May 25, 2023

♪ Christine: Hello and welcome to "Amanpour and Company."

Here's what is coming up.

>> If this technology goes wrong, it can go quite wrong.

Christine: The leaders of ChatGPT calling for regulation of super intelligent AI.

>> We have seen that social regulation of companies does not work and that we need to have a different playbook.

Christine: I asked the architect of the artificial intelligence Bill of Rights about the Biden administration's efforts to regulate it.

And -- >> We have instances of people doing all these things they need as basic medical care under an umbrella fear.

Christine: South Carolina passes a six week abortion ban.

A new study warns health-care providers are unable to meet their duties.

Michelle Martin talks to the authors of that study.

Also ahead -- ♪ Christine: A forgotten treasure back on Broadway.

I speak to actor Oscar Isaac and producer Jeremy O. Harris about taking on the sign in Sidney Brustein's window.

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Thank you.

Christine: Welcome to the program.

I'm Christiane Amanpour in New York.

As we enter an era of artificial intelligence, we begin with the risk of a creation turning on its creator.

OpenAI, the company behind ChatGPT, is calling for an international regulator, much like the U.N. nuclear watchdog to protect a catastrophe.

OpenAI's three cofounders right, we can have a dramatically more prosperous future, but we have to manage risk to get there.

Given the possibility of existential risk, we cannot just be reactive.

The real world impact of this technology, which is still only in its infancy, is already being felt, like the bogus AI image of an explosion of the Pentagon, which caused a selloff on the stock market.

It is also driving incredible scientific breakthroughs, like the paralyzed man who just took his first steps in a decade, thanks in part to AI technology.

The acting director in the White House office of science and technology, policy thereof, and the architect of the Biden administration's blueprint for an AI Bill of Rights was asked by me about the global moves to regulate AI.

Welcome to the program.

With all your experience as a researcher in the executive office as deputy assistant on these matters to the president, you have said, and I will quote you, we are living already in a time of profound uncertainty with looming risk about AI.

Layout for us what you mean.

>> I mean we are building a powerful technology, perhaps the most powerful technology we would have built in our time on this planet.

And that we need to do it with guard rails and with a real clear sense of both the pitfalls and the possibilities of these technologies.

It is a time in which we can all agree that we are worried and that there are looming risks all around and that this powerful technology has a potential to exacerbate many things we are already quite concerned about, including misinformation and disinformation, issues around bias, surveillance, and the like.

Christine: The CEO of OpenAI, one of the originals in this business, testified in Congress last week, and it was quite important because every time these CEOs before Congress, it is an attempt to investigate what is going on and to see how it can be protected as well.

This is what he said about the road ahead.

>> I think of this technology goes wrong, it can go quite wrong, and we want to be vocal about that, to prevent the government to prevent that from happening.

Christine: We have seen this before.

Congress seems to be sort of a bit from for a loop by all the technical P3 around it.

Is Congress, is the administration, prepared to deal with the looming threat of AI?

Alondra: I think this is an incredible window of opportunity, because I think Congress and the executive branch has shown they are getting prepared.

Your point, we saw the social media playbook, we have seen that social regulation of companies does not work, and that we need to have a different playbook for this moment.

What is encouraging here is that conversations are happening early on in the development of the new technological paradigm.

We saw that last week, Senator Blumenthal chaired the hearing you showed that included OpenAI's CEO.

We have seen the fight administration show that it is committed to getting automated systems right and AI technologies right, making sure the benefits are maximized and the harms minimized, and that work has been ongoing, including with policies, laws, and regulations that are already on the books that can be expanded to offer guard rails around AI, and obviously conversations about new ones.

In addition, I have been encouraged to see congressional leaders, so members of Congress who are not just the usual suspects, so not just the members of Congress who have had is an armor on tech policy -- you have had careers and are working on tech policy, but people who think about domestic policy issues as their primary portfolio also thinking about the applications of AI.

I think this moment is different in part because we've got a bigger tent of congressional leadership understanding that this is really an all hands on deck moment and that they all need to be engaged, learning enough about this technology to be able to offer guidance to the nation about how we can use it responsibly.

Christiane: This week we saw an irresponsible use of AI in the visual mechanism whereby it has gone viral, this explosion at the Pentagon which brought back memories of 9/11.

