Ohio Governor Vetoes Heartbeat Bill, But Passes Ban on Abortions After Twenty Weeks

–by Bri Szopinski

Citations:

Sheryl Gay Stolberg, John Kasich Signs One Abortion Bill in Ohio but Vetoes a More Restrictive Measure, N.Y. Times (Dec. 13, 2016), http://www.nytimes.com/2016/12/13/us/kasich-ohio-heartbeat-abortion-bill.html?_r=0.

Emanuella Grinberg, Ohio Governor Bans Abortions After 20 Weeks While Vetoing “Heartbeat” Bill, CNN (Dec. 14, 2016), http://www.cnn.com/2016/12/13/politics/ohio-abortion-bill-veto/.

Laura A. Bischoff, Gov. Kasich Vetoes Heartbeat Bill, Signs 20-Week Abortion Ban, Dayton Daily News (Dec. 13, 2016), http://www.daytondailynews.com/news/state–regional-govt–politics/gov-kasich-vetoes-heartbeat-bill-signs-week-abortion-ban/UbrhWj5zpvwbbCkfNeMInJ/.

Abstract: Ohio simultaneously passed a ban on abortions after twenty weeks while rejecting legislation prohibiting abortions after doctors detect a fetal heartbeat.

***

On Tuesday, December 13, 2016, Ohio Governor John Kasich vetoed Ohio’s controversial “heartbeat bill” while simultaneously passing a bill that prohibits abortions after twenty weeks.

The “heartbeat bill” (House Bill 493) originated in the Ohio House of Representatives. With respect to abortions, the bill prohibited physicians from performing abortions once doctors detect the fetal heartbeat.  Generally, doctors detect heartbeats at about six weeks into the pregnancy.  The “heartbeat bill” did not contain any exceptions allowing women to undergo an abortion in the case of rape or incest.  This bill passed the Ohio Legislature as one of the strictest anti-abortion bills in the country and went to Governor Kasich for a signature or veto.

On December 8, 2016, the Ohio Legislature voted on Senate Bill 127, which also intended to regulate abortion by establishing a blanket prohibition of abortions after twenty weeks.  Like the “heartbeat” bill, Senate Bill 127 also passed both the Ohio House of Representatives and the Senate, and went to Governor Kasich for a signature or veto.

Despite both bills’ passage in the House and Senate, Governor Kasich vetoed the “heartbeat bill” but upheld Senate Bill 127.  He stated that the “heartbeat bill” contradicted the Supreme Court’s rulings in Roe v. Wade, Planned Parenthood v. Casey, and Whole Woman’s Health v. Hellerstedt.  Federal courts had recently struck down similar legislation in other states, suggesting that any legal challenges to the “heartbeat bill” would end similarly to the challenges in those states: in the challenger’s favor.

Senate Bill 127, however, prohibits abortions after twenty weeks into a pregnancy.  Present law requires doctors to find a fetus non-viable, or unable to survive outside the womb, before performing an abortion.  Doctors can make exceptions to this requirement when the pregnancy seriously impacts the woman’s health.  Senate Bill 127 modifies current Ohio abortion law by eliminating the viability test altogether and making a blanket prohibition against abortions after twenty weeks.  However, experts suggest that the point of viability of a fetus averages at about 24 weeks.  While the exception for the mother’s health still remains, doctors that perform abortions after twenty weeks without this exception could face criminal charges, likely a fourth-degree felony.  Doctors cannot make exceptions for cases of rape or incest.

Governor Kasich’s signing of Senate Bill 127 makes Ohio the third state this year to ban abortions after twenty weeks; Georgia and South Carolina also passed similar legislation in 2016.  This makes Ohio one of eighteen states that prohibit abortions after twenty weeks.  The law is expected to take effect in March, although some organizations have discussed challenging the law in the coming months.

Survey: 2015 Health Law

Survey of New York Health law for 2014–2015.

