The first duty of a doctor is to provide the best possible care for the patient. But doctors in Missouri and other red states around America today could face prison time if that duty requires ending a patient鈥檚 pregnancy based on medical concerns that might later be deemed insufficient to justify an abortion under new state bans.
The fact that hospitals in Missouri and around the country have started erring on the side of legal caution, literally endangering their patients鈥 lives in the process, is both horrific and predictable.
But now a could point the way to a response that might finally force anti-choice politicians to consider the real-world implications of their ideological extremism. It alleges that Texas law endangers women鈥檚 lives.
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It does 鈥 clearly 鈥 as does Missouri鈥檚.
Texas, like Missouri, bans all abortions except those deemed to be medical emergencies. In the wording of the Texas law, those are defined as situations that risk either death or 鈥渟ubstantial impairment of a major bodily function鈥 for the woman.
What is 鈥渟ubstantial,鈥 versus unsubstantial? What is 鈥渕ajor鈥 versus minor? For medical professionals forced to make immediate decisions in the course of assessing a pregnancy in distress, these aren鈥檛 academic questions but issues that could, based on subsequent second-guessing by prosecutors, land them in prison.
More than a dozen Texas women now claim in a lawsuit that the Texas abortion law endangered their lives by forcing doctors to hesitate in ending dangerous pregnancies for fear of being unable to later defend that decision in court.
The suit cites multiple cases like that of lead plaintiff Amanda Zurawski of Austin, who ended up in intensive care and almost died after doctors refused to perform an abortion after her water broke at 18 weeks.
鈥淸W]ith the threat of losing their medical licenses, fines of hundreds of thousands of dollars, and up to 99 years in prison lingering over their heads, it is no wonder that doctors and hospitals are turning patients away,鈥 states the suit, referencing the penalties in the Texas abortion ban.
The suit alleges that, 鈥淎s a direct result of Texas鈥檚 abortion bans, Texas is in the midst of a health care crisis.鈥 Among the other Texas women impacted was one who had to travel out of state to end an non-viable pregnancy 鈥 a necessity, the suit states, that made her feel like 鈥渁 medical refugee.鈥
The term is apt.
The suit also points to similar dangers endured by more than 20 women in 11 abortion-ban states outside of Texas, including Missouri.
In a similar Missouri case, Joplin resident Mylissa Farmer last year was 17 weeks pregnant when her water broke, negating the possibility she could carry the fetus to term and presenting potential life-threatening complications if the pregnancy wasn鈥檛 terminated.
But because Missouri鈥檚 near-total abortion ban makes an exception only for a 鈥渕edical emergency鈥 鈥 a situation Farmer arguably wasn鈥檛 in yet, though she eventually, inevitably would be 鈥 doctors in both Missouri and Kansas declined to end the pregnancy for her. This particular medical refugee was finally forced to make the long trip from southwestern Missouri to Illinois to save her life.
Defenders of the abortion bans argue that in these and similar cases, doctors were protected by the statutory exceptions for emergencies. Their certainty that no ambitious prosecutor with an ideological agenda will dispute doctors鈥 definition of that term is, at best, na茂ve. Especially considering the politically charged atmosphere surrounding abortion services since Roe v. Wade鈥檚 reversal last year.
It isn鈥檛 difficult to see where this is going. As Kaiser Family Foundation Health News put it in a report in June: 鈥淭o some physicians and malpractice attorneys, the question is when 鈥 not if 鈥 a pregnant patient will die from lack of care and set the stage for a big-dollar wrongful death claim.鈥
Policymakers in Missouri and other red states can wait for that to happen, bringing with it all the legal and human complications it will bring. Or they can acknowledge that real-world medical issues don鈥檛 align neatly with political and religious dogma, and consider revisiting these extremist laws.