It was totally fake.

It did have an impact on stock market and shook people for a while.

That is a visual demonstration.

That goes to the heart of the misinformation piece of this, the deep fake piece of this, where anything can be faked.

Alondra: that deep fake was quite worrisome on two levels.

It was a story about twitter and about the effective collapse of the verification regime at twitter that would have offered at least a few signals about whether or not this was true or whether or not it could be believed.

We no longer have that system of guardrails at twitter, so it is worrisome in that case.

It was also worrisome because it traveled so quickly.

There are things we could have done to make a different outcome, in addition to Twitter behaving more responsibly.

It is also the case that companies make tools that allow the creation of video.

We are not talking about deliberate bad actors that are going to try to get around these, but at a baseline, you should be able to mark or have to identify that you are using AI systems in the product you are creating, whether it is visual or text.

When I was working in the White House up until a few months ago, we delivered the blueprint for an AI Bill of Rights.

One of the principles was that there should be notification.

One should know when an AI system is being used.

That is kind of a fundamental principle that companies have the ability right now to exercise in the way they are sending out these tools for consumers to use.

That is not going to correct for a bad actor.

But it could do a long way to prevent casual actors, accidental actors, and consumers from being able to create these kinds of dystopian images using these technologies.

Christiane: A famous example from last month, the Washington Post reported that ChatGPT invented a sexual harassment scandal and named a real law professor as the accused.

Not only did it make the story up, it even cited fake articles from the Washington Post that it cited as evidence.

So you talk about the companies, but this was a bad actor, but ChatGPT is being used by just about everybody right now.

Alondra: that's right.

President Biden has been clear, it falls to the companies to make sure that their products are safe and effective and that they are released to consumers in ways that are safe and effective and can be trusted.

It should not be left -- certainly there are ways that the companies are potentially not going to be able to test for every potential outcome.

The tools are too broad in their potential use cases.

But that is something this miss identifying someone as being a sexual predator, having false information, what we call so-called hallucinations, there is much more that can be done on the company's side before these things are released.

Congressional leaders, government leaders, and the American public should demand more.

Christiane: You described the blueprint.

This started very early, in the Biden administration you said it took a year to create this blueprint, but it is not a legal obligation, you are talking about laws.

But on the books already, are there laws to protect in all these areas, whether it is ointment, disinformation, whatever it might be -- employment, disinformation, whatever it might be, that could be employed right now?

Are there laws that could be resurrected as guardrails for this looming threat?

Alondra: That is an excellent question.

There are laws and policies and regulations on the books that are allowing us and can allow us to get traction on the fast-moving pace of automated systems already.

Partly what the blueprint from an AI Bill of Rights was trying to do was to point to some of those.

It is the case that the U.S. equal employment opportunity commission has the ability to regulate discriminatory uses of automated systems, if they are used for recruitment, for hiring, if they are discriminating against people with disabilities, it is the case that the Department of Labor can, in cases of worker surveillance, when there are workers using their rights to organize, require reporting of surveillance tools, including automated systems in those moments.

Part of when we had spun out the blueprint for the AI Bill of Rights, we pointed to think that might need to be done.

For example, we are thinking there is obviously some concerns in the space of education about, is ChatGPT going to allow cheating and the like?

This is another instance in which, if this company with this incredible tool had maybe talked to a few more teachers, I think we could have had better guidance around that.

Christiane: You have probably noticed that the world renowned online teacher Sal Kong, the founder and CEO of the nonprofit Khan Academy, says he sees a future where students and teachers use this technology to improve education all around the world.

Let's talk about the positives.

Did you see that as possible, despite the very real ability to cheat and use ChatGPT, etc.?

Alondra: I would agree this is a possible future for the intersection of education and technology and that AI has an incredible role to play, but it is not just going to happen.

We need all the stakeholders in this space to create that most beneficial outcome.

Christiane: So you say it is not just going to happen.

In my mind, it is fixed a graphic that I saw in the FT written by a very prominent AI researcher, warning of the pitfalls as well as the potential advantages.

It showed a huge disparity in the graph of resources going to capability versus the resources going into making it safe and align this thing without moral values.

