{"id":"https://openalex.org/W7225090940","doi":"https://doi.org/10.1001/jamanetworkopen.2026.41713","title":"Moral Distress Among Abortion-Providing Clinicians After the US Supreme Court Dobbs Decision","display_name":"Moral Distress Among Abortion-Providing Clinicians After the US Supreme Court Dobbs Decision","publication_year":2026,"publication_date":"2026-11-02","ids":{"openalex":"https://openalex.org/W7225090940","doi":"https://doi.org/10.1001/jamanetworkopen.2026.41713","pmid":"https://pubmed.ncbi.nlm.nih.gov/42970290"},"language":"en","primary_location":{"id":"doi:10.1001/jamanetworkopen.2026.41713","doi":"https://doi.org/10.1001/jamanetworkopen.2026.41713","is_oa":true,"landing_page_url":"https://doi.org/10.1001/jamanetworkopen.2026.41713","pdf_url":null,"source":{"id":"https://openalex.org/S4210217848","display_name":"JAMA Network Open","issn_l":"2574-3805","issn":["2574-3805"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-b","doyens","jufo-1","ki-jl-2","medline","norway-1","oarl","poland-20","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320259","host_organization_name":"American Medical Association","host_organization_lineage":["https://openalex.org/P4310320259"],"host_organization_lineage_names":["American Medical Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMA Network Open","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1001/jamanetworkopen.2026.41713","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5066920491","display_name":"Jocelyn Marie Wascher","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I169521973","display_name":"University of New Mexico","ror":"https://ror.org/05fs6jp91","country_code":"US","type":"education","lineage":["https://openalex.org/I169521973"]},{"id":"https://openalex.org/I4405255059","display_name":"University of New Mexico Health Sciences Center","ror":"https://ror.org/02jvjmd55","country_code":"US","type":"education","lineage":["https://openalex.org/I169521973","https://openalex.org/I4405255059"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jocelyn Wascher","raw_affiliation_strings":["Health Sciences Center, University of New Mexico, Albuquerque"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Sciences Center, University of New Mexico, Albuquerque","institution_ids":["https://openalex.org/I169521973","https://openalex.org/I4405255059"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5060714754","display_name":"Dana Howard","orcid":"https://orcid.org/0000-0001-7793-2912","observed_orcids":["https://orcid.org/0000-0001-7793-2912"]},"institutions":[{"id":"https://openalex.org/I52357470","display_name":"The Ohio State University","ror":"https://ror.org/00rs6vg23","country_code":"US","type":"education","lineage":["https://openalex.org/I52357470"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Dana Howard","raw_affiliation_strings":["Division of Bioethics, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Bioethics, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus","institution_ids":["https://openalex.org/I52357470"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5002174909","display_name":"Marta Bornstein","orcid":"https://orcid.org/0000-0002-5200-8181","observed_orcids":["https://orcid.org/0000-0002-5200-8181"]},"institutions":[{"id":"https://openalex.org/I155781252","display_name":"University of South Carolina","ror":"https://ror.org/02b6qw903","country_code":"US","type":"education","lineage":["https://openalex.org/I155781252"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Marta Bornstein","raw_affiliation_strings":["Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia","institution_ids":["https://openalex.org/I155781252"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5074773819","display_name":"Katherine Rivlin","orcid":"https://orcid.org/0000-0002-0454-3534","observed_orcids":["https://orcid.org/0000-0002-0454-3534"]},"institutions":[{"id":"https://openalex.org/I40347166","display_name":"University of Chicago","ror":"https://ror.org/024mw5h28","country_code":"US","type":"education","lineage":["https://openalex.org/I40347166"]},{"id":"https://openalex.org/I4210087865","display_name":"University of Chicago Medical