Kansans challenge constitutionality of state law nullifying end-of-life choices of pregnant women
Five lawsuit plaintiffs, three women and two physicians from Lawrence, are part of a constitutional challenge of a Kansas law nullifying the end-of-life medical care decisions of pregnant women. The suit was filed Thursday in Douglas County District Court. (Tim Carpenter/Kansas Reflector)
TOPEKA — Two physicians and three women are plaintiffs in a Kansas lawsuit challenging constitutionality of a state law invalidating advance medical directives outlining end-of-life treatment for pregnant patients.
The group's lawsuit seeks to prohibit enforcement of a Kansas statute interfering with health care decisions outlined in living wills based exclusively on an individual's pregnancy status. Kansas is among states permitting state interference in advance directives for pregnant patients, regardless of the gestational age of a fetus, when a person was incapacitated or terminally ill.
Issues surrounding end-of-life state law recently took on urgency as a brain-dead pregnant Georgia woman was placed on life support in deference to that state's abortion ban.
Kansas patient plaintiffs Emma Vernon, Abigail Ottaway and Laura Stratton as well as Kansas physician plaintiffs Michele Bennett and Lynley Holman argued in the Douglas County District Court complaint filed Thursday the Kansas law violated rights of personal autonomy, privacy, equal treatment and freedom of speech under the Kansas Constitution's Bill of Rights by disregarding clearly articulated end-of-life choices of pregnant people.
'Because I'm currently pregnant, I don't get the peace of mind a living will is meant to provide,' said Vernon, a Lawrence resident who is pregnant. 'I shouldn't have to fear that my pregnancy could cost me my dignity and autonomy.'
Vernon said she outlined in a living will the medical care she would want if faced with a life-threatening condition, but Kansas' law meant she wouldn't have control over her end-of-life care while pregnant.
'I am no less capable of planning my medical care simply because I am pregnant. I know what is best for me,' she said.
Many states established a boundary for medical directives of pregnant individuals no longer capable of participating in end-of-life care in terms of the viability of a fetus. Kansas' statute invalidated decision-making authority of pregnant women regardless of gestational development of a fetus.
Holman, a Lawrence physician specializing in obstetrics and gynecology, said responsibilities of health care professionals should be centered on honoring patients' autonomy and privacy.
'When a law compels me to act against my patients' clearly expressed decisions, it not only undermines the trust at the heart of the patient-provider relationship, but also threatens the ethical foundation of medical care,' Holman said.
Defendants in the Kansas lawsuit are Kris Kobach, the state attorney general; Richard Bradbury, president of the Kansas State Board of Healing Arts; and Dakota Loomis, district attorney in Douglas County. The lawsuit seeks to prevent Kobach and Bradbury from enforcing state law nullifying directives of pregnant women.
The case was filed by attorneys with Compassion & Choices, a Colorado nonprofit working to improve patient autonomy at the end of life; If/When/How, a California reproductive rights legal nonprofit; and the Topeka law firm of Irigonegaray & Revenaugh.
Attorney Pedro Irigonegaray said Kansans valued individual rights and personal freedoms, but the state's pregnancy exclusion 'betrays those values by denying pregnant people the right to control their own medical decisions.'
'Our plaintiffs are simply asking for the same fundamental rights the Kansas Constitution guarantees to all Kansans,' said Jess Pezley, senior staff attorney at Compassion & Choices. 'Categorically stripping individuals of their right to make deeply personal end-of-life decisions because they are pregnant is not only offensive, it's fundamentally at odds with the values enshrined in the Kansas Constitution.'
The lawsuit says Kansas law 'unjustly, discriminatorily and categorically disregards' the clearly expressed end-of-life decisions of pregnant women.
The women plaintiffs asked the district court to 'affirm that the protections guaranteed by the Kansas Constitution apply equally to them and ensure that their most personal end-of-life decisions will be respected regardless of their pregnancy status.'
In addition, the petition says the physician plaintiffs were 'deeply committed to the foundational medical principle that patients have a fundamental right to determine what treatment they receive, and that providing treatment without a patient's informed consent violates both medical ethics and the law.'
'Yet, Kansas law compels them to disregard their patients' clearly expressed end-of-life decisions, forcing them to provide their pregnant patients with a lower standard of care than any of their other patients receive,' the petition said. 'It demands this diminished care without offering any clarity on what end-of-life treatment they are required to provide — leaving them to guess at what the law expects while exposing them to civil, criminal and professional consequences for getting it wrong.'
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