Skip to content
Search

Latest Stories

Top Stories

Having a glass of wine will be child abuse if Roe is overturned

pregnant woman with wine
Anton Petrus/Getty Images

Why does The Fulcrum feature regular columns on health care in America?

U.S. health care spending grew 9.7 percent in 2020, reaching $4.1 trillion — 19.7 percent of the gross domestic product. Over the long term this is clearly unsustainable. If The Fulcrum is going to fulfill our mission as a place for informed discussions on repairing our democracy, we need to foster conversations on this vital segment of the economy. Maximizing the quality and reducing the cost of American medicine not only will make people's lives better, but will also generate dollars needed to invest in education, eliminating poverty or other critical areas. This series on breaking the rules aims to achieve that goal and spotlights the essential role the government will need to play.

Pearl is a clinical professor of plastic surgery at the Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.

The Supreme Court’s leaked decision to overturn Roe v Wade, if finalized, would eliminate the constitutional right to an abortion, thereby handing over to states a choice that has been guaranteed to women for nearly 50 years.

Such a decision would not only cause major medical harm, but it would also turn tens of millions of women into instant criminals.


As a physician and health care leader, I side with the 80 percent of doctors who support the right of women to make choices about their own bodies. Medically, I concur with the scientific rationale provided in the Supreme Court opinions of Roe (1973) and Casey (1992) that fetal viability (when the child is “potentially able to live outside the mother’s womb”) establishes human life.

What’s been underappreciated in the debate over abortion are the criminal implications that would be created by defining human life at conception. Given the laws on the books, and those scheduled to go into effect should the Supreme Court overturn Roe, women in 22 states would be immediately in violation of child-abuse laws. I don’t believe doing so is what the Supreme Court justices intend or what the people of those states are expecting. But that is what will occur should the current draft become final.

To quote the governor of Oklahoma, who recently signed into law the nation’s strictest abortion ban: “From the moment life begins at conception is when we have a responsibility as human beings to do everything we can to protect that baby’s life and the life of the mother.”

Obviously, exposing fetuses to alcohol and the harmful chemicals in cigarette smoke would violate this prescription. Will law enforcement in the states that define human life at fertilization start prosecuting and potentially jailing any pregnant mother who smokes or drinks alcohol?

If a fetus is a living human, then smoking while pregnant would be equivalent to supplying cigarettes to a minor, punishable in most states by a large fine and possible jail time. Added to those penalties is the possibility of applicable child-endangerment laws. After all, nicotine dangerously reduces oxygen supply while smoke inhalation sends carbon monoxide directly to the fetus, both highly damaging. Prenatal heart defects, cleft lip and even miscarriage are just a few of the well-known consequences of smoking or breathing in second-hand smoke during the early part of fetal development. If such behaviors were to result in the death of a fetus, state prosecutors could see fit to charge parents with manslaughter or negligent homicide.

A similar concern applies to alcohol consumption. Currently, no states criminalize alcohol use during pregnancy, but supplying alcohol to a minor is illegal in every state. In many of them, it’s a felony when the crime results in serious injury or death. Self-reported studies reveal more than 1 in 9 women in the U.S. drink while pregnant. Among those of childbearing age, the prevalence of binge drinking is highest in many red states like Nebraska, Montana and North Dakota — places that are slated to institute abortion bans immediately following the ruling on Roe.

If it is determined that life begins at conception, so does the possibility of the enforcement of child-protection statutes. Any action taken by a pregnant woman that’s deemed harmful to the fetus could be child abuse, no different than if she were to intentionally harm a newborn, toddler or teenager. Research has shown that smoking and drinking in pregnancy negatively impact fetal development. The best approach to helping pregnant women abstain from alcohol and cigarettes are support groups and effective medical treatment programs.

For nearly a decade, attorney Lynn Paltrow has documented cases of pregnant women who’ve been arrested, tried and imprisoned for violating a range of anti-abortion laws, including examples of over-zealous law enforcement prosecuting women for potential harm to developing fetuses. The current Supreme Court draft would further empower such police actions.

