Governor Mike DeWine of Ohio recently signed a new into law. It passed in a vote along party lines in the Republican-controlled state legislature just before Christmas. Tucked midway into the 21-page piece of legislation is a direct assault upon the academic freedom of the state’s public medical schools.
At least two medical clinics in Ohio that provide legal elective abortions have signed agreements with local physicians so that in the event of a medical emergency related to the abortion, the physician agrees to be on call to come to the patient’s aid. The states that these clinics must certify that “the physician does not teach or provide instruction, directly or indirectly, at a medical school or osteopathic medical school affiliated with a state university or college…any state hospital, or other public institution”. The bill then requires that the Ohio Department of Health revoke the licence of these clinics if these on-call physicians are teaching at a state medical school.
Acute complications of an abortion are infrequent – far less frequent, in fact, than the risks of carrying a pregnancy to term. Nonetheless, it is considered best practice in medical education that a medical student and an obstetrics-gynaecology resident-in-training know how to recognise and manage these complications. It has been a very long time since I was a medical student and my specialty is paediatric oncology. Nevertheless, I still know to be on the lookout for bleeding, infection, injury to the bladder or rectum, or a possible pregnancy outside the uterus as rare problems related to an abortion.?
Over the past 40 years, I have been an academic department chair, vice-dean, dean and chancellor/CEO of medical schools and a medical college. Throughout this time, I understood that there was no role for a state government in deliberations about who possessed the requisite education, experience and skills to be appointed to the university faculty – until Ohio disabused me of this belief.?
There is, of course, a long history of powerful people trying to interfere with the selection of university faculty members. In medieval universities, faculty appointments could be dependent on compliance with religious doctrine. In the US, throughout the 19th and 20th centuries, wealthy donors tried to root out members of the economics and business school faculty who did not subscribe to their views of capitalism. White supremacists have tried to force the dismissal of professors who supported equal rights for all. And governors and state legislatures have attempted to influence which professor got hired and fired at state universities based on the professor’s political opinions.
Those who believe in the importance of academic freedom and the free exchange of ideas have raised their voices in opposition to this behaviour. Guarding against external interference was also, in part, why the tenure system was created. Yet the threats never go away.
One would think that the best person to teach medical students and residents about the management of abortion complications would be a doctor experienced in doing just that. The Ohio law, therefore, is a barefaced attempt to interfere with the right of a university to hire its own faculty members, to denigrate physicians fulfilling their responsibility to care for those who need care, and to make it more difficult for Ohio women to obtain the full range of reproductive healthcare options.?
Limiting access to safe and legal abortions will have predicable consequences. The rich will get the abortions they desire anyway. The less rich will cross state lines to obtain them, endangering themselves by travelling more than they should and being unnecessarily far from their treating physician. The poor, meanwhile, will be forced to either run the medical risks of an unwanted pregnancy and bear unwanted children or else risk their lives in criminal backstreet procedures.
I will never forget a story told by a colleague many years ago, the professor and chair of my medical school’s department of obstetrics-gynaecology. He recalled a married woman dying of infection after a criminal abortion performed in the era before Roe v Wade legalised abortion in the US.
“Why?” the woman said from her sickbed, looking up at him. “Why do I have to die because I was born a woman and capable of getting pregnant?”
Why indeed. One of the reasons can be found in the fact that both principal legislative sponsors of the Ohio bill are men, as are 81 per cent of the co-sponsors. Gloria Steinem was correct when she popularised the expression: “If men could get pregnant,?abortion would?be a?sacrament.”?
It is time, once again, to raise our voices in defence of academic freedom. It is under assault in Ohio.?
Edward C. Halperin teaches history of medicine at New York Medical College, where he is also chancellor and chief executive officer. This essay represents his opinion and not that of the college.
