The lies are neatly tied up in these two sentences:
” This past fall, doctors were required to start performing a transvaginal sonogram at least 24 hours ahead of an abortion, a shift they say has had frustrating consequences for clinics and patients.”
“Now the physician performing the abortion — not an ultrasound technician, for example, or a secondary doctor — must conduct the sonogram on a separate day.”
(I have a “Google News search” for articles on the Texas Sonogram law, so I get emails as soon as they’re published. These same lies are duplicated in other articles and op-eds, like this one in “The Jurist,” from a law professor at the Saint Louis School of Law.)
Editor-in-Chief, Evan Smith, and Ramshaw at the Texas Tribune must know they’re publishing emotional falsehoods. Even Judge Sam Sparks knew better.
Anyone who has read the text of HB 15 or Judge Sam Spark’s ruling would know that we’ve had a formal informed consent process and a 24 hour waiting period since 2003, that there is no mandate to use a “transvaginal sonogram,” and that “an agent of the physician who is also a sonographer certified by a national registry of medical sonographers” may perform the sonogram. The doctor is required to show the sonogram “images,” to make the heartbeat audible and to describe the development of the embryo or fetus. That the language did not require that the actual, real-time sonogram be conducted by ” the physician performing the abortion” was clear to Judge Sparks. As he said,
“The net result of these provisions is: (1) a physician is required to say things and take expressive actions with which the physician may not ideologically agree, and which the physician may feel are medically unnecessary; (2) the pregnant woman must not only passively receive this potentially unwanted speech and expression, but must also actively participate—in the best case by simply signing an election form, and in the worst case by disclosing in writing extremely personal, medically irrelevant facts; and (3) the entire experience must be memorialized in records that are,at best, semi-private.”
Still, Ramshaw revealed some truth:
“. . . a scheduling struggle when doctors providing elective abortions are in short supply and rotate between clinics.
“They’ve had to set aside a whole other day doing ultrasounds, visits that in most parts of medicine would be dedicated to people with less training than a physician,” Hagstrom Miller said. “The effect on their travel schedule, on their reimbursement, on patients’ access to them has been tremendous.”
In the typical elective abortion, there’s rarely any on-going doctor-patient relationship and the real problem is bureaucratic and financial. The clinic owners are mostly worried about the money and their ability to get doctors to show up for the informed consent and to return the next day to perform the abortion.
And it’s not all about money. The doctors who “rotate between clinics” usually fly in, sometimes from another state, for “procedure day.” The “Sonogram law” doesn’t force the woman having the abortion to look at her sonogram. But it does force the doctor to spend time counseling the women – possibly more time than the abortion itself will require. They will now have to look the women in the eye and describe the development of the child. How can a doctor “not ideologically agree” with the facts visible on the sonogram when describing the heart or limbs?
See Part 1, here
Media reports say that due to the injunction by Federal Judge Sam Sparks, the Texas Ultrasound law will not go into effect at all until a higher court rules on it. However, the Judge does note that there is a severability clause and that his injunction is narrow. I’m waiting to see opinions from lawyers as to whether abortionists will be held to parts of the law that are not specifically under injunction.
In the meantime, I wonder how many women will meet the abortionist before they are gowned and sedated for the procedure and how many will insist on seeing their sonograms?
In the second half of the Opinion by Judge Sam Sparks, the Judge outlines the specific complaints brought against the new law, HB 15, (text of the law, here ) . Most of those complaints are dismissed, even as the Judge continues to call the new law “unwise” and ultimately imposes an injunction against enforcement.
Sparks disagrees with the Plaintiffs, the Center for Reproductive Rights out of New York, that the definitions of “medical emergency,” “sonogram,” “in a quality consistent with current medical practice,” and “in a manner understandable to a layperson” are unconstitutionally vague. He also disagrees with the Plaintiffs on whether or not “visit” and “abortion-related services” are unclear to most people.
The major complaints upheld by the judge appear to be that the law doesn’t allow for multiple-physician practices or for a switch if the original doctor who informed the woman about her ultrasound cannot, “through some unforeseen circumstances,” perform the abortion, requires a woman to sign an informed consent acknowledgement, and forces the physician to “advance an ideological agenda.” Sparks also does not like the word “soley,” for reasons that I don’t understand.
It is true that one purpose of the law was to ensure that women were given informed consent by the physician who was to perform the abortion, “in a private and confidential setting.” Most abortionists had been satisfying the 24 hour waiting period and informed consent the same way that Dr. Alan Braid’s Reproductive Services of San Antonio, had: over the phone or by referring the woman to the information on the Internet.
However, it doesn’t appear that Sparks overturned these requirements, since the injunction overturns the objection to the requirement that women receive private and confidential informed consent and the exception for those who live more than 100 miles from the abortion clinic. The opinion only finds fault with the lack of accommodations for “unplanned substitutions.”
The judge makes a surprising statement about the requirement that a copy of the informed consent be inserted in the medical record of the woman:
Compounding this problem is newly-added section 171.0121, which requires both that a copy of the above certification be placed in the pregnant woman’s medical records (presumably permanently), and that the facility that performs the abortion retain a copy for at least seven years.See H.B. 15, Sec. 3 (adding TEX. HEALTH & SAFETY CODE ANN. § 171.0121). Given the nature of the certification and the Act’s retention requirements, it is difficult to avoid the troubling conclusion that the Texas Legislature either wants to permanently brand women who choose to get abortions, or views these certifications as potential evidence to be used against physicians and women.
