Summer 2025 Essay Contest
2nd Prize Winner – Medical Student Category
Building the World We Want to Practice In
Essay written by Emma Weisner
In the world I want to practice medicine in, patients can trust not only my medical knowledge, but in the belief that I will prioritize their needs over politics. But today, in the aftermath of the Dobbs decision, that trust is threatened.
In our first year of medical school we receive our white coats and recite the Hippocratic Oath, swearing to respect autonomy, uphold justice, and do no harm to the patients we serve. Even as political and legal changes attempt to erode these principles, we are beholden to the promises we make in those first months of our medical education. These principles may seem like abstract ideals when we discuss them in classrooms and study groups, but they are in fact the foundation of our profession – and this foundation is under threat.
The ethical principles physicians are duty-bound to uphold are in direct conflict with the Dobbs decision.
Autonomy, or the right of patients to make informed decisions about their own bodies and healthcare, is at the center of the ethical debate surrounding abortion care. In no other area of medicine do we deny patients’ access to safe, evidence-based care due solely to personal or political beliefs about “right” and “wrong.” The Dobbs decision makes true autonomy in reproductive healthcare no longer possible.
Beneficence, which requires acting in the best interest of the patient, is also in conflict with Dobbs, as physicians are now legally prohibited from offering the best care in some states. Non-maleficence, the promise we make to “do no harm,” becomes unfeasible when we are forced to delay treatments, like care for a hemorrhaging or septic pregnant patient, to comply with the law. How can we, as trainees and physicians, be faithful to the law and to our oath? How can we practice the care we promise to provide in this new political landscape?
These questions are pressing for all physicians and patients, but especially so for groups that already face huge reproductive inequities. Justice, or the promise to deliver fair and equitable treatment and address healthcare disparities, is also in conflict with these restrictive laws. Marginalized patient groups are already more likely to face barriers to adequate reproductive healthcare and the current medical reality worsens these existing inequalities, a direct affront to justice in medicine.
If we understand that the Dobbs ruling cannot be followed in a world in which we honor and uphold the ethical principles of autonomy, beneficence, non-maleficence, and justice, how are we to proceed? The first step is to acknowledge that medicine is inherently political. When we step in to the exam room, the operating room, or begin our morning rounds, we must understand and reckon with our role in the political system. Regardless of our actions, we shoulder the emotional weight of knowing we may not be able to both follow the law and uphold our ethical duties as physicians.
Though these challenges are too large to take on alone, there are ways that we, even as trainees, can defend the autonomy of patients and the ethical duty of physicians. Full and honest counseling, even when abortion isn’t legally available, is a vital first step. We can be aware of the options a patient may have outside of the institutions that we train in and offer this information to them. There is much to be done outside of the hospital too: we can lend our voices to hearings and briefs to advocate for legislative change. Especially at the state level, medical student voices really do matter – states want to retain future physicians, and we can make clear to lawmakers the reforms that we demand if we are to return as attendings. Even in institutions where clinical skills training is unavailable, we can advocate for medical education reform. If we ensure we are highly trained in ethical reasoning, we will be able to make more informed decisions about providing equitable care to our patients.
In a post-Dobbs world, upholding the time-honored ethics of medicine demands vigilance, courage, and a renewed commitment to placing patients, not politics or our own beliefs, at the center of every decision we make.
As trainees, we are uniquely positioned to envision a future where patient care is guided by ethics and compassion and where physicians act as guardians of autonomy, beneficence, and justice.
Let’s start building the world we want to practice in.
###
2 More Chances this Summer to Get Published & Win Cash Prizes!
Summer 2025 Essay Contest Series is Open to All AMSA Members!
Separate Competitions for Premeds & Medical Students
Explore the AMSA Reproductive Health Project
Find news, tips, tools, opportunities & more!
Sign-up Here for AMSA Repro Project Updates
