. Thirteen of those states have "trigger bans" in place, meaning that restrictions will go into effect immediately.

Speaking from the Supreme Court, President Biden called today's decision "cruel," stating that the effects on patients will be instantaneous in many states.

"The court has done what it has never done before, expressly taking away a constitutional right that is so fundamental to so many Americans," Biden said. "It's a sad day for the Court and for the country."

HHS Secretary Xavier Becerra called the decision "unconscionable," stating that HHS "will double down and use every lever we have to protect access to abortion care."

"Health care providers, who are already under extraordinary strains due to the pandemic, will be forced into an impossible choice between doing what's right for their patients and complying with laws that are at odds with their patient's health interests," added Surgeon General Vivek Murthy, MD.

Medical Groups Sound Off

Many medical organizations -- including the American Medical Association (AMA), American College of Obstetricians and Gynecologists (ACOG), , American Academy of Pediatrics, and , among others -- condemned the decision.

AMA President Jack Resneck, Jr., MD, said the organization is "deeply disturbed" by the Court's decision, which represents "an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship, and a brazen violation of patients' rights to evidence-based reproductive health services."

"States that end legal abortion will not end abortion -- they will end safe abortion, risking [devastating] consequences, including patients' lives," Resneck added.

ACOG stated that today's decision is a "direct blow to bodily autonomy, reproductive health, patient safety and health equity in the United States," adding that the consequences of this decision will fall disproportionately on people who already face barriers to care, including people of color, those living in rural areas, and those who have lower incomes. This is a "dark and dangerous time for the women and doctors of America," said ACOG.

The American Association of Pro-Life Obstetricians & Gynecologists, however, celebrated today's opinion, stating that the "momentous decision" in Dobbs v. Jackson will help the organization serve patients through "offering better options and fully informed consent."

Editors of the New England Journal of Medicine published shortly after it was announced, stating that the "reversal of Roe v. Wade serves American families poorly, putting their health, safety, finances, and futures at risk."

They noted that laws limiting abortion have rested on the basis that it's a dangerous procedure, and tight restrictions are needed to protect the health of those seeking care. But they called this "disingenuous rhetoric," noting that the overall maternal mortality rate in the U.S. is significantly higher than the mortality rate with legal induced abortion (23.8 per 100,000 live births vs 0.41 per 100,000 procedures, respectively).

Others raised concerns about both the medical and legal dangers this decision will place on patients.

Kwajelyn Jackson, executive director of Feminist Women's Health Center, an abortion clinic in Atlanta, said "this opinion is making pregnancy more dangerous in this country not only by forcing unsafe and unplanned pregnancies to continue against one's will, but by further criminalizing pregnancy outcomes."

  • Amanda D'Ambrosio is a reporter on ֱ’s enterprise & investigative team. She covers obstetrics-gynecology and other clinical news, and writes features about the U.S. healthcare system.

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    Joyce Frieden oversees ֱ’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.