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February 16, 1990


Author Affiliations

Columbia School of Public Health New York, NY

Columbia School of Public Health New York, NY

JAMA. 1990;263(7):947. doi:10.1001/jama.1990.03440070031017

To the Editor.—  We fear that the implications of Webster for physicians extend beyond those delineated in the excellent commentary by Allen and Pearse1 and certainly beyond those considered by the American Medical Association in its amicus brief.2 Not only is the physicianpatient relationship threatened in regard to the right of privacy, but the physician's most fundamental obligation to provide optimal medical care is compromised by this decision.Restricted access to abortion for poor women resulting from the prohibition on the use of public resources means that the women most at risk for adverse birth outcome and most at risk themselves are effectively denied preventive health care. Access to legal abortion has been associated with a decline in infant mortality, which is attributed to the prevention of unwanted and high-risk pregnancies, particularly to teenagers.3 Examination of the impact of various health and social services on race-specific