<?xml version="1.0" encoding="UTF-8"?><rss version="2.0"
	xmlns:media="http://search.yahoo.com/mrss/"
	xmlns:content="http://purl.org/rss/1.0/modules/content/"
	xmlns:wfw="http://wellformedweb.org/CommentAPI/"
	xmlns:dc="http://purl.org/dc/elements/1.1/"
	xmlns:atom="http://www.w3.org/2005/Atom"
	xmlns:sy="http://purl.org/rss/1.0/modules/syndication/"
	xmlns:slash="http://purl.org/rss/1.0/modules/slash/"
	>

<channel>
	<title>undermine &#8211; USA NEWS LIVE</title>
	<atom:link href="https://bloggingthree.soflytech.com/tag/undermine/feed/" rel="self" type="application/rss+xml" />
	<link>https://bloggingthree.soflytech.com</link>
	<description>All About USA NEWS</description>
	<lastBuildDate>Wed, 31 Jul 2024 03:06:28 +0000</lastBuildDate>
	<language>en-US</language>
	<sy:updatePeriod>
	hourly	</sy:updatePeriod>
	<sy:updateFrequency>
	1	</sy:updateFrequency>
	<generator>https://wordpress.org/?v=7.1.4</generator>

<image>
	<url>https://bloggingthree.soflytech.com/wp-content/uploads/2024/04/cropped-THE-USA1-e1713184454543-1-32x32.png</url>
	<title>undermine &#8211; USA NEWS LIVE</title>
	<link>https://bloggingthree.soflytech.com</link>
	<width>32</width>
	<height>32</height>
</image> 
	<item>
		<title>Flawed research on electoral fraud can undermine democracy and increase polarization</title>
		<link>https://bloggingthree.soflytech.com/2024/07/flawed-research-on-electoral-fraud-can-undermine-democracy-and-increase-polarization/</link>
		
		<dc:creator><![CDATA[chandankumarsoft]]></dc:creator>
		<pubDate>Wed, 31 Jul 2024 03:06:28 +0000</pubDate>
				<category><![CDATA[News]]></category>
		<category><![CDATA[democracy]]></category>
		<category><![CDATA[electoral]]></category>
		<category><![CDATA[Flawed]]></category>
		<category><![CDATA[fraud]]></category>
		<category><![CDATA[increase]]></category>
		<category><![CDATA[Polarization]]></category>
		<category><![CDATA[research]]></category>
		<category><![CDATA[undermine]]></category>
		<guid isPermaLink="false">https://bloggingthree.soflytech.com/?p=10457</guid>

					<description><![CDATA[Poor election science may cause lasting damage to democracy and undermine public confidence within the electoral process. This is the primary finding of our study, which was published in July 2024 within the journal Public Opinion Quarterly. It examines the Impact of educational claims about electoral fraud within the 2020 South Korean parliamentary elections. The [&#8230;]]]></description>
										<content:encoded><![CDATA[<p></p>
<div itemprop="articleBody">
<p>Poor election science may cause lasting damage to democracy and undermine public confidence within the electoral process.</p>
<p>This is the primary finding of our study, which was published in July 2024 within the journal Public Opinion Quarterly. It examines the <a href="https://doi.org/10.1093/poq/nfae028">Impact of educational claims about electoral fraud</a> within the 2020 South Korean parliamentary elections.</p>
<p>The ruling Democratic Party won that vote by a bigger margin than expected, leading supporters of the opposition United Future Party to assert that <a href="https://thediplomat.com/2020/05/south-korean-politician-adds-china-interference-charge-to-election-rigging-claim/">the manipulation of the outcomes of early voting</a>.</p>
<p>But what began as a typical post-election dispute took a turn when a US-based election fraud researcher analyzed the info and concluded that <a href="https://www.icasinc.org/2020/2020l/2020lwm2.pdf">almost 10% of the votes</a> for the Democratic Party were fraudulent. This finding spread quickly through the South Korean media, appearing in greater than 300 news reports, while the scientist conducted prime-time television interviews concerning the alleged fraud.</p>
<p>What was not immediately clear to the general public – although South Korean political scientists and statisticians <a href="https://www.newsis.com/view/?id=NISX20200521_0001032153&#038;cID=10301&#038;pID=10300">explained later</a> – was that the evaluation <a href="https://www.newsis.com/view/?id=NISX20200521_0001032153&#038;cID=10301&#038;pID=10300">based on a misunderstanding</a> the election data and the South Korean electoral system.</p>
