In a case that will decide whether medical professionals in Idaho, a state with a nearly complete abortion prohibition, can provide emergency abortion care without facing criminal charges, an 11-judge panel of the 9th U.S. Circuit Court of Appeals heard arguments Tuesday.
In 2022, the U.S. Department of Justice filed a lawsuit against Idaho to prevent it from implementing its criminal abortion prohibition for ER doctors who may have to conduct an abortion if a patient is at risk of infection or other potentially dangerous pregnancy-related health issues.
According to the Justice Department, prosecuting doctors in those situations would be against the Emergency Medical Treatment and Labor Act (EMTALA), which mandates that hospitals receiving Medicare provide care to patients who visit the emergency room regardless of their financial situation.
An exception to Idaho’s ban exists in order to save the life of the pregnant patient, but not in order to avoid harmful health consequences, such as the loss of future fertility, which is a danger associated with serious illness or bleeding. Doctors have stated that they are unable to securely determine when to safely intervene to save someone’s life and what qualifies as a good faith decision in the absence of additional clarification in the law.
High-risk obstetric doctors have chosen to fly patients to an out-of-state clinic that is free to execute the treatment before it becomes a life-threatening emergency rather than take the danger. According to administrators at St. Luke’s, the biggest hospital system in the state, such transfers only occurred once at their facilities in 2023. However, six patients were moved between January and April, when the U.S. Supreme Court chose to hear the case and overturned an injunction that prevented the ban’s implementation in emergency care situations.
An attorney for the Idaho Legislature contends that the Act does not address emergency care.
The federal EMTALA legislation, according to Idaho’s lawyers, does not overrule state laws that prohibit abortions, but it does require that an unborn child receive stabilizing therapy. They also argue that Idaho’s provision for saving a life would apply to the circumstances doctors have outlined in which an abortion could be required as a stabilizing treatment.
Taylor Meehan defended the law on behalf of the Legislature, while John Bursch, an attorney with the conservative legal organization Alliance Defending Freedom, argued the case on behalf of Idaho.
President Joe Biden-appointed Judge Salvador Mendoza Jr. questioned Meehan about any amendments to Idaho law that would make it clearer in emergency instances when abortion care would be permitted and a doctor would not face criminal charges. “No,” Meehan answered.
According to Meehan, the more the statute is added, the more it begins to restrict the doctor’s belief in good faith.
Meehan said that it wasn’t intended to handle those circumstances when Mendoza questioned how physicians are supposed to know their activities won’t be prosecuted if they aren’t specifically covered by the law.
This law mainly forbids elective illegal abortions; it has nothing to do with emergency care. Meehan stated that it has nothing to do with medical care.
Judge Lawrence VanDyke, who was appointed during the first term of President-elect Donald Trump, questioned if the six air transfers that took place during the period while the injunction was in effect were really necessary. VanDyke questioned St. Luke’s Health System of Idaho lawyer Lindsay Harrison about the reason those six were moved out of state. According to Harrison, one of them had preeclampsia, a hazardous illness characterized by elevated blood pressure, and five of them had preterm rupture of membranes.
You contend that the infant must be evacuated if the mother wishes to kill them even though it is not required to stop their death. Is that correct? VanDyke stated.
The problem, according to Harrison, is that a doctor cannot instantly assess if a pregnant patient’s life is in danger due to the disease; therefore, the patient is referred to a location where abortion is permitted and all available care alternatives are provided.
The circuit panel is probably going to release an opinion in the next months.
Six months after U.S. Supreme Court justices ruled during the summer that it was too early for them to make a decision and sent the case back to the lower court, Tuesday’s appellate court hearing took place. However, it started in 2022, not long after the Dobbs ruling by the US Supreme Court, which reversed Roe v. Wade and gave states back control over abortion practices.
Because the case is being considered as an en banc case, there were more appellate judges than normal. At first, a three-judge panel ruled against the district court of Idaho’s preliminary injunction, leaving ER doctors vulnerable to punishment under the prohibition.
The 9th Circuit will probably make a decision in the coming months, but it is not required to provide an opinion in a certain amount of time.
In any decision, the panel may choose to uphold the injunction or to revoke it and send the matter back to the district court. After Trump is sworn in and the Department of Justice is run by new officials in January, the case may also be dismissed completely. A fresh plaintiff would then have to begin the case from the beginning.
Among the members of the en banc panel were Chief Judge Mary Murguia, a former Democratic President Barack Obama appointee; two Biden appointees; four Trump appointees during his first term; two former Republican President George W. Bush appointees; and one former Democratic President Bill Clinton appointee.
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