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Mr. Crowley is a Staff Attorney with Legal Services of Central New York, Inc.; J.D., Syracuse University College of Law; B.A., University of Connecticut. Mr. Thater is an Associate with Gale Gale & Hunt, L.L.C.; J.D., Syracuse University College of Law; B.A., Nazareth College. The authors would like to thank Minla Kim for her invaluable research assistance in completing this article. Ms. Kim is an Associate with Gale Gale & Hunt, L.L.C. With one exception, this Article addresses recent developments in New York State and federal health law from July 1, 2014 to June 30, 2015.

New York Court of Appeals Holds “Symptom Threshold” Methodology Is Inadmissible, But Cites “Odor Threshold” Methodology With Approval

—by David M. Katz

Sean R. v. BMW of N. Am., LLC, 48 N.E.3d 937 (N.Y. 2016).

Abstract:

The New York Court of Appeals recently decided that the basis for an expert opinion on the specific concentration of a chemical cannot be predicated solely on a person’s symptoms, but also noted that expert opinion that a chemical was present at the concentration of scent detection could be admissible.

***

On February 11, 2016, the New York Court of Appeals decided Sean R. v. BMW of N. Am., LLC, 48 N.E.3d 937 (N.Y. 2016).

The plaintiff was born with significant physical and mental birth defects.  The plaintiff alleged that his injuries were caused when his mother inhaled high concentrations of gasoline fumes while driving her 1989 BMW 525i during her first trimester of her pregnancy.  Both the plaintiff’s mother and grandmother stated that they could smell gasoline odors in the car.  Additionally, the plaintiff’s mother suffered from “headaches, dizziness and throat irritation” after driving in the car.  Further, the plaintiff’s mother and father stated that they could smell gasoline in their house when the car was parked in the garage.

Two causation experts opined on the nexus between the gasoline vapor exposure, the concentration of the gasoline during the exposure, and the plaintiff’s birth defects.  Using two separate methodologies, the plaintiff’s two causation experts came to the conclusion that the plaintiff’s mother inhaled gasoline at a concentration of 1,000 parts per million based solely on the symptoms exhibited during exposure to the gasoline fumes.

The defendants first filed motions for summary judgment, arguing that the plaintiff’s experts failed to lay a foundation for their opinions.  The trial court denied the motions.  The appellate division modified the order on other grounds.

The defendants then challenged the experts’ “symptom-threshold” methodology, arguing that using symptoms to determine a concentration of a chemical is not generally accepted within the scientific community.  The trial court precluded the plaintiff’s experts from testifying because symptom-threshold methodology was not generally accepted in the scientific community as a means of determining concentrations of chemicals.  On reargument, the court reaffirmed its prior decision.  The appellate division affirmed and granted a motion for leave to appeal to the Court of Appeals.

The plaintiff’s experts employed the symptom-threshold methodology.  Under the symptom-threshold methodology, an expert uses statements regarding odors and the symptoms that resulted to determine the concentration of chemicals that a person was exposed to.  The Court of Appeals began by noting that the plaintiff could not show any scientific literature employing the symptom-threshold methodology for causation purposes.  While the Court of Appeals noted that smelling chemicals and experiencing symptoms could be corroborative of a level of concentration, that evidence alone cannot “divine an otherwise unknown concentration of gasoline vapor.”  Thus, the court found that a symptom-threshold methodology, where symptoms are used to determine the concentration of a chemical, was not generally accepted in the scientific community.

The Court of Appeals distinguished the symptom-threshold methodology from other cases where experts employ the “odor threshold” methodology.  Similar to the methodology employed by the plaintiff’s experts, experts using the odor threshold methodology determine that a chemical concentration exists because the witness smelled a chemical.  However, unlike the plaintiff’s experts, experts employing the odor threshold methodology limit their opinion to the fact that the concentration was at least at the minimum concentration required for humans to smell the chemical.  The Court of Appeals noted that the odor threshold methodology is admissible because the level of detection is self-proving: if someone can smell a chemical, then it must be present at a certain minimum level.  As a result, the Court of Appeals, while rejecting the symptom-threshold methodology, also opened the door for the odor threshold methodology in toxic tort cases where the level of detection is equivalent to the level of toxicity.

