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Access to medical facilities

Hill v. Colorado, 530 U.S. 703 (2000)

Also under Abortions

Outcome:    Very favorable

Issue

The issue here was whether a Colorado statute prohibiting a non-consensual “knowing approach” of another person within 100 feet of a health care facility’s entrance was unconstitutional as a violation of the right to free speech.

AMA interest

The AMA supports the right of access to medical care and believes that health care providers have a fundamental right to freedom from violence.  The AMA opposes acts of intimidation that may impede physicians’ ability to care for their patients.

Case summary

In response to concern about aggressive anti-abortion protests outside facilities that performed abortions or provided abortion referrals, the Colorado legislature enacted a statute to restrict unwanted approaches toward those entering such facilities.  Anti-abortion activists challenged the constitutionality of the statute by suing to enjoin its enforcement.  The state trial court dismissed the complaint, holding that the statute imposed content-neutral time, place, and manner restrictions that were narrowly tailored to serve a significant government interest.  Both the state appellate court and the Colorado Supreme Court affirmed.

The case was then appealed to the United States Supreme Court, which also affirmed.  The Court held that the statute regulated place, not content, and properly protected listeners from unwanted communications.

AMA involvement

The AMA joined an amicus curiae brief with the American College of Obstetricians and Gynecologists to support the Colorado statute.

United States Supreme Court brief

McCullen v. Coakley, 189 L. Ed.2d 502 (2014)

Also under Abortions and Patient privacy

Outcome:    Very unfavorable

Issue

The issue in this case was whether a Massachusetts statute making it a crime to enter or remain on a public way or sidewalk within 35 feet of an entrance to an abortion clinic in order to “counsel” those having abortions is constitutional.

AMA interest

The AMA supports the right of access to medical care and opposes acts of intimidation that may impede physicians’ ability to care for their patients. Further, the AMA believes that physicians should protect patient privacy in all its forms, including the physical privacy of patients and respect for their personal space.

Case summary

The plaintiffs in this case were “pro-life” sidewalk counselors and demonstrators, who characterize themselves as “peaceful” and “non-confrontational.” They parked their cars near various abortion clinics in Massachusetts and attempted to persuade patients of the clinics not to have abortions. They festooned their cars with pro-life signage, carried placards and other signs, prayed aloud, sometimes with the assistance of loudspeakers, and occasionally wore evocative garments (such as a costume of the Grim Reaper). When possible, they would speak with prospective patients and hand out anti-abortion literature. The defendants were the Massachusetts Attorney General and various county prosecutors.

The plaintiffs are challenged a Massachusetts “buffer zone law,” which prohibits persons from encroaching within a specified distance of abortion facilities or the patients at those clinics. The plaintiffs contended that the Massachusetts law infringes their rights under the First and Fourteenth Amendments to the United States Constitution. Both the trial court and the United States Court of Appeals held the buffer zone law constitutional, but the plaintiffs appealed to the United States Supreme Court.

On June 26, 2014, the Supreme Court reversed, holding that the Massachusetts buffer law was insufficiently tailored to accommodate the free speech rights of the plaintiffs.

Litigation Center involvement

The Litigation Center joined the Massachusetts Medical Society and the American Congress of Obstetricians and Gynecologists in an amicus brief to the Supreme Court. The brief argued that the buffer zone law is reasonable and does not unduly infringe the plaintiffs’ constitutional right to communicate with the abortion facility patients.

United States Supreme Court brief

McGuire v. Reilly, 260 F.3d 36 (1st Cir. 2001)

Also under Abortions

Outcome:    Very favorable

Issue

The issue in this case was whether a Massachusetts statute intended to keep pro-life demonstrators at a reasonable distance from persons seeking to enter abortion clinics violated the demonstrators’ First Amendment rights.

AMA interest

The AMA supports the right of access to medical care and opposes violence and acts of intimidation directed against patients, physicians, other healthcare providers, and medical facilities, including abortion clinics.

