Texas doctors 'really scared' amid vague abortion laws. Will state board clarify exceptions?

Palmer, the Fort Worth OB-GYN, would like “clear-cut guidance” on situations when abortions are permitted. She’d like to see the medical board put out exceptions for rape, incest and non-viable fetuses.

“I would love for them to say that there would not be a limitation on being able to intervene when we know a fetus is not going to be compatible with life outside of pregnancy,” she said.

There are situations that are “black and white,” like when a baby is forming without a brain, Palmer said. But there’s also a lot of gray area, for example when talking about conditions like trisomy 18 and trisomy 13, or abdominal wall defects.

“There’s just so many specific circumstances,” Palmer said. “I just really feel like it’s going to be hard to legislate exceptions. But I think there are a handful of places where they could start that would provide precedence and some guidance for physicians and for patients.”

Dr. Shanna Combs, a Fort Worth OBGYN and past president of the Tarrant County Medical Society, said any clarifications should use medical terminology, not terms created for legal purposes. But ultimately, every situation is different and no list of exceptions will ever be complete, she said.

“In theory it sounds nice to have more concrete language, but unfortunately, there’s still so much gray and every situation is different, that I’m not sure how much it would change,” she said. “And then also, the concern that we have is, you can’t make language for every particular situation. Even if you thought of everything under the sun, there’s probably something you didn’t think about.”

Combs also questioned the level of comfort that clarified rules would give doctors.

“Even if the Texas Medical Board says, ‘Oh OK, that’s OK.’ Well, that’s the Texas Medical Board,” Combs said. “What can they do? So they handle our license, so maybe they wouldn’t take our license away, but is that going to stop a prosecutor from pursuing criminal charges? And then also, we still have the civil possibility as well.”

Combs suspects the board will ultimately defer to the Legislature for clarifications.

The Bresnens’ proposed rules outline what is considered “reasonable medical judgment” and lists some of the medical conditions that would be covered by an exception to abortion law.

In a response letter, the board’s general counsel said rule-making options have been under consideration since the law went into effect, and “alternate draft language” will be considered at the March 22 board meeting.

A spokesperson for the board said questions about the process for adopting rules will be addressed Friday. A public comment period of at least 30 days is expected before a rule is adopted.

Brent Annear, a spokesperson for the Texas Medical Association, wrote in an email exchange that the association believes patients and physicians need clarity. The association will offer feedback at the appropriate time during the rule-making process, he said.

Ultimately, Palmer wants common-sense guidelines and exceptions.

“The comment period is obviously going to bring some passionate and heated arguments from both sides of the table, but I’m just hoping that science and medicine prevail, and that we will be able to start doing the right thing for our patients in so many of these situations,” Palmer said.

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