The Parson administration’s response to questions from Missouri hospitals, doctors and others about what's legal under the state’s new abortion ban is to tell people to read the law and otherwise leave it to prosecutors to interpret.
The Missouri law outlaws abortion except in medical emergencies and when necessary to save the life of the mother, but it's unclear what medical issues qualify under that exemption.
Confusion over the law notably led a large Missouri hospital chain to briefly stop providing emergency contraception known as the morning-after pill over questions about whether it could put doctors at risk of criminal charges for providing the medication, even for sexual assault victims.
The attorney general has said unequivocally that the morning-after pill is legal, but questions remain. Hospitals, doctors and attorneys have said the law is vague and sought direction from Republican Gov. Mike Parson's administration and Republican Attorney General Eric Schmitt, who is running for U.S. Senate.
Schmitt's office has not provided further legal guidance on the law.
Parson had said the state health department would provide clarity and review current regulations to ensure they line up with the new law.
The Department of Health and Senior Service's guidance for the most part directs questioners to read Missouri laws on abortion and otherwise leaves it up to prosecutors to interpret.
"Enforcement of the criminal provisions of state statute are left to local law enforcement agencies, local prosecuting attorneys, and the Missouri Attorney General’s Office for enforcement," the document states.
A frequently asked question listed on the health department document is whether the agency can "provide legal advice so that medical professionals and patients can know what is and is not legal."
Gov. Mike Parson listens to a media question during a press conference to discuss the status of license renewal for the St. Louis Planned Parenthood facility on May 29, 2019 in Jefferson City, Missouri.
"No," the factsheet states. "DHSS is not authorized to provide legal advice to third parties."
Prosecutors had been relying on the health department to issue guidance.
Darrell Moore, the head of the Missouri Association of Prosecuting Attorneys, said the factsheet helpfully points to definitions of medical emergencies, abortions and what constitutes reasonable medical judgment in Missouri law.
"The truth is that the decision on what constitutes a ‘medical emergency’ and/or ‘reasonable medical judgment’ will be case specific and left to local prosecuting attorneys, the attorney general, judges, and juries," Moore said in an email. "No one can give advice that will cover every conceivable medical emergency or what constitutes reasonable medical judgment in that medical emergency."
Moore said he expects prosecutors to consult medical providers when determining whether to file charges.
Missouri Hospital Association spokesman Dave Dillon said in a statement that hospitals are "committed to following the law," but "the practical challenge is the interpretation of the law — in real time and on the frontlines of care — where clinical judgement matters."
"The uncertainty of whether that judgement will be second-guessed is the challenge for physicians," Dillon said. "It is impossible to know in advance whether a prosecutor or member of law enforcement will agree about a clinician determination of risk to the life of the mother."
Health department spokeswoman Lisa Cox said there's nothing more the agency can do.
"The department is unable to formulate advisory responses to various situations with distinct fact patterns," Cox said. "The complexity of each situation is why Missouri law gives that analysis to physicians to utilize ‘reasonable medical judgement.’"