BOISE — A federal judge ruled that pregnant women in Idaho are entitled to advance directives, or living wills, for the entire duration of pregnancy.
U.S. District Judge Lynn B. Winmill issued a ruling Tuesday holding that Idaho law cannot require people capable of pregnancy to include language that voids their living wills if they are pregnant. Advance directives are documents that allow people to dictate how doctors should approach treatment if they’re ever incapacitated.
Winmill said the provision of Idaho’s Medical Consent and Natural Death Act that stipulated exclusions for pregnant people “violates the constitutional right of a competent person to refuse unwanted lifesaving medical treatment.”
The lawsuit, Almerico et al. v. Denney et al., was filed in May 2018 on behalf of four women against the state. The women said the law unfairly discriminates based on gender, violates their right to control the decisions relating to their medical care, and subjects pregnant women to treatment that is different than the treatment provided to all other patients, the Associated Press reported at the time.
Winmill cited case law stating that while abortion restrictions only limit the choices of women to seek to terminate a pregnancy, Idaho’s pregnancy exclusion in the Medical Consent and Natural Death Act completely denies the choices of women, regardless of the viability of the fetus, and “forces medical treatment on them.”
“For fifteen years, the defendants promoted on their websites their interpretation that the pregnancy exclusion was required and that any directive to the contrary would be ignored,” wrote Winmill in Tuesday’s memorandum opinion.
Idaho is one of only 10 states that restricts the validity of advance directives if someone is diagnosed as pregnant. Winmill’s ruling could have repercussions for similar laws in Alabama, Indiana, Kansas, Michigan, Missouri, South Carolina, Texas, Utah, and Wisconsin, wrote attorneys who represented the four plaintiffs, all women who reside in the Treasure Valley.
“Pregnancy is no justification for stripping people of their fundamental rights,” said Farah Diaz-Tello, senior counsel and legal director at If/When/How: Lawyering for Reproductive Justice, who represented plaintiffs Anna Almerico, Chelsea Gaona-Lincoln, Micaela Akasha De Loyola-Carkin, and Hannah Sharp alongside Compassion & Choices, Legal Voice, and Perkins Coie, LLP.
During a February hearing, Diaz-Tello argued the law was discriminatory and highlighted the urgency of striking it down during the COVID-19 pandemic, a time when respecting end-of-life decisions is particularly important.
“Our Constitution protects everyone’s right to make health care decisions for themselves. Nobody should have to worry that their end-of-life decisions will be disregarded simply because they are pregnant,” Diaz-Tello said.
Kim Clark, senior attorney for Legal Voice, said Tuesday “the Court properly affirmed that forced intrusions by the state into people’s bodies, including the bodies of pregnant people regardless of the stage of pregnancy, represent an ‘unprecedented and extraordinary step’ that should be subjected to the highest degree of Constitutional scrutiny.”
Almerico, Gaona-Lincoln, Loyola-Carkin, and Sharp are all women of childbearing age, two of whom were pregnant when the lawsuit was filed in 2018. According to court records, the women argued the law violated their constitutional rights to medical decision-making and bodily integrity, gender equality, and freedom of speech.
“Some of their health care directives include provisions regarding pregnancy and some do not, reflecting their different expectations about their medical care if they become terminally ill while pregnant,” wrote attorneys for the women in an amended complaint, filed in 2019.
Plaintiff Hannah Sharp said of the lawsuit, “Before I became pregnant, I did not understand that I would have different rights than everyone else simply because I was pregnant.”
“In the midst of a global health crisis where pregnancy increases the risk of becoming severely ill, it is paramount that whatever happens, my decisions about what treatment I would get, and who I would want to speak for me, are respected,” she said.