I wonder what you think about that, because that is happening now.

Big disparity and yet the G7 leaders, the most powerful economies, actually did talk about this and what they need to do.

A global, potential, solution.

Alondra: It was interesting that the communiqué included a commitment to the Hiroshima process, G7 countries talking to each other about international collaboration, about how we get to a place of responsible use of artificial intelligence.

That was really encouraging.

Let's be clear that the G7 was going to take place in Japan and the summit in Hiroshima anyways, before the release of ChatGPT and the consumer facing generative AI tools.

But it was a very poignant place for this to take place, for this conversation to take place at the international level about AI systems.

One of President Obama's last speeches and international trips was to Hiroshima, and he gave an incredible speech in which, kind of paraphrasing him, we can't have a technological revolution without a moral revolution.

I was encouraged by the announcement of the Hiroshima process in this place where there is a lot of poignancy about how technologies have been used in the past and how they have cause harm in the past, as an opportunity to work collaboratively to sort of create a future that is different.

Part of this will require, as your question suggests, big investments in research and development.

Right now it is the companies that are making the big investments.

I think we need public sector investments.

Christiane: You mentioned the poignancy of where the G7 communiqué came from.

Hiroshima and Nagasaki are the only atomic bombs to have been dropped in the whole process of mutually assured destruction, and people in AI now say this is like unleashing the atom again.

I get what you are saying about the poignancy.

The communiqué said we should advance international discussions on inclusive artificial intelligence, governors, and interoperability to achieve our common vision and goal of trustworthy AI in line with our shared democratic values.

That is all well and good for those who share democratic values, but what happens with known interviewers and disinformation experts, China, Russia, and all the other state actors?

Forget companies, state actors who will potentially not be bound by this.

Alondra: I think this is very much in the space of national security questions.

Their economic security questions.

Part of what we have to watch the disruption to how people work and live their lives.

There is also why of security and other nuclear security issues that need to be of shaded -- bio security and other leaders security issues that need to be looked at.

There have been historically and there are being in the current moment sort of sets of tools and levers that we can use.

These include things like international treaties, things like export controls, sort of not sending the enabling capabilities, the technical capabilities to actors that we don't think are going to use them safely.

It is the case that there is a whole suite of levers that can apply in the AI research and development space with regards to whether or not they get in the hands of other kinds of actors.

There is also an opportunity here for collaboration and conversation well beyond the G7.

I think we both want to constrain, on the one hand, what can be the most dangerous uses, but also appreciate that it many cases, even our adversaries don't want them as catastrophic outcomes to the extent that they might be in deep planetary.

There are opportunities to work on both sides.

Christiane: Thank you for that detail blueprint as it stands now.

Thank you for joining us.

Alondra: Thank you for having me.

Christiane: Now from those threats to American society to one of its greatest assets, theatre.

It has been over three years since stages when quiet because of the coronavirus, but Broadway audiences are finally back to pre-pandemic levels, according to the Broadway league.

A revival of a 1960's play is getting rave reviews -- "The Sign in Sidney Brustein's Window ."

it stars Hollywood actors Oscar Isaac and Rachel Brosnahan.

It follows a diverse group of friends in the 1960's in Greenwich Village, New York, trying to juggle the harsh realities of life and there idealistic dreams.

Oscar Isaac, known for "Star Wars" and "Dune," joins me from New York, and Jeremy O. Harris, the playwright, join me from can, to talk about it.

Welcome to our program.

Oscar: Thank you for having us.

Jeremy: Thank you so much.

Christiane: Oscar, you are about to do another performance this evening on Broadway.

What was the inspiration for you to want to do this character in this play?

Oscar: It had been about six years since I had last on a play, which was "Hamlet."

This came to me serendipitously through a friend, Andy Kaufman.

We did a reading of the play.

The feeling I had when I read it was a feeling of profound freedom.

There was something about reading those words, the interactions with the characters, the kind of exercising of a lot of fear and demons and shame and a lot of the things that she talks about are placed in the world as artists and human beings and activists that spoke to me in a really profound way.

Also, I am so attracted to troubled characters, characters that are prickly, that are not asking to be loved, that seem to be not worthy of our attention, yet somehow breaking that shell, I find a magic trick in that.