Taxing the Human Body

—by Kelly Pare

Perez v. Comm’r, 144 T.C. No. 4 (2015)

Abstract:

Advances in modern medicine have brought new meaning to the idea of selling one’s body. Surrogacy arrangements, egg and sperm donations, and even black market kidney transactions are commonplace in today’s society. From a tax perspective, these types of commercial transactions are very interesting.

***

Perez v. Comm’r, a 2015 United States Tax Court case, seems to raise more questions than it answers about the tax treatment of income derived from egg donations.  Nichelle Perez contracted with Donor Source, a for-profit California company, to donate eggs. See Perez v. Comm’r, 144 T.C. No. 4 (2015). Nichelle received $20,000 in 2009 for the pain, suffering, time, and inconvenience that the egg donation caused her. Id. Donor Source sent Nichelle a 1099 in the amount of $20,000. Id. Instead of reporting this income on her tax return, Nichelle concluded that the money was excluded from gross income under section 104(a) of the Tax Code. I.R.C. 104(a) (2014) (excluding from gross income damages received on account of personal physical injuries or physical illness).

The tax court rejected Nichelle’s argument, reasoning that the payments, although in compensation for physical pain and suffering, arose out of a consensual contract between Nichelle and Donor Source and did not merit exclusion from gross income. See Perez v. Comm’r, 144 T.C. No. 4 (2015).  Consequently, Nichelle had to pay income tax on the money she received by Donor Source. The court was adamant in addressing only the particular issue and facts before it, and expressly stated what the case was not about.  The court refrained from deciding whether human eggs are capital assets, figuring out how to allocate basis in the human body, determining the holding period for human body parts, or deciding the character of the gain from the sale of human body parts. Id. at 9.

The decision in Perez is narrowly confined to the facts of the case and decided only the tax liability of the particular individual at issue.  Moreover, current law is ambiguous as to the tax treatment of transfers in human body parts and the IRS offers little guidance. See Lisa Milot, What Are We—Laborers, Factories, or Spare Parts? The Tax Treatment of Transfers of Human Body Materials, 67 Wash. & Lee L. Rev. 1053, 1053 (2010).  This lack of clarity surrounding the taxability of transfers in human body parts makes tax planning and compliance difficult. Id. at 1108. Given the increasing volume of these types of transactions, perhaps the time is ripe for Congress to legislate in this area.

Unfortunately, the questions left unanswered by the court in Perez are more thought provoking and interesting from a tax standpoint than the questions on which the court focused.  Do human body parts properties constitute capital assets?  Is your basis in your body zero, or does it adjust upward and downward?  If for example, you sell a kidney that you have stored outside your body for more than a year, can the proceeds of that sale be characterized as a capital gain?  At the very least, the unanswered questions posed by the court in Perez would surely make for an interesting conversation at a bar, and the facts in Perez provide ideas for a great law school exam hypothetical.

For a more comprehensive overview of the taxation of transfers of human body parts and a framework of how these transactions should be taxed, see Lisa Milot, What Are We—Laborers, Factories, or Spare Parts? The Tax Treatment of Transfers of Human Body Materials, 67 Wash. & Lee L. Rev. 1053 (2010) and Bridget J. Crawford, Our Bodies, Our (Tax) Selves, 31 Va. Tax Rev. 695 (2012).

Sodium Wars: New York City’s Effort to Warn

— by Forrest Young

ABSTRACT:   In 2015, New York City’s Board of Health announced new regulations requiring chain restaurants to provide warnings about the sodium in their menu options.  In February, a trial judge rejected the National Restaurant Association’s challenge. The First Department issued a temporary stay while the case is on appeal.

