Veto of Oklahoma abortion bill steps back war on doctors

[Updated 5:53 p.m. EDT] Oklahoma Gov. Mary Fallin (R) on Friday vetoed the most aggressive attempt yet to legislatively rein in abortion on medical grounds, suggesting lawmakers had gone too far in their attempts to punish doctors who performed abortions.

The bill, passed Thursday, would have made performing an abortion a felony and revoked the medical license of any doctor who participated in an abortion, except in cases where the mother’s life is at risk.

It followed a series of antiabortion laws that have taken shape in red states across the nation, from Florida to Utah to Texas. Such laws adopt medical language to describe their objectives, even as major mainstream medical organizations – including the American College of Obstetricians and Gynecologists and the American Medical Association – say restricting women’s access to safe and legal abortion often forces them to turn to riskier methods to terminate their pregnancies.

By casting its bill in medical terms – punishing doctors for performing a procedure deemed legal by the United States Supreme Court – Oklahoma legislators were attempting to ramp up a perceived war on abortion doctors, medical experts say.

“The messaging around a bill like this just deepens the stigma against abortion providers,” says Daniel Grossman, an assistant clinical professor in the department of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco.

“It has a broader impact on entrenching stigma around abortion and sends a statement that abortion is not health care and that doctors who perform abortions aren’t the same kind of doctors that you know and love and go see for your primary care,” he says. 

On Friday, Governor Fallin said she vetoed the bill partly because it “would not withstand a criminal constitutional legal challenge.”

“While I consistently have and continue to support a re-examination of the United States Supreme Court’s decision [to legalize abortion] in Roe v. Wade, this legislation cannot accomplish that re-examination,” she wrote in a statement. 

But she also addressed the concern of some medical experts, saying that the bill was “so ambiguous and so vague that doctors cannot be certain what medical circumstances would be considered necessary to preserve the life of the mother.”

Professor Grossman says that if the bill had become law, it could have negatively affected how doctors decided when to perform abortions, causing them to hesitate even when terminating a pregnancy is the best way to protect the mother’s life.

“It’s not like there’s a list of situations that everybody agrees, ‘This is a situation where abortion is necessary to save the life of the mother,’ ” Grossman says. “Like most things in medicine, there’s a lot of gray area.”

Fallin agreed. “The absence of any definition, analysis or medical standard renders this exception vague, indefinite and vulnerable to subjective interpretation and application,” she wrote.

Other antiabortion laws across the country have forced abortion clinics to take steps that many medical experts say are not relevant to what the clinics do. These include ensuring that abortion doctors have admitting privileges at a local hospital or that the clinic maintains the standards of an ambulatory surgical center. Many abortion clinics in states with such laws have shut down, unable to meet those standards. 

Supporters of such laws argue that the burden is on providers to ensure the highest standards in care.

“Health and safety standards close no clinics,” Kristi Hamrick, a spokesperson for antiabortion legal group Americans United For Life, wrote in an e-mail to the Monitor in April. “Abortionists close clinics when they don't want to invest their profits in protecting women’s health and safety.”

The wrangling over such laws underscores how different interpretations of medical science have become central to the abortion debate. The Oklahoma bill, however, was an attempt to take things to a new level, Grossman says.

“It’s in the same kind of category in that it’s targeting the providers rather than women,” he says. But this bill was “extreme.”

Oklahoma lawmakers were explicit about the bill’s purpose to aid efforts to overturn Roe v. Wade.

“Since I believe life begins at conception, it should be protected, and I believe it’s a core function of state government to defend that life from the beginning of conception,” state Sen. Nathan Dahm (R) of Tulsa County, who sponsored Senate Bill 1552, told the Associated Press.

State Sen. Ervin Yen (R) of Oklahoma City, a physician who voted against SB 1552, described the bill as “insane,” the AP reports; and in the last five years, eight of Oklahoma’s antiabortion measures have been challenged in court as unconstitutional.

Which isn’t to say lawmakers do not have a role in regulating medical care, says Steven Ralston, an obstetrician and associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School’s Center for Bioethics. He notes that the Federal Drug Administration and the Centers for Disease Control and Prevention exist to ensure the quality of the care, products, and procedures that medical practitioners in the US provide Americans.

But “I think it’s very important to distinguish between the government regulating medical practice and the government outlawing medical practice,” Professor Ralston says.

“It’s about sticking up not just for women’s reproductive rights but for physicians’ professional autonomy,” he adds. “[The bill is] designed to send … a message of intimidation to physicians: ‘If you are willing to provide a service that is legal in every other place [in the United States], you’ll get in trouble in Oklahoma.’ ”