Allison M. Whelan, J.D.
Senior Fellow, Center for Biotechnology & Global Health Policy, University of California, Irvine School of Law
On Wednesday, March 25, Arizona legislators passed a bill prohibiting women from buying insurance plans that cover abortions on the federal health exchange. Senate Bill 1318 also includes a provision on medical abortions, which are typically used during the first nine weeks of gestation. Medical abortions involve taking two pills within a few days of each other. The law requires doctors performing such abortions to tell their patients that if they reconsider their abortion after taking their first pill, they should return to the doctor for a procedure that can allegedly “reverse” the abortion. The law amends Arizona Statute § 36-2153 to add that at least twenty-four hours before an abortion is performed, the physician must orally and in person inform the woman that “it may be possible to reverse the effects of a medication abortion if the woman changes her mind but that time is of the essence.” The law also requires the Department of Health Services to update its website to include information about the potential ability to reverse a medical abortion. Republican Governor Doug Ducey, who opposes abortion rights, signed the law on March 30, 2015.
Like any law addressing abortion, the law is controversial. Abortion opponents lauded the bill, stating that Wednesday, March 25th was a “great day for women in Arizona who are considering getting an abortion to get all the facts they need.” On the other hand, women’s rights and health care providers’ groups oppose the coverage exclusion and vehemently oppose the abortion “reversal” provisions. Senate Minority Leader Katie Hobbs called it “junk science” and “quack medicine.” Arizona-based gynecologist Ilana Addis stated that there is no evidence to support this provision and women would essentially be “unknowing and unwilling guinea pigs.”
This law raises some serious questions about the democratic process, particularly as it relates to regulating the practice of medicine. Should there be a requirement that legislation addressing the provision and practice of health care have some basis in evidence? Should legislators be required to demonstrate a certain level of prior knowledge or research on a subject before making demands of health care providers? Should health care providers be required to inform their patients of “facts” they believe are not supported by evidence?
Although states have a clear and valid interest in regulating the practice of medicine to ensure it is performed safely and competently, laws such as this one come perilously close to the state itself practicing medicine. This law’s requirements are seemingly antithetical to informed consent by giving women misleading and potentially incorrect information. Requiring doctors to provide information to their patients that is neither supported by evidence nor the majority of medical professionals is problematic and potentially dangerous.