Judge Rules Public Hospitals Must Offer Abortion Services If They Offer Maternity Services

By Darren Smith, Weekend Contributor

skagit-regional-health-logoRuling on statutory grounds, Skagit County, Washington Superior Court Judge Raquel Montoya-Lewis held that a public hospital offering maternity services to women must also offer abortion services. Referring patients to Planned Parenthood, the court ruled, violates state law regarding abortion services provided to patients. The suit was brought on behalf of a plaintiff patient by the American Civil Liberties Union.

The fundamental conflict in the case litigated was ostensibly due to the defendant hospital district’s position that while agreeing to offer such services, it experienced difficulty in complying due to lack of health professionals willing to perform abortions. State law does allow heath care professionals to decline to perform voluntary abortions for personal reasons.

For other public hospital districts, the ACLU served notice requesting similar compliance with state law.

In Coffee v. Public Health District No. 1, the ACLU filed on behalf of plaintiff Kevan Coffee who alleges she was unable to carry her pregnancy to term “without facing severe severe, life-threatening birth defects.” The defendants are primarily Public Hospital District No. 1, Skagit County, d/b/a Skagit Regional Health, along with several of the hospital district’s commissioners and its CEO in their official capacities. A copy of the complaint may be read HERE.

In the lead-up to the lawsuit, Plaintiff served two demand letters to Defendants in July, 2014 and February, 2015 requesting that Defendants provide medication abortions and surgical abortions in compliance with Washington state law.

In their response, two days following the second demand letter, Defendants adopted by resolution a policy concerning the Washington Reproductive Privacy Act, stating that they do not prohibit or have a written policy against providing termination services to women. Plaintiff argues, however, that Defendants do not comply with this act despite the resolution in that they do not provide for “substantively equivalent services for terminations as it does maternity care, and Defendants continue to have a practice of never performing medication abortions and of rarely performing surgical abortions for patients seeking or needing such medical care.”

In her cause of action, Plaintiff alleges the following statutory violations:

RCW 9.02.100(2) provides that “[e]very woman has the fundamental right to choose or refuse to have an abortion….”
RCW 9.02.100(4) provides, “[t]he state shall not discriminate against the exercise of these rights in the regulation or provision of benefits, facilities, services, or information.”
RCW 9.02.160 provides that “[I]f the state provides, directly or by contract, maternity care benefits, services, or information to women through any program administered or funded in whole or in part by the state, the state shall also provide women otherwise eligible for any such program with substantially equivalent benefits, services, or information to permit them to voluntarily terminate their pregnancies.”

The suit asked for Defendant to be enjoined from violating these statutes, provide such abortion services, and pay legal costs and expenses.

In a statement provided by the WA ACLU, the advocacy group stated the following information:

Kathleen Taylor, Executive Director of the ACLU of Washington, said the decision affirms reproductive rights in Washington. “The right of women to choose or to refuse to have an abortion is fundamental and has long been recognized under Washington law. We brought the lawsuit to ensure that women can access the full range of reproductive health care at public health facilities in their own communities. We hope this ruling makes the promise of the state’s Reproductive Privacy Act a reality for all women across Washington state,” Taylor said.

ACLU Senior Staff Attorney Brigitte Amiri said, “Today’s decision is a huge victory for women seeking access to abortion, and we hope it will serve as an example for hospitals throughout the country. At a time when much of our nation is facing numerous restrictions on access to abortion, it’s a breath of fresh air to have a court ensure women can get the care they need.”


The suit is part of a statewide effort by the ACLU to ensure that all public hospitals are complying with the RPA. As a result of ACLU advocacy, Jefferson Healthcare, the public hospital district in Jefferson County, put in place a new reproductive health policy that will lead to a Port Townsend hospital providing abortions as part of its full range of women’s health services.

Handling the case for the ACLU are cooperating attorneys Aalok Sharma, Kimberly A. Haviv, Rebecca Tarneja, Lauren C. Fujiu-Berger, Amara Levy-Moore, Alice Tsier, and Marvin E. Bonilla of White & Case LLP and Karen Koehler of Strittmatter Kessler Whelan; and ACLU staff attorneys La Rond Baker, Margaret Chen, Leah Rutman, and Brigitte Amiri.