<p>Although the electoral science research was flawed, the damage was done: the erroneous claims of electoral fraud significantly undermined public confidence within the electoral process in South Korea. As a direct result, the National Election Commission was forced to <a href="https://en.yna.co.kr/view/AEN20231227007900320">resort to costly hand counting again</a> to avoid any allegations of electoral fraud. </p>
<p>And our study shows that the impact is larger than expected.</p>
<p>In one experiment, we randomly varied the knowledge given to 1,750 eligible South Korean voters several months after the 2020 election. One control group was given no information in any respect about foreign academic research on voter fraud, while others were presented with academic research that suggested either a high or low likelihood of fraud.</p>
<p>Those who were shown studies suggesting a high risk of fraud were 12 percentage points more more likely to imagine that fraud had actually occurred than those that weren&#8217;t shown such studies. This represents a 52% increase within the likelihood of somebody believing that fraud had occurred.</p>
<p>We found that respondents who were presented with scientific research suggesting a high risk of fraud were 65% more more likely to vote than those that pushed for an investigation into voter fraud.</p>
<p>These effects were focused on supporters of the losing party within the 2020 elections.</p>
<h2>Why it is vital</h2>
<p>As political polarization <a href="https://www.washingtonpost.com/politics/2020/11/06/americans-hate-other-side-politics-so-do-europeans/">deepens within the highly developed democracies</a>Disputes over allegations of electoral fraud are commonplace.</p>
<p>And the evaluation of suspected fraud by academic researchers and other experts can have a major impact, as <a href="https://statmodeling.stat.columbia.edu/2022/04/03/the-journal-public-choice-goes-the-way-of-lancet-and-publishes-a-paper-that-is-riddled-with-errors-but-comes-to-a-political-conclusion-that-they-want-to-support/">the controversy</a> surrounding American economists <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3756988.">John Lott&#39;s fraud allegations</a> in reference to the 2020 US presidential election.</p>
<p>Our study highlights how academic research can significantly influence public perceptions of election integrity. The results show that voters&#39; responses are consistent with pre-existing beliefs &#8211; supporters of the losing party found allegations of fraud more credible, while supporters of the winning party showed little change.</p>
<p>Crucially, our findings also show how the publication of flawed scientific research on electoral fraud can exacerbate political polarization and undermine democracy itself. </p>
<p>Poor research can result in widespread distrust of electoral processes, undermine faith in democratic institutions and deepen political divisions. </p>
<h2>What will not be yet known</h2>
<p>Our research was limited to South Korea. As one in all Asia&#39;s most stable democracies, the country shares similarities with other advanced democracies. However, a few of our findings will not be applicable to elections in other countries.</p>
<p>Particularly where elections were conducted fairly but polarized, misinformation suggesting fraud may are likely to widen the divide between supporters and opponents of the winning party. Conversely, in countries affected by actual electoral fraud, such information could mobilize opposition against the guilty parties, increase election monitoring, and promote democracy. </p>
<p>And although the media played an important role in spreading the flawed evaluation to the South Korean public, our study didn&#8217;t examine the extent to which traditional media contributed to this in comparison with social media. We suspect that flawed research findings may spread more easily through social media because they&#8217;re subject to fewer oversight bodies and may be shared indiscriminately by partisans.</p>
<h2>What&#39;s next</h2>
<p>Our findings highlight the danger that arises when flawed research influences public opinion. </p>
<p>In the longer term, we plan to explore strategies to combat the influence of such misleading results on public opinion. Scientists have long tried to balance objectivity and accuracy with communicating results that may influence opinion.</p>
<p>As polarized politics increasingly involves experts based on scientific evidence, the educational community must determine how one can higher inform the general public while stopping flawed research from undermining trust in democratic foundations. Adhering to rigorous standards while clearly communicating the reality shall be critical.</p>
