Abortion tourism in a post-Roe v. Wade era
Abortion tourism in a post-Roe v. Wade era
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后罗伊诉韦德时代的堕胎旅游
DOI：
10.1080/19485565.2022.2100051
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发表时间：
2022
影响因子：
1.3
通讯作者：
Matsuura Hiroaki
中科院分区：
文献类型：
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作者：
松浦広明;Matsuura Hiroaki
6月24日，最高法院推翻了罗伊诉韦德案，这是一项具有里程碑意义的裁决，该裁决在近50年前确立了堕胎的宪法权利（多布斯诉杰克逊妇女健康组织2022）。由于这一决定，管制堕胎的权力现在交还给“人民及其选出的代表”，禁止堕胎的决定权掌握在州立法机构手中。根据古特马赫研究所的数据，26个州的法律表明他们打算禁止堕胎，其中13个州的触发禁令在这一决定后自动生效（古特马赫研究所2022）。美国的孕产妇死亡率已经是高收入国家中最高的，在弱势群体中甚至更高（Declercq和Zephyrin 2020）。一项研究已经估计，假设的全国范围内的堕胎禁令对孕产妇健康的后果已经产生了灾难性的影响（史蒂文森，2021年）。其他研究发现，与获得堕胎护理的妇女相比，被剥夺堕胎护理的妇女不仅面临健康问题，而且面临经济和社会方面的对手（米勒，Wherry和Foster，2020 a，2020 b）。在禁止堕胎的州，想要避免被拒绝堕胎的孕妇仍然可以进行地下堕胎，或者通过前往另一个州或国家来逃避限制性的堕胎法。虽然在美国没有州一级的证据，但跨国研究发现，拥有自由堕胎法的国家比限制堕胎的国家更有可能提供安全的堕胎护理（Ganatra et al. 2017）。这意味着居住在禁止堕胎的州的妇女可能会在他们居住的地方面临不安全的堕胎。出于这个原因，堕胎旅游被认为是一个可行的解决方案，可以让居住在卡瓦诺法官和三位反对派法官（卡根，布雷耶和索托马约尔）在法庭意见中禁止堕胎的州的妇女获得安全的堕胎护理。双方一致认为，宪法充分保护了前往其他州寻求堕胎护理的权利，至少目前是这样。然而，他们不同意卡瓦诺对这种宪法保护持乐观态度的程度，而三位反对派法官担心旅行禁令可能是宪法挑战的下一个前沿。虽然堕胎旅游在罗伊时代之前更为普遍，但在过去十年中，它已经被视为解决一些州未满足的堕胎护理需求的一种解决方案。例如，在德克萨斯州西部，诊所被迫停止提供堕胎护理，因为他们在2010年代中期面临许多繁重和昂贵的法规（Sethna和Davis 2019）。因此，该地区的居民需要前往其他州接受堕胎护理。同样的情况也发生在其他州（Venator and弗莱彻，2021）。最近的一项研究发现，具有更严格的堕胎法律的州平均有12%的患者离开其他州接受堕胎护理，而具有中间立场或支持性法律的州平均分别有10%和3%的患者离开（Smith等人，2022）。然而，无力前往其他州的弱势群体很可能被抛在后面。2020年，波兰的一家法院决定，在胎儿异常或严重疾病的情况下进行堕胎，占所有法律的堕胎的98%，
On the 24th of June, the Supreme Court overturned Roe v. Wade, a landmark ruling that established the constitutional right to abortion almost five decades ago (Dobbs v. Jackson Women’s Health Organization 2022). As a result of the decision, the authority to regulate abortion is now returned to “the people and their elected representatives,” leaving the decision of abortion bans in the hands of state legislatures. According to the Guttmacher Institute, 26 states have laws indicating that they intend to ban abortions, including 13 states with trigger bans that go into effect automatically after this decision (Guttmacher Institute 2022). The US maternal mortality rate has already been the worst among high-income countries and even higher among vulnerable groups (Declercq and Zephyrin 2020). One study has already estimated that the maternal health consequences of a hypothetical nation-wide abortion ban have seen catastrophic impacts (Stevenson 2021). Other studies found that women denied abortion care face not only health but also economic and social adversaries than women with access to abortion care (Miller, Wherry, and Foster 2020a, 2020b). Pregnant women who want to avoid denied abortion in states with an abortion ban can still go with an underground abortion or seek to escape restrictive abortion laws by traveling to another state or country. Although there is no state-level evidence within the United States, cross-country studies have found that countries with liberal abortion laws are much more likely to provide safe abortion care than countries where abortion is restricted (Ganatra et al. 2017). This implies that women residing in states with an abortion ban will likely face unsafe abortions where they live. For this reason, abortion tourism was addressed as a feasible solution to receive safe abortion care for women who reside in states with an abortion ban in court opinions by both Justice Kavanaugh and the three opposing Justices (Kagan, Breyer, and Sotomayor). Both sides agreed that the constitution sufficiently protects the right to travel to other states to seek abortion care, at least for now. However, they disagreed on the extent that Kavanaugh was optimistic about such constitutional protection, while the three opposing Justices were concerned that travel bans could be the next frontier of the constitutional challenge. Although abortion tourism was much more common in the pre-Roe era, it is already seen as a solution to the unmet needs of abortion care in some states over the last ten years. For example, in western Texas clinics were forced to stop providing abortion care because they faced numerous burdensome and costly regulations in the mid-2010s (Sethna and Davis 2019). As a result, residents in this region needed to travel to other states to receive abortion care. The same also happened in other states (Venator and Fletcher 2021). A recent study identified that states with more restrictive abortion laws averaged 12 per cent of patients leaving to other states to receive abortion care, while states with middle ground or supportive laws averaged 10 per cent and 3 per cent leaving, respectively (Smith et al. 2022). However, vulnerable populations who cannot afford to travel to other states are likely to be left behind. In 2020, a court in Poland decided that abortions in the case of abnormalities or serious illnesses of the fetus, which makes up about 98 per cent of all legal abortions, were