While most pro-life Americans are understandably focused on the Presidential election and key Congressional races, citizens in several states will also vote on life-related ballot initiatives on November 6th.  Below is a summary of these initiatives, and why they are important.

Florida Amendment 6 – “Florida Abortion Amendment”

Florida Amendment 6 includes two provisions.  First, the amendment provides that “[p]ublic funds may not be expended for any abortion or for health-benefits coverage that includes coverage of abortion.”  Exceptions are provided for when an expenditure is required by federal law, when the life of the mother is in danger, or when the pregnancy results from rape or incest.  This provision is very similar to the Hyde Amendment, a federal appropriations rider that is added annually to the appropriations bill for the Department of Health and Human Services (and applies to all funds appropriated through that Department, including Medicaid).

Second, Florida Amendment 6 provides that the state’s constitution “may not be interpreted to create broader rights to an abortion than those contained in the United States Constitution.”  In other words, given that the U.S. Constitution does not confer “abortion rights,” this Amendment will ensure that Florida’s courts will not continue to perpetuate the false assertion that the Florida Constitution creates a broader “right” to abortion than that invented by the U.S. Supreme Court in Roe v. Wade.

Authors of the amendment contend that the second provision will overrule state court decisions holding that the “right of privacy” under the Florida Constitution is broader than that in the United States Constitution.

Massachusetts Question 2 – “Death with Dignity” Initiative

Advocates for physician assisted suicide failed to advance their agenda in Massachusetts earlier this year when the state legislature did not vote on whether to legalize the practice. However, they will get a second “bite at the apple” when, on November 6, citizens in Massachusetts vote directly on whether assisted suicide should be legalized.

If Question 2 is enacted into law, Massachusetts will become the third state (after Oregon and Washington) to legalize assisted suicide.  The initiative provides that “[a]n adult resident of Massachusetts who is capable and has been determined by his or her attending physician and consulting physician to be suffering from a terminal disease [i.e., “incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months”], and who has voluntarily expressed his or her wish to die, may make a written request for medication that the patient may self-administer to end his or her life. . . .”

While the initiative purports to include safeguards that will protect vulnerable individuals who are considering taking their lives, it fails to adequately do so.  A family member (or someone else who stands to gain from a patient’s death) may serve as one of the two required witnesses to the patient’s request.  Further, physicians are not mandated to refer patients for psychiatric counseling or a palliative care consultation—they have discretion on whether psychiatric consultation is necessary, and are only required to inform patients about the availability of “feasible alternatives” to ending their lives.

Another troubling provision permits lethal medications to be dispensed to an “agent” of the patient, creating the danger that life-ending drugs could be ingested by someone else or administered by a third party and not the patient.  Further, doctors are only expected to “substantially comply in good faith” with the law to be immune from civil or criminal liability, or professional disciplinary action.  This raises a critical question—which provisions may a doctor bypass and still be in “substantial compliance?”

Physician assisted suicide does not affirm the life or the dignity of individuals facing serious illness or death.  Rather, it opens the door to a litany of abuses and dangers for extremely vulnerable individuals, and can begin the journey down a “slippery slope” towards legal assisted suicide for other categories of individuals (e.g., disabled individuals, those with severe chronic pain, or individuals with psychological illness), and active or even involuntary euthanasia.

Montana Legislative Referendum No. 120: “Montana Parental Notification Measure”

Efforts to protect pregnant minors and their unborn children in Montana have been thwarted by courts and Governor Brian Schweitzer.  While a parental notification law in Montana was upheld against a federal constitutional challenge in 1997,[1] a permanent injunction was issued against the enforcement of the law in a state constitutional challenge, Wicklund v. State.[2] Moreover, in 2011, Governor Schweitzer vetoed SB 97, the “Parental Notice of Abortion Act of 2011,” purportedly on state constitutional law grounds.

