Will Women’s Medical Records End Up In the Hands of George Tiller’s Killer?

calluna

As jury selection in the trial of Scott Roeder for the murder of Dr. George Tiller grinds to a, Mrs Tiller faces a defense request that would put the names of her husband's Tiller's patients in the hands of his killer. 

As jury selection in the trial of Scott Roeder for the murder of Dr. George Tiller ground to a temporary halt after a Kansas judge decided that a jury might consider a charge of "voluntary manslaughter," the doctor’s widow went to court to try to quash a defense motion that would put the names of Tiller’s patients in the hands of his killer.  

Late last week, Roeder’s defense served Jeanne Tiller with a subpoena
demanding she produce "professional calendars, appointment books,
records of scheduled procedures, or similar document," for all
procedures scheduled at Tiller’s Wichita clinic between May 1st  and
June 31, 2009.

Roeder murdered Tiller on May 31, 2009.

In Kansas, "voluntary manslaughter" is defined as an "unreasonable but
honest belief that circumstances existed that justified deadly force"
during an intentional killing.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Clearly, in demanding these documents, Roeder’s defense wants to show that his client believed he
was saving the lives of perhaps dozens of unborn children when he
gunned the 67-year old doctor down in the foyer of the Reformation
Lutheran Church in Wichita.

In their motion, Mrs. Tiller’s lawyers argue that those records are held not by Mrs.
Tiller personally, but in a medical trust administered by the law firm,
as required by Kansas state law, so that former patients might access
them should they be needed in the future.

Releasing these
records would not only violate precedent, it would be a "failure to
provide adequate protections to the privacy of Dr. Tiller’s patients,
who sought or obtained constitutionally protected medical services.
Disclosure of patient names alone, let alone other identifying
information to the public, and most certainly to an avowed
anti-abortion terrorist, would constitute the most egregious violation
of their rights of privacy imaginable"

"There is no law or logic which places any rights of the defendant above those rights of privacy."

Foreshadowing arguments prosecutors are likely to make before Judge Warren Wilbert regarding a defense of "voluntary manslaughter," Mrs. Tiller’s
attorneys say in their filing that the records are "wholly irrelevant
to any material issue in the pending case." Roeder can’t argue
justification, "insamuch as the imperfect use of force codified" in
state law "requires that any act be in defense of a ‘person,’" and a
fetus is not defined as a person under that same state law.

Mark Rudy, Scott Roeder’s public defender, has been trying to gain access to
this information months, and has told a blogger for the Wichita Eagle
that “what we’re going to do now is turn our efforts to getting the
records from the medical trust."

Stay tuned…

 

Cross-posted from Open.Salon.com

Analysis Law and Policy

Justice Kennedy’s Silence Speaks Volumes About His Apparent Feelings on Women’s Autonomy

Imani Gandy

Justice Anthony Kennedy’s obsession with human dignity has become a hallmark of his jurisprudence—except where reproductive rights are concerned.

Last week’s decision in Whole Woman’s Health v. Hellerstedt was remarkable not just for what it did say—that two provisions in Texas’s omnibus anti-abortion law were unconstitutional—but for what it didn’t say, and who didn’t say it.

In the lead-up to the decision, many court watchers were deeply concerned that Justice Anthony Kennedy would side with the conservative wing of the court, and that his word about targeted restrictions of abortion providers would signal the death knell of reproductive rights. Although Kennedy came down on the winning side, his notable silence on the “dignity” of those affected by the law still speaks volumes about his apparent feelings on women’s autonomy. That’s because Kennedy’s obsession with human dignity, and where along the fault line of that human dignity various rights fall, has become a hallmark of his jurisprudence—except where reproductive rights are concerned.

His opinion on marriage equality in Obergefell v. Hodges, along with his prior opinions striking down sodomy laws in Lawrence v. Texas and the Defense of Marriage Act in United States v. Windsor, assured us that he recognizes the fundamental human rights and dignity of LGBTQ persons.

On the other hand, as my colleague Jessica Mason Pieklo noted, his concern in Schuette v. Coalition to Defend Affirmative Action about the dignity of the state, specifically the ballot initiative process, assured us that he is willing to sweep aside the dignity of those affected by Michigan’s affirmative action ban in favor of the “‘dignity’ of a ballot process steeped in racism.”

Meanwhile, in his majority opinion in June’s Fisher v. University of Texas, Kennedy upheld the constitutionality of the University of Texas’ affirmative action program, noting that it remained a challenge to this country’s education system “to reconcile the pursuit of diversity with the constitutional promise of equal treatment and dignity.”

It is apparent that where Kennedy is concerned, dignity is the alpha and the omega. But when it came to one of the most important reproductive rights cases in decades, he was silent.

