Opinion ID: 1309503
Heading Depth: 2
Heading Rank: 3

Heading: Medical Necessity Defense

Text: In a third argument, the defendant contends that the indictment is defective because it does not attempt to negate the exception ... of a medical necessity to treat the patient. This omission, the defendant says, shifts the burden of proving the exception to him in violation of the Supreme Court's ruling in United States v. Vuitch, 402 U.S. 62, 91 S.Ct. 1294, 28 L.Ed.2d 601 (1971). There, the accused was charged with violation of a statute in which the enacting clause proscribed abortion unless the same were done as necessary for the preservation of the mother's life or health. Id. at 67-68, 91 S.Ct. at 1297-1298. The Court stated and then applied the rule that when an exception is incorporated in the enacting clause of a statute, the burden is on the prosecution to plead and prove that the defendant is not within the exception. Id. at 70, 91 S.Ct. at 1298. But when, as here, the exception is made in a substantive clause subsequent to the enacting clause of the statute, ... we hold it to be a matter of defense for the defendant to assert and not for the indictment to deny. Russo v. Commonwealth, 207 Va. 251, 259, 148 S.E.2d 820, 826 (1966), cert. denied, 386 U.S. 909 (1967). The rule in Russo is not inconsistent with that in Vuitch. Once a defendant invokes § 18.2-74.1 as a defense, the Commonwealth has the burden of negating maternal health necessity beyond a reasonable doubt. In a related argument, the defendant says that he raised the defense in his testimony and that the Commonwealth's evidence was insufficient to establish the absence of necessity. The defendant testified that his patient appeared upset and depressed when he examined her and that he became concerned about the possibility of suicide. But his patient, who acknowledged that her principal concern was to abort without her parents' knowledge, testified that she was [s]cared, but nothing else. Furthermore, the defendant's handwritten notes in the clinic's records described P. M.'s condition as normal and showed that the saline procedure was performed without any complications. We find such evidence fully sufficient to refute any claim of maternal health necessity.