Improve Women's Health Care with Physician Admitting Privilege Laws

Following the death of a young elementary school teacher, Jennifer Morbelli, I had the sad duty of speaking at a press conference in Germantown, MD, in February 2013. Mrs. Morbelli died from complications from a late term (33 week) abortion performed by Dr. LeRoy Carhart. She experienced complications in between office visits, but neither her family nor the ER to which she was eventually admitted was able to locate Carhart. Her cause of death was determined to be an amniotic fluid embolism; the same condition that killed Christin Gilbert, another of Carhart’s patients in 2005.

Maryland, does not have a requirement that physicians performing abortions have admitting privileges at local hospitals, and Dr. Carhart had none in any of the states where he travels to perform risky, late-term abortions. If abortion is meant to be “safe, legal, and rare” why then do we not take every precaution to make sure that women are protected?

Timely hospital admission by a competent physician who had performed her procedure would have provided continuity of care and may have made all the difference for Jennifer Morbelli, whose story should haunt us all.

The murder trial and ultimate conviction of abortionist Kermit Gosnell, along with at least 29 other investigations and/or citations of abortion providers in the U.S. since 2009 should serve as a wake-up call. Although abortion has been legal for 40 years in the U.S., it remains largely unregulated. Requiring physicians to obtain admitting privileges for procedures such as outpatient surgery is a common, non-onerous practice that can save lives.

Despite the obvious benefits to women’s health, abortionists and their allies continue to challenge these health and safety standards in court. Recently, a slew of judicial decisions regarding admitting privileges have made news, including Alabama District Judge, Myron Thompson’s decision to overturn admitting privileges requirements.

Thompson claimed that these regulations impose “undue burdens” on women seeking abortions -- a standard set by the Supreme Court in 1992 to judge the constitutionality of abortion regulations. The Fifth Circuit recently overturned a similar law in Mississippi because the law would likely cause the closure of the last abortion facility in Mississippi, as none of the doctors there are able to obtain admitting privileges.

The effect of these decisions is a that a single judge or group of judges dictates to a state that it must have at least one abortion facility operating within its borders no matter the public health and safety concerns. Especially in light of the horrors we have observed from abortion practices without proper health and safety measures, these dictates are ill advised and irresponsible.

Another recent Fifth Circuit decision (Planned Parenthood v. Abbott) upheld Texas’ physician admitting requirement, highlighting the testimony in support of the law by Dr. John Thorp, board certified Ob/Gyn.

Thorp noted that common-sense admitting privilege requirements allow for more thorough evaluation of the competency of doctors, ensure vital of continuity of care for patients, facilitate better communication between doctors and hospitals regarding patient information and potential complications, and validate important ethical considerations by preventing patient abandonment. Such tremendous benefits for the health and safety of women should compel every state to enact physician-admitting requirements.

Dr. Thorp also cited analysis and statistics noting that, “73 percent of ERs nationwide…lack adequate on-call coverage by specialist physicians, including Ob/Gyns. Thus, requiring abortion providers to obtain admitting privileges will reduce the delay in treatment and decrease health risk for abortion patients with critical complications.”

The court also noted “[…] a report of a joint commission of hospitals, including Johns Hopkins, Mayo Clinic, and New York Presbyterian, which concluded that ‘80 percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed-off.’” Such errors could surely be mitigated by the enforcement of physician admitting requirements.

Planned Parenthood’s lament that not enough doctors are able to obtain admitting privileges should raise warning flags about the competence of abortion doctors currently performing abortions. The Fifth Circuit addressed this grave concern by citing testimony from three Ob/Gyn doctors who noted that hospital credentialing of physicians is an important layer of protection for patients because it allows hospitals to screen out “untrained and incompetent” providers.

Common sense dictates that we protect the public by requiring doctors to be properly recognized and credentialed. Making an exception for abortion doctors is not only illogical, it is dangerous.

The “undue burden” argument falls flat in these cases, logically and constitutionally. There exists no constitutional right for abortionists to perform abortion outside of regulation from the state. A law that may result in the closure of an abortion facility is not necessarily unconstitutional.

It is not the duty of the state to ensure that at least some abortions are provided within its borders. Rather, it is the duty of the state to ensure the health and safety of its citizens, and the Supreme Court has made it clear that the state is permitted to regulate abortion.                                              

Senator Richard Blumenthal has introduced a bill that would have removed virtually all state-level regulation of abortion providers. Dr. Monique Chireau, Professor of Ob/Gyn at Duke University gave powerful testimony (video here) before the Senate Judiciary Committee against the bill.

It is irrational to overturn a common-sense law enacted to protect women’s health because some abortion doctors may not be able to comply. Such reasoning invites incompetence and potentially dangerous practices. If facilities close as a result of requiring from abortion doctors what is often required for doctors that practice other outpatient procedures, the fault lies with the abortionist whose qualifications are in question.

It is time we recognize that abortion is not safe for women and that requiring abortion facilities to meet certain health and safety standards is permissible constitutionally. Physician admitting privilege laws, far from being a “burden,” rather work to protect public health and safety.