I suspect there could be a later question locally in the state as to simply allowing physicians and other Planned Parenthood professionals to have hospital rights at public hospitals, or perhaps some form of business venture with planned parenthood that links their facility with that of the hospital or a contracting of providers. On a political perspective it is doubtful the current legislature and governor will muster enough votes to change Chapter 9.02 RCW to repeal such requirements recognized by the Court. The law in question stems from a citizens initiative passing in 1991.

On a national level future issues are likely to generate from this decision, especially if the ACLU brings similar actions on behalf of other plaintiff patients in states having analog statutes.

There have been concerted efforts in a few state legislatures to effectively deny hospital privileges for physicians providing this service by several means, both administrative and statutory. And in the case of such conflicts between mandates of hospitals and availability of qualifying physicians to perform abortion services in-house, hospitals could face liability.

By Darren Smith

The views expressed in this posting are the author’s alone and not those of the blog, the host, or other weekend bloggers. As an open forum, weekend bloggers post independently without pre-approval or review. Content and any displays or art are solely their decision and responsibility.


Skagit County Clerk’s Office via ACLU (Complaint)
Chapter 9.02 RCW
American Civil Liberties Union of Washington State

71 thoughts on “Judge Rules Public Hospitals Must Offer Abortion Services If They Offer Maternity Services”

  1. I have to leave the blog for a few weeks. They are knocking on the door now to take me away. I am called a bi polar guy and I am not a bear. Maybe there will be a computer in the nuthouse.

  2. Maybe kill the parents. Keep the kid. Society will have to pay to raise the kid anyway. Sterilize the kid soon after birth. Sterilize all people on welfare. Sterilize all people who belong to golf clubs. End such things in America like kindergarten. Home school all the kids. College is for dorks. We need trade schools and that is it. No more law schools. No more doctors. No more priests. No more principals– they are not pals. Doctor, doctor, what you say? How bout letting me out today? Ain’t no reason for me to stay. Cause everybody is far away. Get me back on my feet again. etc

  3. Evidently physicians and hospitals that provide abortions must have a specific type of liability insurance which is quite expensive. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636480/ OB/GYN have specific insurance for it, from what I gather, but if a family practice physician wants to perform one, the insurance is rough. It would be interesting to find out if a hospital & physician must have a specific insurance liability policy. Considering the way our society operates, i suspect they do. I’m also thinking the insurance could be prohibitive, especially for a small hospital.

    There is a certain ER physician my mother likes to the point she would do an ER visit, if she knew he was on duty. I was in the treatment room one day when she asked him why he did not go into private practice. He told her it was almost cost prohibitive these days.

    As far as PP is concerned, they basically fly over fly-over country. Their PR that they exist to provide services in areas where women have no access to what they provide is a crock. I did a study about where they provided service (for my blog). I was shocked. Ae example is basically after a person leaves the Dallas-Ft. Worth area west to ABQ, there are no PP facilities. They seem to exist primarily in larger cities and university communities.

  4. RosieS:

    “Sub-standard? What dark hole did you pull that out of, KCFleming?”

    I don’t know. He might have a point. If you were at a cocktail party at a medical professional mixer, and there was this round table, “What do you do” – you’d have neurosurgeon, cardiovascular surgeon, pulmonologist, epidemiologist…and then you’d have some guy who was an abortion provider at PP. Sounds like a factory worker among white collar professionals. Even plastic surgery, which is also a kind of high throughput, repetitive occupation, has quite a bit of art to it, as pics of those who get a bad surgeon can attest. I get the impression that the best and brightest at med school don’t go in for repetitive jobs at PP.

    And it’s true that most doctors choose their profession because they want to save lives and make people healthy. Killing a healthy fetus must be hard for at least some of them. Right now, they have the right to refuse to do it. But if they can force hospitals to participate, they can force doctors, too. And that brings up medical ethics. How do you reconcile the Hippocratic Oath with abortion? Of course, THAT’s a whole other can of worms.

