Sticking With Precedent

Chief Justice John Roberts sided with the liberal Justices in a 5-4 decision striking down the Louisiana abortion law. The law would have required that every doctor performing abortions in the state have admitting privileges at a nearby hospital in the event of any complications arising from the procedure. The law required that a receiving hospital must be within thirty minutes of any medical clinic performing abortions. The law was passed by the Louisiana legislature and signed by the Governor but had not gone into effect pending the Supreme Court ruling on its legality. The law was not designed to make abortions illegal in the state, but was intended to ensure the safety of the patient undergoing the procedure. Abortions are not without risk, chiefly from hemorrhage in the acute setting and secondary infections in the immediate post-procedure interval. Complication rates are generally low (one percent or less) at most facilities but that can vary depending on the age of the mother, her overall health and co-morbidities, the number of weeks gestation of the fetus, and the experience and skills of the staff at the clinic. The thirty minute rule regarding the proximity of a hospital is actually “pushing the envelope” in the event of a true emergency. If a patient goes into shock (usually from blood loss) the quicker that individual can get to a hospital for definitive care the greater is their chance of survival. Any delay in receiving hospital care could be fatal and it would be advantageous if the clinic doctor also had staff privileges at a nearby hospital. The clinic physician would already be aware of the patient’s condition and would be able to transcribe orders to EMS and admitting personnel. From a medical standpoint the SCOTUS ruling doesn’t make good medical sense. If enough abortions are performed, there will be complications and striking down this law will eventually result in complications and possible deaths.

When Justice Kennedy was still on the bench the Court ruled 5-4 against a very similar Texas law for which Justice Roberts voted with the conservative justices. But this time Roberts actually cited the previous ruling for part of his decision in this case. He also noted that since only two physicians had admitting privileges at nearby hospitals, this would severely limit abortion access. “The Louisiana law imposes a burden on access to abortion just as severe as that imposed by the Texas law, for the same reasons. Therefore Louisiana’s law cannot stand under our precedents,” the chief justice wrote. Unless and until President Trump is elected to a second term and has the option of appointing another justice (or two) to the SCOTUS, the Pro Choice ruling on Roe vs Wade appears safe for the time being.

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