Update from the Associated Press: The Supreme Court has struck down Texas' widely replicated regulation of abortion clinics in the court's biggest abortion case in nearly a quarter century.

The original column continues below:

KERMIT Gosnell's ears must be burning.

For months, his name has been dropped again and again by anti-choice advocates in Texas who are invoking Gosnell to justify restrictions that have made it harder than ever for women to exercise their legal right to an abortion.

On Monday, the U.S. Supreme Court will rule whether those restrictions are justified or are unjustly blocking a woman's right to choose to end her pregnancy.

Either decision will have ramifications beyond the borders of the Lone Star State - proving that Gosnell's grotesque legacy lives on, even as he rots for life in state prison in Huntingdon, Pa.

Gosnell, in case anyone needs the reminder, is the West Philly doctor who was convicted of first-degree murder in 2013 in the deaths of three infants born alive during abortion procedures at his clinic. Gosnell also was convicted of involuntary manslaughter in the death of a woman who received a lethal dose of narcotics while under his care. His fetid Women's Medical Society, rightfully dubbed "the House of Horrors" in the press, reeked of urine.

Flea-ridden cats roamed its filthy halls.

Attendants used unsterilized equipment on women, infecting some with venereal diseases.

Patients moaned in pain on dirty recliners beneath blood-stained blankets.

Procedures were carried out by unlicensed practitioners, and potent drugs were dispensed by untrained workers - including, unbelievably, a teenage girl.

Gosnell's story, which made national headlines, resulted in a grand-jury investigation that yielded recommendations aimed at ensuring that monsters like him would never practice again.

Among the recommendations was that free-standing Pennsylvania abortion clinics must be licensed as ambulatory surgery facilities to force greater, regular scrutiny by the state's health department. This was because the department had failed horribly, on numerous occasions, to follow up on complaints it received about Gosnell's practice.

The recommendation was overkill beyond comprehension, given that ambulatory surgery centers perform a broad range of procedures far riskier than abortion, one of the safest medical procedures there is. The rates of complications and infections from abortion, in fact, are so low that in some facilities it can hardly be measured.

So the argument that this recommendation is about protecting women's health is a lie.

But that didn't stop Pennsylvania from imposing the restriction, which effectively shut many centers that couldn't afford to retrofit their operations. The centers - and the women they served - essentially were punished because health department flunkies preferred to blame bureaucracy instead of their own lack of follow-up for Gosnell's ability to stay below the radar for so long.

Besides, Gosnell operated his practice illegally on so many levels, it's not as if he - or other practitioners so inclined - would suddenly clean up their act because the law said to.

Monsters do what they do.

Other states have since pushed the ambulatory-surgery lie, including Texas, which in 2013 also began requiring abortion doctors to have admitting privileges at a nearby hospital in case of patient emergencies.

Because, what, a woman in medical distress can't use a hospital's ER without her doctor's say-so?

The Texas ruling - known as HB2 - resulted in a massive closure of free-standing clinics that could not afford to retrofit their facilities to conform with the new regulations. The closures have left many women in Texas without reasonable access to a licensed, quality abortion facility.

Those concerns did not move one of the bill's co-sponsors, State Rep. Jason Isaac, an anti-choice advocate whose real motive for the restrictive bill was apparent in a March interview with National Public Radio. Isaac said that women who live hundreds of miles from the closest abortion clinic should just suck it up.

"Hopefully," he told NPR, "they'll be more preventative and not get pregnant." They should realize, he said, that, "Hey, that might still be an option legally, but now I live 300 miles away from the nearest place - I should probably be more careful."

And that's what these restrictions are really about: punishing women for getting pregnant when they don't want to be.

Well, we know what happens to women who can't afford or access safe abortion services when they desperately need them, for reasons that are none of Isaac's business or anyone else's.

They seek out Gosnells.

Attorneys for Pennsylvania's Women's Law Project said as much in a brief supporting the repeal of HB2's restrictive measures.

A principal justification of HB2, they wrote, is "that such a scheme will stop the next Kermit Gosnell, the infamous Philadelphia criminal, from preying on vulnerable women seeking abortions.

"Far from protecting women's health and safety, the Texas regulations heavily burden high-quality providers without medical justification and thereby threaten to drive patients to medically unsupervised home remedies or to criminals, like Kermit Gosnell, who endanger women's lives."

Pro-choice advocates fought HB2's restrictions but lost on appeal. So it has been kicked up to the Supreme Court for a ruling, due Monday. If the court upholds HB2, it could become the rule of the land, not just of the Fifth Circuit that encompasses Texas.

The responsibility of the U.S. Supreme Court is not to support new ways to block rights that the Constitution guarantees. It's to protect them from "undue burdens" - that's the court's own phrase - that would render them moot.

Gosnell was a horror and an aberration. But if the court upholds HB2, predators like him will be as common as they were before Roe v. Wade.

Do we really want to go back there?


215-854-2217 @RonniePhilly

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