Ethical Conflicts for Clinicians under Tennessee Abortion Law

This perspective article analyzes the ethical dilemmas clinicians face under Tennessee’s restrictive abortion law (effective August 2022), which criminalizes abortion except to prevent maternal death or irreversible bodily harm. The authors outline five core ethical commitments in obstetric care including prioritizing maternal health over fetal benefit when conflicts arise and respecting patient autonomy and demonstrate how the law violates these principles through case examples (e.g., a lupus nephritis patient denied abortion despite health risks, and a Black woman forced to carry a nonviable fetus). The law compels clinicians to either breach ethical standards or risk prosecution, exacerbating racial and socioeconomic disparities in care. A 2023 amendment (excluding ectopic pregnancies and replacing "good faith" with "reasonable medical judgment") fails to resolve these conflicts.

This perspective article analyzes the ethical dilemmas clinicians face under Tennessee’s restrictive abortion law (effective August 2022), which criminalizes abortion except to prevent maternal death or irreversible bodily harm. The authors outline five core ethical commitments in obstetric care including prioritizing maternal health over fetal benefit when conflicts arise and respecting patient autonomy and demonstrate how the law violates these principles through case examples (e.g., a lupus nephritis patient denied abortion despite health risks, and a Black woman forced to carry a nonviable fetus). The law compels clinicians to either breach ethical standards or risk prosecution, exacerbating racial and socioeconomic disparities in care. A 2023 amendment (excluding ectopic pregnancies and replacing "good faith" with "reasonable medical judgment") fails to resolve these conflicts.