Christiane: It is magical onstage and certainly for the audience.

Jeremy O. Harris, Oscar just talked about going from Shakespeare to Lorraine Hansberry.

What was it about her and the magic that Oscar talks about that but you involved and made you bring it from off runway to where it is now?

Jeremy: I am so grateful that you got to see it and that Oscar is a part of it.

A player cannot sing without an amazing vocalist.

Oscar and Rachel and this entire company are amazing vocalists.

I think that seeing she had written this complicated text, a text that is very difficult to make seen, with as many harmonies as she put into it, it seemed like it was singing so well, and that told me it needed to be in the house.

The architecture of a Broadway theater in specific.

Grandma passed away when she was 34 years old.

I am about to turn 34.

I turn 34 on June 2.

I feel a deep kinship to her because I had a great play called "Slave Play," but I also have had problem plays that happened in and around " Slave Play" that take a great ensemble to be seen beautifully and might not have been stood by critics, but I hope in the future there will be some ensemble that features an Oscar or Rachel that could help make that placing or those other plays seen.

The ability to facilitate hearing this music, the sound, these voices so clearly, felt pertinent to me.

We lost one of our greatest voice much too soon.

Christiane: Give us a synopsis, because it is a period play, written during the height of the civil rights movement.

It was on Broadway at the time.

As you say, it is about activism but also a profound family drama very specific to that time.

Oscar: It is change and the nature of change.

A brief synopsis is that there is a man, Sidney, who is a leftist, an ex-activist -- he has kind of had it, put his cards out there, and the results are subpar for him.

He wants to retreat to the mountains.

He has a young wife which he envisions as a specific person he has created.

He is seeing all these things change around him and shift right in front of his eyes.

It is like a greased pole.

There was an apartment in 1964 in Greenwich Village where his friends who are artists and activists come together and start with this paper, this newspaper that he feels is going to be able to express himself through arts and crafts now that he is done with politics.

And the world starts to pull at him.

At the heart of this is the marriage between Sidney and Iris, who the incredible Rachel Brosnahan plays, and her coming into her own as a woman constrained by this particular time and particular misogyny.

It is dealing with all these issues, and then in the second act it breaks wide open.

Christiane: I want to take this moment to play a clip that we have from you all, about -- well it is you, obviously, Oscar, talking about political activism being drawn back into it in this newspaper in things not necessarily turning out as you had hoped.

We do not want to do a spoiler alert, but this is where you break off a relationship with the politician Wally O'Hara.

>> It is no damn good.

You have forced me to take a position, finally, the thing I never wanted to do just not being for you.

It is not enough.

To live, to breathe.

I have to be against you.

>> Goodbye, O'Hara.

I will see you again, but let me warn you, thanks to you, I will be tougher, more seasoned, harder to deceive.

>> Sidney, you really are a fool, always have been.

Christiane: It is all there, the idealism and getting that slapped around.

It was quite dramatic to watch that bit.

Was it a mistake for the character to have taken on this politician who sold him a bill of goods?

Oscar: No, I do not think it was a mistake necessarily.

I think what is amazing and so brilliant about what Lorraine does, the question is not, should you do something or should you not do something, or what the right political move is.

It is not so much about that.

He starts with I don't want to be a part of it, and then he gets convinced to yes, be a part of it, but what do you do when that fails, the inevitable disillusionment?

She talks about that and how the world is about to crack right down the middle and all one can do is change and continue to change and find new ways to change when the inevitable disillusionment is going to happen.

It speaks to this time and so many of my friends and to me, who have gone through what the world is going through right now.

I have heard them say it, I can't do it anymore.

I always have a pang of shame during the play when in that scene, Wally says to me, you know, you've got a gift for writing, for music, you turn people on.

Stay in your lane, basically.

Often I find myself saying, well, I am a storyteller, let me stick to that, I will do my acting, and music, I don't have to be involved.

It doesn't matter if you don't want to be involved.

It is going to come to your doorstep.

Christiane: Indeed.

Let me ask you, Jeremy, Lorraine was a formidable force, but as you say, her career was cut short by illness and she died.

This play I think had been on for two to three months I the time she had died.