This is not entirely surprising: For Kennedy, the dignity granted to pregnant women, as evidenced by his opinions in Planned Parenthood v. Casey and Gonzales v. Carhart, has been steeped in gender-normative claptrap about abortion being a unique choice that has grave consequences for women, abortion providers’ souls, and the dignity of the fetus. And in Whole Woman’s Health, when Kennedy was given another chance to demonstrate to us that he does recognize the dignity of women as women, he froze.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

He didn’t write the majority opinion. He didn’t write a concurring opinion. He permitted Justice Stephen Breyer to base the most important articulation of abortion rights in decades on data. There was not so much as a callback to Kennedy’s flowery articulation of dignity in Casey, where he wrote that “personal decisions relating to marriage, procreation, contraception, family relationships, child rearing, and education” are matters “involving the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy.” (While Casey was a plurality opinion, various Court historians have pointed out that Kennedy himself wrote the above-quoted language.)

Of course, that dignity outlined in Casey is grounded in gender paternalism: Abortion, Kennedy continued, “is an act fraught with consequences for others: for the woman who must live with the implications of her decision; for the persons who perform and assist in the procedures for the spouse, family, and society which must confront the knowledge that these procedures exist, procedures some deem nothing short of an act of violence against innocent human life; and, depending on one’s beliefs, for the life or potential life that is aborted.” Later, in Gonzales, Kennedy said that the Partial-Birth Abortion Ban “expresses respect for the dignity of human life,” with nothing about the dignity of the women affected by the ban.

And this time around, Kennedy’s silence in Whole Woman’s Health may have had to do with the facts of the case: Texas claimed that the provisions advanced public health and safety, and Whole Woman’s Health’s attorneys set about proving that claim to be false. Whole Woman’s Health was the sort of data-driven decision that did not strictly need excessive language about personal dignity and autonomy. As Breyer wrote, it was a simple matter of Texas advancing a reason for passing the restrictions without offering any proof: “We have found nothing in Texas’ record evidence that shows that, compared to prior law, the new law advanced Texas’ legitimate interest in protecting women’s health.”

In Justice Ruth Bader Ginsburg’s two-page concurrence, she succinctly put it, “Many medical procedures, including childbirth, are far more dangerous to patients, yet are not subject to ambulatory-surgical-center or hospital admitting-privileges requirements.”

“Targeted Regulation of Abortion Providers laws like H.B. 2 that ‘do little or nothing for health, but rather strew impediments to abortion,’ cannot survive judicial inspection,” she continued, hammering the point home.

So by silently signing on to the majority opinion, Kennedy may simply have been expressing that he wasn’t going to fall for the State of Texas’ efforts to undermine Casey’s undue burden standard through a mixture of half-truths about advancing public health and weak evidence supporting that claim.

Still, Kennedy had a perfect opportunity to complete the circle on his dignity jurisprudence and take it to its logical conclusion: that women, like everyone else, are individuals worthy of their own autonomy and rights. But he didn’t—whether due to his Catholic faith, a deep aversion to abortion in general, or because, as David S. Cohen aptly put it, “[i]n Justice Kennedy’s gendered world, a woman needs … state protection because a true mother—an ideal mother—would not kill her child.”

As I wrote last year in the wake of Kennedy’s majority opinion in Obergefell, “according to [Kennedy’s] perverse simulacrum of dignity, abortion rights usurp the dignity of motherhood (which is the only dignity that matters when it comes to women) insofar as it prevents women from fulfilling their rightful roles as mothers and caregivers. Women have an innate need to nurture, so the argument goes, and abortion undermines that right.”

This version of dignity fits neatly into Kennedy’s “gendered world.” But falls short when compared to jurists internationally,  who have pointed out that dignity plays a central role in reproductive rights jurisprudence.

In Casey itself, for example, retired Justice John Paul Stevens—who, perhaps not coincidentally, attended the announcement of the Whole Woman’s Health decision at the Supreme Court—wrote that whether or not to terminate a pregnancy is a “matter of conscience,” and that “[t]he authority to make such traumatic and yet empowering decisions is an element of basic human dignity.”

And in a 1988 landmark decision from the Supreme Court of Canada, Justice Bertha Wilson indicated in her concurring opinion that “respect for human dignity” was key to the discussion of access to abortion because “the right to make fundamental personal decision without interference from the state” was central to human dignity and any reading of the Canadian Charter of Rights and Freedoms 1982, which is essentially Canada’s Bill of Rights.

The case was R. v. Morgentaler, in which the Supreme Court of Canada found that a provision in the criminal code that required abortions to be performed only at an accredited hospital with the proper certification of approval from the hospital’s therapeutic abortion committee violated the Canadian Constitution. (Therapeutic abortion committees were almost always comprised of men who would decide whether an abortion fit within the exception to the criminal offense of performing an abortion.)

