State high court limits reach of Missouri abortion consent law

Out-of-state doctors no longer risk getting sued under Missouri's parental consent abortion law after the state Supreme Court upheld a narrow application of the statute. In-state doctors also cannot be held liable for giving advice to teens seeking the procedure.

In May the high court clarified the scope of the unprecedented law letting parents sue anyone who would "intentionally cause, aid or assist" their teenage daughters in obtaining an abortion without consent. Neighboring Illinois was a target, said parties on both side of the issue, because it does not have a parental consent or notification law.

Rather than overturn the statute, the high court stopped it at the state border. Justices also unanimously concluded that in Missouri the law "cannot be construed to include protected activities, such as providing information and counseling." But it bans non-speech activities, such as providing money or transportation.

The court also said the law does not impose an undue burden on Missouri minors because they still can ask a court to bypass parental consent, if necessary. The measure went into effect immediately after the ruling.

Planned Parenthood of Kansas and Mid-Missouri challenged the 2005 law, saying it infringed on the First Amendment rights of doctors, family members, clergy or any other adult that minors trust for advice.

Peter Brownlie, the organization's president and CEO, praised the court's decision, saying it allows doctors to continue helping young women with information and counseling about the procedure.

"The ruling affirms that what we do will remain legal in Missouri," he said. The decision takes doctors out of the difficult position of choosing between protecting a minor patient's health and safety and protecting themselves from liability, he added.

Just across the Illinois border from St. Louis, doctors at the Hope Clinic for Women also are encouraged by the ruling, said Sally Burgess, the clinic's executive director.

Although most teens seeking abortions already have their parents involved, Burgess noted, some seek help from a doctor or relative for fear they might be abused or kicked out of the house by their parents. About 6% of the clinic's patients are teens. Of those, 40% are from Missouri, compared with 50% from Illinois.

The clinic still is investigating one portion of the ruling that says Missouri lacks the authority to regulate conduct that occurs "wholly outside" the state. It raises concern about legal repercussions for activities that don't transpire fully out of state.

The clinic is still worried it could be held liable if, for example, a Missouri teen makes a phone call to set up an appointment in Illinois, Burgess explained. Until the issue is clarified, Hope Clinic will comply with Missouri's law by requiring teens to show identification and proof of parental consent, she said.

Abortion foes pleased, too

Meanwhile, anti-abortion advocates also applauded the high court's decision, saying it reinforces parents' rights to be involved in their child's medical care.

"Parents must be informed of their children's decision" to seek an abortion, "and today's ruling upholds that belief," said Missouri Gov. Matt Blunt, who signed the law.

William Beckman, executive director of the Illinois Right to Life Committee, said the ruling would make doctors or others think twice about helping minors get abortions without parents' permission. "People motivated to provide the money or give transportation who are Missouri citizens can no longer do that risk free and might be dissuaded," he said.

Meanwhile, Illinois is poised to put its parental notification law into effect, Beckman said. The Illinois Supreme Court earlier this year issued rules needed to implement the state's 1995 law. Anti-abortion groups intended Missouri's statute as "a stopgap measure" to prevent minors from crossing state lines until Illinois activated its law, Beckman said.

The Missouri State Medical Assn. and Illinois State Medical Society had no position on the parental consent law or the Supreme Court ruling.

American Medical Association policy on mandatory parental consent to abortion states that doctors should encourage teenagers to discuss pregnancy with their parents or alternative sources if parents are not going to be involved in the abortion decision.