Patient-Practitioner Relationship in the Post-Dobbs American Landscape

The patient-practitioner relationship is among the most sacred and fundamental in health care, particularly in the realm of reproductive care. Laws regulating what practitioners can and cannot discuss in the exam room with patients have made a resurgence in the post-Dobbs era. In the reproductive care context, these restrictive laws impact patients’ access to critical medical services but also the fundamental underpinnings of the patient-practitioner relationship. In a post-Dobbs era, laws restricting abortion are increasingly dangerous to the health of those seeking these services. With no federal protection for access to abortion services and abortion services hinging on individual states, access to abortion is perilous, and the patient-practitioner relationship is widely under siege across the United States. Government intervention in the examination room is not new. However, prohibiting or compelling a practitioner from providing professional, ethical, and legally obligated medical care has become unreasonable and detrimental to the patient’s health. Indeed, a core tenet of medical care echoed by bioethicists is providing care in the patient’s best interest. Furthermore, the political theater, often on display in state legislatures but certainly brought to the fore in Dobbs, compromises the often tenuous trust between practitioners and patients in the healthcare ecosystem. These cascading impacts of Dobbs extend to the healthcare workforce, complicating the future of aspiring practitioners and engendering an exodus of current practitioners away from restrictive states. This paper will discuss these implications on the patient-practitioner relationship in the broader context of trust within the social contract of the practice of medicine.