Tuesday Talk*: Empty Exceptions

Kate Cox was the perfect patient to suit the Texas exception for the health of the mother. The circumstances could not have aligned better to test the merits of the law that, it was argued, didn’t ban all abortion, but allowed for medical intervention when the mother’s life or health was at risk. And despite her desire to have a child, her non-viable pregnancy was doomed, removing any cries of murder.

But her doctor had a point. This was Cox’s medical reality, but Texas Attorney General Ken Paxton, no stranger to indictment himself, was of the view that he, and not those damn doctors, got to decide whether aborting Cox’s pregnancy was a crime. Even a judge ruling in her favor wasn’t enough to stay Paxton from control, and so he appealed and obtained an injunction from the Texas Supreme Court, which was apparently unaware that it lacked the jurisdiction to prevent medical harm from coming to Kate Cox while letting time go by.

Ultimately, Cox was constrained to leave Texas to obtain the medical treatment that wouldn’t wait, to which the exception purportedly applied, and for which she had already jumped through a hoop that showed the exception to be unexceptional.

This case is unusual for Cox’s willingness to wage a legal fight while suffering a medical catastrophe, but not for the cruel bind the state placed her in. The day Cox received the terrible news about her fetus, the Texas Supreme Court was hearing oral arguments in Zurawski v. Texas, a suit brought by two doctors and 20 women who had been denied medically necessary abortions and were seeking to clarify the scope of emergency exemptions to the state’s ban. Among the plaintiffs is Amanda Zurawski, who was 18 weeks pregnant after a year and half of fertility treatments when her water broke. Although her pregnancy had no chance of surviving, she was denied an abortion until she became septic. Zurawski ended up spending days in an intensive care unit, and has been left with damage to her reproductive tract that will most likely make it harder for her to become pregnant again.

If this is the path down which a woman must go in order to obtain the medical care she and her physician deem necessary, then the path leads nowhere. As if to emphasize the point, the Texas Supreme Court, after Cox decided to end the waiting game and obtain the medical care she needed, ruled unanimously.

The unanimous decision Monday directs a lower court to vacate a temporary restraining order that authorized a doctor to perform an abortion on 31-year-old Kate Cox last week. Cox earlier on Monday said she couldn’t wait on the Supreme Court’s decision and would leave the state for care.

Saying that the decision isn’t up to the courts, the Supreme Court deferred decisions on Cox’s medical care to her doctors. The opinion notes that in the underlying lawsuit Cox’s doctor didn’t assert that Cox had a “life-threatening physical condition,” which is the standard in Texas as an exception to the abortion ban.

“Some difficulties in pregnancy, however, even serious ones, do not pose the heightened risks to the mother the exception encompasses,” the court wrote.

Cox could have been rendered infertile, and that just wasn’t bad enough to meet the “life-threatening condition” requirement. Had her doctor uttered the magic words, would it have been different, or would the state then have challenged her diagnosis to say it wasn’t life-threatening enough? So what if the fetus isn’t viable? So what if the physical harm to the mother is serious? As long as she wouldn’t die (imminently, supposedly), she failed to meet the exception.

Although the opinion requires that the woman’s life be at risk, it says that the doctor won’t be held to certainty and need not “wait until the mother is within an inch of death.”

“The exception is predicated on a doctor’s acting within the zone of reasonable medical judgment, which is what doctors do every day,” the opinion reads. “An exercise of reasonable medical judgment does not mean that every doctor would reach the same conclusion.”

At every turn, these determinations are subjective. If a woman’s physician says so, is that good enough that neither the doc nor patient will be prosecuted by Paxton, or sued under Texas’ dread SB 8? How is anyone to know? Should a doctor assume the peril of prosecution to treat a patient? Must the patient (and her family) risk imprisonment or harm, or perhaps even death, at Paxton’s whim?

As states enact laws that permit abortions within unrealistically short time frames, the argument is that these laws include exceptions, inter alia, for the mother’s health or life. For some, this provided the minimal safety valve. Are they just empty exceptions, good only for begging for litigation and prosecution and inadequate to serve their purpose? Is there any subjective exception that won’t be gamed by mutts like Paxton to render them cynical and worthless?

Was this the way legislators saw their laws being squandered while women suffered?

*Tuesday Talk rules apply, within reason.


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8 thoughts on “Tuesday Talk*: Empty Exceptions

    1. Hunting Guy

      And we like it like that.

      Keeps them damn Yankees up north.

      Now if we could just get those #%+-“* Californians to move to NY instead of polluting our great state things would be a lot better.

  1. Miles

    The “life of the mother” will seem pretty clear to many, but is it? Is it only life or death, or a substantial impairment of functioning (whatever that means). What about the woman who will end up a vegetable with no brain function, but still breathing. Alive? Is that good enough?

    If failure to abort will cost a woman a functioning bodily organ, does that not implicate her life? If not, where is the line, death or nothing?

    1. j a higginbotham

      That’s making it needlessly complicated: An abortion is allowed if there is a “life-threatening physical condition,” which condition is likewise simply determined by waiting and observing whether the woman has expired (based on the well-established test for witchery).

  2. Pedantic Grammar Police

    This just goes to show how stupid Republicans are. This is the perfect time for them to show up the Democrats by being graceful winners. But no, they have to make even their supporters hate them by being just as extreme as the Democrats were when they had the Supreme court on their side.

    1. JMK

      > But no, they have to make even their supporters hate them

      Indeed. I’m pro life and I’m disgusted by what the Republicans are currently doing. For years I’ve dismissed the “the cruelty is the point” as hyperbole but it’s becoming clear that it is, in fact, true for an alarming number of elected officials.

      It’s disheartening.

  3. David

    So this has basically been a fight about bullshit to create the appearance of reasonable exceptions and then make it impossible to invoke the exception? Assholes.

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