A House committee voted Wednesday to stop a Tucson nurse practitioner from performing surgical abortions. The legislation, HB2269, does not name Mary Andrews, who works for Planned Parenthood Arizona. Instead, it would spell out in state law that abortions cannot be performed in this state by a nurse practitioner.
That may - or may not - override laws governing what these specially trained nurses can do. In fact, the state Board of Nursing, now reviewing a complaint against Andrews, has yet to decide whether she is doing anything illegal.
But Rep. Bob Stump, R-Peoria, House Health Committee chairman, said he sees no need to wait until that board rules.
More to the point, Stump said the issue of who gets to do what should be defined by the Legislature.
A majority of the panel agreed, voting 6-3 to send the measure to the full House.
At the heart of the debate is the question of whether a nurse practitioner is qualified to perform the procedure.
While state law regulates nursing, the issue of what nurses can do is generally spelled out in regulations. That is particularly true of registered nurse practitioners, who have advanced training.
Nothing in the rules specifically addresses the question of abortions, stating instead that these people are entitled to perform therapeutic procedures the registered nurse practitioner is qualified to perform.
Michelle Steinberg, a Planned Parenthood spokeswoman, said her organization has been using a nurse practitioner for eight years "with fewer complications than the national average."
Steinberg said there are various more complicated procedures that nurse practitioners are allowed to perform, ranging from inserting an intrauterine device for birth control to lumbar punctures and placing a catheter in a jugular vein. "There's nothing to indicate that nurse practitioners are not within the scope of practice to do this."
What happened last June, though, is that someone - the name is not public record - filed a complaint against Andrews with the Board of Nursing.
Valerie Smith, the agency's associate director for investigations and compliance, said board members considered the matter in November but were unable to make a decision. Smith said the board directed the staff to investigate further, with the issue now on the agenda for a meeting later this month.
Cathi Herrod, president of the Center for Arizona Policy, said failure of the Board of Nursing to halt the practice immediately shows the need for lawmakers to step in. She said 37 states prohibit nurse practitioners from performing abortions.
Herrod acknowledged her organization has consistently lobbied to make all abortions illegal or, at the very least, impose restrictions. But she doesn't see this measure as part of the perennial debate over the merits of legal abortion.
"This is really, in my view, a women's health issue," she said. "It's about how women are going to be taken care of who are having abortions and who legally should be allowed to perform legal surgical abortions."
Steinberg countered that there is absolutely no evidence abortions performed by nurse practitioners are unsafe. She also said that more complex procedures, particularly if a woman is further along in her pregnancy, are always performed by a physician.
Complicating the debate are other laws already on the books regulating abortion clinics.
Those statutes, Herrod said, clearly refer only to "doctors" when spelling out who can legally terminate a pregnancy.
But Smith said the Board of Nursing is empowered to decide the question of whether Planned Parenthood's Andrews is acting improperly, based solely on the regulations.