Just to situate himself, her ex-husband, the producer at the time, said the very data play opened, Khrushchev fell from power in the Soviet Union.

And the Chinese set off their atomic bomb.

It was happening in the midst of this global sort of seismic shift in our history, not to mention what was going on inside the U.S. She had written "raisin in the sun," which was a huge success.

Tell me a little more about her.

She was very iconoclastic.

Jeremy: She was.

She was an activist.

She worked with a lot of young, queer, angry people inside of New York, people who were rightfully angry.

She worked with a lot of black activists.

She was attempting to create a space for thinkers and movers and shakers to actually inspire the work she was writing so she could wake people up.

That is what is so important about this work.

This young woman truly was a soothsayer.

She saw both what was happening in her time and what is happening right now.

That is what brought so much urgency to doing this play on Broadway today.

Ron DeSantis just announced he's running for the presidency.

We are in the midst of meeting many people of ending the major freedoms we have had in this country that we have taken for granted, because we have looked the other way for much too long.

What she is saying with this play is you can draw your little pictures, make your little jazz bar, but if you are not politically active, if you put your bill behind the wrong person, and if you get disillusioned and don't keep fighting for something true or something better, then we are all going to end up in the worst situation possible.

I am in so much fear for our country right now, because my partner is Iranian.

His parents fled the Iranian revolution, much like what you know about.

They say to me all the time, are you watching the news?

This is not new, this is familiar, and this play proves it.

This is not new.

This is familiar.

Everyone who comes to see this play, wake up, get active, move and shake and don't be afraid to change.

Christiane: I am really hearing what you are saying, and it is clearly landing in a very personally and politically current and relevant time right now.

I want to ask you, Oscar, weather, because in the gram, when we sit there and see the play, the program says it did not get a full run, and yet the big producers, the actors, Mel Brooks, Anne Bancroft, and others banded together to make sure it kept going.

I found that a really incredible active collaboration at this very broad political time in the United States.

How did that strike you?

Oscar: So beautiful, and in a way, there is a mirror image to what it has been like to put on the play right now.

It is provocative, antiestablishment.

There is not an easy solution.

People are not sure, who am I supposed to be rooting for, who is the villain?

And politically, you have people transgressing in the most public, horrible ways, and yet we are still last to see them with love and see them with possibility for redemption.

So it is incredibly rewarding and feels rebellious to be putting it on, and to know that people who are very near and dear to me that I look up to feel that spirit in it and that provocation.

Christiane: Nasty prickly, you are a Guatemalan American.

And may I ask you quickly, you are a Guatemalan American and Cuban as well, so you've got all that heritage that is very prevalent these days, with the migrant prices, with the way refugees and asylum-seekers are treated within the United States and elsewhere around the world.

That part of it, does that resonate with you as well?

Oscar: Absolutely.

About being lost and the feeling of being helpless as well, not knowing what to do, and the feeling of what I could possibly do, and to double down and say that there must be something.

The alternative is death.

Christiane: Can I ask you to reflect on "Scenes from a Marriage?"

It is one of the last big things you are so well known for, and it turned the original story on its head, making a woman the breadwinner and etc., turning the gender dynamic on its head.

You played the husband, Jessica Chastain played the wife.

Let's play the clip.

>> They say when the woman is the provider and the male is the caregiver, the marriage has a better chance of success.

>> Loud and clear.

>> Has a couple, nothing can hurt you.

Christiane: That resonated with many people, especially successful women.

Was it turning the convention on its head that was most attractive for you, or what?

Oscar: In some ways, there are similarities with this play.

It was harrowing to read.

It was none intellectual idea of this and that.

Those things we kind of repelled me.

When I would read it, I would shake and be afraid.

I did not necessarily connect with the character right away.

It was the situations and scenarios that were just harrowing.

That kind of led me to constantly think about it.

When that itch starts to happen, I follow it.

Christiane: What is next for you, Jeremy O. Harris, on Broadway or elsewhere?

Jeremy: On the Broadway side, I have a play that is going to open next year, and then I have a new AIM producing on Broadway that is going to be announced very soon that I am very excited about.

So much of my work is about celebrating writers I want to see.

Christiane: Oscar Isaac, it must be really draining to do this play sometimes twice a day.

It is really raining.

And it is long.

