A group of physicians in South Carolina claim that exceptions in the state's abortion ban are too vague and infringe on their religious beliefs in a federal lawsuit, the Arkansas Advocate reported Feb. 10.
Here are eight things to know about the legal challenge:
1. The state currently has a "fetal heartbeat" law that was passed in 2023. According to the law, physicians cannot terminate a pregnancy after an ultrasound detects the sound of cardiac activity, except in medical emergencies.
2. While the law has been upheld as an effective six-week ban, the law does not specify the week of pregnancy that determines the cutoff for abortion care, nor does it define a medical emergency.
3. Five OB-GYNs filed the lawsuit Feb. 5 asking a federal court to stop the state from enforcing the law or to require law enforcement to defer to a woman's physicians in cases of abortions performed for medical emergencies.
4. Physicians in the lawsuit argue that the legislation violates the First Amendment's due process clause by being overly vague. Natalie Bingham, MD, an OB-GYN who practices in Columbia, S.C., told the Advocate that the law has sparked debate over whether a fetus that is determined to have only a few hours or days to live constitutes a fatal condition as outlined in the law, and that the state has "turned what were previously medical questions into legal ones."
5. The report cited several other examples of situations where it remained unclear what constitutes a fetal anomaly as "incompatible with sustaining life after birth" and forcing physicians to operate under uncertain definitions of medical emergency, fearing that they will lose their jobs or face legal action.
6. Patricia Seal, MD, an OB-GYN in Columbia, S.C., and a plaintiff in the suit, told the South Carolina Daily Gazette in a January report that a patient came to her to end her "much-desired pregnancy" because it was worsening her kidney disease. Dr. Seal's hospital refused to approve an abortion until the woman was close to needing dialysis. Due to this delay, the patient's condition worsened to the point of possibly needing a kidney transplant.
7. Physicians must report abortions provided under the law for compliance and maintain related records for seven years. They must also provide detailed medical documentation that supports the diagnosis of a fatal fetal anomaly. Some of the hospitals employing plaintiffs in the lawsuit require consensus from multiple physicians, leading to concern that their judgement could be second-guessed after the fact by prosecutors.
8. The physicians are also flipping the religious exemption in state law, as the lawsuit claims that the abortion ban discriminates against physicians who believe abortion care is fundamental to their religious beliefs. The presentation of this argument is among the first in the country, according to the report.
"If there is a right to refuse care, there certainly seems to be the corollary where we have a right to provide care, particularly based on our conscience, and then the tenets of each of our own religions, and based on years of training and dedication," Dr. Bingham said. She added that South Carolina has a conscience law that allows health providers to refuse care.
Four of the five OB-GYNs in the lawsuit are Christians of various denominations, including one Presbyterian, Lutheran, Methodist and Catholic backgrounds. One did not give specific religious affiliation but "believes as a matter of conscience that the measure of a person's virtue is how they treat others," according to the lawsuit.