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PerfectAdviceNewslettersBecome a MemberVox logoAbortion bans criminalize
doctors. For black physicians, the risks are even higher.PoliticsAbortion bans
criminalize doctors. For black physicians, the risks are even higher.The
upcoming Supreme Court decision on abortion could further criminalize health
care providers. It’s extra risky for black doctors.by Adia Harvey WingfieldMar
3, 2020, 4:40 PM UTCPolice stand guard between a group of anti-abortion
protesters and a group of abortion rights activists outside a clinic in Little
Rock, Arkansas. Greg Smith/CORBIS/Corbis via Getty ImagesOn Wednesday, the
Supreme Court will hear oral arguments in June Medical Services v. Gee, which
will focus on whether doctors performing abortions must have admitting
privileges, or permission to admit patients for treatment, at nearby
hospitals.These laws are being used to undermine Roe v. Wade. In Louisiana,
where this case was originally filed, the law would shut down all of the state’s
abortion clinics. But similar laws were long used to maintain divides not just
in who has access to care, but who provides it. Historically, hospitals used
admitting privileges to maintain racial segregation. By refusing to allow black
doctors to admit patients to hospitals that served whites, hospitals could
ensure that black doctors (and patients) were relegated to segregated
facilities. This gatekeeping practice left black practitioners without the same
opportunities, facilities, and resources as their white counterparts. Today,
admitting privileges rules and other legislation, such as “heartbeat bills” that
outlaw abortion after fetal pole cardiac activity can be detected, make it
harder for patients seeking abortions to do so safely by limiting access. These
laws stand to disproportionately affect pregnant people who are low-income
and/or of color. But left out of the conversation is that they put black health
care providers in danger, too, by risking criminal prosecution for those who
perform these abortions. When it comes to the medical field, black practitioners
are significantly underrepresented. Black workers are only about 4 percent of
practicing physicians and 9 percent of nurses. And like underrepresented
professionals in other fields, black health care providers face some common
challenges: assumptions of incompetence, racial stereotyping, and subtle
suggestions that they are not qualified for their jobs. Laws that erode medical
practitioners’ authority have the potential to worsen existing obstacles for
black health care professionals who already occupy a tenuous position in the
field.For the past 15 years, I’ve been conducting research on black
professionals working in the health care industry. My findings suggest that
widespread racial stereotypes of black people as less intelligent, capable, and
hardworking than white people create workplace environments that are unwelcoming
and stressful for black health care practitioners.In one interview, Dante, a
doctor, identified here by a pseudonym to protect his privacy, told me he has
always been watched more closely and had his work second-guessed by colleagues
and even subordinates: “I’ve been accused of not practicing medicine correctly
by a nurse, [one time] by a respiratory therapist. And they would never think to
say this to a white doctor. [They would think,] ‘He did it different than we’re
used to.’” Dante went on to say that as a result of the nurse’s accusations, the
hospital decided — in a violation of its written policy — to open up an
investigation into his work. For Dante, this additional level of scrutiny was a
source of frustration and anger. It also had material costs, as he kept a lawyer
on retainer to protect him from unjust retaliation. Other black doctors
described the challenge of getting patients to trust them. Max, an emergency
medicine doctor, reported, “I’ve taken care of patients [who] made it very
clear—‘I’ll sue you if you don’t get me a white doctor.’” These patients did not
bother to conceal their suspicion and distrust, nor the fact that their concerns
were racially motivated. Let’s also not forget how rampant stereotypes of
criminality disproportionately affect black workers, even when they’ve done
nothing wrong. Even black doctors from elite schools who practiced in the
nation’s best hospitals were still not immune from the reach of these tropes.
One doctor, Yusef, recalled an incident when he and his colleagues learned that
someone had been impersonating a doctor and stealing supplies. The
administrative assistant publicly accused Yusef of the theft. Despite having
worked at his hospital for three years in a highly visible role, Yusef found
himself a suspect.  Some doctors have already noted that legislative bans will
make their jobs significantly more difficult by obstructing the doctor-patient
relationship, curtailing their autonomy, and causing them to weigh providing
care with the threat of prosecution. But my research indicates that these bans
may have a chilling effect for black doctors in particular.Black physicians
already encounter environments where patients, colleagues, and subordinates may
be more likely to undermine their authority, question their judgment, and openly
doubt their capabilities. What happens when these doctors — who already deal
with heightened visibility — do this work knowing that they could potentially be
charged with crimes for exercising their best medical judgment?   And in states
that bring criminal cases against doctors who perform abortions, bans may put
black physicians at higher risk of prosecution. In 2012, a black Baltimore
doctor, Nicola Riley, was charged with murder under Maryland’s fetal homicide
law after an abortion she performed resulted in serious complications for the
pregnant patient. Riley’s case was the first time this fetal homicide law was
applied to a doctor attempting to provide an abortion in the state. It
underscores the risks for doctors when abortions are criminalized, and the
potential for black doctors to face higher scrutiny and possibility of
prosecution. Of course, pregnant patients who are low-income and/or people of
color will likely be affected the most by these bans. But it is important to
highlight that these patients are also the ones who are most likely to be seen
by black providers — who are themselves uniquely impacted by these proposed
laws. Abortion bans ask black doctors, who already often face hostile
environments, to surmount these barriers in an environment where they could face
criminal prosecution simply for doing the work they were trained to do. Adia
Harvey Wingfield is the Mary Tileston Hemenway professor of arts and sciences
and associate dean for faculty development at Washington University in St.
Louis. Her most recent book is Flatlining: Race, Work, and Health Care in the
New Economy. You’ve read 1 article in the last monthHere at Vox, we believe in
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