Medical Standards by Federal Fiat

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Copyright © 2026 Massachusetts Medical Society. All rights reserved.

Document Type

Article

Publication Date

7-2026

ISSN

0028-4793

Publisher

Massachusetts Medical Society

Language

en-US

Abstract

The constitutional structure of the United States gives the states broad regulatory authority over medical standards. This authority applies even — or perhaps especially — in contested areas of medicine, such as gender-affirming care for young people. Yet in recent executive actions, the U.S. government has moved to federalize medical standards, threatening to imperil the financial viability of hospitals and investigate physicians providing certain types of contested care if their actions are contrary to a politically appointed federal official’s views about medicine. The federal government’s legal theories could jeopardize the practice of medicine for all physicians and the health of all patients, not just those who provide or pursue gender-affirming care.

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