Iowa Supreme Court allows telemed-abortion system to continue
The Iowa Supreme Court decided Tuesday to let Planned Parenthood of the Heartland continue using its controversial video-conferencing method for dispensing abortion pills – for the time being.
The justices granted a last-minute stay of the Iowa Board of Medicine's 2013 decision to effectively ban use of the system. If the court had not granted the stay, Planned Parenthood would have had to stop using the system today while the justices considered its appeal in the case.
Planned Parenthood is appealing a Polk County district judge's ruling that would effectively shut down the system, which is the first of its kind in the nation.
Judge Jeffrey Farrell last month upheld a 2013 decision by the Iowa Board of Medicine, which declared that Planned Parenthood doctors' use of the system to dispense abortion pills was unsafe. Farrell wrote that his Aug. 18 ruling would take effect in 30 days unless he or the Supreme Court ordered another stay.
Planned Parenthood doctors in Des Moines and Iowa City use the videoconferencing system to interact with patients in outlying clinics, then to dispense pills that cause early-term abortions. More than 6,400 abortions have been provided this way since 2008. Supporters say efforts to shut down the system are a blatant attempt to limit rural women's access to a safe and legal method of abortion.
The medical-board rules would require doctors to see patients in person and perform physical examinations before dispensing abortion medications. It also would require them to do in-person follow-up visits.
The Supreme Court still could agree with Farrell and the medical board that Planned Parenthood's telemedicine system is improper. But the court's ruling Tuesday allows Planned Parenthood to continue using the system while the justices review the matter.
Suzanna de Baca, Planned Parenthood of the Heartland's new president, praised the Supreme Court's ruling. "A woman has a constitutional right to access to a safe, trusted abortion provider, no matter what ZIP code she lives in," de Baca wrote in an email to the Register "As our fight for Iowa women continues, we're pleased that the court has upheld this right and we're proud to continue to provide the same exceptional care that we always have, no matter what."
Jenifer Bowen, executive director of Iowa Right to Life, expressed frustration that the Supreme Court had issued a stay. "The people of Iowa have shown overwhelming bipartisan support for eliminating Planned Parenthood of the Heartland's webcam abortions," wrote Bowen, who leads Iowa's largest anti-abortion group. "There are many wonderful uses of telemedicine, but denying a woman an exam by a trained medical professional and sending her home to hemorrhage alone for up to four weeks is not one of them."
Mark Bowden, the medical board's executive director, also expressed disappointment in the Supreme Court's ruling. "The extension of the stay perpetuates what the board believes is inadequate health care and treatment for Iowans who seek medical abortions," he wrote.
Planned Parenthood argues that its system is similar to video-conferencing arrangements used to provide other types of health care, such as psychiatry. Its lawyers have contended that Gov. Terry Branstad stacked the medical board with abortion opponents in order to shut down the system. "If this court does not grant a stay, the rule will make it impossible for petitioners to provide abortion services at seven out of nine clinics where they currently provide them – over 70 percent of currently available sites," the lawyers wrote. "To receive care, women will have to travel up to more than 500 miles round trip, multiple times, to Des Moines or Iowa City, the only two cities with clinics where a physician is physically present."
Branstad, a Republican who opposes abortion, has denied doing anything improper. He has praised the medical board's ruling in the matter.
In papers filed with the court, medical-board lawyers noted that state law says only physicians may provide abortions. The board said providing abortion pills falls under that requirement.
"Abortion-inducing drugs are not over the counter medications," the state lawyers wrote. "Unless and until such a time when abortion-inducing drugs are no longer required to be dispensed by physicians, physicians must do so within the confines of the standard of care. The Board of Medicine determined the standard of care requires a physical examination prior to dispensing abortion-inducing drugs."
The board lawyers wrote that they have seen no evidence that any other U.S. doctors have used telemedicine to provide abortion pills without doing a physical exam.
The dispute is being watched nationally. Abortion opponents have hailed the medical board's decision, and legislators in 15 other states have pre-emptively banned such systems from being set up.
The Iowa Medical Society, which is the state's largest physicians' group, has criticized the way the medical board made its decision on the issue. The American College of Obstetricians and Gynecologists also is backing Planned Parenthood's side. In a brief filed with the Iowa Supreme Court, the national group said forcing Planned Parenthood to stop using the telemedicine system, "would result in immediate and significant harm to Iowa women's health, dramatically curtailing their access to safe healthcare and unnecessarily exposing them to increased risk of serious clinical complications and other health risks."