Ethical research when abortion access is legally restricted

Risks and benefits of some clinical research may be altered The legal landscape surrounding abortion in the United States has shifted dramatically since the Supreme Court's June 2022 decision in Dobbs v. Jackson Women's Health Organization eliminated a nationwide right to abortion (1). In the year since, roughly half of US states have expanded abortion restrictions. Some consequences of heightened restrictions-including increased maternal morbidity and mortality and deepening socioeconomic and racial inequities-have quickly come into view. However, little attention has focused on the ethical, legal, and practical implications that such restrictions have for research involving people who could become pregnant during research and research staff. Notably, limited access to abortion can pose risks to clinical research participants and potentially compromise the scientific and social value of some research. As a result, assessments of potential research risks and benefits may be altered. We outline points for various stakeholders [such as sponsors, investigators, research sites, and institutional review boards (IRBs)] to consider in addressing these issues.