On November 9, 2016, as the stock market fell 800 points and the Canadian immigration website crashed, we elected what other countries call a “dangerous” and “unthinkable” President. Here is Germany’s take: http://www.spiegel.de/international/world/spiegel-editorial-trump-is-a-dangerous-president-a-1120925.html.  Canada had this to say: https://www.thestar.com/news/world/uselection/2016/11/09/donald-trump-wins-america-elects-an-unthinkable-president.html.

In the U.S., more than half the population of this country (particularly those who work in the areas of bioethics, health law, healthcare, or human rights ) compared waking up on November 9th to waking up in a nightmare. Here’s a sample of the editorials from that morning:

http://www.nytimes.com/2016/11/09/opinion/were-near-the-breaking-point.html?action=click&pgtype=Homepage&clickSource=story-heading&module=span-abc-region&region=span-abc-region&WT.nav=span-abc-region

https://www.washingtonpost.com/opinions/a-prayer-for-america/2016/11/08/05fee4d2-a5e8-11e6-8fc0-7be8f848c492_story.html

In terms of national and global impact, the reality of a Trump Presidency is only comparable to 9/11. What some are calling “mourning in America”; “11/9”; “Trumpocalypse” or an “electoral catastrophe”, the United States under a President Trump will be, for many, like watching a car crash in slow motion. Aside from the risk of global and climate disasters at the hands of a President who does not believe in climate change, can still be “baited with a tweet”,  and has declined (as of this writing) his daily intelligence briefings, bioethics in the United States is about to go through a hostile takeover. There are four main categories that will be affected once the transfer of power is complete.

Healthcare access. Repeal of the Affordable Care Act as well as repeal or reform of Medicare and Medicaid are on the agenda. This seems especially likely with the pick of Tom Price for Health and Human Services Secretary. See: http://www.nytimes.com/2016/11/30/opinion/tom-price-a-radical-choice-for-health-secretary.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-right-region&region=opinion-c-col-right-region&WT.nav=opinion-c-col-right-region&_r=0

and

http://www.nytimes.com/2016/11/28/us/politics/tom-price-secretary-health-and-human-services.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=a-lede-package-region&region=top-news&WT.nav=top-news&_r=0

Reproductive justice. Attempts to defund Planned Parenthood, not cover contraception, and repeal of Roe v. Wade are all on the 2017 menu. Although Trump’s first SCOTUS appointment does not necessarily guarantee revisiting Roe v. Wade, challenges to the law are sure to come. If abortion law returns to the jurisdiction of individual states, there could be access in blue states, but most of the country is currently under Republican rule. So we could be looking at more stories like this:  http://www.nytimes.com/2016/11/29/us/tennessee-woman-accused-of-coat-hanger-abortion-faces-new-charges.html?module=WatchingPorta

Human rights violations. Since the election, white supremacy hate crimes – especially targeting Muslims, Hispanics, African Americans and Jews – have skyrocketed. How will we navigate the intersection of healthcare and human rights? For example, will Muslim healthcare providers feel safe in a post-Trump America? Will Muslim patients? What about the prospect of “sanctuary hospitals”? With a reported “white nationalist” appointed as Chief White House strategist (see: http://www.nytimes.com/2016/11/15/us/politics/donald-trump-presidency.html)  and an Attorney General pick with a documented history of racism (see: http://www.cnn.com/2016/11/17/politics/jeff-sessions-racism-allegations/) things are getting morally uncomfortable. Here is the ACLU’s position on some of these issues: https://www.aclu.org/letter/aclu-letter-president-elect-trump-published-new-york-times

Conflicts of Interest. The President-Elect has a dizzying and multi-layered thicket of conflicts of interest that violate the Emoluments Clause, even if his children run his business instead. How can any healthcare provider be expected to adhere to conflicts of interest policies when POTUS 45 could openly use the Presidency to enrich himself? See:

http://www.nytimes.com/2016/11/26/us/politics/donald-trump-international-business.html?_r=0

http://www.nytimes.com/2016/11/25/opinion/donald-trumps-caldron-of-conflicts.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-left-region&region=opinion-c-col-left-region&WT.nav=opinion-c-col-left-region&_r=0

http://www.huffingtonpost.com/entry/donald-trump-conflict-of-interest_us_58349547e4b09b6055ff367d?section=us_politics

More veterans. With the pick of Michael Flynn for the NSA, we may see a fresh ground war and a draft. (But — perhaps a decline of obesity in those we draft.) See: http://www.nytimes.com/2016/11/19/opinion/michael-flynn-an-alarming-pick-for-national-security-adviser.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-left-region&region=opinion-c-col-left-region&WT.nav=opinion-c-col-left-region.

Presidential Capacity. With a President who struggles with impulse control, shows clear signs of narcissistic personality disorder, and questionable competencies to run the country, there may indeed be a need for invoking the 25th Amendment, section 4. Let’s see what happens in December before I go into this.

One thing is clear: we’ll certainly have a White Christmas in a Trump Administration.