Center","ror":"https://ror.org/0076kfe04","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087865"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Katherine Rivlin","raw_affiliation_strings":["Department of Obstetrics and Gynecology, University of Chicago Medicine, Chicago, Illinois"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology, University of Chicago Medicine, Chicago, Illinois","institution_ids":["https://openalex.org/I40347166","https://openalex.org/I4210087865"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":6,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":3000,"currency":"USD","value_usd":3000},"apc_paid":{"value":3000,"currency":"USD","value_usd":3000},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.88809718,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"9","issue":"11","first_page":"e2641713","last_page":"e2641713"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11537","display_name":"Ethics in medical practice","score":0.8217999935150146,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11537","display_name":"Ethics in medical practice","score":0.8217999935150146,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10600","display_name":"Reproductive Health and Contraception","score":0.10670000314712524,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13147","display_name":"Ethics and bioethics in healthcare","score":0.05739999935030937,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/moral-distress","display_name":"moral distress","score":0.9990000128746033},{"id":"https://openalex.org/keywords/abortion-care","display_name":"abortion services","score":0.5389999747276306},{"id":"https://openalex.org/keywords/abortion-providers","display_name":"abortion providers","score":0.7260000109672546},{"id":"https://openalex.org/keywords/dobbs-v-jackson-women-s-health-organization","display_name":"Dobbs v. Jackson Women's Health Organization","score":0.8519999980926514},{"id":"https://openalex.org/keywords/abortion-policy","display_name":"abortion policy","score":0.7059999704360962},{"id":"https://openalex.org/keywords/conscientious-objection","display_name":"conscientious objection","score":0.7409999966621399},{"id":"https://openalex.org/keywords/resource-constraints","display_name":"resource constraints","score":0.5899999737739563},{"id":"https://openalex.org/keywords/clinician-burnout","display_name":"clinician burnout","score":0.6420000195503235},{"id":"https://openalex.org/keywords/employee-attrition","display_name":"employee attrition","score":0.7900000214576721}],"concepts":[{"id":"https://openalex.org/C139265228","wikidata":"https://www.wikidata.org/wiki/Q5283089","display_name":"Distress","level":2,"score":0.6693000197410583},{"id":"https://openalex.org/C106399304","wikidata":"https://www.wikidata.org/wiki/Q868123","display_name":"Snowball sampling","level":2,"score":0.6230000257492065},{"id":"https://openalex.org/C2778642596","wikidata":"https://www.wikidata.org/wiki/Q8452","display_name":"Abortion","level":3,"score":0.545199990272522},{"id":"https://openalex.org/C74196892","wikidata":"https://www.wikidata.org/wiki/Q7781188","display_name":"Thematic analysis","level":3,"score":0.5005999803543091},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.4805000126361847},{"id":"https://openalex.org/C2778272461","wikidata":"https://www.wikidata.org/wiki/Q190752","display_name":"Supreme court","level":2,"score":0.461899995803833},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.4237000048160553},{"id":"https://openalex.org/C77805123","wikidata":"https://www.wikidata.org/wiki/Q161272","display_name":"Social psychology","level":1,"score":0.3928999900817871},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3855000138282776},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.31679999828338623},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.30059999227523804},{"id":"https://openalex.org/C158154518","wikidata":"https://www.wikidata.org/wiki/Q7310970","display_name":"Relevance (law)","level":2,"score":0.3001999855041504},{"id":"https://openalex.org/C100363876","wikidata":"https://www.wikidata.org/wiki/Q690661","display_name":"Nonprobability sampling","level":3,"score":0.2976999878883362},{"id":"https://openalex.org/C56995899","wikidata":"https://www.wikidata.org/wiki/Q1126687","display_name":"Focus