Some legislators and lawyers are concerned that Missouri's trigger law, which took effect June 24, has vague language that will cost people their lives.
The wording, they say, makes it unclear at what point doctors are able to intervene when someone has an ectopic pregnancy.
Chapter 188 of Missouri's revised statutes — which contains the Right to Life of the Unborn Child Act — makes provisions for abortions in the case of medical emergencies: a situation that would "necessitate the immediate abortion of her pregnancy to avert the death of the pregnant woman or for which a delay will create a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman."
Lisa Larson-Bunnell, a regulatory health care attorney with a Missouri hospital, worries that language isn't clear enough.
"There are a few things that are concerning about this definition. The first is the immediacy language. A plain language reading would imply that it would need to occur “right now” in order to avert death," Larson-Bunnell said in an email. "Does that mean that you cannot perform an abortion in a situation where a woman will experience death with no intervention, but, perhaps not right now? How do you prove that someone was close enough to death to warrant the abortion?"
Asked by the News-Leader on Friday whether the state planned to issue further clarification on the law's definition of "medical emergency" pregnancies, Gov. Mike Parson said, "I'm sure the health department will come out with some clarifications or guides on that."
He reiterated that emergency contraception, or Plan B, is still legal under the law and that there was "a lot of misinformation out there."
A spokesperson for the Missouri Department of Health and Senior Services did not immediately respond to an inquiry on whether it was developing clarifications or guidelines on the definition.
Doctors and health care workers have already expressed concern to Sen. Lauren Arthur, a Democrat, especially in considering how to handle ectopic pregnancies. In ectopic pregnancies, a fertilized egg implants in a place other than the uterus. These pregnancies are not able to be moved and are not viable, but they often continue to develop, and can even have cardiac activity.
"I was talking to someone yesterday, and he said we’re concerned that if someone presents with an ectopic pregnancy and isn’t in immediate danger, we would be opening our doctor up for liability (if we treat them)," Arthur said, "but we’re also concerned that if we wait, not only does that potentially risk the patients, it also opens our doctor up to liability, because he or she can be sued for not providing appropriate medical treatment at the right time."
The News-Leader asked Attorney General Eric Schmitt's office whether he considers ectopic pregnancies a medical emergency, AG office spokesperson Chris Nuelle replied with the statute's definition of a medical emergency.
That silence, Larson-Bunnell says, is preventing decisive action.
"As an attorney, I cannot risk speculation with my clients. All I know is that there is a law in place, and the AG nor the Department of Health and Senior Services has said they do not plan to enforce, or that they will carve out ectopic pregnancies. This is a very gray area right now," Larson-Bunnell said.
Arthur hopes that Parson will convene a special session that would clarify the language. As of publication, he had only called a special session for an income tax cut.
Both Arthur and Larson-Bunnell expressed concern over legislators writing laws that govern how medical providers do their jobs.
"I hope that your readers understand that human reproduction is complex and we are in a situation where non-medical providers are writing laws that are vague, and overreaching," Larson-Bunnell said. "It is important for us all to pay attention and hold our political leaders accountable."
Susan Szuch is the health and public policy reporter for the Springfield News-Leader. Follow her on Twitter @szuchsm. Story idea? Email her at email@example.com.
Galen Bacharier covers Missouri politics & government for the News-Leader. Contact him at firstname.lastname@example.org, (573) 219-7440 or on Twitter @galenbacharier.
This article originally appeared on Springfield News-Leader: Attorney: 'Medical emergency' abortion language needs clarification