***

On February 26, 2016, New York Supreme Court Judge Eileen Rakower issued an order denying the National Restaurant Association’s petition to prevent implementation of New York City’s new health code regulation requiring select restaurants to label foods with high sodium content. Nat’l Restaurant Ass’n v. N.Y.C. Dep’t of Health and Mental Hygiene, No. 654024/15, 2016 WL 751881 (Sup. Ct. New York Cty. 2016).

The new regulation, enacted as Section 81.49 of the New York City Health Code, would require chain restaurants (those with 15 or more locations under the same name) to post a saltshaker symbol next to standard menu items with 2,300 milligrams of sodium or more. The regulation also mandates the menu to include a warning that reads “Warning: [this salt symbol] indicates that the sodium (salt) content of this item is higher than the total daily recommended limit (2300 mg). High sodium intake can increase blood pressure and risk of heart disease and stroke.” Restaurants found in violation of the section would be required to pay a 200 dollar fine.

In New York, an administrative regulation will be upheld if it has a “rational basis, and is not unreasonable, arbitrary or capricious.” Nat’l Restaurant Ass’n, 2016 WL 751881 at *1.  To receive a preliminary injunction, the petitioner must show by clear and convincing evidence that must show (1) a likelihood of success on the merits, (2) a danger of irreparable harm without such relief, and (3) a balancing of equities in its favor. Id.   The National Restaurant Association argued that Section 81.49 was invalid because (1) it violated separation of powers; (2) it is arbitrary and capricious; (2) it violates members’ First Amendment rights; and (4) it was preempted by the federal Nutrition Labeling and Education Act (NLEA). Id.

The court took these issues in turn, first holding that the sodium warnings do not violate separation of powers because the Board of Health relied on its public health expertise in regulating restaurants and the rules are not outside the bounds of its authority. The court held that the Board did not overstep into legislative-policy making because it “relied on its expertise in weighing the scientific evidence concerning the risks associated with excess sodium consumption.” The court distinguished these regulations from previous regulations limiting proportions of sugary drinks because “in contrast to the Soda Ban, by adopting Section 81.49, the Board did not devise a new rule that “significantly changes” the manner in which menu items containing sodium are provided to customers at eating establishments. It is within the Board’s regulatory authority to require the posting of information and warning labels concerning health risks.” Id. at *3.

Next, the court rejected the Association’s claim that the regulations were arbitrary and capricious finding that the agency’s determination was predicated on rational concerns regarding known health risks caused by high sodium intake. Nat’l Restaurant Ass’n, 2016 WL 751881 at *3.   Judge Rakower accepted the City’s contention that the regulations were a reasonable approach to the problem because the average New Yorker consumes nearly 1,000 milligrams more than the daily recommendation, and the average chain restaurant meal contains 3512 milligrams of sodium,. Id. The court held that the regulations were not unduly burdensome on chain restaurants because of their uniformity of menus options and preparation techniques.   Id.

The First Amendment challenge was dismissed on the basis that the warnings empower consumers with necessary information. Although the court recognized that commercial speech is protected, it found that the regulation simply provides consumers with “factual and uncontroversial” information. Id. at *4. Judge Rakower reasoned that “[p]ersonal autonomy is not hindered, but rather encouraged by providing information so that consumers can make informed decisions about health; said differently, information promotes autonomy, giving a consumer the opportunity to make choices appropriate to himself or herself individually.” Id. at *2.

Finally, the court directly rejected the Association’s preemption claim using a plain language interpretation. The NLEA “provides that express preemption provision ‘shall not be construed to apply to any requirement respecting a statement in the labeling of food that provides for a warning concerning the safety of the food or component of the food.’” Id. at *4. The court held that this language clearly allows states and localities to require their own food safety warnings, and that Section 81.49 falls squarely within those confines. Id.

For those reasons, the court ultimately rejected both the Association’s petition for declaration judgment, and preliminary injunction.   On February 29, 2016, the First Department granted an interim stay on enforcing the new rule, which would have gone into full-effect on March 1, 2016.

