FAQ: The Next Abortion Battle: The Courts And Hospital Admitting-Privilege Laws

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Even if you鈥檙e trying, it鈥檚 tough to keep score on what鈥檚 happening with various lawsuits challenging some state abortion laws.

FAQ: The Next Abortion Battle: The Courts And Hospital Admitting-Privilege Laws

States led by anti-abortion governors and legislatures have been passing a broad array of measures over the past few years aimed at making the procedure more difficult for women to obtain. About two dozen states enacted 70 such measures in 2013, according to the Guttmacher Institute. Those laws range from imposing waiting periods to requiring ultrasounds to limiting the use of the 鈥渁bortion pill鈥 mifepristone, or RU486.

The latest set of laws to be challenged in court, however, have to do with requiring physicians who perform abortions to have admitting privileges at a nearby hospital.

For example, a federal district court judge聽in Alabama this week struck down as unconstitutional a portion of state law requiring physicians who perform abortions to have admitting privileges. Last week, a federal appeals court panel struck down a . And a third law of the same type is awaiting a ruling .

All these laws 鈥 as well as a that a federal appeals court allowed to take effect last November 鈥 have one thing in common: They represent the latest fight over efforts to make abortion either less available (according to one side) or safer (according to the other).

Here are some frequently asked questions about the laws and the lawsuits surrounding them.

What are admitting privileges?

Admitting privileges are the right of a physician to admit patients to a particular hospital, and to provide specific services in that facility. In order for a physician to be granted privileges, a hospital generally checks the individual鈥檚 medical credentials, license and malpractice history.

Many hospitals also require physicians to admit a minimum number of patients to the hospital each year before they will grant or renew privileges. Others require the doctor of the hospital.听

How do admitting privilege requirements relate to abortion?

Supporters of the laws say it鈥檚 about safety. 鈥淥nce a physician assumes the responsibility for overseeing the provision of a medical procedure, there鈥檚 an obligation on the physician to follow the care through to its ultimate conclusion,鈥 including any emergencies that might occur, said Ovide Lamontagne, general counsel of the anti-abortion group Americans United for Life.

Lamontagne also said the process itself for doctors to obtain hospital privileges is another safety check. 鈥淎dmitting privileges are sort of the profession鈥檚 way of validating the credentials of a provider,鈥 he said.

Opponents of the laws, however, say they are more about making abortion less available.

鈥淎dmitting-privileges legislation would impose stricter requirements on facilities where abortions are performed than on facilities that perform much riskier procedures,鈥 said Jeanne Conry, former president of the American College of Obstetricians and Gynecologists. 鈥淎s an example, the mortality rate associated with a colonoscopy is more than 40 times greater than that of abortion,鈥 yet gastroenterologists who perform such procedures outside of the hospital setting do not face similar requirements 鈥渋n the context of safety.鈥

And opponents point out that most abortion providers cannot meet the number-of-admissions standard for gaining privileges because so few of their patients .

How many states have passed admitting privileges laws?

According to the , which tracks reproductive health issues, 15 states require abortion providers 鈥渢o have some affiliation with a local hospital,鈥 while 11 specifically require admitting privileges. Many of those laws are not in effect, however, having either been blocked by courts or are too new ( and ) to have taken effect.

Americans United for Life with 鈥渁n enforceable admitting-privileges requirement for abortion providers,鈥 and four currently in litigation: Alabama, Mississippi, Texas, and Wisconsin.

In some states with admitting-privileges laws, physicians have been able to gain hospital access. In North Dakota, for example, a earlier this year when physicians at the state鈥檚 only abortion clinic were granted privileges at one hospital.

What have the courts said about the laws?

Under current Supreme Court precedent, states cannot limit abortion in a way that imposes an on a woman鈥檚 ability to obtain an abortion.

But different courts have had dramatically different responses to admitting privileges requirements for abortion providers.

In Texas, found the admitting privileges portion of that state鈥檚 omnibus abortion restriction law unconstitutional. Then in May, a three-judge panel of the Fifth Circuit Court of Appeals .

鈥淓ven if we were to accept that both clinics in the Rio Grande Valley were about to close as a result of the admitting privileges provision鈥his finding does not show an undue burden,鈥 written by Judge Edith Jones.

The opinion also noted that the lower court鈥檚 finding that 鈥溾檛here will be abortion clinics that will close鈥 is too vague.鈥

Since the ruling, the last remaining clinics in the Rio Grande valley . That left San Antonio, which is between 150-250 miles away, the closest city where legal abortions can be obtained for women in more than 20 Texas counties.

Texas now has as it had before the law took effect, and that could drop even further depending on the outcome of 聽regarding another provision of the Texas law. That provision requires abortion clinics to meet the same facility standards 聽as 聽鈥渁mbulatory surgical centers鈥 that do more complex surgeries. Those include such details as minimum door widths, and allowable types of materials to be used in floors and ceilings.

In Mississippi, a different set of judges from the Fifth Circuit Court of Appeals that the state鈥檚 admitting-privileges law could not take effect, because it would have forced the closure of the last remaining abortion clinic in the state.

鈥淢ississippi may not shift its obligation to respect the established constitutional rights of its citizens to another state鈥 wrote Judge E. Grady Jolly .听

Meanwhile, Alabama District Court Judge Myron Thompson cited the inability of doctors in the state鈥檚 abortion clinics to be able to get admitting privileges at nearby hospitals in his Aug. 4 opinion .

鈥淭he evidence compellingly demonstrates that the requirement would have the striking result of closing three of Alabama’s five abortion clinics,鈥 Thompson wrote in his . 鈥淚f this requirement would not, in the face of all the evidence in the record, constitute an impermissible undue burden, then almost no regulation, short of those imposing an outright prohibition on abortion, would.鈥

A trial over ended in June. A decision is that case is expected soon.

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