If the early reads on the U.S. Supreme Court are anywhere near right, Idaho’s new abortion law may have a sweeping and deep effect in many states around the country.
More effects than many people even realize, or even can calculate.
Idaho’s law is being challenged in the Supreme Court by federal agencies, which point out that the Emergency Medical Treatment and Active Labor Act of 1986 requires emergency rooms (those which receive Medicare) to provide at least stabilizing medical care for patients who show up. The Idaho law appears to run counter to that, ordering that abortion cannot be part of any medical treatment unless the mother is at clear risk of dying. Abortion is a treatment for a number of medical problems which may not be solvable otherwise, and without which a woman may either die or her body may be severely damaged.
Federal Solicitor General Elizabeth B. Prelogar, described the impact: “Today, doctors in Idaho and the women in Idaho are in an impossible position. If a woman comes to an emergency room facing a grave threat to her health, but she isn’t yet facing death, doctors either have to delay treatment and allow her condition to materially deteriorate or they’re airlifting her out of the state so she can get the emergency care that she needs.â€
Idaho is in other words in the process (a number of cases have become public already) of dumping desperately ill patients on other states which will take care of them. Which Idaho won’t.
If a law like Idaho’s were in place in all states, the talk would shift to cover airlifts out of the country entirely.
Prelogar didn’t get into the point that a large portion of Idaho’s obstetricians have exited the state, mostly because of the new law; there was no place in her argument for it, this being a mere practical consideration rather than legal analysis.
But if the Supreme Court does what hearing questioning seemed to suggest – that the Idaho law will be upheld – the result won’t be just singular. It will be a vast array of impacts, as varied as the patients who show up at hospital emergency rooms.
The Supreme Court waded into that point during the hearing, even if the implication was left mostly undrawn. Numerous what-ifs were posed during oral arguments, but the number of potential questions opened by the laws on a practical level could multiply almost to infinity.
Every person’s medical conditions are at least somewhat unique – our bodies are all at least slightly different from each other – which means that pregnancies are all slightly different too. That’s why even a sophisticated algorithm won’t replace a good physician: Conditions aren’t always normal and natural processes (like a pregnancy or any other medical condition) won’t always go according to plan. There’s no good replacement for on-the-spot and in-the-moment judgment.
The same reason an algorithm won’t work in managing every pregnancy is the same reason no law, however well crafted (and many of the nation’s new abortion laws are shoddy) can cover every case. Each pregnancy is its own unique situation, often involving important decisions along the way. Normally, up to now, those critical decisions have been made by the parents or the mother, with help from medical professionals. Many medical conditions (not just, but including pregnancies) require running monitoring and adjustment, and calculation of cost and risk that add up to a series of very personal responses – calculations different people will make in different ways. No one outside that immediate circle can understand all the factors that weigh in every decision.
You can’t call the Supreme Court or the state legislature to cover every contingency, every decision, of which the life-threatening situations are just the most visible part of the iceberg.
The new abortion laws seem to contemplate that you can. The friction between those rules and life in the real world, and discussion about it, is going to grow.
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