Sometimes, a physician must face the responsibilities of medical ethics and abortion in one crucial moment. For me, it was a patient who requested that I pause after I had begun a surgical abortion procedure.
She seemed clear about her decision during our consultation, but under sedation, she whispered to me that she wasn’t sure. I could have continued, disregarding her doubts—but I stopped everything.
In my work, I must always have a patient’s informed consent. Treatment should not proceed unless the patient feels certain. Healthcare is about more than just treatment—it’s also about trust. That means respecting each patient’s autonomy—the right to control what happens to their bodies. But autonomy is only one piece of the puzzle.
My commitment also includes doing what’s best for them, avoiding harm, and making sure I provide fair treatment to everyone. These are the promises I make to everyone who walks into my clinic, especially when reproductive rights are under attack and access to basic healthcare varies drastically by zipcode.
Let’s examine the ethical pillars that guide my profession and share why they matter so deeply—not just to me as a provider but to every patient whose rights and health are on the line.
Autonomy: The Foundation of Ethical Care
When a patient asks questions, I see myself as a guide, not a gatekeeper. Autonomy—the right of each person to make informed decisions about their care—is the foundation of ethical medicine.
Practically speaking, patients should always be free to weigh their options without pressure and decide what feels right. But with reproductive rights under attack and access to abortion a political battleground, supporting autonomy has become a daily challenge.
The AMA Journal of Ethics discusses how choice architecture can help patients freely make decisions based on what feels right. My approach cultivates that trust so they know they can ask questions or reconsider.
Take the example I mentioned earlier—the woman who hesitated, leading me to stop a medical procedure. At that moment, my only agenda was to support whatever decision she ultimately made. That’s what autonomy looks like in real time—honoring her uncertainty and making sure she felt empowered rather than rushed or judged.
Autonomy also means making sure my patients have the information they need to make these choices confidently. I discuss risks, benefits, and alternatives openly. Especially now, with restrictions and policies aimed at limiting options, voluntary choice feels more crucial than ever. When patients leave my office, I want them to feel they are holding the steering wheel, driving their healthcare journey.
Beneficence and Nonmaleficence: Acting in the Patient’s Best Interest
Beneficence and nonmaleficence are two sides of the same coin, guiding me to act in ways that support and protect the well-being of my patients.
Beneficence is the commitment to do good—choosing actions that are genuinely in the patient’s best interest. Nonmaleficence, on the other hand, is the promise to “do no harm”—as spoken in a doctor’s solemn Hippocratic Oath. It means my actions should never create more risk than benefit.
These principles might sound straightforward, but they come into play constantly, especially in reproductive healthcare. I’ve had patients facing unwanted pregnancies, health risks, or just the uncertainty of not knowing what they wanted to do next. My role is to balance their needs with my medical judgment.
For example, if a patient is struggling with a decision about terminating a pregnancy, beneficence means I need to think through not just her immediate physical health but also her mental and emotional well-being. What options give her the best possible outcome with the least possible distress? Nonmaleficence means helping her navigate these choices without rushing so she doesn’t feel pressured into a path that could cause regret or harm.
Restrictive laws create bureaucratic barriers that often interfere with a doctor’s ethical obligations, shifting the focus from patient care to policy. When a patient is forced to wait or jump through hoops, it adds stress, delays care, and can amplify feelings of fear or uncertainty. As Human Rights Watch highlights, these delays often serve no medical purpose. Instead, they create hardship, elevate the risk of emotional harm, and sometimes diminish the quality of care.
Justice: Ensuring Fairness in Healthcare
Justice in healthcare is about fairness—the commitment to treat every patient with equal respect and ensure that everyone has access to the care they need, regardless of their background, income, or circumstances.
In reproductive health, this principle takes on added urgency, especially as access to services like abortion becomes more restricted across the country. In my work at Desert Star Institute for Family Planning, I’ve seen restrictive laws create stark inequities—patients with the means to travel can access care, while those without are often left with fewer options. That’s why we focus on serving medically underserved communities, especially Black, Indigenous, LGBTQ+, and other marginalized groups. We offer long-term contraception for uninsured patients, provide educational outreach, and work to meet people where they are.
Justice also means advocating for policies that support fair access to reproductive care. We must also dismantle barriers that prevent patients from exercising their right to decide about their bodies.
Healthcare should be seen as a right, not a privilege. But as Johns Hopkins Public Health reports, the Dobbs decision widened these gaps. Only a select few may soon be able to make their own reproductive decisions.
Upholding Ethics in Every Encounter
To me, ethical care means committing to principles supporting individual health and broader community well-being. Autonomy, beneficence, nonmaleficence, and justice guide my practice and drive me to advocate for equitable healthcare delivery.
Today’s restrictions on reproductive healthcare make this commitment even more urgent. I see how barriers, such as economic disparity and restrictive laws, affect patients’ decision-making ability. To build a more just healthcare system, we must challenge these barriers and support policies that protect everyone’s right to safe, compassionate treatment.
My commitment to ethical healthcare means involving myself in community education, policy change, and addressing healthcare inequities. My commitment to justice shows my community that my role extends beyond the exam room. Dignity, respect, and real support for each patient—these values form the heart of my work and are what we need to build a healthcare system that serves everyone equally.
