Opinion ID: 797832
Heading Depth: 4
Heading Rank: 2

Heading: Life and Health Exception

Text: 40 The life and health exceptions in the Michigan statute provide as follows: 41 (2) A physician or an individual performing an act, task, or function under the delegatory authority of a physician is immune from criminal, civil, or administrative liability for performing any procedure that results in injury or death of a perinate while completing the delivery of the perinate under any of the following circumstances: 42 (a) If the perinate is being expelled from the mother's body as a result of a spontaneous abortion. 43 (b) If in that physician's reasonable medical judgment and in compliance with the applicable standard of practice and care, the procedure was necessary in either of the following circumstances: 44 (i) To save the life of the mother and every reasonable effort was made to preserve the life of both the mother and the perinate. 45 (ii) To avert an imminent threat to the physical health of the mother, and any harm to the perinate was incidental to treating the mother and not a known or intended result of the procedure performed. 46 Mich. Comp. Laws § 333.1083. The district court found the health exception in part (2)(b)(ii) of the statute inadequate because in every abortion, the physician knows the outcome of the procedure to be the demise of the perinate. 384 F.Supp.2d at 987. Thus, the district court concluded that the exception is essentially inoperative on its own terms, as it would prohibit every D & E and D & X procedure used to protect the health of the woman, in contravention of the holding in Stenberg. Similarly, with regard to the life exception in part (2)(b)(i), the provision that every reasonable effort must be made to save the life of the perinate requires the physician to balance the life of the woman with that of the perinate. The Supreme Court has found life exceptions to be inadequate where they require the mother to bear an increased medical risk in order to save her viable fetus. Thornburgh v. American College of Obstetricians & Gynecologists, 476 U.S. 747, 769, 106 S.Ct. 2169, 90 L.Ed.2d 779 (1986). Because the life exception here does just that, the district court also found it to be unconstitutional. 384 F.Supp.2d at 987-88. 47 As discussed above in Part II of this opinion, the Supreme Court's holding in Stenberg pertaining to the need for a health exception to otherwise valid D & X prohibitions was modified somewhat in Gonzales. It is not immediately apparent how this decision should affect Michigan's statute. On the one hand, Gonzales's holding that an exception allowing D & X might not always be medically necessary was premised on a conflicted factual record, and doubts about the medical need for such an exception would appear to apply with equal force in this case. On the other hand, the factual findings that cast doubt on the safety implications of D & X were not part of the record in this case, were not a basis for the passage of the Michigan statute, and were made by the legislative body of an entirely separate sovereign, suggesting the possibility that they could be of diminished relevance here. 48 The most straightforward implication of Gonzales in this context might be its statement that facial challenges are not the preferred mechanism for challenges pertaining to health exceptions to prohibitions on the D & X procedure, suggesting that such a challenge should not be entertained here. Even so, it is not apparent how and whether Gonzales diminishes the rule requiring an exception to protect the woman's life that does not impose upon her an increased medical risk. See Thornburgh, 476 U.S. at 769, 106 S.Ct. 2169 (prohibiting a `trade-off' between the woman's health and additional percentage points of fetal survival.') (citing Colautti v. Franklin, 439 U.S. 379, 397-401, 99 S.Ct. 675, 58 L.Ed.2d 596 (1979)). The federal statute contains an apparently adequate life exception that allows D & X where necessary to save the life of the woman, which went unchallenged in Gonzales. See 18 U.S.C. § 1531(a) (This subsection does not apply to a partial-birth abortion that is necessary to save the life of a mother . . .). This suggests that the Supreme Court's precedent pertaining to the life exception remains unchanged. 49 For purposes of resolving the instant case, we can affirm the district court's decision without addressing the complicated implications of Gonzales for the life and health exceptions of the Michigan statute. The bottom line is that the life and health exceptions are exceptions to an unconstitutional and un-fixable general prohibition on certain abortion procedures. That is to say it is unnecessary for us to address exceptions to an unconstitutional and unenforceable general rule. Because we find the general prohibition to be unconstitutional, and we are unable and unsuited to rewriting a prohibition on the D & X procedure alone, there is little to gain by an attempt to resolve this issue.