I urge the Supreme Court justices to reconsider their preliminary opinions. As written the ruling would not only risk harm to the health of women but criminalize current law-abiding individuals. If the Supreme Court overturns Roe and allows states to define human life as beginning at fertilization, many unwarranted, unexpected and unfair prosecutions surely will follow.

Read More

Veterans’ Care at Risk Under Trump As Hundreds of Doctors and Nurses Reject Working at VA Hospitals
Photo illustration by Lisa Larson-Walker/ProPublica

Veterans’ Care at Risk Under Trump As Hundreds of Doctors and Nurses Reject Working at VA Hospitals

Veterans hospitals are struggling to replace hundreds of doctors and nurses who have left the health care system this year as the Trump administration pursues its pledge to simultaneously slash Department of Veterans Affairs staff and improve care.

Many job applicants are turning down offers, worried that the positions are not stable and uneasy with the overall direction of the agency, according to internal documents examined by ProPublica. The records show nearly 4 in 10 of the roughly 2,000 doctors offered jobs from January through March of this year turned them down. That is quadruple the rate of doctors rejecting offers during the same time period last year.

Keep ReadingShow less
Protecting the U.S. Press: The PRESS Act and What It Could Mean for Journalists

The Protect Reporters from Excessive State Suppression (PRESS) Act aims to fill the national shield law gap by providing two protections for journalists.

Getty Images, Manu Vega

Protecting the U.S. Press: The PRESS Act and What It Could Mean for Journalists

The First Amendment protects journalists during the news-gathering and publication processes. For example, under the First Amendment, reporters cannot be forced to report on an issue. However, the press is not entitled to different legal protections compared to a general member of the public under the First Amendment.

In the United States, there are protections for journalists beyond the First Amendment, including shield laws that protect journalists from pressure to reveal sources or information during news-gathering. 48 states and the District of Columbia have shield laws, but protections vary widely. There is currently no federal shield law. As of 2019, at least 22 journalists have been jailed in the U.S. for refusing to comply with requests to reveal sources of information. Seven other journalists have been jailed and fined for the same reason.

Keep ReadingShow less
Policing or Occupation? Trump’s Militarizing America’s Cities Sets a Dangerous Precedent

A DC Metropolitan Police Department car is parked near a rally against the Trump Administration's federal takeover of the District of Columbia, outside of the AFL-CIO on August 11, 2025 in Washington, DC.

(Photo by Kevin Dietsch/Getty Images)

Policing or Occupation? Trump’s Militarizing America’s Cities Sets a Dangerous Precedent

President Trump announced the activation of hundreds of National Guard troops in Washington, D.C., along with the deployment of federal agents—including more than 100 from the FBI. This comes despite Justice Department data showing that violent crime in D.C. fell 35% from 2023 to 2024, reaching its lowest point in over three decades. These aren’t abstract numbers—they paint a picture of a city safer than it has been in a generation, with fewer homicides, assaults, and robberies than at any point since the early 1990s.

The contradiction could not be more glaring: the same president who, on January 6, 2021, stalled for hours as a violent uprising engulfed the Capitol is now rushing to “liberate” a city that—based on federal data—hasn’t been this safe in more than thirty years. Then, when democracy itself was under siege, urgency gave way to dithering; today, with no comparable emergency—only vague claims of lawlessness—he mobilizes troops for a mission that looks less like public safety and more like political theater. The disparity between those two moments is more than irony; it is a blueprint for how power can be selectively applied, depending on whose power is threatened.

Keep ReadingShow less
Democrats Need To Focus on Communication

Democrat Donkey phone operator

AI illustration

Democrats Need To Focus on Communication

The Democrats have a problem…I realize this isn’t a revelation, but I believe they’re boxed into a corner with limited options to regain their footing. Don’t get me wrong, the party could have a big win in the 2026 midterms with a backlash building against Trump and MAGA. In some scenarios, that could also lead to taking back the White House in 2028…but therein lies the problem.

In its second term, the Trump administration has severely cut government agencies, expanded the power of the Executive branch, enacted policies that will bloat the federal deficit, dismantled parts of the social safety net, weakened our standing in the world, and moved the US closer to a “pay for play” transactional philosophy of operating government that’s usually reserved for Third World countries. America has veered away from being the model emulated by other nations that aim to build a stable democracy.

Keep ReadingShow less