    I never really thought about abortion. If asked, I would have probably said I was Pro Choice. However, since I was older when I had my son, I had plenty of ultrasounds. I didn’t know they did abortions so late until I was older. I thought it was just in the really tiny “ball of cells” window. But as I cooed over ultrasound after ultrasound, and watched him flipping around in there at just 10 weeks, I suddenly realized that people get abortions during many of those stages. I’d look at an ultrasound of my beloved, making out the curve of his head and his little leg, and I’d realize people could still kill their babies at that age. Kind of brought home grim reality and the heartbreak that not every mom feels that fierce protective instinct for the child in her belly. Not everyone’s mom will fight grizzly bears for them. And when I hear the Pro Choice side, it’s typically that it’s nobody’s business what a woman does to her body. However, late trimester abortion is still illegal. So at some point, it does become everybody’s business what a woman does to her body. Between one day and the next, it goes from no one’s beeswax to totally illegal. (Ask Dr Gosnell in prison.) And all of a sudden, there is not really that much difference between Pro Life and Pro Choice. For most people, it becomes a difference of where the line must be drawn, because for the overwhelming majority, there IS a line.

    I really wish people could regain the ability to talk about tough issues. As of 2016, the Left goes by rote with “you don’t believe the same as I so you must be evil/ignorant/racist/etc.” How about we go back to debate class? Before you present your side, they make you prepare the other side’s position. You can’t defend an idea unless you understand the opposing point of view.

    But too many like to divide and fight rather than see the similarities, find common ground, and just talk about issues.

  5. PhillyT

    Your comment telling another commentator to commit suicide is unacceptable and has been deleted, as have several others for lesser issues.

    Either refrain from expressing comments such as these or find another website to engage in that type of discord as they are not considered professional or welcomed here.

  6. A major hospital nearby doesn’t even have a cardiac unit at all.

    If you actually watch the video where the doctor who performed 1200 abortions describes the procedure, he indicates that you pull a baby out one limb at a time through a blind procedure. You use forceps which clamp on and don’t release, and then you twist until you feel a pop, pulling the limb through.

    So…if that’s not “gory”, I don’t know what is. I’m particularly squeamish, however. So maybe there are a lot of people who aren’t bothered.

    However, it seems odd to assume that every single doctor who refuses to perform an abortion fears for his life. Is it impossible that a doctor could simply not want to perform it? In fact, I have a video of a doctor who changed his mind and stopped wanting to do abortions.

    Also, there is this whole line of reasoning where you should not explain to the mother what happens, because it would gross her out. And you should not show her an ultrasound of her baby moving, because it might upset her. But those same people reason that it couldn’t possibly upset any doctor on Earth.

    For me at least, there are two separate issues. The issue of the legalization of abortion, and what, if any, restrictions to place upon it. (The vast majority of people want there to be at least some restrictions, at least gestational limits.) The second issue is whether you can force people to participate in abortion…an issue that has great medical ethics concerns.

  7. What do we call it when a person no longer has a heartbeat or brain waves? Death.

    What do we do when a 92 year old heart patient arrests? Rapidly apply the paddles to resuscitate that damaged, fading heart. Yet EVERY abortion stops a beating heart. A young, viable heart full of promise and possibilities is snuffed out.

    Does the right to emergency, extended longevity supersede the right to not be killed?

  8. phillyT – I see it as women wanting to have control over unborn children. I do not want them to have that control. I want to set the babies free. Free at last!
    Think of me as the Emancipation Proclamation for the Unborn.

  9. phillyT – the thinking used by slavers is the same used by abortionists. It is neither stale nor invalid.

  10. phillyT is obviously a masochist. KCF will need some ice for those swollen fists. He landed several haymakers today. I think phillyT might be suffering from CTE.

  11. If I was a doctor I would not do abortions. Not because of religion. I would want to be on the road to saving life not ending it. Maybe free condoms in all schools and all sorts of birth control for age ten up.

