The Louisiana Admitting-Privileges Case Is Headed To The Supreme Court…

…and naturally the case, June Medical Services v. Russo, is being talked about as (1) a direct affront to Roe v. Wade and (2) a likely defeat for the team at the Louisiana Attorney General’s office who are working to defend a state law requiring doctors with admitting privileges at abortion clinics passed by an overwhelming legislative majority.

At issue is a law which simply requires that all ambulatory medical clinics, meaning walk-in doctor’s offices where outpatient surgery is performed, and that includes abortion clinics, to have someone working at all business hours who has admitting privileges at a local hospital. The reason for such a law isn’t to shut down abortion clinics, it’s that more often than not if you’re having an abortion and something goes wrong you’re unlikely to be able to admit yourself – for two reasons. First, you’re probably going to be under some sort of anasthetic, and that would make you unable to answer questions like what kinds of medication you take or what allergies you might have. And second, if you need to be admitted to a hospital from an abortion clinic it’s likely because you’re hemorrhaging and it’s a serious emergency, and there should be a competent doctor on hand who can shepherd you into the medical care you’re going to need.

That the abortion clinics in Louisiana immediately screamed this law would put them out of business was not a particularly good reflection on the state of medical care available at those clinics, to say the least. It was more or less an admission the industry was full of quack doctors who failed at every other kind of medicine and this is the last leg of their careers. When it was found that Delta Women’s Clinic in Baton Rouge had an unlicensed doctor performing abortions a couple of years ago, it was more or less proof that Louisiana had a legitimate basic to pass a law like this.

But the abortion industry and its political allies see any attempt to regulate them as a rollback of abortion rights, which is interesting seeing as though those allies are more often than not the same people who would regulate every other form of economic activity straight to death.

In any event, this morning the Attorney General’s office put out a primer on the admitting-privileges law which is worth reading if you’re going to follow the June Medical Services case…

The United States Supreme Court will hear oral arguments on Louisiana’s pro-woman admitting privileges law on Wednesday, March 4, 2020. In light of misinformation being published and false comparisons being made about the case, the Louisiana Attorney General’s Office issued the following information for clarification purposes:

Louisiana is not Texas. Louisiana Act 620 is not Texas H.B. 2. June Medical Services vs. Russo is not Whole Woman’s Health v. Hellerstedt; our facts, our evidence, and our generally applicable medical regulations are all different.

Louisiana’s law does not force clinic closures.
The Fifth Circuit Court of Appeals found that Louisiana’s law would not force any abortion clinic closures, saying, “there is no evidence that any of the clinics will close as a result of the Act,” and reiterating later that “the only permissible finding, under this record, is that no clinics will likely be forced to close on account of the Act.” This is different that Texas’ law which, the Supreme Court concluded, “led to the closure of half of Texas’ clinics, or thereabouts.”

Louisiana abortion providers are able to obtain admitting privileges – if they provide competent care.
Before Act 620, four of the six abortion providers contracted with Louisiana’s abortion clinics had admitting privileges during their medical careers – including at times they were performing abortions. After examining Act 620, the Fifth Circuit determined “with the definite and firm conviction that the district court erred in finding… that the application process creates particular hardships and obstacles for abortion providers in Louisiana” and that “there is insufficient evidence to conclude that, had the doctors put forth a good-faith effort to comply with Act 620, they would have been unable to obtain privileges. Instead… the vast majority largely sat on their hands, assuming that they would not qualify.” Three abortion providers in Louisiana currently have qualifying privileges, and hundreds of obstetrician/gynecologists and family practice doctors have privileges and are qualified to perform abortions if they chose to do so. A doctor’s decision on whether or not to perform abortions is a personal decision.

Louisiana did not single out abortion providers.
Under Louisiana law, all Ambulatory Surgery Center (ASC) medical staff are required to have admitting privileges at nearby hospitals – regardless of the procedure. This rule recognizes the higher degree of risk to patients at facilities where a high volume of surgical procedures are performed. Act 620 closed a statutory loophole by requiring abortion clinics to meet the same standards as other Louisiana Department of Health-licensed outpatient surgical facilities in the State. Texas’ law, in contrast, did not require ASC medical staff to have privileges. Louisiana’s law simply ensured women receive proper care if they have complications; it did not have new building requirements and it conforms with pre-existing facility requirements. H.B. 2 – the law challenged in Hellerstedt – required only abortions providers to have admitting privileges and also mandated abortion clinics meet physical plant standards for ASCs. Texas neither grandfathered in any existing facilities, as it had done in the past, nor allowed abortion clinics to apply for a waiver (even though it had given many to ASCs).

Louisiana provided abundant state-specific evidence of the purpose and the benefits of admitting privileges. 
Public records, legislative testimony, and expert witnesses provided to the court in June Medical Services vs. Russo show the appalling history of substandard care by abortion providers, abortion clinics’ failure to perform any meaningful credentialing review for competency in hiring medical staff, and serial non-compliance with basic health and safety standards in Louisiana. This egregious conduct by both abortion providers and abortion clinics necessitated the passage of Act 620. Among other evidence, the Legislature and the Courts have heard how abortion clinics in Louisiana like June Medical failed women by hiring radiologists and ophthalmologists to perform abortions, not reporting rapes of young girls, and not monitoring vital signs of sedated women. The Fifth Circuit acknowledged that “the admitting privileges requirement performs a real, and previously unaddressed, credentialing function that promotes the well-being of women seeking abortion.”

Louisiana did not impose criminal penalties against providers or women.
Violations of the Texas law at issue in Hellerstedt were misdemeanor crimes. Louisiana’s law is a regulatory matter, not a criminal matter. Act 620 provides exclusively for a fine, assessed by the Louisiana Department of Health, against the abortion clinic and exposes the abortion provider to a referral by LDH to the doctor’s professional licensing body, which may or may not result in any consequences as determined by the Louisiana State Board of Medical Examiners.

Louisiana abortionists have gone to extraordinary lengths to block this bipartisan law that promotes the well-being of women and protects minor girls who may find themselves in the hands of incompetent providers and under unsafe conditions. The Attorney General’s Office will not waver in defense of the pro-woman law, and we will continue to do all we legally can to protect Louisiana’s women and girls.

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