Tomorrow the US Supreme Court begins hearing a case which – so abortion supporters say – could end the constitutional right to abortion. In June Medical Services v. Russo, a clinic is appealing a Louisiana law which requires abortion doctors to have admitting rights at a nearby hospital.
According to the New York Times, it “could prevent some 70 percent of women in Louisiana from being able to get an abortion in the state”. In other words, abortion would effectively be banned even though Roe v Wade is still in place.
But, contend the National Association of Catholic Nurses USA and the National Catholic Bioethics Center in their amicus brief, this is an entirely reasonable requirement which safeguards women’s health. Below are some excerpts from their submission to the Court.
At least 14 states have adopted laws that require abortionists to have admitting privileges at a nearby hospital. Generally, when a doctor has admitting privileges, the doctor can transfer a patient to a local hospital if complications arise during or after an abortion and can provide the continuity of care that is needed.
H.B. 388 requires that abortionists have admitting privileges at local hospitals within thirty miles (50 km) from the place of the abortion. These laws are intended to raise the standard and quality of care for women seeking abortions, and protects their health and welfare.
A physician having local hospital privileges is critical for several reasons.
First, hospital privileges help ensure qualified and competent doctors work at the hospital. This is because: “The physicians on the hospital’s credentialing committee investigate the applicant’s background to determine the extent of his past medical training and performance, whether he is licensed and board certified, he carries malpractice insurance, and any other information that they believe is relevant.”
Second, physical complications can occur during or after an abortion that requires hospitalization. For example, some reports claim that approximately 1,000 Texas women per year require hospitalization due to complications of the abortion. Planned Parenthood’s expert admitted at the trial concerning Texas H.B. 2 that annually at least 210 women went to the emergency room and some have “complications that require an Ob/Gyn specialist’s treatment.”
Third, in many hospitals, specialists such as Ob/ Gyns are not on call … Thus, the court concluded that “requiring abortion providers to obtain admitting privileges will reduce the delay in treatment and decrease health risks for abortion patients with critical complications.” Such safety measures are reasonable and protect women.
Fourth, an abortionist not having local hospital privileges is like an itinerant surgeon which the American College of Surgeons proscribes. In states such as South Dakota, the abortionist is flown in from another state for the day to do abortions and flies home at the end of the day. Therefore, if a woman has complications, “local doctors who are strangers to the patient and were in no way involved in the abortion procedure must see her.” This practice is not in the best interests of women.
The American College of Surgeons has standards concerning the relationship of the surgeon to the patient and its proscription of what is called “itinerant surgery.” Part of the ethical responsibility of the surgeon is to “ensure appropriate continuity of care of the surgical patient.”
In Louisiana, if the abortionist does not have local hospital privileges, he or she would not be able to provide the continuity of care that is critically necessary when complications occur. This in essence is a de facto itinerant surgeon.
The importance of an on-going relationship
In addition, it is important for a woman to have an ongoing relationship with her doctor as this Court assumed in Roe because complications can arise either immediately or over time. The scientific studies demonstrate that approximately 10 percent of post-abortive women suffer from immediate complications. Of this number, one-fifth or 2 percent were considered major complications. Some complications take time to develop and will not be apparent for days, months or even years. The physical complications may have life-long consequences.
For example, Jackie Bullard, who had an abortion, states that:
Five days later, I went to the hospital with cramping, bleeding, and running a fever. I had a raging infection, and an emergency D & C was done to scrape out the baby parts that had been left inside of me. . . . After unsuccessful fertility treatments, a test revealed scar tissue damage from the complications of my incomplete abortion. When the doctor told me I could never have children, I was devastated. That day I knew I had taken the life of the only child I would ever carry.
Therefore, when complications arise, it is not in the best interests of the woman to have local doctors who are “strangers” to the patient and were not involved in the abortion procedure. Itinerant surgery is proscribed.
Thus, for the health and safety of women, H.B. 388 provides a reasonable requirement that an abortionist have local hospital privileges. … [Its] provision requiring admitting privileges regulates the medical profession and is not a substantial obstacle to the woman’s exercise of the right to choose…
A normal doctor-patient relationship
At the heart of Roe is the assumption that the abortion decision should be made by a woman in consultation with her personal doctor.
In its decision, the Roe Court repeatedly referenced the assumption that the woman’s decision would be made privately in consultation with her physician. Abortion practice, however, does not usually involve a normal doctor-patient relationship, nor is it a voluntary, informed private decision between a woman and her doctor.
Usually women do not see the abortionists until just before the procedure is performed. While the Court’s opinion in Roe focused on the woman’s initial decision to obtain an abortion, the underlying assumption that the attending physician would be involved – by parity of reasoning – the woman should have the benefit of counsel from her physician if complications should arise post-abortion.
For example, the physician who performed the abortion would normally be in the best position to assess the complication, based on his or her knowledge of the woman’s condition and the procedures that either had been used, or not used, during the abortion.
It would be potentially harmful to the woman to be admitted to a hospital post-abortion, and not have the advice and care of the physician who performed the abortion – a medical procedure which the Roe Court itself acknowledges can lead to complications.
Documents are available on a clearinghouse website concerning abortionists’ lack of continuing care, where there should have been an ongoing doctor-patient relationship, which would have helped and benefited the woman.
For example, abortionist James Pendergraft, a Florida abortionist, sent a patient to the hospital for a potential uterine perforation, but he failed to tell the physicians at the hospital that he had already removed the baby’s leg. Because the hospital physician did not know this, he had to search the woman’s uterus and then do X-rays and a CT scan to make sure he did not cause an infection by leaving the missing body part in her uterus. The Administrative Law Judge found that Pendergraft “breached the standard of care” which constituted medical malpractice …
Abortion poses significant physical risks including death, and therefore, H.B. 388 enacted reasonable protections for women by providing a qualified doctor who can give continuity of care. H.B. 388’s requirement for abortionists to have hospital privileges is necessary for the health and safety of women and supports [the Supreme] Court’s assumption in Roe of a normal doctor-patient relationship.
This is an excerpt from an amicus brief in June Medical Services v. Russo submitted by the National Association of Catholic Nurses USA and the National Catholic Bioethics Center.