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![handle is hein.sag/sagmd0109 and id is 1 raw text is:
ABORTION
STATUTORY INTERPRETATION - WHETHER SECTION 20-208 OF
THE HEALTH-GENERAL ARTICLE PROHIBITS NURSE
PRACTITIONERS, CERTIFIED NURSE MIDWIVES, AND
PHYSICIAN ASSISTANTS FROM PROVIDING MEDICATION
ABORTIONS - WHETHER THE SAME STATUTE PROHIBITS
PHYSICIAN ASSISTANTS FROM PERFORMING SURGICAL
ABORTIONS
January 10, 2020
The Honorable Ariana Kelly
Maryland House of Delegates
You have requested our opinion on two questions about the
requirement in State law that [a]n abortion must be performed by
a licensed physician. Md. Code Ann., Health-Gen. (HG) § 20-
208. First, you ask whether that physicians-only statute prohibits
nurse practitioners, certified nurse midwives, and physician
assistants from prescribing and providing to a patient the necessary
drugs to produce a medication abortion, i.e., a regimen of two
prescription drugs that a patient can take to terminate a pregnancy.
Second, you ask whether the statute prohibits a physician assistant
from performing a surgical abortion under a delegation agreement
with a supervising physician. In our opinion, a Maryland court
would likely conclude, as to your first question, that nurse
practitioners, certified nurse midwives, and physician assistants
may provide medication abortions but that, as to your second
question, only physicians, not physician assistants, may perform
surgical abortions.
As to medication abortions-which were not yet available in
the United States when HG § 20-208 was enacted-the statute's
text is ambiguous. Although the word abortion in isolation may
be most often understood to include all methods of inducing the
termination of a pregnancy, the phrase an abortion must be
performed, when read as a whole and in context, seems to have a
narrower surgical connotation. After all, one would not ordinarily
say that a health care practitioner has performed an abortion
merely by prescribing drugs that the patient then chooses to take
herself. At the very least, there is some ambiguity about whether
the language of the statute should be read to apply to medication
abortions, such that a Maryland court would likely turn to other
indicia of the General Assembly's intent, including the legislative
history, the historical context, and the legislative purpose to
determine the meaning of the statute. And here all of those indicia
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