By Dr. Kate Eby
HB303, presented by its proponents as a bill to provide protections to medical practitioners, healthcare institutions, and healthcare payers based on their conscience, presents a real and imminent danger to the health and wellbeing of Montanans. This bill doesn’t just provide for all of these entities to refuse to participate in certain crucial aspects of medical care (with its primary focus being abortion). It also requires that those who are willing to provide these services provide affirmative consent, in writing, prior to being requested or assigned to participate in these services in any way.
This bill is dangerous on many levels. First, and perhaps most obviously, it limits the care available to Montanans. The American College of Obstetrics and Gynecology describes abortion as “an essential component of comprehensive, evidence-based health care.” This bill represents another step to limit access to this critical aspect of healthcare. Abortion is healthcare and should be treated as any other aspect of healthcare would be. Allowing healthcare entities to refuse to provide this service has serious, and potentially fatal, consequences.
In a case cited by the Department of Health and Human Services (HHS) which, under the Trump administration, passed a rule similar to the one currently being considered, abortion services were denied to a patient carrying a nonviable pregnancy. The patient, Tamesha Means, presented to the only hospital within 30 minutes of her – a Catholic hospital. She was 18 weeks pregnant and went into early labor. She was not advised that her pregnancy was likely nonviable, nor was she offered the (medically appropriate) treatment option of terminating her pregnancy. Instead, she was discharged home with pain medication and told to keep her scheduled followup appointment the next week. She returned to the hospital the following morning with a fever and severe pain. Despite her treating physician’s suspicion that she had a severe infection which could result in her infertility or death, she was again discharged home. She returned to the same hospital for the third time that night with severe, painful contractions, and as the hospital was preparing to discharge her home for the third time, she delivered a baby that lived only for a few short hours. Several years later, she sued the Conference of Catholic Bishops, something that the HHS described as an attempt to coerce organizations into performing abortions against their will.
As a healthcare worker with a lifetime of experience providing care to patients facing emergent and acute illnesses, I can say with confidence that the care she received was substandard by any definition. A patient presented with a severe, life-threatening emergent medical problem – a problem which has a clear and appropriate course of treatment: termination of the pregnancy. However, the organization and its employees, based on religious beliefs, failed to provide her with appropriate care. They endangered her life and wellbeing. HB 303 would allow organizations and healthcare providers in Montana to not only refuse to provide this type of medically appropriate care, it would also allow them to refuse to refer the patient to other sources for this care. In a state with already limited resources, this further narrows the options that patients are given to receive the most appropriate care.
The Lancet, among the oldest and most respected journals in the medical community, put it best when they said, “The Justices who vote to strike down Roe will not succeed in ending abortion, they will only succeed in ending safe abortion. Alito and his supporters will have women’s blood on their hands.” HB303 represents yet another insidious attempt to rob women of reproductive rights and access to safe, evidence-based, medically appropriate healthcare.
Dr. Kate Eby is a dually certified Family and Adult Geriatric Acute Care Nurse Practitioner. She received her masters degree from MSU-Bozeman and completed her doctorate and post-doctoral studies at the University of Colorado. She has practiced in a variety of acute care and inpatient settings. She is also a Certified Nurse Educator through the National League for Nursing, and teaches at the undergraduate and graduate levels.
American College of Obstetrics and Gynecology. (2022). Abortion Policy. https://www.acog.org/clinical-information/policy-and-position-statements/statements-of-policy/2022/abortion-policy.
Means vs. United States Conference of Catholic Bishops. (2016). https://law.justia.com/cases/federal/appellate-courts/ca6/15-1779/15-1779-2016-09-08.html
The Lancet. (2022). Why Roe v. Wade must be defended. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00870-4/fulltext