<p><em>The Research Brief is a summary of interesting scientific papers.</em></p>
</p></div>
<p><em>image credit : theconversation.com</em></p>
]]></content:encoded>
					
		
		
		<media:content url="https://images.theconversation.com/files/607908/original/file-20240718-23-cl0t2w.jpg?ixlib=rb-4.1.0&#038;rect=0%2C174%2C4672%2C2336&#038;q=45&#038;auto=format&#038;w=1356&#038;h=668&#038;fit=crop" medium="image"></media:content>
	</item>
		<item>
		<title>State laws threaten to undermine academic freedom in U.S. higher education</title>
		<link>https://bloggingthree.soflytech.com/2024/05/state-laws-threaten-to-undermine-academic-freedom-in-u-s-higher-education/</link>
		
		<dc:creator><![CDATA[chandankumarsoft]]></dc:creator>
		<pubDate>Thu, 30 May 2024 09:04:10 +0000</pubDate>
				<category><![CDATA[News]]></category>
		<category><![CDATA[academic]]></category>
		<category><![CDATA[Education]]></category>
		<category><![CDATA[freedom]]></category>
		<category><![CDATA[Higher]]></category>
		<category><![CDATA[laws]]></category>
		<category><![CDATA[state]]></category>
		<category><![CDATA[threaten]]></category>
		<category><![CDATA[U.S]]></category>
		<category><![CDATA[undermine]]></category>
		<guid isPermaLink="false">https://bloggingthree.soflytech.com/?p=4894</guid>

					<description><![CDATA[In recent years, Republican lawmakers in 35 states have introduced greater than 150 bills to limit academic freedom on campus, 21 of which have now been enacted. This laws is described intimately in a brand new White Paper published by the Center for the Defense of Academic Freedoma project of the American Association of University [&#8230;]]]></description>
										<content:encoded><![CDATA[<p></p>
<div itemprop="articleBody">
<p>In recent years, Republican lawmakers in 35 states have introduced greater than 150 bills to limit academic freedom on campus, 21 of which have now been enacted.</p>
<p>This laws is described intimately in a brand new White Paper published by the <a href="https://www.aaup.org/programs/academic-freedom/center-defense-academic-freedom">Center for the Defense of Academic Freedom</a>a project of the American Association of University Professors (AAUP). Overall, this legislative assault has undermined academic freedom and institutional autonomy in five distinct and overlapping ways.</p>
<h2>1. Academic Intelligence Orders</h2>
<p>As detailed within the report, state legislators have passed 99 classroom gag orders through the 2021, 2022, and 2023 legislative sessions. All 10 of those gag orders were passed by Republican governors. These bills claim that teaching about structural racism, gender identity, or unvarnished portrayals of American history harms students.</p>
<p>These news blackouts are widely referred to as “divisive concepts” or “anti-CRT” laws. CRT is an acronym for Critical Race Theory, an instructional framework that sees racism as deeply rooted in America’s legal and political system. The partisan activists, like <a href="https://manhattan.institute/person/christopher-f-rufo">Christopher Rufus</a>have used this term to explain a “<a href="https://nymag.com/intelligencer/2021/07/christopher-rufo-and-the-critical-race-theory-moral-panic.html">moral panic</a>“ as a part of a political response to the 2020 Black Lives Matter protests. </p>
<p>For example, Florida Governor Ron DeSantis signed House Bill 7 in April 2022, which “<a href="https://legiscan.com/FL/text/H0007/id/2544468/Florida-2022-H0007-Enrolled.pdf">Stop the Woke Law</a>.&#8221; The law defines a &#8220;divisive term&#8221; as one of eight vague claims. These include claims that &#8220;virtues similar to merit, excellence, exertions, fairness, neutrality, objectivity, and racial blindness are racist or sexist.&#8221; </p>
<p>US District Judge Mark Walker described this law as “<a href="https://law.justia.com/cases/federal/district-courts/florida/flndce/4:2022cv00304/442797/63/">downright dystopian</a>.” He noted that the federal government’s lawyers themselves have admitted that the law would likely make any classroom discussion of the merits of affirmative motion illegal. The vague wording of this news blackout has a <a href="https://rethinkingschools.org/articles/the-chilling-effects-of-so-called-critical-race-theory-bans/">deterrent effect</a>This leaves many teachers unclear about what they&#8217;re legally allowed to debate at school and what they are usually not.</p>
