Opinion ID: 2015657
Heading Depth: 1
Heading Rank: 2

Heading: Threats to Health

Text: The first certified question asks whether Public Law 187 excuses compliance with Ind.Code § 16-34-2-1.1 when such compliance would in any way pose a significant threat to the life or health of the woman. Plaintiffs put forth three arguments for the position that Public Law 187's medical emergency exception does not support an affirmative answer to the first question. First, they claim that the plain language does not support the construction. Second, they contend that even if the language is capable of such a construction, such is not what the legislature intended. Finally, they argue that Public Law 187 is not identical to the Pennsylvania Abortion Control Act and it should not be given the same flawed construction accorded similar statutes by federal courts. Resolution of the first two arguments renders discussion of the third unnecessary. We conclude that Public Law 187's language contemplates that all relevant factors pertaining to a woman's health can, indeed must, be considered when deciding whether to dispense with the statute's informed consent provisions. Plaintiffs rely on the absence of the word health in the statute and they note the statute does not contain an immunity provision for the medical professional who dispenses with the informed consent requirements. We conclude instead that a doctor's regard for all relevant factors pertaining to a woman's health is implicit in the term clinical judgment. The inclusion of the term clinical judgment allows the attending physician the flexibility to exercise to the fullest extent her professional judgment when diagnosing a patient. [7] If this diagnosis indicates that an abortion is medically necessary, then the physician may perform it without delay. The references to death or substantial impairment [8] simply focus the physician's clinical judgment on medical necessity rather than lesser and regular conditions normally associated with pregnancy. Furthermore, a physician who acts with care and good faith has no rational fear of criminal prosecution when deciding to dispense with the statute's informed consent provisions; thus, a positive provision for immunity is not necessary to shield a physician from prosecution on the basis of professional judgment. Plaintiffs seem to suggest that the word delay in the impairment clause (or for which delay would create serious risk) is limited to the statutory eighteen-hour waiting period. Such a limited interpretation of delay would not cover certain medical conditions [9] about which plaintiffs' expert testified in District Court. We think the statute affords women protection from risk connected with delays more generally, not just an eighteen hour delay. Medical conditions indicating the necessity of therapeutic abortion are serious enough threats to a woman's health to permit a physician to dispense with the informed consent provisions. The simple reality is that the informed consent requirements are virtually meaningless when an abortion is the medically indicated treatment, and there is no evidence that the legislature intended to impose an undue burden on women so afflicted. Plaintiffs argue alternatively that Indiana's legislature removed the term health from the definition of medical emergency because it intended a tough and restrictive exception. They maintain that for the Court to give it a broader interpretation would amount to a judicial rewrite of the statute by removing a burden that the legislature explicitly declared should be imposed. (Brief at 18.) This explicit declaration does not appear in Public Law 187, but rather in two remarks made on the floor of the House of Representatives by the bill's sponsor, Representative Michael Young. Representative Young remarks spoke of restricting the exception to circumstances when a woman was in grave danger and of distancing Public Law 187 from Doe v. Bolton, [10] the companion case to Roe v. Wade . He also spoke of preventing the exception from swallowing the rule by open(ing) it up to every abortion you can think of whether it's an emergency or not. (Plaintiffs' Exh. 38, r. at 1.) In interpreting statutes, we do not impute the opinions of one legislator, even a bill's sponsor, to the entire legislature unless those views find statutory expression. O'Laughlin v. Barton, 582 N.E.2d 817, 821 (Ind.1992). Moreover, the Attorney General points to a fair amount of evidence in plaintiffs' submissions that the legislature actually and deliberately copied Pennsylvania's law. Pl. Exh. 31, pp. 100212, 100220. There is evidence in the District Court record that the bill's sponsor knew of and relied on the Abortion Control Act's construction when drafting and promoting the bill. [11] Pl. Exh. 31, pp. 1000056, 100146, 100220. This question asks whether a woman may be excepted from compliance with the statutory informed consent provisions when she faces significant and imminent threats to her life or health. Our answer is affirmative. Such a tight causal link clearly comes within the statute's plain language. Where a woman faces imminent, serious harm absent prompt action, the attending physician may perform the medically-indicated abortion. We think the statute permits immediate abortion far short of medical calamities. An attending physician may dispense with the statutory informed consent requirements when she concludes in her best clinical judgment that her patient's condition indicates an abortion is medically necessary. The General Assembly intended the medical emergency exception to apply to all significant factors relevant to a woman's health. As we noted above, our response about the meaning of this statute is necessarily rendered without a tight examination of the contours of federal court decisions concerning abortion. This is the task of the District Court. If this Court was called upon to assess the constitutionality of this statute, we might well modify our view of the statute's demands if doing so would preserve its constitutionality. Burris v. State, 642 N.E.2d 961, 968 (Ind.1994), cert. denied,  U.S. ___, 116 S.Ct. 319, 133 L.Ed.2d 221 (1995) (statute will not be held unconstitutional if reasonable construction renders it constitutional).