Texas Medical Board clarifies abortion exceptions

The Texas Medical Board unanimously approved guidelines for how doctors should interpret exceptions to the state's abortion ban.

This comes after feedback from hundreds of citizens, doctors, and professional associations after a proposed draft in March. 

Changes include adding the definition of ectopic pregnancy, which doctors are able to treat. The guidance also says doctors don't need to wait until threat to life or imminent harm to treat someone. 

"We added in language around imminence because there were concerns that language not being in there, even though it was in a Supreme Court ruling, would make it more confusing around issues around imminence," Dr. Sherif Zaafran, president of the Texas Medical Board, said.

Last month, the Texas Supreme Court said exceptions to the abortion ban as written are broad enough that doctors would be misinterpreting if they didn't perform an abortion when a mother's health is in danger. This came after a group of women, who had serious pregnancy complications, filed a lawsuit in March 2023 hoping to get more clarity on when an exception to the abortion ban is allowed. 

The new guidance does not include a list of conditions that would allow for an abortion.

"The idea of listing conditions that would fall under the statute is essentially, I think, actually, restrictive because there are circumstances where in one instance it may be appropriate, but in a different circumstance, the same condition may not be appropriate. The other concern is, is that if you don't list a certain condition, which again may be appropriate, but if it's not listed there, there may be concerns by physicians that virtue of it not being listed, that it may not be appropriate, which may not be the case," Zaafran said. "The exceptions are black and white. Medical judgment around whether an exception is met or not is gray. That's where the medical board and medical judgment really comes into factor from that standpoint."

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Doctors do have to provide medical documentation within seven days explaining why an abortion had to be performed.

In the original draft, doctors would've had to document if they tried to transfer a patient to another provider to avoid abortion. The new rules removed that provision.

The Board says they can't change legal definitions. That would have to come from the legislature. 

"I cannot take away the hesitation of physicians and the anxiety of physicians to act appropriately when these cases come before them. They need to act like they would in any other case within the confines of the law. They need to make sure that the patient is safe. They need to make sure that if there's imminent potential harm, that they take care of that in a timely fashion. We are trying to put out as much information as we can to help allay anxiety and fear, but they still have to try to work through the process as best as possible."

The guidance also says if there's a complaint against a doctor, an investigation by the Board would be separate from a criminal or civil case.