<h2>2. Prohibitions on DEI programs</h2>
<p>Expanding diversity, equity, and inclusion (DEI) services on campus was a significant consequence of the 2020 protests for racial justice. But in 2023, the legislative backlash was in full swing. During the 2023 legislative session, 40 bills were introduced to limit DEI efforts, seven of which became law.</p>
<p>For example, <a href="https://legiscan.com/TX/text/SB17/id/2820276/Texas-2023-SB17-Enrolled.html">Texas Senate Bill 17</a> was based directly on the tactic developed by Rufo and <a href="https://media4.manhattan-institute.org/sites/default/files/model_dei_legislation013023.pdf">Manhattan Institute</a>a right-leaning think tank. SB 17 banned diversity statements and considerations in hiring. It also restricted diversity training on campus and defunded DEI offices on Texas public university campuses. </p>
<p>As detailed within the AAUP white paper, only a handful of individuals testified in favor of SB 17, and just about all of them had declared or undeclared ties to right-wing think tanks. In contrast, greater than 100 <a href="https://capitol.texas.gov/tlodocs/88r/witlistmtg/pdf/c5352023040609001.pdf">Educators and residents testified or got here forward to testify against</a> the law. Since its passage, Texas public universities have seen the closure of DEI programs and the reduction of campus services for minority students. For example, after lawmakers accused the University of Texas-Austin of violating SB 17, the university was forced to shut its DEI office. This affected <a href="https://www.insidehighered.com/news/quick-takes/2024/04/04/ut-austin-closes-former-dei-division-lays-employees">Dismissal of 40 employees</a>.  </p>
<figure>
<p><iframe title="TPPF&#039;s Sherry Sylvester&#039;s Testimony in favor of SB 17" width="1170" height="658" src="https://www.youtube.com/embed/nLmDuOKdkcM?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></p><figcaption><span class="caption">&#8220;Sherry Sylvester of the Texas Public Policy Foundation, a right-leaning think tank, advocates for a ban on diversity, equity and inclusion programs.&#8221;</span></figcaption></figure>
<h2>3. Weakening of the term of office</h2>
<p>Tenure protections were put in place to guard faculty members from external political pressure. Tenure protections allow faculty members to show, conduct research, and speak publicly without fear of losing their jobs because their statements anger those in power. However, as detailed within the report, 20 bills were introduced through the 2021, 2022, and 2023 legislative sessions, with two bills weakening tenure protections becoming law. <a href="https://www.aaup.org/file/AAUP_Florida_final.pdf">in Florida</a> and one other <a href="https://www.aaup.org/article/lessons-aaup-advocacy-texas">in Texas</a>.</p>
<p>In Florida, for instance, SB 7044 <a href="https://legiscan.com/FL/text/S7044/id/2544315/Florida-2022-S7044-Enrolled.html">created a post-tenure system</a> Review, which allows administrators to conduct a review of tenured faculty every five years. The law also empowers administrators to fireside those whose performance is deemed unsatisfactory. The law also requires faculty to post course content in a public and searchable database.  </p>
<p>The <a href="https://www.aaup.org/file/AAUP_Florida_final.pdf">AAUP criticizes the law</a>and noted that SB 7044 &#8220;significantly weakened tenure in the Florida State University System and, if fully implemented as written,&#8221; would &#8220;effectively eliminate employment protections.&#8221; Now even tenured faculty have reason to fear that what they teach may very well be construed as a &#8220;divisive concept,&#8221; CRT, or promoting DEI.  </p>
<h2>4. Required content</h2>
<p>In addition, legislators in several states have passed laws mandating diversity of opinion, establishing recent academic programs and centers to show conservative content, and shifting curriculum decision-making away from teachers. </p>