Anna Higgins is a senior fellow at Family Research Council.

Following the death of a young elementary school teacher, Jennifer Morbelli, I had the sad duty of speaking at a press conference in Germantown, MD, in February 2013. Mrs. Morbelli died from complications from a late term (33 week) abortion performed by Dr. LeRoy Carhart. She experienced complications in between office visits, but neither her family nor the ER to which she was eventually admitted was able to locate Carhart. Her cause of death was determined to be an amniotic fluid embolism; the same condition that killed Christin Gilbert, another of Carhart’s patients in 2005.

Maryland, does not have a requirement that physicians performing abortions have admitting privileges at local hospitals, and Dr. Carhart had none in any of the states where he travels to perform risky, late-term abortions. If abortion is meant to be “safe, legal, and rare” why then do we not take every precaution to make sure that women are protected?

Timely hospital admission by a competent physician who had performed her procedure would have provided continuity of care and may have made all the difference for Jennifer Morbelli, whose story should haunt us all.

The murder trial and ultimate conviction of abortionist Kermit Gosnell, along with at least 29 other investigations and/or citations of abortion providers in the U.S. since 2009 should serve as a wake-up call. Although abortion has been legal for 40 years in the U.S., it remains largely unregulated. Requiring physicians to obtain admitting privileges for procedures such as outpatient surgery is a common, non-onerous practice that can save lives.

Despite the obvious benefits to women’s health, abortionists and their allies continue to challenge these health and safety standards in court. Recently, a slew of judicial decisions regarding admitting privileges have made news, including Alabama District Judge, Myron Thompson’s decision to overturn admitting privileges requirements.

Thompson claimed that these regulations impose “undue burdens” on women seeking abortions -- a standard set by the Supreme Court in 1992 to judge the constitutionality of abortion regulations. The Fifth Circuit recently overturned a similar law in Mississippi because the law would likely cause the closure of the last abortion facility in Mississippi, as none of the doctors there are able to obtain admitting privileges.

The effect of these decisions is a that a single judge or group of judges dictates to a state that it must have at least one abortion facility operating within its borders no matter the public health and safety concerns. Especially in light of the horrors we have observed from abortion practices without proper health and safety measures, these dictates are ill advised and irresponsible.

Another recent Fifth Circuit decision (Planned Parenthood v. Abbott) upheld Texas’ physician admitting requirement, highlighting the testimony in support of the law by Dr. John Thorp, board certified Ob/Gyn.

Thorp noted that common-sense admitting privilege requirements allow for more thorough evaluation of the competency of doctors, ensure vital of continuity of care for patients, facilitate better communication between doctors and hospitals regarding patient information and potential complications, and validate important ethical considerations by preventing patient abandonment. Such tremendous benefits for the health and safety of women should compel every state to enact physician-admitting requirements.

Dr. Thorp also cited analysis and statistics noting that, “73 percent of ERs nationwide…lack adequate on-call coverage by specialist physicians, including Ob/Gyns. Thus, requiring abortion providers to obtain admitting privileges will reduce the delay in treatment and decrease health risk for abortion patients with critical complications.”

The court also noted “[…] a report of a joint commission of hospitals, including Johns Hopkins, Mayo Clinic, and New York Presbyterian, which concluded that ‘80 percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed-off.’” Such errors could surely be mitigated by the enforcement of physician admitting requirements.

Planned Parenthood’s lament that not enough doctors are able to obtain admitting privileges should raise warning flags about the competence of abortion doctors currently performing abortions. The Fifth Circuit addressed this grave concern by citing testimony from three Ob/Gyn doctors who noted that hospital credentialing of physicians is an important layer of protection for patients because it allows hospitals to screen out “untrained and incompetent” providers.

Common sense dictates that we protect the public by requiring doctors to be properly recognized and credentialed. Making an exception for abortion doctors is not only illogical, it is dangerous.

The “undue burden” argument falls flat in these cases, logically and constitutionally. There exists no constitutional right for abortionists to perform abortion outside of regulation from the state. A law that may result in the closure of an abortion facility is not necessarily unconstitutional.

It is not the duty of the state to ensure that at least some abortions are provided within its borders. Rather, it is the duty of the state to ensure the health and safety of its citizens, and the Supreme Court has made it clear that the state is permitted to regulate abortion.                                              

Senator Richard Blumenthal has introduced a bill that would have removed virtually all state-level regulation of abortion providers. Dr. Monique Chireau, Professor of Ob/Gyn at Duke University gave powerful testimony (video here) before the Senate Judiciary Committee against the bill.

It is irrational to overturn a common-sense law enacted to protect women’s health because some abortion doctors may not be able to comply. Such reasoning invites incompetence and potentially dangerous practices. If facilities close as a result of requiring from abortion doctors what is often required for doctors that practice other outpatient procedures, the fault lies with the abortionist whose qualifications are in question.

It is time we recognize that abortion is not safe for women and that requiring abortion facilities to meet certain health and safety standards is permissible constitutionally. Physician admitting privilege laws, far from being a “burden,” rather work to protect public health and safety.

Anna Higgins is a senior fellow at Family Research Council.