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Alaska medical board at center of fight over abortion

JUNEAU — A legal battle over Alaska abortion restrictions has moved out of the courts and into the hands of the usually noncontroversial state medical board.

Planned Parenthood sued the state in November, arguing that the restrictions violated the privacy, equal protection and due process rights set out in the Alaska Constitution. The suit challenged a pair of decades-old regulations on second-trimester abortions that, the group argues, has the effect of forcing women to travel Outside for the procedures.

Last month, the two sides agreed to put the lawsuit on hold while the state medical board revised the regulations. One regulation requires doctors to consult with a second physician before performing second-trimester abortions; the other says blood transfusion equipment, along with an operating room ready for "major surgery," must be on hand for the procedure.

The board released its proposed updates Friday for public comment. They would eliminate the physician consultation requirement entirely and replace the operating room regulation with one that says abortions performed "after the point in time when a fetus becomes viable" can be done only in hospitals with a neonatal intensive care unit.

Most medical experts say the "age of viability" is 24 weeks, when half or more of fetuses born survive, while the U.S. Department of Health and Human Services says that the second trimester extends through the 28th week of pregnancy.

Planned Parenthood officials, who are working with attorneys from the American Civil Liberties Union and the Center for Reproductive Rights, wouldn't say Tuesday if they would withdraw their lawsuit if the proposed revisions were adopted.

But the proposed hospitalization requirement seems to conflict with one of the points in Planned Parenthood's complaint, which says many medical procedures comparable to second-trimester abortions — and even some that are riskier — are legally done in outpatient clinics in Alaska. The complaint cites colonoscopies and vasectomies among its examples.

Members of the eight-person medical board, meanwhile, have been thrust into the charged debate over abortion in a sharp break from their usual work. The board's business typically consists of licensing doctors and policing their conduct, and it has historically tried to stay away from political issues, said Leslie Gallant, the board's former executive administrator.

"I worked for the board for 17 years and we never said the 'A'-word out loud," Gallant said in a phone interview Tuesday, referring to "abortion."

Of six board members contacted Tuesday, just one, Cam Carlson, agreed to a phone interview. She's a Fairbanks Republican activist and abortion opponent who was originally appointed by former GOP Gov. Sean Parnell, and reappointed last year by Gov. Bill Walker, an independent.

Carlson argued that the board approached the new regulations "from a medical perspective."

"I have never felt like there's anything really political," Carlson said, referring to her nearly four years on the board. "Our main purpose is to make sure we don't have any doctors here that are incompetent and are going to kill people."

She added: "I think we've responded to what was considered outdated and outmoded and all of that."

Minutes from the board's meetings show that members — five doctors, a physician assistant and two public members — were initially divided over how far to scale back the existing abortion regulations.

Five of the board members were initially appointed by Parnell, who opposes abortion, while a sixth was first appointed in 2009 by another abortion opponent, Sarah Palin, before being reappointed in 2013 by Parnell. Walker has also said he opposes abortions, but also that he wouldn't impose his view on anyone else.

At a December meeting, after more than two hours of closed-door discussion in an executive session, the board split 4-4 on a proposal from one member, Juneau pediatrician Joy Neyhart, that would have eased the requirements for the operating room and transfusion equipment — allowing them to be available "at a nearby hospital" instead of simply "immediately available."

Neyhart — a Walker appointee who disclosed at the start of the meeting that she'd donated money to Planned Parenthood — expressed concern "with potential harm to public safety by the board not taking action on the abortion regulations," according to minutes from the meeting.

Carlson responded, according to the minutes, that "it is not the board creating a safety issue, but the results of litigation by Planned Parenthood."

The tie vote meant that Neyhart's proposal failed.

The board then decided to issue a public notice saying it was planning on revising the regulations. And at a subsequent meeting this month, after nearly two more hours in executive session, members took a series of votes approving the proposed changes that are now open for public comment.

All the votes passed unanimously or with one member opposed or abstaining.

Planned Parenthood is now reviewing the changes and will almost certainly submit comments, said Hannah Brass Greer, chief legal counsel for the group's Northwest branch.

"There's new language that we'll have to take a very careful look at to see how that plays out in the delivery of the health care," she said in a phone interview.

Anti-abortion advocates are also trying to register their opinions, though there's been a learning curve when it comes to dealing with the medical board, according to Christopher Kurka, executive director of Alaska Right to Life.

"Honestly, I didn't even know who was on the medical board until this issue came up," Kurka said.

He said the group is submitting testimony urging members "to not cave in."

Public testimony is due by March 24. At that point, the board can adopt the proposed regulations without substantive changes, said Debora Stovern, the board's executive administrator. Or, she said, it can propose further changes, though the board would then have to go through another public notice process.

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