Summary
The Montana Supreme Court affirmed a preliminary injunction barring enforcement of Montana's physician-and-physician-assistant restriction on pre-viability abortion services. The court held that nurse practitioners and certified nurse midwives had standing to challenge the restriction and that their claims were ripe. It further held that the plaintiffs presented sufficient evidence of threatened constitutional injury and irreparable harm to support preliminary relief.
Topics
Practice areas
Questions Presented
- Whether Weems and Doe had standing to challenge Montana Code Annotated section 50-20-109(1)(a).
- Whether the plaintiffs' claims and request for preliminary injunctive relief were ripe for adjudication.
- Whether the District Court manifestly abused its discretion or committed legal error by granting a preliminary injunction based on threatened irreparable injury.
- Whether the preliminary injunction improperly altered rather than preserved the status quo.
Holdings
- The plaintiffs had standing because they alleged a concrete threatened injury caused by the statute and sought relief that would alleviate that injury; health care providers may also assert their patients' Montana constitutional privacy rights when governmental regulation affects access to lawful medical procedures.
- A plaintiff seeking a preliminary injunction need establish only a prima facie case of a constitutional violation and threatened harm, not entitlement to final judgment or proof beyond a reasonable doubt that the challenged statute is unconstitutional.
- The plaintiffs' challenge was ripe and the evidence established irreparable injury because the statutory restriction presented a present barrier to training, competency development, and provision of lawful medication and aspiration abortion services.
- The preliminary injunction did not improperly alter the status quo; for purposes of the plaintiffs' challenge, the relevant rights preserved were women's rights to obtain the lawful medical procedure recognized in Armstrong, rather than the mere continued existence of the challenged statute.
Key quotations
“"Prima facie" means literally "at first sight" or "on first appearance but subject to further evidence or information."” (¶ 18)
“Status quo means "the last actual, peaceable, noncontested condition which preceded the pending controversy."” (¶ 26)
Factual background
Plaintiffs Helen Weems, a certified nurse practitioner, and Jane Doe, a certified nurse midwife and women's health nurse practitioner, alleged that early-term medication and aspiration abortions fell within or could be developed within their professional competencies. The record included evidence that advanced practice registered nurses routinely perform procedures comparable in skill and risk to early-term abortions, that Weems had prescriptive authority and prior experience dispensing medication-abortion drugs, and that the safety and efficacy of early abortion were comparable across physicians, physician assistants, nurse practitioners, and certified nurse midwives. Plaintiffs also presented evidence that the statutory restriction limited access to abortion services and prevented them from obtaining training and developing competency to provide those services.
Procedural history
A certified nurse practitioner and certified nurse midwife sued for declaratory relief, alleging that the physician-and-physician-assistant restriction violated Montana constitutional rights to privacy, equal protection, and dignity. After considering affidavits and legal argument without an evidentiary hearing, the District Court granted a preliminary injunction on April 4, 2018, finding that enforcement during the litigation would cause irreparable injury. The Montana Supreme Court affirmed.