group","level":2,"score":0.2892000079154968},{"id":"https://openalex.org/C558461103","wikidata":"https://www.wikidata.org/wiki/Q154430","display_name":"Anxiety","level":2,"score":0.2881999909877777},{"id":"https://openalex.org/C57996006","wikidata":"https://www.wikidata.org/wiki/Q6909105","display_name":"Moral disengagement","level":2,"score":0.2816999852657318},{"id":"https://openalex.org/C143916079","wikidata":"https://www.wikidata.org/wiki/Q2629248","display_name":"Burnout","level":2,"score":0.2809000015258789},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2711000144481659},{"id":"https://openalex.org/C504631918","wikidata":"https://www.wikidata.org/wiki/Q152074","display_name":"Bankruptcy","level":2,"score":0.26579999923706055},{"id":"https://openalex.org/C2778079182","wikidata":"https://www.wikidata.org/wiki/Q1342132","display_name":"Unsafe abortion","level":5,"score":0.26570001244544983},{"id":"https://openalex.org/C2781439373","wikidata":"https://www.wikidata.org/wiki/Q11883221","display_name":"Moral agency","level":2,"score":0.26190000772476196},{"id":"https://openalex.org/C2781011336","wikidata":"https://www.wikidata.org/wiki/Q1465133","display_name":"Time limit","level":2,"score":0.2535000145435333}],"mesh":[{"descriptor_ui":"D000028","descriptor_name":"Abortion, Induced","qualifier_ui":"Q000331","qualifier_name":"legislation & jurisprudence","is_major_topic":true},{"descriptor_ui":"D000028","descriptor_name":"Abortion, Induced","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D000028","descriptor_name":"Abortion, Induced","qualifier_ui":"Q000941","qualifier_name":"ethics","is_major_topic":true},{"descriptor_ui":"D000098463","descriptor_name":"Ethical Dilemmas","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011247","descriptor_name":"Pregnancy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D035521","descriptor_name":"Supreme Court Decisions","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D036301","descriptor_name":"Qualitative Research","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1001/jamanetworkopen.2026.41713","doi":"https://doi.org/10.1001/jamanetworkopen.2026.41713","is_oa":true,"landing_page_url":"https://doi.org/10.1001/jamanetworkopen.2026.41713","pdf_url":null,"source":{"id":"https://openalex.org/S4210217848","display_name":"JAMA Network Open","issn_l":"2574-3805","issn":["2574-3805"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-b","doyens","jufo-1","ki-jl-2","medline","norway-1","oarl","poland-20","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320259","host_organization_name":"American Medical Association","host_organization_lineage":["https://openalex.org/P4310320259"],"host_organization_lineage_names":["American Medical Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMA Network Open","raw_type":"journal-article"},{"id":"pmid:42970290","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42970290","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMA network open","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1001/jamanetworkopen.2026.41713","doi":"https://doi.org/10.1001/jamanetworkopen.2026.41713","is_oa":true,"landing_page_url":"https://doi.org/10.1001/jamanetworkopen.2026.41713","pdf_url":null,"source":{"id":"https://openalex.org/S4210217848","display_name":"JAMA Network Open","issn_l":"2574-3805","issn":["2574-3805"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-b","doyens","jufo-1","ki-jl-2","medline","norway-1","oarl","poland-20","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320259","host_organization_name":"American Medical Association","host_organization_lineage":["https://openalex.org/P4310320259"],"host_organization_lineage_names":["American Medical Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMA Network Open","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9391000270843506,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"},{"score":0.666700005531311,"display_name":"Peace, justice, and strong