<p>For example, <a href="https://legiscan.com/FL/text/S0266/id/2798308/Florida-2023-S0266-Enrolled.html">Florida Senate Bill 266</a> expanded the Hamilton Center for Classical and Civic Education on the University of Florida, without faculty involvement or oversight. The original proposal for the Hamilton Center stated that the goal of the middle was to &#8220;<a href="https://www.chronicle.com/article/how-a-center-for-civic-education-became-a-political-provocation">a conservative agenda</a>“ within the curriculum.</p>
<p>SB 266 also gave the boards that oversee the university and college systems the ability to make your mind up which courses count toward the core curriculum. That power was exercised in November 2023 after Manny Diaz, Florida&#39;s education commissioner, asked the boards to <a href="https://www.tampabay.com/news/education/2023/11/09/florida-board-advances-rule-limiting-discussion-social-issues-campus/">an introduction to the sociology course</a>He explained on social media that the discipline “<a href="https://www.chronicle.com/article/what-removing-sociology-as-a-core-course-option-means-for-floridas-students">hijacked by left-wing activists</a> and no longer serves its intended purpose as a general education course for students.”  </p>
<h2>5. Weakening of accreditation</h2>
<p>The accreditation process is a narrowly defined area of ​​academic administration by which colleges and universities usually undergo external peer review. These institutional performance reviews are conducted by nonprofit accreditation agencies. </p>
<p>As detailed within the report, six bills were introduced through the 2021-2023 legislative sessions – three of which were passed – that weaken the accreditation process and thus make it easier for political interests to influence higher education policy.</p>
<p>For example, the accrediting body of the University of North Carolina-Chapel Hill, the Southern Association of Colleges and Schools Commission on Colleges, warned the university’s Board of Trustees that the establishment of the <a href="https://www.insidehighered.com/news/2023/02/08/unc-chapel-hill-leaders-diverge-what-new-school-will-be">School for Civic Life and Leadership</a> without oversight and consultation with the college raised serious concerns about institutional independence. The legislature responded with <a href="https://legiscan.com/NC/text/S680/id/2799117/North_Carolina-2023-S680-Amended.pdf">Senate Bill 680</a>which might require public universities in North Carolina to decide on a special accrediting agency each accreditation cycle. This policy was eventually passed as a part of Omnibus House Bill 8 and allows schools to <a href="https://www.insidehighered.com/news/governance/accreditation/2023/10/10/new-north-carolina-law-forces-changes-accreditation">“Shopping” for an accreditation agency</a> less more likely to object to such political interference within the curriculum. </p>
<p>These five overlapping and reinforcing attacks on academic freedom and institutional autonomy threaten to radically transform public higher education in ways in which serve the partisan interests of those in power.</p>
</p></div>
<p><em>image credit : theconversation.com</em></p>
]]></content:encoded>
					
		
		
		<media:content url="https://images.theconversation.com/files/596876/original/file-20240528-19-9rlr2u.jpg?ixlib=rb-4.1.0&#038;q=45&#038;auto=format&#038;w=1356&#038;h=668&#038;fit=crop" medium="image"></media:content>
	</item>
		<item>
		<title>Fetal personality decisions could undermine a pregnant patient&#039;s desire for end-of-life care</title>
		<link>https://bloggingthree.soflytech.com/2024/04/fetal-personality-decisions-could-undermine-a-pregnant-patients-desire-for-end-of-life-care/</link>
		
		<dc:creator><![CDATA[chandankumarsoft]]></dc:creator>
		<pubDate>Thu, 25 Apr 2024 23:04:40 +0000</pubDate>
				<category><![CDATA[Health]]></category>
		<category><![CDATA[care]]></category>
		<category><![CDATA[decisions]]></category>
		<category><![CDATA[desire]]></category>
		<category><![CDATA[endoflife]]></category>
		<category><![CDATA[Fetal]]></category>
		<category><![CDATA[patient39s]]></category>
		<category><![CDATA[personality]]></category>
		<category><![CDATA[pregnant]]></category>
		<category><![CDATA[undermine]]></category>
		<guid isPermaLink="false">https://bloggingthree.soflytech.com/?p=1607</guid>

					<description><![CDATA[The Alabama Supreme Court issued an unprecedented ruling in February 2024, finding that stored frozen embryos created for in vitro fertilization, often known as IVF, &#8220;minor children” under a state wrongful death law. The impact on the medical community was immediate and acute. Fearing recent civil or criminal liability if embryos were now considered “persons” [&#8230;]]]></description>