Are you going to do another play, or is it TV, movies after this?

Oscar: It is very draining.

It is an incredible athletic feat to have to do.

I start the week on a Tuesday flow state, and by the second show, Wednesday, I am just letting the the architecture of the play hold me.

I am a creature of the stage, so maybe there is more theatre, not so long this time.

Christiane: It is an amazing treat for those of you who get to see it.

Oscar Isaac, Jeremy O. Harris, thank you.

Run, don't walk, to see it.

South Carolina's governor has just signed a bill banning most abortions as early as six weeks into law.

South Carolina is the latest state to tighten its grip on abortion access since Roe v. Wade was overturned last June.

A new study has found that states blocking female reproductive rights are putting lives at risk.

The co-authors of the report joined me to discuss how these bans are endangering women.

Michel: Thank you both so much for joining us.

Dr. Grossman let me start with you.

What was the intention behind this study?

How did it get started?

What were you thinking about?

What did you want to know?

Dr. Grossman: I was really concerned.

These bans generally allow abortion in the pregnancy threatens the life of the pregnant person, but as a practicing physician for almost 30 years, what constitutes a life-threatening condition is not always as clear as it seems.

It is not black and white.

How severe does the condition need to be?

How immanent does the threat need to be?

Since these answers were someone clear, I was concerned that my colleagues in states with abortion bands were going to hesitate to provide the care that was medically necessary.

After the Dobbs decision, we did see some reports in the media about cases where patients had pregnancy complications but could not get the care they need, even though the condition threatened their life.

At the same time, we were hearing reports that doctors were being told by their hospitals and employers not to talk to reporters.

Their voices were being silenced.

That is why we started this project, to give doctors and nurses and midwives, nurse practitioners, pharmacists, anyone who cares for a patient an opportunity to be able to share these stories about quality care anonymously if they want to.

Michel: Dr. Grossman is a clinician, so you are interested in what is going on.

Katrina, you are a sociologist.

Were you interested in thinking about the patterns?

Katrina: absolutely.

My focus is on the patient experience, particularly with navigating reproductive health care.

This is something not generally recognized.

There are a heartbreakingly large number of ways that pregnancy can go wrong.

Generally we think of pregnancy as a positive thing.

People are excited about it.

We think of it as resulting in babies and family growth.

In actuality, there are a number of ways it can go wrong.

I was really interested in understanding what the patient experience is, what they are facing, what they learn about, and what the consequences of having a pregnancy in states that have banned abortion and therefore have taken that tool out of the toolkit of the prenatal care providers, of all the people who are supposed to take care of these patients.

What happens to the patient then?

That is why I joined this study.

Michel: You partnered with investigators at the University of Texas Austin, which started looking into the impact of the ban in Texas on abortions after six weeks.

Dr. Grossman but maybe you will start here, but were researchers seeing?

Dr. Grossman: My colleagues were already talking to doctors back in and they were seeing that patients could not always get the care they needed, because it was not always clear when a situation was life-threatening enough to provide lifesaving care.

So they started seeing some of these reports, essentially, Texas, because of the six-week ban, they got a web what the post op world was going to look like for the rest of the country.

Michel: Then the setting expanded out.

What were some of the other locations you looked at?

The purpose was to give people the opportunity to report without jeopardizing themselves professionally or legally.

But as broadly as you can, tell me who are some of the people you heard from in this story.

Prof. Kimport: We structured it to be fully anonymous, to allow people to submit cases even when their hospital system was discouraging them from speaking about it and even when they were concerned that maybe they potentially would be at risk of legal work criminalization.

We heard from doctors and nurses in states that have abortion bans about cases, patients who they took care of where they were not able to offer the standard of care.

We also heard from physicians and states that were receiving these patients.

When the patients were not able to get standard medical care, many times they would travel to a state that did not have an abortion ban in order to receive what they could have received for the Dobbs decision in their own hospital, from their own providers.

In our study, thankfully we did not get any reports of deaths.

Miraculously, all of the cases we heard about resulted in the patient ultimately getting the care they needed.

But I think the question is at what cost.

We have seen they have had to travel.

They had to experience both the physical extension and repercussions of the delay in receiving standard medical care, and they had to be away from family and friends and for some they had to fear that what they were doing was illegal.

