Document ID: ./input/supremecourt_opinions/opinions/19pdf/18-1323_c07d.pdf
Page Number: 118

Cite as:  591 U. S. ____ (2020) 

3 

GORSUCH, J., dissenting 

passed Act 620 only after extensive hearings at which ex-
perts  detailed  how  the  Act  would  promote  safer  abortion
treatment—by  providing  “a  more  thorough  evaluation 
mechanism of physician competency,” promoting “continu-
ity  of  care”  following  abortion,  enhancing  inter-physician
communication, and preventing patient abandonment.

Testifying physicians explained, for example, that abor-
tions  carry  inherent  risks  including  uterine  perforation,
hemorrhage,  cervical  laceration,  infection,  retained  fetal
body parts, and missed ectopic pregnancy.  Unsurprisingly,
those risks are minimized when the physician providing the 
abortion is competent.  Yet, unlike hospitals which under-
take rigorous credentialing processes, Louisiana’s abortion 
clinics historically have done little to ensure provider com-
petence.  Clinics have failed to perform background checks
or  to  inquire  into  the  training  of  doctors  they  brought  on 
board.  Clinics have even hired physicians whose specialties 
were unrelated to abortion—including a radiologist and an
ophthalmologist.  Requiring hospital admitting privileges,
witnesses testified, would help ensure that clinics hire com-
petent professionals and provide a mechanism for ongoing 
peer review of physician proficiency.  Loss of admitting priv-
ileges, as well, might signal a problem meriting further in-
vestigation by state officials.  At least one Louisiana abor-
tion  provider’s  loss  of  admitting  privileges  following  a 
patient’s  death  alerted  the  state  licensing  board  to  ques-
tions about his competence, and ultimately resulted in re-
strictions on his practice.

The  legislature  also  heard  testimony  that  Louisiana’s 
clinics and the physicians who work in them have racked
up dozens of citations for safety and ethical violations in re-
cent years.  Violations have included failing to use sterile
equipment,  maintaining  unsanitary  conditions,  failing  to 
monitor  patients’  vital  signs,  permitting  improper  admin-
istration of medications by unauthorized persons, and ne-
glecting  to  obtain  informed  consent  from  patients.    Some