										<content:encoded><![CDATA[<p></p>
<div itemprop="articleBody">
<p>The Alabama Supreme Court issued an unprecedented ruling in February 2024, finding that stored frozen embryos created for in vitro fertilization, often known as IVF, &#8220;<a href="https://publicportal-api.alappeals.gov/courts/68f021c4-6a44-4735-9a76-5360b2e8af13/cms/case/343d203a-b13d-463a-8176-c46e3ae4f695/docketentrydocuments/e3d95592-3cbe-4384-afa6-063d4595aa1d">minor children” under a state wrongful death law</a>. </p>
<p>The impact on the medical community was immediate and acute.  Fearing recent civil or criminal liability if embryos were now considered “persons” under Alabama law, IVF clinics needed to make an overnight decision whether to supply patient care or incur that liability.  As a result, there are several IVF clinics across the state <a href="https://www.theguardian.com/us-news/2024/feb/21/university-alabama-ivf-embryo-care-paused-supreme-court-ruling">IVF procedures were immediately suspended</a>.  And that <a href="https://www.washingtonpost.com/health/interactive/2024/ivf-couples-alabama-ruling/">most direct effect</a>Naturally, <a href="https://www.newsweek.com/ivf-alabama-court-ruling-1872708">Was on patients</a>.</p>
<p>As <a href="https://www.american.edu/spa/faculty/waters.cfm">Legal and policy researcher on reproductive rights</a> – and girls of childbearing age – we fear that as debates over fetal versus embryonic personality proceed, healthcare providers can be faced with an increasing number of recent situations by which they have to balance legal liability and patient well-being. </p>
<p>These conflicts are already playing out over abortion, but one other looming example stays under the radar: whether a physician will have the ability to honor a patient&#39;s end-of-life wishes if she is pregnant.</p>
<p>In many states the reply might be no.</p>
<h2>Doctors assess legal liability</h2>
<p>The <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf">Supreme Court decision Dobbs v. Jackson</a> In June 2022, the elemental right to access abortion care ended, returning the problem of abortion access to the states and reopening political debates about fetal personality.  Doctors who treat pregnant patients are actually subject to a patchwork of abortion bans and restrictions <a href="https://states.guttmacher.org/policies/">vary from state to state</a>. </p>
<p>Many gynecologists navigating this maze now practice with the looming fear of civil or criminal liability in the event that they come into conflict, even unknowingly, with rapidly changing state laws and judicial or prosecutorial interpretations of those laws.  These fears should not unfounded: state attorneys general have threatened to prosecute doctors who provide medical care <a href="https://www.cbsnews.com/texas/video/ag-paxton-issues-warning-to-hospitals-doctors-after-judge-approves-emergency-abortion/?ftag=MSF0951a18">medically essential abortion care</a> or assisting a patient in a state that has a ban on abortion <a href="https://www.lawdork.com/p/doj-alabama-abortion-right-to-travel">have an abortion performed out of state</a>.  In fact, there have been pregnant women <a href="https://apnews.com/article/ohio-miscarriage-prosecution-brittany-watts-b8090abfb5994b8a23457b80cf3f27ce">criminally charged with miscarriage</a>. </p>
<p>These balancing acts occur even when pregnant patients find themselves in emergency situations.</p>
<p>A study from January 2024 <a href="https://doi.org/10.1001/jamanetworkopen.2023.52109">details these conflicts in 13 states</a>.  After the Dobbs decision, gynecologists were found to delay clinical look after pregnant patients &#8211; even in emergency situations &#8211; out of fear of liability under the brand new unclear state laws.</p>
<figure>
<p><iframe title="Beyond Abortion: The Fight Over Fetal Personhood Is Here" width="1170" height="658" src="https://www.youtube.com/embed/J-9Evt6j8SQ?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></p><figcaption><span class="caption">Under fetal personality laws, the unborn could have the identical rights as some other human being.</span></figcaption></figure>
<h2>Living will and exclusion of pregnancy</h2>
