Judge says AMA is right: Title X gag rule violates medical ethics
“This is madness,” wrote U.S. District Judge Michael McShane in Portland, Oregon, in a scathing rebuke of the Trump administration’s new Title X regulations that includes a gag rule dictating what physicians must and must not say to their patients in the Title X program about family planning.
“The gag rule prevents doctors from behaving like informed professionals,” McShane wrote. “At the heart of this rule is the arrogant assumption that government is better suited to direct the health care of women than their medical providers.”
McShane’s ruling detailed how the regulations would violate the AMA Code of Medical Ethics, damage public health and state economies with it, and violate provisions of the Affordable Care Act and Administrative Procedure Act without explaining what problem the new regulations seek to address.
The Oregon lawsuit (PDF) was led by the AMA, Planned Parenthood and its local affiliates, and the Oregon Medical Association, but the case was consolidated with another lawsuit and the ruling covers the plaintiffs in both cases. That includes 20 states, the District of Columbia and individual health professionals.
McShane said a nationwide ban was appropriate because Planned Parenthood operates in 48 states, AMA members reside in all 50 states, AMA members provide counseling to pregnant women served by the Title X program, and that there was “ample evidence” of potential harm to public health across the nation.
North Dakota Supreme Court upholds state’s cap on noneconomic damages
On May 29, 2012, Chenille Condon gave birth to a child at St. Alexius Medical Center.After birth, she experienced complications that required follow up surgery. During the procedure an injury occurred which caused bleeding and ultimately lead to Condon suffering from a stroke. Condon filed a medical malpractice claim against the physician and medical center and the jury returned a verdict finding negligence and awarding Condon $265,000 in past economic loss, $ 1.735-million in future economic loss, $150,000 in past noneconomic loss and $1.350-million in future noneconomic loss.
Dr. Booth sought a reduction of noneconomic damages under N.D.C.C. § 32-42-02, and a reduction of the past economic damages pursuant to the collateral-source rule, which allows expenses to be reduced if they were paid by a third-party (e.g. an insurance policy). Condon opposed the reductions and challenged the constitutionality of the statute. The district court granted Dr. Booth’s motion with regard to the collateral-source reduction, but found that N.D.C.C. § 32-42-02 was unconstitutional on equal protection grounds.
On April 22, 2019 the North Dakota Supreme Court reversed the lower court decision, finding that N.D.C.C. § 33-42-02 does not violate the Equal Protection Clause because there is a sufficiently “close correspondence between the damage cap at issue in this case and legitimate legislative goals to satisfy the intermediate level of scrutiny” under the North Dakota Constitution.
An AMA Litigation Center brief was successful in raising the important role that N.D.C.C. § 33-42-02 plays in making affordable professional liability insurance available for North Dakota health care providers while also curbing the impact that such cost increases would have on the affordability and availability of health care for North Dakotans. The brief also empirically demonstrated that “states that limit noneconomic damages generally experience increases in physician supply per capita compared to states without caps.”