Injured? You May be Covered: Court Of Appeals Extends the Duty of Care Owed by Medical Providers to Members of the General Public

— By Andrew Stewart

Davis v. South Nassau Communities Hosp., 2015 NY Slip Op 09229 (December 16, 2015).

Abstract: The Court of Appeals recognized a legal duty owed by medical providers to a non-patient, third party even in the absence of a special relationship. In doing so, the Court has joined the trend of other States, expanding the duty of care jurisprudence to include members of the general public.

***

In 2009, Lorraine Walsh drove herself to the Hospital and was checked into the emergency room. At 11:00 AM, two medical professionals (collectively with the Hospital referred to as “Defendants”) intravenously administered Dilaudid, an opioid narcotic painkiller and Ativan, a benzodiazepine drug. Examination of the warning labels supplied with the drugs, in addition with testimony elicited by an expert, established that the common side effects of Ativan include “sedation, dizziness, and disorientation”, which can create a “sedative/hypnotic” state. Additionally, Dilaudid can be up to eight times as powerful as morphine, with effects lasting between two to four hours. Dilaudid’s warning labels explicitly warn against the dangers of “driving a car or operating machinery.” Nevertheless, the two medical professionals at the Hospital failed to warn Walsh about the dangers of driving after receiving the medications. At 12:30 PM, only 90 minutes after administration of both drugs, Walsh was released from the hospital. Nineteen minutes later, she crossed the double centerline and crashed into another vehicle, seriously injuring the driver, Edwin Davis.

Davis filed suit alleging medical malpractice because Defendants failed to warn Walsh of the effects of the medication. His wife also alleged a derivative action for loss of consortium. Defendants moved to dismiss for failure to state a cause of action, which was granted by the trial court. The Appellate Division affirmed, stating that the Defendants did not owe a duty of care to the plaintiff because of the lack of a physician-patient relationship (that relationship existed between Walsh and Defendants, not Davis).

The Court of Appeals disagreed. It concluded that the duty of care extended to Davis: “the defendants owed to plaintiffs a duty to warn Walsh that the medication administered to her either impaired or could have impaired her ability to safely operate an automobile.”

Before reaching its conclusion, the Court of Appeals reviewed New York’s history of evaluating duty questions in the context of the medical profession. It noted the court’s precedent had been reluctant to impose a duty of care to “the general public” because it consists of “indeterminate, faceless, and ultimately prohibitively large class of plaintiffs, as opposed to a

‘known and identifiable group.’” The Court had only recognized a small exception for “special relationships.” Special relationships were limited to “members of a patient’s immediate family or household who may suffer harm as a result of the medical care a physician renders to that patient” because those plaintiffs are of a definable class. Importantly, the Court noted it had expanded the duty in such cases because the third party’s injury resulted from the physician’s performance of the duty of care owed to the patient [emphasis added]. The Court, therefore, concluded it had left the door open to expand the duty of care between a treating physician who takes the affirmative step of administering medication, but fails to warn the patient of the dangers of operating a motor vehicle, to a member of the general public who is affected by that omission [emphasis added].

In the instant case, the Court imposed a duty of care extending from the Defendants to Davis. In parting from previous decisions, the court identified several others factors that are used to calculate whether a duty should exist. Those include capacity of the parties to bear the loss, a policy of preventing future injuries, and the moral blame attached to the wrongdoer. Further, the Court quoted Prosser and Keaton; “no better general statement can be made than that the courts will find a duty where, in general, reasonable persons would recognize it and agree that it exists.” Torts § 54 at 359 {5th Ed. 1984).