Sparks says that the medical record is “semi-private,” and is concerned that it might someday be subpoenaed for use in a court case. The only time that these would be seen in Court is if the woman herself sues the doctor.
Sparks also engages in a bit of ideological speech of his own about the requirement for the abortionist to describe “the presence of cardiac activity,” and “the presence of external members and internal organs.”
“ The Court does not think the disclosures required by the Act are particularly relevant to any compelling government interest, but whatever relevance they may have is greatly diminished by the disclosures already required under Texas law, which are more directly pertinent to those interests.”
and, from page 50:
The net result of these provisions is: (1) a physician is required to say things and take expressive actions with which the physician may not ideologically agree, and which the physician may feel are medically unnecessary; (2) the pregnant woman must not only passively receive this potentially unwanted speech and expression, but must also actively participate—in the best case by simply signing an election form, and in the worst case by disclosing in writing extremely personal, medically irrelevant facts; and (3) the entire experience must be memorialized in records that are,at best, semi-private. In 7 the absence of a sufficiently weighty government interest, and a sufficiently narrow statute advancing that interest, neither of which have been argued by Defendants, the Constitution does not permit such compulsion.
Edit to add this question: How can a doctor “not ideologically agree” with the facts visible on the sonogram when describing heart or limbs?
In my opinion, the worst part of the ruling is Spark’s legal-speak on “compelling’ and his insistence on bringing back the ever-moving line of “viability:”
Second, while Casey refers to the government’s interest in potential life as “important,” “substantial,” and “legitimate,” it stops short of characterizing it as “compelling.” Indeed, one of the holdings of Roe v. Wade, and one this Court does not interpret Casey as having overruled, was that “[w]ith respect to the State’s important and legitimate interest in potential life, the ‘compelling’ point is at viability.”
Tell me, Judge Sparks, just what is “viability?” 24 weeks, 20 or 18 weeks?
link to Part 1 and “sticky” added September 5, 2011 12:19 PM BBN
Will someone tell me why it is logical for Federal Judge Sam Sparks to assume that “less-skilled providers” will be willing to meet the “onerous requirements” that more-skilled providers won’t?
” The Court has grave doubts about the wisdom of the Act, but that is no legal basis for invalidating it. The Act’s onerous requirements will surely dissuade or prevent many competent doctors from performing abortions, making it significantly more difficult for pregnant women to obtain abortions. Forcing pregnant women to receive medical treatment from less-skilled providers certainly seems to be at odds with ‘protecting the physical and psychological health and well-being of pregnant women,’ one of the Act’s stated purposes.”
I’m a doctor, not a lawyer, so I may not understand all of the words and references in the opinion, but I’m shocked that any self-respecting Federal Judge would allow such a frankly biased opinion out of his office. Perhaps Sparks doesn’t mind burning his chances of ever being appointed to another Court, and is quite happy with his life time appointment in the Federal Court at Austin.
I’m halfway through the ruling and thought I’d post some thoughts before these comments got too long.
Sparks decided that it’s not really important for the Plaintiffs to be someone actually harmed by the Law in order to have standing in his Court. He approved the class action suit filed by a New York State corporation, The Center for Reproductive Rights, who filed a class action suit on behalf of all the abortionists in Texas, supported by affidavits from three abortionists:
If R. v. W. isn’t found to be gross misconduct, this ruling should be. Sparks can’t resist a revealing his prejudice and mocking the legislature.
Citing Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833, 846 (1992), a US Supreme Court ruling on abortion limitations and Equal Protection, Sparks not only has to admit that the Texas law is legitimate under prior law and Court rulings, but that:
“This legitimate interest obviously justifies “singling out” abortion providers and the patients thereof, because they pose a serious potential risk to “the life of the fetus that may become a child.”’
However, he goes on to admit his prior bias:
“The Court has grave doubts about the wisdom of the Act, but that is no legal basis for invalidating it. The Act’s onerous requirements will surely dissuade or prevent many competent doctors from performing abortions, making it significantly more difficult for pregnant women to
obtain abortions. Forcing pregnant women to receive medical treatment from less-skilled providers certainly seems to be at odds with “protecting the physical and psychological health and well-being of pregnant women,” one of the Act’s stated purposes. H.B. 15, Sec. 12(1). However, rational basis review requires this Court to accept even tenuous rationales for the advancement of a legitimate government interest.
In short, if the Texas Legislature wishes to prioritize an ideological agenda (2) over the health and safety of women, the Equal Protection Clause does not prevent it from doing so under these circumstances. Accordingly, the Court must reject Plaintiffs’ Equal Protection arguments. (p. 20/55)
That footnote (2) ?
“2 It is ironic that many of the same people who zealously defend the state’s righteous duty to become intimately involved in a woman’s decision to get an abortion are also positively scandalized at the government’s gross overreaching in the area of health care.”
“(It) is difficult to avoid the troubling conclusion the Texas Legislature either wants to permanently brand women who choose to get abortions, or views these certifications as potential evidence to be used against physicians and women,” Sparks wrote.