In other countries, too, “human dignity” has been a key component in discussion about abortion rights. The German Federal Constitutional Court explicitly recognized that access to abortion was required by “the human dignity of the pregnant woman, her… right to life and physical integrity, and her right of personality.” The Supreme Court of Brazil relied on the notion of human dignity to explain that requiring a person to carry an anencephalic fetus to term caused “violence to human dignity.” The Colombian Constitutional Court relied upon concerns about human dignity to strike down abortion prohibition in instances where the pregnancy is the result of rape, involves a nonviable fetus, or a threat to the woman’s life or health.

Certainly, abortion rights are still severely restricted in some of the above-mentioned countries, and elsewhere throughout the world. Nevertheless, there is strong national and international precedent for locating abortion rights in the square of human dignity.

And where else would they be located? If dignity is all about permitting people to make decisions of fundamental personal importance, and it turns out, as it did with Texas, that politicians have thrown “women’s health and safety” smoke pellets to obscure the true purpose of laws like HB 2—to ban abortion entirely—where’s the dignity in that?

Perhaps I’m being too grumpy. Perhaps I should just take the win—and it is an important win that will shape abortion rights for a generation—and shut my trap. But I want more from Kennedy. I want him to demonstrate that he’s not a hopelessly patriarchal figure who has icky feelings when it comes to abortion. I want him to recognize that some women have abortions and it’s not the worst decision they’ve ever made or the worst thing that ever happened to him. I want him to recognize that women are people who deserve dignity irrespective of their choices regarding whether and when to become a mother. And, ultimately, I want him to write about a woman’s right to choose using the same flowery language that he uses to discuss LGBTQ rights and the dignity of LGBTQ people.  He could have done so here.

Forcing the closure of clinics based on empty promises of advancing public health is an affront to the basic dignity of women. Not only do such lies—and they are lies, as evidenced by the myriad anti-choice Texan politicians who have come right out and said that passing HB 2 was about closing clinics and making abortion inaccessible—operate to deprive women of the dignity to choose whether to carry a pregnancy to term, they also presume that the American public is too stupid to truly grasp what’s going on.

And that is quintessentially undignified.

Analysis Law and Policy

What Monday’s Supreme Court Decision Means in the Fight for Abortion Rights

Jessica Mason Pieklo

Monday's decision striking two provisions of Texas' HB 2 doesn't just threaten similar laws nationwide; it could be the basis for finally stemming the onslaught of anti-science abortion restrictions in the states.

Read more of our coverage of Whole Woman’s Health v. Hellerstedt here.

Abortion rights advocates have insisted, since the beginning of the fight over targeted regulation of abortion providers (TRAP) laws, that despite anti-choice lawmakers’ claims to the contrary, the evidence proved these restrictions harmed rather than advanced patient safety. On Monday, the U.S. Supreme Court finally listened.

Monday’s decision in Whole Woman’s Health v. Hellerstedtwhich struck as unconstitutional Texas’ requirements in HB 2 that all doctors performing abortions in the state have admitting privileges at a nearby hospital and that all clinics meet the same requirements as stand-alone surgical centers—is not just a win for advocates and patients in Texas. It produced an opinion that has the potential to turn back the seemingly endless wave of restrictions from the states and to reinforce abortion as a fundamental right.

First things first. Whole Woman’s Health is a data-heavy opinion, and there is probably no better justice to pen one than Justice Stephen Breyer. The man seems to live for statistical analysis. He may offer up rambling hypotheticals during oral arguments, but his written opinions are more often than not grounded in data.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

The reason this matters is that both the conservatives on the Roberts Court and their supporters in the Fifth Circuit have tried their damnedest for years to sidestep piles and piles of facts. Such as the fact that in 2013, the year Gov. Rick Perry (R) signed HB 2 into law, the number of Texans who traveled out of state to have an abortion increased to 681, a jump Rewire reported as amounting to more than the previous four years combined. Conservatives also tried to explain away the fact that prior to the implementation of HB 2, there were 41 facilities providing abortion services in the state; by the end of 2013, 16 of those facilities had either stopped providing abortion services or closed altogether. And they tried to manipulate the legal standard governing how courts review abortion restrictions to do so. Justice Breyer, his liberal colleagues, and even noted abortion rights skeptic Justice Anthony Kennedy finally put a stop to all that nonsense. Here’s how.

When upholding the Texas abortion restrictions, the Fifth Circuit relied heavily on a line of reasoning in Gonzales v. Carhartthe 2007 Supreme Court case that upheld the so-called federal partial-birth abortion act. As part of that decision, the Court ruled that when there is a question of scientific or medical uncertainty, legislators could essentially pick a side they agree with and draft laws accordingly. We’ve all witnessed what happened next. Anti-choice lawmakers in the states went bananas concocting abortion restrictions with not much more than a hand-wave that those restrictions were grounded in science and designed to advance patient safety. The Fifth Circuit Court of Appeals took that ruling one step further in the fight over HB 2 and ruled that once legislators announce their justification for an abortion restriction, there was little, if anything, the federal courts could do to second-guess that reasoning.