We have had instances of people doing all these things that they need is basic medical care under an umbrella of fear that what they are doing could result in going to jail, being fined, and potentially long-term physical repercussions.

Michel: It is my understanding that you got submissions from about 50 providers across 14 states, but I take it you still feel the findings are important to highlight.

Why is that, for people who would argue or question that that is not a huge number, given how many practitioners there are, given how many pregnancies there are, what would you say?

Prof. Kimport: We believe this is the tip of the iceberg.

These are the cases where somebody observed that a patient did not receive standard medical care, new enough about our study today then be able to report it, and took the time to complete that form.

We can only imagine there are other cases -- and it is hard at this point estimate what that number would be, but there are going to be plenty of cases where somebody either did not know about the study or did not have time to report it.

Fundamentally, what these cases represent, and remember they happened immediately after these legal changes went into effect, and what we are looking at is just a six-month shot Michel: Dr. Grossman, walk me through some of the reports that stood out.

Dr. Grossman: There were many different scenarios.

No two were alike, but there were broad themes that allow us to break the cases.

Some were cases where there was a medical complication in pregnancy where it became necessary to terminate the pregnancy.

An example is the case of a person who was pregnant at about 16 weeks whose water breaks and because this puts a woman at a very high risk of infection or heavy bleeding, and it is also very unlikely that she will be able to continue the pregnancy to a point where the baby could survive outside of her, the standard care is to at least offer the woman adoption of having a termination.

But that was not the case in these scenarios, and many of them came back and had very serious infections, and some of them came.

Some came very close to dying.

And there were complications with the fetus.

There were women pregnant with a fetus that had anomalies that were generally incompatible with life.

Before Dobbs, patients had the option of having an abortion in these scenarios, but that is no longer possible now.

Women were faced with the very difficult decision to either travel to another state to obtain abortion care and all the logistical complexities and financial costs associated with that, or continue the pregnancy, carrying a baby that they knew was -- it was impossible for the baby to survive.

It was likely the baby would have a short and painful life.

The third category would be patients having a miscarriage.

There was one case of a woman who was prescribed medication by her doctor she could not get it at a pharmacy because the pharmacist was concerned that it was being used to induce an abortion.

There were a couple of patients who had symptoms and were concerned that they were having a miscarriage and they lived in a state with an abortion ban, but they were so scared to even go to a hospital or see a doctor because they were worried that they might be accused of possibly having done something on their own to end the pregnancy, and instead they traveled hundreds of miles to try to get care in another state.

Michel: I was interested in the fact that many of these physicians were going out of their way to coordinate with callings, some of them hundreds of miles away.

I was wondering whether that affected their ability to care for people with more routine medical concerns.

I am mindful of the fact that the maternal mortality rate in the United States is very high for a country as affluent as it is.

In fact, it ranks among one of the highest for a country as wealthy as the United States is, and particularly amongst certain groups.

Like women have a far higher rate of maternal mortality than other groups -- black women have a far higher rate of maternal mortality than other groups.

I wonder if this is part of the discussion.

Prof. Kimport: Absolutely, the United States has a crisis of maternal mortality, and it is particularly devastating for black and brown women.

It is across the United States, but there are also specific some states with even higher maternal mortality rates.

These are women dying in childbirth or within a short time after giving birth.

It is even more devastating in many of the states that have enacted these abortion bans.

These abortion bans are layered on top of a maternal mortality crisis.

The people who wrote in and shared their cases in our study described going to extreme lengths, spending a huge amount of time and resources.

It follows that that meant were taking away time and effort toward other patients.

The other piece that is important to underscore about the effort that these physicians were taking on behalf of their patients to ensure that they could get the standard of care, many of them were relying on their personal social networks.

They were contacting their colleagues and friends in other states that did not have an abortion ban.

What that means from a patient perspective is that your care and your ability to have standard medical care may actually depend on the social networks of your physician.

This is something that suddenly now, whether or not you are able to have standard of care, depends on who your physician is friends with.

Michel: Did the clinicians talk at all about the toll on themselves?

Did they talk about wanting to leave medicine, for example?

Did they talk about the fear of criminal prosecution?

