Guam laws impose unreasonable barriers to women’s choice


By Dr. Ellen Bez

This past year our country has experienced a deadly pandemic, civil unrest, destructive protests, and a violent insurrection. As a result, across the country, we are recommitting ourselves to democracy—to finding ways to affect change among diverse interests and points of view. In our community, we must do the same with respect to access to safe and legal abortion.

This is an emotionally charged issue, and there are strong convictions on both sides. We may differ in our views, but we all want to be able to live a safe and healthy life. We all want to be free to define our own path. As a community, we need to begin to have respectful conversations to ensure that our laws reflect these values.

The decision to become a parent is one of the most important decisions we make, one every person should be able to make in consultation with their family, their own conscience, and their doctors.

That’s why, as a doctor and a resident of this island for nearly three decades, I am proud to support a lawsuit filed to challenge two Guam laws that impose unreasonable barriers to a woman’s choice and deny her access to healthcare.

By preventing the use of telemedicine for medication abortion care, Guam’s abortion laws do not reflect the changes in current medical practices. Medication abortion is incredibly safe, effective, and has been approved by the FDA for more than 20 years. The process for medication abortion involves taking 2 different pills that will result in a miscarriage over 1-2 days, not unlike the 10-15% of women who naturally miscarry each year. These treatment options allow patients to avoid more invasive procedures. Indeed, statistics show that most eligible patients prefer medication abortion to an abortion procedure. And research and experience from across the United States and abroad show that these medications can be prescribed using telemedicine. Even insurance companies and Medicare accept telemedicine as being comparable to an in-person meeting. We need to update our laws to make them relevant for today’s medicine.

There are real, practical consequences to our laws being so out of touch with medicine today. With no abortion providers on Guam, these requirements force patients to fly to Hawai’i for care—an expensive, burdensome trip that is even more difficult during the coronavirus pandemic.

There are other problems with Guam’s outdated abortion laws, as well. For example, abortion reporting law requires physicians to provide the government with 25 pieces of personal data about each patient who has an abortion. In so doing, this law interferes with a woman’s right to privacy by requiring so much personal information that her identity could be revealed. No other medical treatment or procedure requires a patient to disclose so much personal information to the government.

These restrictions represent more than limiting the right to have an abortion. They take away each woman’s right to make medical decisions for herself-privately. They violate a woman’s right to privacy by requiring disclosures so excessive that the woman seeking an abortion can be identified. They deny women access to healthcare which is their legal right. They undermine the physician-patient relationship by raising suspicions that a doctor may be reacting to the fear of being prosecuted rather than the patient’s interest.

The Catholic Church is clearly opposed to abortion. The church has an active group that promotes legislation designed to place these obstacles before all the women in Guam. Laws are not written for one church or another. Laws are not intended to espouse religious doctrine—or to negate church teachings. Laws can, however, co-exist with religious teachings.

Legislators need to create laws that protect not just the Church but the entire community that it serves. As physicians, we advocate for safe healthcare that meets accepted medical standards. Laws must ensure that individuals have access to safe healthcare services without the threat of harming the individual or the health professionals who serve the individual. Laws must also protect the individual’s right to choose and the individual’s right to privacy.

There are no simple answers to resolving the dilemma of opposing viewpoints to abortion. Often this discussion focuses on the divisive stands. We need to approach abortion on the common ground of care, compassion, and respect in our community, even if we may not agree with each other. While we may not all agree about abortion, we can all agree that when people can make decisions that are best for their lives, families thrive.

(Ellen P. Bez, MD, FACP is a women’s health physician at the Marianas Physicians Group in Tamuning, Guam.)

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