Tim Tai, Photography Editor

A young female doctor told Naftali Kaminski that she did not want to attend her medical society’s upcoming meeting in Nashville because “she felt unsafe,” he recalled.

The woman did not necessarily know if she was pregnant, but worried about being in the early stages. She was scared that if something went wrong with a potential pregnancy while in Nashville, she would not be able to get the reproductive care she needed. 

The woman and Kaminski were both part of the American College of Chest Physicians, but Kaminski — the Boehringer-Ingelheim Endowed Professor of Internal Medicine and chief of pulmonary, critical care and sleep medicine at the Yale School of Medicine — was a more senior doctor. Last October, he wrote an open letter to the ACCP calling on the society to only hold meetings in places that protected access to healthcare. Not places, like Nashville, that had “draconian abortion bans,” he maintained.

Kaminski worried about young female members of the society who had to choose their safety over the advantages these meetings offered to their careers. He said “almost every step” of his career happened at a conference.

“These societies are like their bread and butter,” Kaminski said. “You give talks, you get elected to roles that help you in your academic career. The people who review your papers go to these conferences. This puts an undue pressure on younger people, mostly women.”

Kaminski reflected on a patient he saw in medical school. A young woman came in with an ectopic pregnancy — a life-threatening condition where a fertilized egg grows outside the uterus — and had to be rushed to the operating room. If the doctors had waited for a judge to make a ruling on whether surgery could be performed in that case, the woman would have died, he explained.

“Going to a place where injustice is happening and pretending that everything’s okay is unacceptable,” Kaminski added. 

On June 24, 2022, the Supreme Court ruled that there was no constitutional right to abortion. The case, Dobbs v Jackson Women’s Health Organization, overturned 50 years of precedent established by Roe v. Wade, giving states the authority to decide abortion rights. 

As of April 19, 13 states have banned abortions while several others have introduced strict gestational limits.

In response, the American College of Obstetrics and Gynecology, which represents 60,000 obstetrician-gynecologists, changed their 2023 annual meeting location from Louisiana to Maryland due to the former’s strict anti-abortion laws.

“My concern is that other societies are not following ACOG because they don’t see as much of a direct relevance to them,” said Cary Gross, professor of general medicine and epidemiology at the Yale School of Medicine. “I think that’s a colossal mistake because [of] the physician-patient relationship, access to appropriate health care and frankly, concerns around state legislators dictating what type of care people can and can’t receive — all these things should worry members of any and every [medical] professional society.”

Kaminski partnered with Kathleen Akgün, associate professor of pulmonary medicine at the Yale School of Medicine, to write an article in the journal of the American Thoracic Society. Akgün clarified that the views she expresses are hers, not of the ATS Ethics and Conflict of Interest Committee, which she currently chairs. The two Yale physicians called on medical professional societies to not sponsor large meetings in states that strongly restrict access to abortions. 

Kaminski emphasized that Equity Florida, the largest LGBTQ+ organization in the state, recently issued a travel advisory suggesting that Florida is unsafe for people who can become pregnant, communities of color and LGBTQ+ people. He called on medical societies to take a similar stance.

Drawing on her background in clinical ethics, Akgün emphasized the field’s four main principles: beneficence, nonmaleficence, autonomy and justice. She felt that the Dobbs decision violated the principle of autonomy by eliminating a person’s ability to control what happens to their body. Akgün said it was “inexcusable” that a patient would be forced to carry on with an unwanted pregnancy, and argued that restricting healthcare for half the population would set the country back by decades. 

“When patients are put in positions beyond their control due to state control, that’s certainly a bridge too far,” Akgün said. “I felt as though human rights were under attack.”

In deciding to not host events in states that ban abortion, Akgün hopes that medical societies can put pressure on states in an organized fashion and counter anti-abortion groups. Akgün acknowledged that some societies may not be able to change contracts already made with convention centers without paying a penalty, but emphasized the importance of advocating through boycotts.

Medical societies attract thousands of medical professionals to their days-long annual meetings. Money does not just go to the convention center they reserve — by patronizing local businesses, society members offer a substantial financial incentive for states. According to Akgün, one argument against their boycott has been the potential losses faced by community members in anti-abortion states, but she emphasized that in general, it is not guaranteed that every state will get to host a meeting. As Gross put it, if you put your medical conference in one state, you are already not putting it in 49 other states.

“As far as the idea of ethical consumerism, why would you bring these tremendous resources to states that are enacting these [anti-abortion] laws?” Gross said.

Gross is a primary care doctor who has been on the Yale School of Medicine faculty for 20 years. In an editorial written with Yale Law School professor Katherine Kraschel, he laid out the clinical and ethical considerations for holding society meetings in states that protect abortion rights.

Gross acknowledged that not every member of a professional society will agree about access to abortion. However, medical professional organizations should have a mechanism for reaching a consensus. Though unanimity is unlikely in any case, he argued that organizations need to take a stance, and said that “frankly, to not act, is acting.” 

Some people have expressed to Gross that taking a stance on abortion could lead to a “slippery slope,” in terms of then having to address the “myriad” of other political issues. However, he argued that this argument is used as a “wedge” to avoid making tough decisions and having contentious conversations.

“It sounds very reasonable on the surface, but also it can be used by people in positions of power to never make a stand on anything,” Gross said. “[Against] any potential egregious law or human rights violation because ‘that might be a slippery slope.’” 

Gross argued that societies need to reflect on what professional norms and values they hope to espouse. If those norms include a desire to preserve the doctor-patient relationship, then it matters that patients have a right to choose, and that there is not disproportionate harm posed to women of color and people with fewer resources, he said. 

Gross urged societies to “vote with their feet” and hold meetings in locations consistent with those values.

“I do not have the expectation that every single physician is out there marching in the streets, getting really active politically,” Gross said. “However, it is naive to think that medicine is not a political undertaking. It is detrimental to the profession if physicians recede into the woodwork when there are critical public health and societal issues that affect the wellbeing of people and patients in our society.”

In 2021, the American College of Obstetrics and Gynecology, alongside 24 other medical organizations, submitted an amicus brief in the Dobbs case that opposed abortion restrictions and emphasized the potential harm to patient wellbeing and the patient-clinician relationship.