A Matter of Urgency: Advocating for Clearer Guidelines in Texas' “Medical Abortion Exceptions”

After months of outcry over the ambiguity surrounding "medical abortion exceptions" under Texas' extreme abortion bans, the Texas Medical Board finally released new guidance on the state's "medical emergency" exception. However, the guidance fell disappointingly short of providing the clarity Texans desperately need. The guidance fails to lay out clear definitions and qualifying conditions for what constitutes a "medical emergency,” leaving health care providers and pregnant individuals in a state of uncertainty. Without a clear roadmap, Texas' "medical abortion exceptions" are hollow and meaningless, failing to issue the necessary reassurance for those in urgent need of care.

The urgency of this issue cannot be overstated. Out of fear of legal repercussions, doctors are refusing to perform life-saving abortions in emergencies, putting pregnant people’s lives at risk. It's a situation that demands action.

Before the Texas Medical Board finalizes its decision, our voice can make a significant impact. Take a stand by submitting your comments on the Texas Medical Board website, urging for clarity on medical abortion exceptions and advocating for the protection of both doctors and pregnant individuals. Below, we've outlined step-by-step instructions for submitting comments to the Texas Medical Board, along with talking points to help you voice your concerns. Let's join forces to protect reproductive rights and safeguard Texans’ lives.

How To Submit A Comment to the Texas Medical Board: 

You’ll have to submit separate comments for each of the three rule chapters (165.7, 165.8, and 165.9). Follow the instructions below and use the Talking Points to inform your comments. The comment period ends June 1st, 2024. 

1. Go to the Texas Medical Board comment submission page.
2. Click “Start Now” and follow the instructions in the form.
3. When asked “Position on this rule”, select “Opposed”.
4. When asked, “Do you want to provide additional comment?” select “Yes”.
5. Write your comment for Chapter 165.7 using the Talking Points below for reference. 
6. Repeat steps 4-5 for commenting on Chapters 165.8 and 165.9. 
7. When asked, “Do you have any other comments?”, select “Yes” and write additional comments (this is where you can submit more personalized or general comments about the rule), or select “No” and click “Next”. 
8. Click “Submit”.

Talking Points

Topline: Ensuring clarity and protection for doctors providing emergency abortions in Texas is crucial to safeguarding the health and safety of pregnant individuals.

Bottom Line: The Texas Medical Board must take immediate action to address the lack of clarity surrounding the medical emergency exception. Failure to do so will exacerbate the reproductive health care crisis in the state and put pregnant individuals at greater risk.

Chapter 165.7

• Clarifying Definitions: Key terms such as "serious risk" and "substantial impairment" need to be clearly defined as used in Chapter 171 of the Texas Health and Safety Code.
• Incorporating Judicial Interpretations: The guidance must Include already-established judicial interpretations to help doctors make informed decisions when providing emergency care. For example, recent Texas Supreme Court rulings regarding the definition of "medical emergency" should be incorporated to ensure accurate understanding and application by doctors. 
  • According to the Texas Supreme Court, the imminent death of the patient is not required for doctors to perform an abortion. It is essential to include this information in the guidance for doctors to understand they are protected and do not need to wait until a patient is about to die before they can perform a life-saving abortion. 
  • The guidance should also include the Texas Supreme Court’s explanation of “reasonable medical judgment” in an emergency, which states doctors do not need to wait for consultation with other doctors, and “reasonable medical judgment” does not mean all doctors would reach the same conclusion on how to treat a patient. 

Chapter 165.8

• Reducing Administrative Burden: Section 165.8(b) imposes excessive documentation burdens on doctors who provide “medical emergency” abortions. These requirements hinder standard medical care and complicate and delay critical care for pregnant individuals.

Chapter 165.9

• Concerns Regarding Complaint Evaluation: Section 165.9 is unclear on how the Medical Board will evaluate doctors' “reasonable medical judgment” during emergencies. Clear guidelines are necessary to ensure consistent and equitable assessment of complaints.

Additional Points: 

• Reproductive Health Care Crisis: Since the implementation of S.B. 8 and the fall of Roe v. Wade, Texans have faced significant barriers to accessing abortion care, exacerbating the reproductive health care crisis and putting pregnant people's lives at risk. Urgent action from the Medical Board is needed to address this crisis.
• Advocating for Changes: We urge the Texas Medical Board to revise these rules by incorporating relevant case law, eliminating excessive documentation requirements, and providing clear guidance on evaluating doctors' medical judgment. These changes are crucial to addressing the reproductive health care crisis and safeguarding the rights and health of pregnant Texans.