<p>The abortion and IVF examples illustrate the tense and unsure legal landscape that medical professionals must navigate in time-critical and emergency situations.  In short: There are not any rules and the chance is great.  </p>
<p>We anticipate that physicians can be forced to weigh these same uncertainties and risks in probably the most traumatic situation: treating a patient who has no hope of survival.  In such situations, physicians typically seek to bear in mind any pre-expressed end-of-life wishes the patient could have, similar to those contained herein <a href="https://www.nia.nih.gov/health/advance-care-planning/advance-care-planning-advance-directives-health-care#">Advance Directives</a>.  These instructions may include: <a href="https://code-medical-ethics.ama-assn.org/ethics-opinions/withholding-or-withdrawing-life-sustaining-treatment">Decisions about life-sustaining treatments</a> and designation of 1 <a href="https://code-medical-ethics.ama-assn.org/ethics-opinions/advance-directives">Healthcare representative</a>. </p>
<p>Simply put, living wills are a way for patients to inform their families and doctors how they would really like to be treated medically in the event that they later grow to be incapacitated, similar to in a coma.  All 50 states plus Washington DC <a href="https://aspe.hhs.gov/reports/advance-directives-advance-care-planning-legal-policy-issues-0">recognize the validity</a> of patient directives.  </p>
<p>But not once you&#39;re pregnant.  As of early 2024, greater than half of the US states will <a href="https://scholarship.law.unc.edu/faculty_publications/636/">have laws on the books</a> which robotically invalidate an incapacitated patient&#39;s previously expressed end-of-life wishes if the patient is pregnant.  Law professor <a href="https://scholarship.law.unc.edu/faculty_publications/636/">John Krause</a> refers to those as “pregnancy restrictions” and notes that they exist in no less than 30 states.  In some states, these cancellations of living wills only apply on <a href="https://scholarship.law.unc.edu/faculty_publications/636/">Point of fetal viability or possibility of live birth</a>.  However, in 12 states, these advance directives are considered “pregnancy exclusions.” <a href="https://revisor.mo.gov/main/OneSection.aspx?section=459.025#">They occur at every stage of pregnancy</a>. </p>
<p>That signifies that even when a pregnant patient previously had a written, notarized advance directive stating that she didn&#8217;t need to depend on organ support if she was unlikely to ever get well, a physician may very well be required under 30 state laws to disregard it fulfilling those desires and keeping her alive to sustain the pregnancy.  And in 12 of those states, this requirement would apply even when the pregnancy was not viable.  These exclusions would essentially require physicians to proceed organ preservation care in order that the pregnant patient&#39;s body may very well be used as an incubator for a fetus. </p>
<p>Currently, there are few reported cases of pregnant patients&#39; living wills being revoked, although there are some heartbreaking examples.  </p>
<p>A highly publicized case from 2014 <a href="https://www.npr.org/sections/health-shots/2014/01/28/267759687/the-strange-case-of-marlise-munoz-and-john-peter-smith-hospital">detailed, like Marlise Muñoz</a>A Texas woman who was 14 weeks pregnant when she was declared brain dead was kept on life support for 3 months, although she and her family had clearly expressed a desire to not proceed her life artificially. </p>
<p>The reason?  The hospital in Texas said this was the case <a href="https://statutes.capitol.texas.gov/Docs/HS/htm/HS.166.htm">prohibited by the Texas Living Will Act</a> Because Muñoz was pregnant and so they had an obligation to preserve the lifetime of the fetus, they weren&#8217;t allowed to show off life support.</p>
<p>However, we suspect that scenarios like that of the Muñoz family could occur <a href="https://doi.org/10.1001%2Fjama.2019.2587">should not sufficiently reported</a>.  Families in crisis often won&#8217;t pursue legal options or make their trauma public.  We also expect these situations to grow to be more common in a post-Dobbs world as physicians proceed to grapple with emerging uncertainties and fears of legal liability related to end-of-life look after pregnant patients.</p>
<figure>
