Texas Supreme Court overrules lower court's temporary restraining order against state's abortion law

 December 12, 2023

A Texas judge issued a temporary restraining order against the state's restrictive abortion law last week in a case involving a woman who sought an exemption to the law following a near-certain fatal diagnosis for her unborn baby that likely also threatened her own life and health.

The Texas Supreme Court ruled on Monday that the lower court had overstepped its bounds and erroneously issued the order that barred the state from enforcing the abortion law, according to The Hill.

Rather ironically, because the woman reportedly fled the state to obtain an abortion elsewhere while awaiting the Supreme Court's decision, the high court made it clear that the whole matter was unnecessary since the woman was likely qualified for an exception that already existed in the state's abortion law.

Texas court issued temporary restraining order against abortion law

The Texas Tribune reported that Dallas resident Kate Cox filed a lawsuit last week seeking court-ordered relief after her doctor refused to perform an abortion, due to fear of state punishment, after her unborn baby was diagnosed with a rare chromosomal disorder known as Trisomy 18 that meant almost certain death for the infant and loss of fertility for the mother if the fetus was carried to term.

On Thursday, Travis County District Judge Maya Guerra Gamble ruled in favor of Cox and issued a temporary restraining order to block Texas from enforcing its abortion law against Cox, her husband, and her doctor, but on an emergency appeal from state Attorney General Ken Paxton, the Texas Supreme Court placed the lower court's ruling on hold on Friday while it considered the matter over the weekend.

In the interim, though, and reportedly following multiple visits to an emergency room, according to her attorneys, Cox left the state to obtain the sought-after abortion at some other unspecified place and time.

Abortion law already contains adequate exception for mother's life and health

According to the seven-page ruling issued on Monday by the Texas Supreme Court, however, Cox didn't need to flee the state to obtain an abortion as she likely was qualified for the abortion law's existing exception, and further ruled that the lower court's temporary restraining order was an unnecessary overreach.

Under Texas' otherwise restrictive abortion law, the procedures are lawful when, in an "exercise of reasonable medical judgment," a pregnant woman's physician determines there is "a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy that places the female at risk of death or poses a serious risk of substantial impairment of a major bodily function unless the abortion is performed or induced."

"A woman who meets the medical-necessity exception need not seek a court order to obtain an abortion," the justices wrote. "Under the law, it is a doctor who must decide that a woman is suffering from a life-threatening condition during a pregnancy, raising the necessity for an abortion to save her life or to prevent impairment of a major bodily function."

"The law leaves to physicians -- not judges -- both the discretion and the responsibility to exercise their reasonable medical judgment, given the unique facts and circumstances of each patient," they added.

Lawsuit and order unnecessary as Cox likely qualified for exception

In this particular case, the Texas Supreme Court determined that Cox's physician, Dr. Damla Karsan, "asked a court to pre-authorize the abortion yet she could not, or at least did not, attest to the court that Ms. Cox’s condition poses the risks the exception requires." Yet, despite that legal shortcoming, the lower court nonetheless issued its temporary restraining order.

"Judges do not have the authority to expand the statutory exception to reach abortions that do not fall within its text under the guise of interpreting it," the justices wrote. "The trial court erred in applying a different, lower standard instead of requiring reasonable medical judgment."

As for Cox, the high court stated, "Our ruling today does not block a life-saving abortion in this very case if a physician determines that one is needed under the appropriate legal standard, using reasonable medical judgment. If Ms. Cox’s circumstances are, or have become, those that satisfy the statutory exception, no court order is needed."

In the end, the justices urged the Texas Medical Board to "provide guidance" to the public -- including to "assess various hypothetical circumstances, provide best practices, identify red lines, and the like," similar to how it did during the COVID-19 pandemic -- to help avoid future "confusion" about the abortion law and unnecessary legal proceedings like this one.

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