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Judge: Iowa medical board can halt telemedicine abortions [The Gazette, Cedar Rapids, Iowa :: ]
[August 20, 2014]

Judge: Iowa medical board can halt telemedicine abortions [The Gazette, Cedar Rapids, Iowa :: ]

(Gazette (Cedar Rapids, IA) Via Acquire Media NewsEdge) Aug. 19--DES MOINES -- State medical regulators had the authority last year to adopt rules curtailing doctors' ability to dispense abortion-inducing pills via a video-conferencing system, an Iowa district judge has ruled.

The 40-page ruling by Polk County District Judge Jeffrey Farrell is a victory for pro-life advocates who sought to halt a first-in-the-nation telemedicine practice at clinics operated by Planned Parenthood of the Heartland. Planned Parenthood officials said Tuesday they plan to appeal the decision.

The Iowa Board of Medicine voted 8-2 a year ago to approve an administrative rule that would establish standards of practice for physicians who prescribe and administer abortion-inducing drugs. Board members cited concerns over the medical care being provided to rural women as a reason to require in-person meetings between doctors and patients along with direct after-care services.

"The crux of the board's decision to adopt the rule is that an in-person physical examination should be done before prescribing abortion-inducing drugs. There are legitimate reasons to support the board's decision," the judge wrote in Monday's ruling.

Farrell said the Iowa Code gives the state board considerable authority to set the standards of practice for the medical profession. "Those standards include the authority to adopt and enforce standards regarding the minimal standards of acceptable and prevailing practice," the judge noted.

The rules were to take effect last Nov. 6, but a district judge granted Planned Parenthood's request for a temporary stay that blocked the rule's implementation pending this week's outcome. Under Farrell's ruling, the Board of Medicine's rule would take effect in 30 days, but a Planned Parenthood spokeswoman said her agency planned an appeal to "block enforcement of a rule that ends abortion access" in rural and medically underserved areas.

"The board is pleased the district court has affirmed the board's authority and the legal process that was used to adopt this rule, which protect the health and safety of Iowans," said Mark Bowden, executive director for the Iowa Board of Medicine.

"The board carefully studied the issue and provided ample opportunity for public comment before adopting the rule," he added. "The board considers a thorough medical history and physical examination to be the cornerstone of good medical care. The rule requires this valid physician-patient relationship prior to prescribing abortion-inducing drugs, and the rule requires an appropriate follow-up appointment to confirm the termination of the pregnancy and to evaluate the woman's medical condition." Jenifer Bowen, executive director of Iowa Right to Life, said her organization welcomed the district court ruling "in favor of the Iowa Board of Medicine's decision to ban the dangerous practice of webcam abortion" in Iowa.

Abortion opponents asked the state board to block the program, saying it violates state medical standards and poses a health risk to women because it doesn't entail a face-to-face meeting with the doctor.

"Iowa Right to Life first sounded the alarm on webcam abortion in 2008," Bowen said in a statement. "Over the last six years, we have worked tirelessly to educate Iowans about this dangerous practice that risks the health of women all over Iowa.

"While the plaintiffs have vowed to appeal this common-sense decision, we know having reviewed the Iowa Board of Medicine's rationale behind the rule at question in the case and after hearing from women who have suffered complications and negative effects of the procedure, a ban on the practice was the only logical outcome in this case," she added.

Penny Dickey, chief operating officer of Planned Parenthood of the Heartland, called the ruling "incredibly disappointing" in affirming a ban on "tele-health delivery of medication abortion" that has been demonstrated "to be just as safe and effective" as in-person protocols used at her agency's clinics.

"Planned Parenthood of the Heartland will continue to provide the full range of reproductive health services at our health centers, while this dangerous rule remains blocked by the courts," Dickey said in a statement.

"While the Board of Medicine claims it is acting to protect women's safety and health, its true purpose is to prevent women from receiving an abortion if and when they need one. And the rule would actually jeopardize women's health by delaying their care," she added. "Planned Parenthood of the Heartland will continue to fight for evidence-based medicine and a woman's right to make her personal health care decisions." The situation in Iowa is part of "a dangerous trend," said Cecile Richards, president of Planned Parenthood Federation of America. "Using any means necessary, politicians are imposing restrictions on abortion that will take safe and legal abortion away from women living in parts of the country where access to health care is already very limited." At issue is a practice whereby licensed physicians use a remote-controlled system to conduct medical assessments with patients in rural Iowa clinics. They then are able to dispense Mifepristone, also known as RU-486, in the early stages of a pregnancy.

Proponents say Planned Parenthood's practice -- implemented in 2008 -- is safe and patients get the same level of care as those who see a doctor in person. They also contended the telemedicine procedure was thoroughly researched to ensure it was in full compliance with Iowa law and service helps women in remote parts of the state.

But board member Monsignor Frank Bognanno of Des Moines expressed concern before last August's vote that abortion-related services were being provided without adequate guidelines and administered by medical assistants with minimal training.

During the 2014 legislative session, the Republican-controlled Iowa House voted 55-42 to approve a measure that would have banned the practice of doctors prescribing abortion-inducing drugs from remote locations using a two-way video link. Under House File 2175, doctors could have been fined and had their licenses suspended, but the Iowa Senate led by majority Democrats did not consider the measure.

___ (c)2014 The Gazette (Cedar Rapids, Iowa) Visit The Gazette (Cedar Rapids, Iowa) at Distributed by MCT Information Services

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