The exception to abortion bans which allows doctors to save mothers’ lives took center stage during the first presidential debate. The most striking statement about it was not during the argument, however. It was the subject of a TV advertisement from the Biden campaign which aired during a break. The commercial featured a Louisiana woman who says that doctors refused to provide her care after her miscarriage because of the state’s abortion ban. But is it true?
All states with an abortion ban, including Kentucky, have a provision which clarifies the freedom of doctors to save the life of a pregnant mother. Unfortunately, many pro-choice doctors and advocates have claimed that these exceptions are too narrow and unclear, forcing them to withhold life-saving care.
In recent weeks, national media coverage has focused on the Supreme Court in the state of Texas, which recently upheld the current medical exemption. In Zurawski v. State of Texas, a group of women claimed that doctors are confused by the existing exceptions. According to the women, doctors felt that they had to withhold essential treatment out of a fear of being prosecuted.
The Wall Street Journal’s major article on the story highlighted the essential fact of the case: the doctors’ argument that these exceptions are unclear is simply wrong. As Texas Supreme Court Justice Jane Bland said in her opinion: “A physician who tells a patient, ‘Your life is threatened by a complication that has arisen during your pregnancy, and you may die, or there is a serious risk you will suffer substantial physical impairment unless an abortion is performed,’ and in the same breath states ‘but the law won’t allow me to provide an abortion in these circumstances’ is simply wrong in that legal assessment.” Failure to provide life-saving medical care for pregnant women when the law allows it lies with doctors who’ve politicized the issue, not with lawmakers who’ve made life-saving exceptions abundantly clear.
Texas law defines an emergency: “a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy that, as certified by a physician, places the woman in danger of death or a serious risk of substantial impairment of a major bodily function unless an abortion is performed.” (Tex. Health and Safety Code § 171.002).
If doctors are ignorant of clearly written state law, that is no excuse for withholding care of life-threatening conditions and trying to upend the whole abortion ban. Medical professionals have the responsibility to determine what does and does not constitute a life-threatening condition. And their ethical training should teach them to evaluate based on the principle of “double effect:” their positive actions are to save life. Unlike abortion, they do not intend and directly cause the death of the unborn child.
Kentucky law is clear on what constitutes a medical emergency for a pregnant woman: “A medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, that a prudent layperson would reasonably have cause to believe constitutes a condition that the absence of immediate medical attention could reasonably be expected to result in: 1. Placing the health of the individual or, with respect to a pregnant woman, the health of the woman or her unborn child, in serious jeopardy; 2. Serious impairment to bodily functions; or 3. Serious dysfunction of any bodily organ or part” (KRS 304.17A-500).
The ancient Hippocratic Oath says that it is the responsibility of doctors to “first do no harm.” Christian ethics recognizes the principle of “double effect.” In rare and difficult situations, a doctor may need to act to save the life of the mother. But this never requires actively causing the death of the unborn child (though it may be an unintended effect).
Kentucky law recognizes the life-saving work that doctors do to protect pregnant women who have what’s called an ectopic pregnancy. An unborn child is never an imposition to that work. In tragic occasions which are very rare (about 1-2% of pregnancies), the actions to save a life may indirectly result in another life being lost. That’s a legal protection for women with life-threatening pregnancies in every state in America, and it’s not an abortion.
Kentucky’s abortion statutes go on to clarify that these circumstances are specially exempt. Any doctor who performs such a lifesaving procedure must then file a report with the state explaining his decision (KRS 311.723). It’s good policy to leave such life-saving medical judgment to doctors and require documentation when an unborn life unfortunately ended.
Pro-choice advocates may hope to convince pro-life Americans of a supposed lack of clarity. But the goal of the pro-choice side is not and has never been moderate allowances for extreme circumstances. As was seen in the 2022 battle over Amendment 2 in Kentucky, opponents lied and stoked fear, insisting that a pro-life Kentucky would ban doctors from giving essential medical care to women. This was blatantly false. Pro-choice logic leads not to compassion but to abortion on demand for any reason up to birth.
It’s clear that in both Texas and Kentucky, existing law protects unborn life and acknowledges tragic medical difficulties when doctors must act—not to end a life but to save it. Pro-life Kentuckians may be faced with this deceptive pro-choice argument if it is presented to our own state Supreme Court. A clear reading of Kentucky’s statute should direct our justices to the same conclusion as Texas’.