Last week’s Supreme Court decision to overrule Roe v. Wade returned the power to regulate reproductive health to individual states.
In the midst of what will surely become a wave of legal challenges and a confusing landscape of inconsistent policy, one thing remains constant:
ASCO’s singular focus on assuring every individual with cancer—regardless of who they are or where they live—is able to receive high quality, equitable, evidence-based cancer care.
For people who are diagnosed with cancer during pregnancy, already a devastating life circumstance, decisions about what treatments to pursue—and when—are urgent and best made with an informed physician who can consider all evidence-based, scientific options, including termination.
Many cancer treatments can impact the pregnancy, result in miscarriage, or harm the fetus. In those circumstances, pregnancy termination is an important component of high-quality cancer care and it must remain an option for patients.
Patients must be able to trust their doctors and we are therefore concerned about the potential impact of the decision that inserts the government and even lay-people into the most private and personal decisions patients face.
The loss of the right to choose creates a social construct where women are devalued or even stigmatized, dissatisfied with their reproductive medical care, and less likely to participate in cancer screening and prevention programs or present at symptom onset for early cancer diagnosis.
The Dobbs ruling creates uncertainty and confusion that can undermine the sacred doctor-patient relationship.
Already, the prevailing confusion and fear has caused many physicians, including those where access to abortion is protected, to question whether delivering standard evidence-based cancer care could result in harassment, prosecution, prison sentence, or revocation of their medical license. These concerns are a threat to high-quality, equitable cancer care.
Per ASCO’s (and others’) evidence-based guidelines, for people of child-bearing age, high-quality, evidence-based cancer care should include careful consideration and discussion of fertility preservation.
ASCO’s 2018 clinical practice guideline on fertility preservation specifically recommends that providers discuss fertility preservation options with all patients of child-bearing age as early as possible to allow for the widest array of options for fertility preservation.
ASCO is committed to the availability of these options even as they are potentially threatened by the Dobbs ruling.
The Dobbs decision pushes regulation and control to the individual states. For now, ASCO is closely monitoring related activity in state legislatures and especially the 13 that have so-called “trigger laws” that would serve almost immediately to impose bans or strict limitations on reproductive health services, mainly abortion. Other states have signaled intentions to impose similar limitations while some states are making plans to assure continued access to abortion.
As this situation is rapidly evolving, with each state making individual decisions, we are closely reviewing and analyzing state laws to understand the implications for patients with cancer and their physicians so we can provide support to our colleagues.
We will continue to advocate for patients’ access to appropriate fertility preservation care, and will work with ASCO State Affiliates and others in the cancer community to educate lawmakers on the impact of relevant policy developments on cancer care.
No court decision, regulation, or legislation should deprive our patients of high quality, potentially life-saving, life-extending, or palliative treatment.
Further, no oncologist should fear for their safety or profession as they provide evidence-based, high-quality care to their patients.
ASCO’s North Star is high-quality, equitable, evidence-based cancer care—and we intend to do everything within our means to ensure patients have access to this level of care.
