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'More harm than good': Montana doctors speak out against born-alive ballot measure, LR-131

Posted at 8:45 AM, Oct 25, 2022

BILLINGS — More than 700 Montana healthcare providers have signed a letter voicing opposition to a ballot measure in front of Montana voters this November, saying it could do more harm than good.

Joining the opposition to LR-131 are three Billings doctors—Dr. Nathan Allen, Dr. James Guyer, and Dr. Alison Rentz.

Together, the doctors have more than 70 years of combined medical experience. None of them have provided abortions in their career, but they have worked on the front end of family medicine, medical ethics, pediatrics, and neonatal care. On the ballot this November is something they see as a threat to providers across their profession.

"I am here as a physician who has cared for families who have had to make these decisions," said Guyer, associate director of the Montana Family Medicine Faculty. "These decisions are not made easily, and the state of Montana has no role in it."

Working for three different Billings healthcare organizations, the doctors are voicing their opinions on LR-131 on their own, not as representatives of their employers.

Legislative Referendum 131, or LR-131, called the Born Alive Infant Protection Act, requires healthcare providers to preserve the life and health of a born-alive infant, meaning an infant who breathes, has a beating heart, or voluntary muscle movement—including infants born during an attempted abortion.

The penalty for violating the law is a fine up to $50,000, imprisonment up to 20 years, or both.

Healthcare providers say they're concerned that the language of bill is too broad and will apply to situations far beyond abortion and all providers involved in the care of these cases, from EMTs to ethicists, will potentially face penalties.

"Some of the biggest red flags to me are that there will be a lot of unintended consequences for this potential ballot measure and this change to Montana law, that could significantly impact the health of newborns and the rights of Montana parents to help determine what’s best for their families," said Allen, emergency medicine physician and medical ethicist at Billings Clinic.

LR-131 made it to the ballot after it was passed by the Montana Legislature in 2021—one of four pieces of legislation challenging access to abortion passed during the session.

Federal and state law already establishes penalties for doctors who negligently or knowingly cause the death of a premature baby, but Rep. Matt Regier, a Republican from Kalispell who carried the bill, said the current law in Montana does not go far enough.

"This is not about the disingenuous narrative that if biology takes your baby then you’re going to get prosecuted, that’s not at all what’s going to happen under LR-131," Rep. Regier said. "This is if you’re a medical provider and you’re intentionally letting a baby die, then there needs to be a penalty for that."

But these Montana doctors say the devil is in the details and the reach goes beyond what Montanans want or need.

"Resuscitative measures are painful, they’re invasive, they prevent bonding, they prevent time with the mother and baby, they prevent religious ceremonies, they prevent a lot of things that parents need to move in the next steps of grieving and healing from infant loss," said Rentz, pediatrician and neonatologist at St. Vincent Healthcare. "It’s just very concerning that there would be a legislative action to regulate that and the language in the bill does not specify any of the things that we just talked about."

"It’s just too blunt an instrument to operate in these special circumstances," said Guyer.

Regier says the information coming from healthcare providers is misleading and the bill fundamentally is about protecting the lives of babies—not just a target on abortion.

"I am disappointed in the disingenuous narrative from the opposition," Regier said. "They’re putting out narratives that this would take away terminally ill babies from their parents and that’s not medically necessary or reasonable. So that’s just flat-out lies from the opposition."

Here's the full text of LR-131:

"This Act legally protects born-alive infants by imposing criminal penalties on health care providers who do not act to preserve the life of such infants, including infants born during an attempted abortion. A born-alive infant is entitled to medically appropriate care and treatment. A health care provider shall take medically appropriate and reasonable actions to preserve the life and health of a born-alive infant. A born-alive infant means an infant who breathes, has a beating heart, or has definite movement of voluntary muscles, after the complete expulsion or extraction from the mother. A health care provider found guilty of failing to take medically appropriate and reasonable actions to preserve a born-alive infant's life under this Act faces punishment of a fine up to $50,000 or imprisonment up to 20 years, or both."