Here, the Defendants took affirmative step to administer medication, but had failed to warn the patient about the risks to driving. Their failure to warn created a peril affecting every driver in Walsh’s vicinity. A duty of care must be imposed on medical professionals in this scenario, said the Court, because the “cost” of imposing the duty is small: he or she must simply warn the patient of the dangers. Physicians often advise patients of the risks of certain medications; requiring them to do so imposes no additional, significant obligations. Just as a pharmacist administers warnings to a patient that prescribed medication could impair the ability to drive when the patient picks up his or her prescription, a medical provider should be required to take a similar, simple prophylactic measure [emphasis added]. Furthermore, the Court recognized that other States extend the duty of care from the physician to members of the general public to warn the patient about adverse side effects of medications when the physician has administered the medication, or in other ways has treated the patient.

“This is an instance in which defendants’ ‘relationship with. . .the tortfeasor. . .placed them in the best position against the risk of harm.’” Therefore, the Court concluded that the Defendants owed a duty of care to Davis as a third party member of the general public.

New Developments in Assisted Suicide Legislation

by Shannon Crane

 

This month, the California legislature passed the “End of Life Option” bill into law. This makes California the fifth state to legalize physician-assisted death by either legislative action or court ruling. Under section 443.2 of the law, an adult resident of California may request a prescription for an “aid in dying” drug if they meet all of the following criteria: (1) diagnosed with a terminal disease, (2) voluntarily wish to receive the prescription, (3) established California residency, (3) documented official request form, (4) establish the physical and mental ability to self-administer the “aid in dying” drug. The law prohibits consideration of any requests made solely because of age or disability. Further, the law prohibits any requests made via proxy or surrogate, including through power of attorney or any other legally recognizable health care decision-maker.

A key aspect of the new law falls under section 443.13. Under this section, the sale or procurement of life, health, or annuity insurance plans “may not be conditioned upon or affected by a person making or rescinding a request for an aid-in-dying drug” and “death resulting from the self-administration of an aid-in-dying drug is not suicide, and therefore health and insurance coverage shall not be exempted on that basis.” Further, a qualified individual’s self-administering of an “aid-in-dying drug shall not have an effect upon” any of the aforementioned policies, and shall be considered in the same way that a natural death from the underlying disease would be treated. This is crucial because many insurance policies can be affected, or even voided by the act of suicide.[1]

In New York, Public Health Law section 2989 specifically prohibits physician assisted death. However, there is pending legislation in the New York Assembly, sponsored by Linda B. Rosenthal, that almost identically mirrors the California law. Past versions of physician-assisted suicide have failed to pass in New York, but with the wave of recent successful laws across the country, there may be a better chance for success. The bill will likely be heavily contested.

 

[1]John Dorfman, How Life Insurance Policies Deal with Suicide, Time: Money (Aug. 15, 2014), http://time.com/ money/3117698/how-life-insurance-policies-deal-with-suicide/

Survey: 2014 Health Law

Survey of New York Health law for 2013–2014.

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Ms. Lerch is an Associate with Gale Gale & Hunt, LLC; J.D., State University of New York at Buffalo; B.A., State University of New York College at Geneseo. Mr. Crowley is a Staff Attorney with Legal Services of Central New York; J.D., Syracuse University College of Law; B.A., University of Connecticut.

Survey: 2013 Health Law

Survey of New York Health law for 2012–2013.

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Ms. Lerch is an Associate with Gale Gale & Hunt, LLC; J.D., State University of New York at Buffalo; B.A., State University of New York College at Geneseo. Mr. Johnson is also an Associate with Gale Gale & Hunt, LLC; J.D., Fordham University School of Law; B.A., State University of New York College at Geneseo. This Article addresses recent developments in New York State and federal health law from July 1, 2012, to June 30, 2013.

Survey: 2012 Health Law

Survey of New York Health law for 2011–2012.

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Kirsten A. Lerch is an Associate with Gale, Gale & Hunt, LLC. J.D., State University of New York at Buffalo; B.A., State University of New York College at Geneseo.

Stephen F. Johnson is also an Associate with Gale, Gale & Hunt, LLC. J.D., Fordham University School of Law; B.A., State University of New York College at Geneseo.