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Could Docs Refuse a Woman Miscarrying in AL?

by Nuzha Nuseibeh

Despite what some members of the GOP would have you believe, the war on women is very much alive, and raging on. It's tempting to see it everywhere: According to the American Civil Liberties Union (ACLU), Alabama's HB31 — also know has the Health Care Rights of Conscience Act, which allows any health care provider to refuse to participate in abortion, sterilization, human cloning and embryonic stem cell research — would enable hospitals in the state to turn away miscarrying women, even if their life was at stake. The bill, put forward by state Rep. Becky Nordgren’s (R), is certainly worrying. Any medical professional — from a counselor, to a nurse, to a doctor, to a pharmacist — can refuse to provide any medical assistance relating to abortion (and human cloning, human embryonic stem cell research and sterilization). That's including prescribing and dispensing drugs, diagnosing, testing, surgery, providing therapy — you name it. Basically, if the procedure violates "the religious, moral, or ethical principles held by a health care provider," they can just sit back and fold their arms. Writes the ACLU:

This week, the Alabama Senate is set to consider a cruel bill ( HB 31 ) that would permit the hospital staff, including any doctor, nurse, counselor, or lab technician, to refuse to participate in any phase of patient medical care related to ending a pregnancy, even if that is what a patient like this woman needs to protect her own health and future fertility ... The bill would also protect health care professionals from liability for refusing to provide necessary medical care. What's more, the bill would exempt the hospital from liability under Alabama law. This means that even if the hospitals know that the on-duty doctor won't provide appropriate medical care, Alabama law says that in most cases they have no obligation to find someone who will. In effect, the Alabama legislature is saying to a pregnant woman in distress, "Good luck. You are on your own."

Still, though, the ACLU's assertion that the bill will enable hospitals to turn away pregnant woman experiencing miscarriages, even when the mother's health is in danger, is perhaps an exaggeration. The bill specifically states that "no health care provider shall be civilly, criminally, or administratively liable for declining to participate in a health care service that violates his or her conscience except when failure to do would immediately endanger the life of a patient."The add: "Notwithstanding any other provision in this act, in a life-threatening situation where no other health care provider is available or capable of providing or participating in a health care service, a health care provider shall provide and participate in treatment, care, or procedures until an alternate health care provider capable of providing or participating in the emergency treatment, care, or procedures is found or otherwise becomes available."

The bill also states that the health care professional would need to inform his higher-ups in writing, no less than two days earlier, if he didn't want to go through with a certain procedure. "The notice shall be provided within a reasonable time, but in no case less than twenty-four (24) hours prior to any service or procedure objected to under this section by the health care provider," the bill says. It's unclear, though, whether that notice applies across the board or still only on a case-by-case basis — that is, whether a doctor would need to notify his superiors only the one time of his objection to performing abortions, and then be forever exempt from performing them, or whether he'd have to write in each time he refused to terminate a pregnancy. The difference is significant: the latter case wouldn't allow doctors to refuse care in emergency or unforeseen situations. The ACLU raises a valid point regardless — what happens when the mother's life isn't immediately in danger? What happens when a mother isn't hemorrhaging at that moment, but risks dying later from sepsis? What happens when failing to terminate a pregnancy might lead to fertility problems in the future? What happens when a mother isn't allowed to even find out if she should terminate the pregnancy, because her doctor knows that allowing her to get tested might lead to her wanting an abortion — an abortion the doctor doesn't want to provide?

The issue with the act is that it's vague, it's sweeping, and it lifts liability. Incredibly, it passed the state House last week — it's due to be debated in the state Senate in the next few days.