Did they talk about the toll on themselves in the study?

Dr. Grossman: They did.

These laws are scary.

There was a risk that they could go to jail, and in some of these narratives, they talked about that fear.

And the moral distress they were experiencing, because they felt like their hands were tied, that they had been trained for so long to provide high quality medical care, and now they were unable to do that.

They had to watch their patients essentially suffer or find a way to get them care in another state.

Prof. Kimport: One of the things we saw too, while not many reported they were intending to leave medicine altogether, there were several that said they were planning to relocate to a state that would not tie their hands.

And there were others who were committed to their community and their patients and had no intention to leave, but said they would discourage a future resident physician or a nurse from moving to the area and starting a practice.

I think we are going to see, maybe not immediately, but down the line we are going to start to see a shift in the work force , and that is going to have even more consequences for patient care.

Michel: I have to ask both of you a question that clearly there are medical providers who do think, who do agree that abortion should be illegal, or at least illegal in many cases, so I am going to ask each of you, did any of your respondents take that view?

Dr. Grossman: No, no one took that view.

We were specifically asking doctors and nurses to tell us about the cases where the care was different from the standard.

Really, in all the submissions, they talked about how care was different, it was worse quality, and this is a serious problem.

They were all very critical of the laws.

Michel: There are clearly significant numbers of people in this country, including some medical practitioners, who do believe abortion should not be permitted.

I am going to ask you that there are those that would say you found what you are looking for.

How would you respond?

Prof. Kimport: 21 of these findings show is the disconnect between how we think in a public setting, politicians in administration, and what it actually means in a medical setting.

This idea between law and on the ground medical care.

This idea in law and often in our public discussion about abortion, is that there is a black-and-white setting, this is an abortion ban this is not.

What we get into, in actual medical care, is a lot more gray and becomes a lot more difficult to draw a really firm line.

What we see in this study is that over and over again, when people try to draw a line through the law, what ended up happening was that patients got sicker, patients were denied the care that they needed, that their physicians, doctors, and nurses knew was the best care.

There really is no bright line where you can just segment off abortion and say that this is never necessary or is not a part of reproductive health care.

Instead, what we find is that abortion and the procedures related to abortion are fundamentally important tools in keeping patients safe.

And doing things like insuring their future fertility, insuring that they have reduced risk of complications and mortality.

Dr. Grossman: I recognize that people have different belief systems and may feel differently about abortion bans and these laws restricting abortion, but I want people to know that these laws are having an additional effect.

They are causing real harm to the very pregnant women that I think we all care about and want to protect.

It just feels really important to me now to share this information about the harms we are seeing so that people are aware of this as they are having discussions and thinking about what kinds of laws and policies they want in their state.

Clinicians like myself just want to provide the best high-quality care weekend to patients.

That is no longer possible in some of these states.

I want people to hear about this, learn about this, and be as concerned as I am.

Michel: Professor Kimport, what do you hope people will take away from this conversation?

Prof. Kimport: I hope this helps recognize the way these abortion bans are creating dangerous situations for pregnant patients , and it means that they are being denied standard medical care.

I think that was in every way people talked about abortion bans or understood what their effects could be, but it is what we are seeing, and it needs to be part of the conversation.

Michel: Thank you both for talking so much about this.

Christiane: an important conversation.

Finally tonight, a moment to reflect on the legacy of Tina Turner, in music and beyond.

A famous woman who spoke hourly and 11 generations of other women to find their voice.

Before she was at queen of rock and roll, Tina Turner was an early advocate for victims of domestic abuse.

Speaking out against the violence she said she faced from her husband and former sickle partner Ike Turner.

Later she told CNN why she went public with her story.

Tina: I did not know what happened at that point, because it had died down and the divorce was final.

My life was getting back on the road, and I did not know what would happen.

I did not know what kind of message it would stir.

I had to take a deep breath and make a decision.

I guess it was instinct, that I felt that getting it out and not suppressing it any work, letting the world really know.

Christiane: Can the world would indeed really know Tina Turner as she went on to create her own stratospheric solo career alongside Beyoncé, who described herself as the epitome of power and passion.

We leave on one of her greatest hits, "River Deep, Mountain High," this time performed solo without Ike.

It was 1989.

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