  12. RosieS,
    In the paper you cited they noted that even the abortion-seeking patients looked down on MDs doing abortions!
    Not violence causing stigma, but stigma arising from the very people seeking abortions.

    “However doctors also feel looked down upon by patients and medical colleagues. They perceive they are judged as deficient, morally and technically. For example, one physician reported that patients seeking abortion communicate moral disapproval: I feel very judged, she said. Patients think we’re bad people even though we’re doing what they want us to do. Another described a kind of ‘piety’ claimed by doctors who do not perform abortions. He perceived that doctors who do not provide abortion care feel that “there’s another moral plane to be on.” In other words, there appeared to be both high and low moral ground in medicine, and abortion providers occupied the low ground.”

    People don’t like abortionists.
    That’s from the same paper you quoted.

  13. Not to mention the selling of fetus parts.
    That might bother a few docs.

    Not liberals, though.
    They love themselves some fetal pancreases.

  14. RosieS,
    The authors drew a conclusion not supported by any evidence.
    1. There are threats against abortion providers.
    2. Abortion providers are viewed as deviant and substandard.
    The paper concluded that 1 caused 2.

    Possible, but no evidence was provided.
    1. Is true, but the extent and pervasiveness is unknown and it is also unknown whether that causes MDs to avoid abortions.
    The connection between 1 and 2 is pure conjecture.
    Perhaps 2 causes 1.

    And it is equally plausible that like most stereotypes, this one is true, that most people don’t want to do abortions because others look down on them.

    Also, after a few years of bringing in big bucks killing fetuses, their consciences start to bother them, especially once they’ve had their own kids.

    Like this guy:

    “One particular abortion changed Brewer’s life. “I remember an experience as a resident on a hysterotomy (a late-term abortion delivered by caesarean section). I remember seeing the baby move underneath the sack of membranes as the caesarean incision was made, before the doctor broke the water.”

    The thought came to me, ‘My God, that’s a person.’ Then he broke the water. And when he broke the water, it was like I had a pain in my heart, just like when I saw the first suction abortion. And then he delivered the baby, and I couldn’t touch it. I wasn’t much of an assistant. I just stood there, and the reality of what was going on finally began to seep into my calloused brain and heart.”

    SJWs want to force people to do this.
    Typical fascists.

  15. Rosie S.- The Skagit Co. Superior Court itself laid out a requirement that if OB/GYN/maternity services are provided by the hospital, it must also make abortions available.
    Those are that court’s parameters, evidently convinced by the ACLU’s demands that that hospitals, etc. are obligated to be “full service providers” of abortions if they have OB/ GYN/ maternity services.
    I don’t know if the budget for this hospital allows for them to pursue protracted appeals of this decision.
    That’a dilema for that hospital, and for any health care provider who generally has, outside of Skagit County, opt out protections under federal law.
    A similar opt-out provision in Washington State law does not require health care providers to participate in assisted suicide of patients.
    If the ACLU, in its sacred mission, won a case in a Superior Court in a WA. county that required health care providers to participate in assisted suicide if they are involved in the health care of terminally ill patients, they could comply, they could retire, they could ignore the court’s decision, etc.
    That kind of a decision from a county Superior Court judge with the vast experience of 18 months on the bench could ignore, or refuse to accept, the opt-out provision of the WA.assisted-suicide law.
    The Skagit County hospital, IF this Superior Court decision holds, has limited options. A- cave to the court’s demand that they now provide abortions B- get involved in a protracted appeals process C- ignore the court decision D-eliminate OB/ GYN services to avoid being put into a position where they are forced to provide abortion.
    This Superior Court decision put them in that position. As delighted as the ACLU may be with the decision, the hospital itself and, possibly their patients, are in a difficult situation.
    If you read the comment carefully, you may pick up on the fact that Philly T., not me, made the suggestion that hospitals comply or “go do something else”….get out of the hospital business.
    I don’t think the court decision under discussion here goes that far, and I’ve laid out the limited options the hospital currently has, thanks to the ACLU and a small county superior court judge.

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