<p><iframe title="The role of fetal personhood in the anti-abortion movement and legislation" width="1170" height="658" src="https://www.youtube.com/embed/zz9LsfZHAPk?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></p><figcaption><span class="caption">Abortion regulations have far-reaching implications for IVF and a wide range of other fundamental personal decisions that girls must make.</span></figcaption></figure>
<h2>Legislative labyrinths</h2>
<p>It is evident that advance directives should not exempt from the personality debate, as the first goal of pregnancy exclusions is to guard the lifetime of the fetus. </p>
<p>Just as abortion restrictions vary from state to state, so do advance directive laws.  The laws are extremely complex and sometimes require an intricate compilation of varied sections of state law.  Therefore, even when a patient has an advance directive, it is probably going that few understand that these pregnancy exclusions even exist, let alone that they&#8217;re fully relevant.</p>
<p>Additionally, many states haven&#8217;t yet brought their advance directive laws into compliance with their abortion laws.</p>
<p>Arkansas, where <a href="https://states.guttmacher.org/policies/arkansas/abortion-policies">Abortion is currently banned</a> at any point in pregnancy provides an illustrative example. </p>
<p>When it involves end-of-life care, <a href="https://casetext.com/statute/arkansas-code-of-1987/title-20-public-health-and-welfare/subtitle-2-health-and-safety/chapter-17-death-and-disposition-of-the-dead/subchapter-2-arkansas-rights-of-the-terminally-ill-or-permanently-unconscious-act/section-20-17-203-when-declaration-operative">Arkansas law</a> stipulates that physicians “shall” act in accordance with a certified patient’s health guidelines.  </p>
<p>However, if the patient is pregnant, Arkansas law requires that the <a href="https://casetext.com/statute/arkansas-code-of-1987/title-20-public-health-and-welfare/subtitle-2-health-and-safety/chapter-17-death-and-disposition-of-the-dead/subchapter-2-arkansas-rights-of-the-terminally-ill-or-permanently-unconscious-act/section-20-17-206-treatment-of-qualified-patient">The same guideline mustn&#8217;t be followed</a> “as long as it is possible for the fetus to develop to live birth with continued life-sustaining treatment.” </p>
<p>An Arkansas doctor attempting to respect a pregnant patient&#39;s advance directive and terminate organ-preserving care—and thus the pregnancy—would due to this fact be faced with quite a few questions: When is it “possible” for a fetus to become live birth? could?  Is this an issue of clinical fetal viability, which in line with the American College of Obstetricians and Gynecologists is extremely case specific? <a href="https://www.acog.org/advocacy/facts-are-important/understanding-and-navigating-viability">impossible to “definitely explain”</a>?  And how does a physician reconcile Arkansas&#39; abortion ban with the advance directive law, which apparently allows treatment to be withheld until &#8220;the fetus can develop to the point of live birth&#8221;? </p>
<h2>Specific advance directives</h2>
<p>Recent abortion and IVF cases have highlighted how medical decision-making is consistently changing and what this implies for medical care.  Given this shifting terrain, it&#8217;s unimaginable to predict with any degree of certainty how policies regarding end-of-life look after a pregnant person can be interpreted, even within the few states that allow it for patients <a href="https://scholarship.law.unc.edu/cgi/viewcontent.cgi?article=1635&#038;context=faculty_publications">Express your wishes within the event of pregnancy</a>.</p>
<p>However, it might be a sensible practice for pregnant patients &#8211; or those that may sooner or later grow to be pregnant &#8211; to try to know the complexities of their state&#39;s laws and create a transparent and specific advance directive that directly addresses their wishes within the event of pregnancy enters pregnancy.</p>
</p></div>
<p><em>image credit : theconversation.com</em></p>
]]></content:encoded>
					
		
		
		<media:content url="https://images.theconversation.com/files/585882/original/file-20240403-20-d15zx2.jpg?ixlib=rb-4.1.0&#038;rect=116%2C0%2C9586%2C4742&#038;q=45&#038;auto=format&#038;w=1356&#038;h=668&#038;fit=crop" medium="image"></media:content>
	</item>
	</channel>
</rss>
