Docs Can’t Challenge Midwifery Law

JEFFERSON CITY, Mo. (CN) - Missouri physicians' associations do not have the standing to constitutionally challenge a bill legalizing midwifery in Missouri, the state Supreme Court ruled 5-2.

The Missouri State Medical Association, The Missouri Association of Osteopathic Physicians and Surgeons, Missouri Academy of Family Physicians, and the St. Louis Metropolitan Medical Society challenged the law and claimed that the portion of the bill legalizing midwifery violated the bill's original purpose. The Missouri Supreme Court's ruling overturned a trial court's ruling in favor of the associations.

To have standing, Judge Stephen Limbaugh wrote in the majority opinion, the court requires the plaintiff to have some legally protected interest in the litigation so as to be directly and adversely affected by the outcome.

"Plaintiffs' primary claim of standing is premised on a concern that physicians' voluntary cooperation with nurse midwives who are not 'licensed' may subject those physicians to professional discipline by the Board of Registration for the Healing Arts," Limbaugh wrote. "It does not necessarily follow, however, that this prohibition against disciplining physicians is also a grant of authority to impose discipline ... Moreover, any negative implication of a grant of authority to impose discipline, at least as applied to physicians who assist or cooperate with certified midwives, would fly in the face of section 376.1753's express legalization of certified midwifery."

But Judge William Ray Price disagreed. "As to the ability to practice, the physicians allege that they will have to interact with the midwives either by advising their patients of their services or collaborating in the treatment of the patients," Price wrote in the dissenting opinion. "Further, they allege, that complications arise during pregnancy and birth that require the skill of the physician and the facilities of a hospital. When these emergency situations arise during home births, the physicians will be required to provide difficult and high risk emergency care. These allegations are sufficient to establish the physician's individual standing to challenge the constitutionality of the statute."

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