Not so, the Court ruled Monday. “The statement [by the Fifth Circuit] that legislatures, and not courts, must resolve questions of medical uncertainty is also inconsistent with this Court’s case law,” Breyer wrote. “Instead, the Court, when determining the constitutionality of laws regulating abortion procedures, has placed considerable weight upon evidence and argument presented in judicial proceedings” holding that the “Court retains an independent constitutional duty to review factual findings where constitutional rights are at stake.”

Justice Breyer put that last part in italics just to drive home that yes, when it comes to the fundamental right to abortion, the federal courts are not simply rubber stamps for state lawmakers.

With that point made clear, Breyer then laid out—basically in a listicle—the number of places the Fifth Circuit got its review of the data wrong as to the effect of admitting privileges on the availability of reproductive care. It’s an impressive list that goes on for pages and includes “[a] collection of at least five peer-reviewed studies on abortion complications in the first trimester, showing that the highest rate of major complications including those complications requiring hospital admission—was less than one-quarter of 1%” as “[e]xpert testimony to the effect that complications rarely require hospital admission, much less immediate transfer to a hospital from an outpatient clinic.”

There’s more, but Breyer summed it up nicely: “In our view, the record contains sufficient evidence that the admitting-privileges requirement led to the closure of half of Texas’ clinics, or thereabouts. Those closures meant fewer doctors, longer waiting times, and increased crowding.”

Moving on to those claims made by attorneys for the State of Texas that the ACS provisions in particular advanced patient safety, Justice Breyer dropped some more data bombs. “Nationwide, childbirth is 14 times more likely than abortion to result in death, but Texas law allows a midwife to oversee childbirth in the patient’s own home,” Breyer wrote.

Colonoscopy, a procedure that typically takes place outside a hospital (or surgical center) setting, has a mortality rate 10 times higher than an abortion. The mortality rate for liposuction, another outpatient procedure, is 28 times higher than the mortality rate for abortion. Medical treatment after an incomplete miscarriage often involves a procedure identical to that involved in a nonmedical abortion, but it often takes place outside a hospital or surgical center. And Texas partly or wholly grandfathers (or waives in whole or in part the surgical-center requirement for) about two-thirds of the facilities to which the surgical-center standards apply. But it neither grandfathers nor provides waivers for any of the facilities that perform abortions.

How good does it feel to hear the Supreme Court call shenanigans on lawmakers who insist the best way to protect the health and safety of patients is by making comprehensive reproductive health care impossible to access? Probably as good as it feels to hear the Supreme Court shut down in the same opinion all the nonsense from abortion rights opponents claiming rogue provider Dr. Kermit Gosnell is proof positive that all abortion providers are dangerous predators that require the kind of regulation advanced in HB 2. “Gosnell’s behavior was terribly wrong. But there is no reason to believe that an extra layer of regulation would have affected that behavior,” Breyer wrote. “Determined wrongdoers, already ignoring existing statutes and safety measures, are unlikely to be convinced to adopt safe practices by a new overlay of regulations. Regardless, Gosnell’s deplorable crimes could escape detection only because his facility went uninspected for more than 15 years.”

Breyer went on: “Pre-existing Texas law already contained numerous detailed regulations covering abortion facilities, including a requirement that facilities be inspected at least annually. The record contains nothing to suggest that H. B. 2 would be more effective than pre-existing Texas law at deterring wrongdoers like Gosnell from criminal behavior.”

And: scene.

Immediately, Monday’s decision means that similar TRAP restrictions in other Fifth Circuit states like Louisiana are likely to be found unconstitutional. In states like Missouri or Kansas, it’s too soon to tell how the decision will affect those kinds of laws, but advocates are no doubt looking into that issue right now given the opening Monday’s decision creates.

And importantly, it makes it much more difficult for anti-abortion lawmakers to advance additional restrictions like “dismemberment bans” without being able to scientifically prove those laws actually advance patient care. These are laws that would effectively criminalize surgical abortions pre-viabilty, and are anti-abortion lawmakers’ latest attempts to cut off access to abortion while claiming to advance patient safety.

This is why Whole Woman’s Health v. Hellerstedt has the potential to reach far beyond TRAP laws in the fight for comprehensive reproductive health care. Finally, we’ve got a Supreme Court decision that demands facts over rhetoric and data over belief, and doesn’t fall into the “difficult decision that people disagree on” false equivalence. Monday’s decision is a clear, data-driven defense of the importance of access to comprehensive reproductive health care and an affirmation of abortion as a fundamental right. And that kind of defense has been a long time coming.