However, the people of Montana will get the opportunity to provide some protections for some minors on November 6 when they vote on Legislative Referendum No. 120.  L.R. 120 “prohibits a physician from performing an abortion on a minor under 16 years of age unless a physician notifies a parent or legal guardian of the minor at least 48 hours prior to the procedure. Notice is not required if: (1) there is a medical emergency; (2) it is waived by a youth court in a sealed proceeding; or (3) it is waived by the parent or guardian. A person who performs an abortion in violation of the act, or who coerces a minor to have an abortion, is subject to criminal prosecution and civil liability.”

While L.R. 120 does not protect minors who are 16 or 17 years old, it provides a great improvement on the status quo in Montana.

Parental involvement laws are widely supported because parents usually possess information essential to a physician’s exercise of his or her best medical judgment concerning the minor child.  The medical, emotional, and psychological consequences of abortion are often serious and can be lasting, particularly when the patient is immature.   Also, parents who are aware that their daughter has had an abortion may better ensure the best post-abortion medical care.    Further, girls who obtain “secret” abortions often do so at the behest of the older men who impregnated them, and then return to abusive situations.

Quite simply, minor girls are at risk in Montana every day because the state does not maintain and enforce a parental involvement law.

Other Notable Initiatives

Several states have initiatives on the ballot responding to the Affordable Care Act’s (ACA) provisions requiring and regulating health insurance coverage.  While these initiatives do not directly address the anti-life provisions in the ACA, their enactment would potentially protect the freedom of conscience of individuals, employees, and healthcare providers in their states.  However, given that the ACA is a federal law, it is questionable how strong an impact these initiatives can have on blunting the anti-life effects of the healthcare law.  Notably, some of the amendments address state law as well.

Alabama Amendment 6

This amendment would provide that “a law or rule shall not compel, directly or indirectly, any person, employer, or health care provider to participate in any health care system.”  Further, persons and employers may “[p]ay directly for health care services” and health care providers “may accept direct payment for lawful health care services.”  Finally, the “purchase or sale of health insurance in private health care systems shall not be prohibited by law rule.”

Possible implications for life: If individuals, employers, and healthcare providers are not required to participate in a particular health care system, their freedom of conscience to object to providing or paying for certain services that are included in that system (e.g., abortion or “contraception” with life-ending effects) is protected.

Florida Amendment 1

Florida Amendment 1 is substantially similar to Alabama Amendment 6, providing that “a law or rule may not compel directly or indirectly, any person or employer to purchase, obtain, or otherwise provide for health care coverage.”  The amendment similarly protects the right to directly pay for healthcare services and to receive payment for the services.

Possible implications for life:  Same as Alabama Amendment 6 (above).

Wyoming Constitutional Amendment A

Wyoming Constitutional Amendment A is similar to Alabama Amendment 6 and Florida Amendment 1.  It provides that the right to make health care decisions is reserved to the citizens of the state of Wyoming, and permits any person to pay and any health care provider to receive direct payment for services.

Possible implications for life:  Same as Alabama Amendment 6 (above).

Missouri Senate Bill No. 464

Missouri Senate Bill No. 464 prohibits the establishment of a health insurance Exchange (required by the ACA) by any means other than: (a) a legislative bill; (b) an initiative petition, or; (c) a referendum.  The governor is prohibited from “establishing, administering, or operating” an Exchange through an executive order.

Possible implications for life:  This provision could ensure that Governor Jay Nixon, who is pro-abortion, does not use any discretion (given to states by the ACA) to institute anti-life policies through the state’s Exchange.

Montana Legislative Referendum No. 122

Legislative Referendum No. 122 prohibits “the state or federal government from mandating the purchase of health insurance or imposing penalties for decisions related to purchasing health insurance.”

Possible implications for life:  Again, as with the Alabama and Florida initiatives discussed above, individuals who object to purchasing certain insurance plans—because to do so would violate their freedom of conscience—are protected by this provision.

[1] Lambert v. Wicklund, 520 U.S. 292 (1997).

[2] No. ADV-97-671 (Mont. Dist. Ct., Feb. 25, 1999) (unpublished opinion), appeal dismissed, (Mont. Nov. 29, 1999).