institutions","id":"https://metadata.un.org/sdg/16"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":26,"referenced_works":["https://openalex.org/W1984016890","https://openalex.org/W1985615083","https://openalex.org/W2000369298","https://openalex.org/W2061192983","https://openalex.org/W2073418260","https://openalex.org/W2323796081","https://openalex.org/W2331393505","https://openalex.org/W2559605511","https://openalex.org/W3094070651","https://openalex.org/W3145741391","https://openalex.org/W3157574611","https://openalex.org/W4249125051","https://openalex.org/W4293239066","https://openalex.org/W4321180226","https://openalex.org/W4380769151","https://openalex.org/W4381612892","https://openalex.org/W4387485908","https://openalex.org/W4389505185","https://openalex.org/W4390940379","https://openalex.org/W4401214708","https://openalex.org/W4402430863","https://openalex.org/W4403586714","https://openalex.org/W4409170971","https://openalex.org/W4409471932","https://openalex.org/W4411205465","https://openalex.org/W4414532861"],"related_works":["https://openalex.org/W7162990887","https://openalex.org/W4396947015","https://openalex.org/W4402430863","https://openalex.org/W4396946882","https://openalex.org/W7171842995","https://openalex.org/W7090272136","https://openalex.org/W4409170971","https://openalex.org/W4387485908","https://openalex.org/W4399626235","https://openalex.org/W7130631336"],"abstract_inverted_index":{"Importance:":[0],"Moral":[1],"distress":[2,26,111,163,187,223,254],"among":[3,27],"abortion-providing":[4,28],"clinicians":[5,29,75,237],"could":[6],"lead":[7],"to":[8,62,93,127,150,201,207,214,218,225,258],"burnout":[9],"and":[10,50,67,98,115,121,172,221,231,241,261],"attrition":[11],"from":[12,60,90],"the":[13,31,71,80,83,136,151,226],"workforce,":[14],"worsening":[15],"reproductive":[16],"care":[17,78,216],"disparities.":[18],"Objective:":[19],"To":[20],"describe":[21],"situations":[22,106,159,183,245,260],"associated":[23,108,160,184,246],"with":[24,109,161,185,247],"moral":[25,110,162,186,248,253],"since":[30],"US":[32,81],"Supreme":[33],"Court's":[34],"Dobbs":[35],"v":[36],"Jackson":[37],"Women's":[38],"Health":[39],"Organization":[40],"decision":[41],"across":[42,70],"a":[43],"range":[44],"of":[45,174,182,195],"policy":[46,118,166],"environments.":[47,119],"Design,":[48],"Setting,":[49],"Participants:":[51],"For":[52],"this":[53,234],"qualitative":[54,235],"study,":[55,236],"purposive":[56],"sampling":[57,69],"was":[58,103],"conducted":[59],"May":[61],"December":[63],"2023":[64],"through":[65],"listservs":[66],"snowball":[68],"US.":[72],"Participants":[73],"were":[74,88,107,125,169,188],"providing":[76],"abortion":[77,117,196],"in":[79,82,112,164,238],"year":[84],"following":[85],"Dobbs.":[86],"Data":[87],"analyzed":[89],"March":[91],"2024":[92],"April":[94],"2025.":[95],"Main":[96],"Outcomes":[97],"Measures:":[99],"The":[100,155],"primary":[101],"outcome":[102],"determining":[104],"which":[105],"both":[113,170,239],"protective":[114,171],"restrictive":[116,173],"Deductive":[120],"inductive":[122],"coding":[123],"approaches":[124],"used":[126],"analyze":[128],"open-ended":[129,153],"responses.":[130],"Results:":[131],"Of":[132],"310":[133],"respondents":[134,157],"completing":[135],"full":[137],"survey":[138],"(271":[139],"women":[140],"[87.7%];":[141],"132":[142],"aged":[143],"36-45":[144],"years":[145],"[43.6%]),":[146],"160":[147,156],"(51.6%)":[148],"responded":[149],"optional":[152],"question.":[154],"described":[158],"state":[165],"environments":[167,243],"that":[168],"abortion.":[175],"Through":[176],"thematic":[177],"analysis,":[178],"3":[179],"main":[180],"themes":[181],"identified:":[189],"(1)":[190],"bans":[191],"prohibiting":[192],"conscientious":[193],"provision":[194],"care;":[197],"(2)":[198],"forced":[199,206],"adjustments":[200],"medical":[202],"practice,":[203],"including":[204,263],"being":[205],"provide":[208],"inaccurate":[209],"information,":[210],"substandard":[211],"care,":[212],"or":[213,267],"limit":[215],"due":[217],"resource":[219],"scarcity;":[220],"(3)":[222],"related":[224],"broader":[227],"national":[228,268],"environment.":[229],"Conclusions":[230],"Relevance:":[232],"In":[233],"abortion-protective":[240],"abortion-restrictive":[242],"reported":[244],"distress.":[249],"Solutions":[250],"for":[251],"combating":[252],"should":[255],"be":[256],"targeted":[257],"specific":[259],"sources,":[262],"at":[264],"institutional,":[265],"state,":[266],"levels.":[269]},"counts_by_year":[],"updated_date":"2026-11-05T12:25:35.769452","created_date":"2026-11-03T00:00:00"}