Case summary

In response to concerns of violence, harassment, and intimidation outside medical facilities that perform abortions, Massachusetts enacted a statute which created a buffer zone to keep anti-abortion demonstrators at a reasonable distance from patrons seeking to enter abortion clinics.

The anti-abortion demonstrators challenged the constitutionality of the statute by seeking a preliminary injunction against its enforcement.  The district court granted the preliminary injunction and enjoined various Massachusetts government officials from enforcing the statute.  The defendants appealed to the First Circuit.

The First Circuit upheld the statute, reversing the low court decision.

AMA involvement

The AMA, the Massachusetts Medical Society, and the American College of Obstetricians and Gynecologists joined in an amicus brief supporting the Massachusetts statute.

Planned Parenthood of Greater Texas Surgical Health Services v. Abbott,

Also under Abortions

Outcome:    Very unfavorable

Issue

The issue in this case was whether a Texas law imposed an undue burden on the right to abortion because it (1) required physicians who perform abortions to have medical staff privileges at a hospital within 30 miles of where the abortions are performed and (2) limited drug-induced abortions to the protocol approved by the Food and Drug Administration.

AMA interest

The AMA supports (1) the right of access to medical care and (2) physicians’ right to practice ethical medicine, under which they should exercise their best medical judgment solely on behalf of their patients and without concern that such exercise will run afoul of non-medical, legal restrictions.

Case summary

Texas passed a law which required physicians who perform abortions to have medical staff privileges at a hospital within 30 miles of where the abortions are performed. In addition, the law limited drug-induced abortions to the protocol approved by the Food and Drug Administration for the abortifacient drug mifepristone.

The trial court held that the law was facially unconstitutional, because it unduly burdened the right to an abortion. It found it was unnecessary for maternal health to require medical staff privileges as a condition of performing abortions, and doing so would make it substantially more difficult for many women to obtain an abortion. It further found that the FDA protocol for mifepristone was in contravention of established medical practice and that following the protocol could endanger women’s health. Thus, it enjoined enforcement of the law.

The Fifth Circuit found that the law had a rational purpose to protect women’s health. Furthermore, whatever burden the law imposed on the right to abortion was, for all but a small number of women, minimal. The court found the law facially constitutional except for a minor issue regarding the time it could become effective. It reversed the lower court injunction and the declaratory judgment.

AMA involvement

The AMA joined with the American College of Obstetricians and Gynecologists in an amicus brief supporting the lower court decision and opposing the Texas law.

United States Court of Appeals for the Fifth Circuit brief

Whole Women’s Health v. Lakey (5th Cir.)

Also under Abortions

Issue

The issue in this case is whether a Texas law, which requires that physicians who perform abortions obtain admitting privileges at local hospitals and that every health care facility offering abortion services meet the same building specifications as ambulatory surgical centers (“ASCs”), is constitutional.

AMA interest

The AMA opposes laws regulating medical care that are unsupported by scientific evidence and that impede, rather than serve, public health objectives. Further, the AMA believes physicians should provide medical care according to their best medical judgment, according to accepted medical standards and their patients’ informed consent.

Case summary

Five Texas clinics, three physicians, and their patients challenged the ASC requirement statewide and the admitting privileges requirement as applied to abortion clinics in two rural areas of the state, where women face the greatest obstacles in accessing abortion care. The trial court held the law constitutionally invalid as an unreasonable restraint on women’s right to have an abortion, and it enjoined enforcement of the Texas law.

The Fifth Circuit stayed enforcement of the trial court injunction, pending full resolution of the appeal. It found, with a minor exception, that law would probably be sustained as a reasonable regulation of medical care.

The plaintiffs appealed to the Supreme Court for review of the Fifth Circuit stay order. The Supreme Court (with three justices dissenting) vacated the stay in part and let the stay order stand in part. The Supreme Court did not provide a rational for its ruling.

AMA involvement

The AMA and the American Congress of Obstetricians and Gynecologists will file an amicus brief in the Fifth Circuit to support the plaintiffs and oppose the Texas legislation.