Court: Some bone marrow donors can be paid

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FILE - In this Feb. 15. 2011 file photo, Kumud Majumder holds a photo of his deceased son, 11-year-old Arya Majumder, outside U.S. Federal Court in Pasadena, Calif. A federal appeals court on Thursday, Dec. 1, 2011 ruled that most bone marrow donors can be paid, overturning the government's interpretation of a decades-old law making such compensation a crime punishable by up to five years in prison. Majumder, a plaintiff in the case against the government, said his son died of leukemia last April. The family had resorted to an imperfect bone marrow donor match in desperation because no perfect match was available. (AP Photo/Nick Ut, File) FILE - In this Feb. 15. 2011 file photo, Kumud Majumder holds a photo of his deceased son, 11-year-old Arya Majumder, outside U.S. Federal Court in Pasadena, Calif. A federal appeals court on Thursday, Dec. 1, 2011 ruled that most bone marrow donors can be paid, overturning the government's interpretation of a decades-old law making such compensation a crime punishable by up to five years in prison. Majumder, a plaintiff in the case against the government, said his son died of leukemia last April. The family had resorted to an imperfect bone marrow donor match in desperation because no perfect match was available. (AP Photo/Nick Ut, File)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); SAN FRANCISCO (AP) — A father who believes a lack of bone marrow donors contributed to his son's death from leukemia says a federal court ruling allowing most bone marrow donors to be paid will save lives and drive down treatment costs.

The appeals court ruled Thursday that most bone marrow donors can be paid, overturning the government's interpretation of a decades-old law making such compensation a crime punishable by up to five years in prison.

In its ruling, the 9th U.S. Circuit Court of Appeals said a technological breakthrough makes donating bone marrow a process nearly identical to giving blood plasma.

It's legal — and common — to pay plasma donors. Therefore, the court ruled, bone marrow donors undergoing the new procedure can be paid as well and are exempt from a law making it a felony to sell human organs for transplants.

The ruling comes after a lawsuit was filed by lawyers at the nonprofit Institute for Justice. The group represents a coalition of patients, doctors and MoreMarrowDonors.org, which is seeking to offer donors $3,000 in the form of a scholarship, housing allowance or gift to charity.

A plaintiff in the lawsuit, Kumud Majumder, said his 11-year-old son, Arya, died of leukemia last April.

The family had resorted to an imperfect bone marrow donor match in desperation because no perfect match was available, the father said at a news conference outside the circuit court's Pasadena chambers

"Arya's tragedy happened in part because of a lack of bone marrow donors," Majumder said. "In the end, creating more and better bone marrow donor matches through a system of modest compensation will save the lives of patients, improve the lives of donors, drive down the costs of treatment and improve the quality of life of cancer patients as they battle to survive."

The unanimous, three-judge panel of the court did say it remains a felony to compensate donors for undergoing an older transplant method, which extracts the marrow from the donors' bones.

But the court said the new technology isn't covered by the law because actual bone marrow isn't taken from the donor. Instead, specialized cells that grow into marrow are taken from a donor's bloodstream, and it's basically a blood donation, not an organ transplant, the court said. It noted that two-thirds of bone marrow transplants employ the newer process.

Tens of thousands of people with leukemia, lymphoma and other blood diseases are saved each year by such procedures. An estimated three thousand others die waiting for donations, which unlike simple blood donations need to be genetically compatible, making matches especially difficult for African Americans.

The decision won't become official for at least 30 days while the U.S. Department of Justice ponders what to do next. The DOJ can ask the appeals court to reconsider the decision or petition the U.S. Supreme Court to take it.

DOJ spokesman Charles Miller said the department is reviewing its options.

Advocates for paying donors said compensation will spur even more donations. Detractors argue that donor compensation will exploit the poor to undergo risky medical procedures to benefit the wealthy.

The National Marrow Donor Program, the nonprofit that provides transplants from volunteers, opposes payments.

"We were surprised and puzzled by the appellate court's decision regarding allowing compensation," said Michael Boo, the program's chief strategy officer. "The National Marrow Donor Program is studying the decision and assessing the impact. We do not anticipate the ruling will change the NMDP's current policies and practices."

The ruling overturns a lower court decision barring compensation for all bone marrow donations.

At the heart of the court's ruling, which is sure to ignite renewed debate over paying medical donors, are two processes for transplanting bone marrow into patients suffering from diseases of the blood.

The first and older one is known as "aspiration" and requires the donor to endure painful and risky procedures that require hospitalization and anesthesia. Long, thick needles are inserted into the cavities of the donor's hip bones to suck out the bone marrow. The court said that process was still covered by the National Organ Transplant Act, which explicitly prohibits paying donors for their bone marrow.

"The point of the ban on selling organs is to protect people from ignoring the medical risk for money," said Arthur Caplan, a bioethicist with the University of Pennsylvania. Caplan said the ruling Thursday may unintentionally support campaigns to pay donors in other medical fields such as compensating women for their eggs.

The newer procedure, which the court ruled exempt from the act, was developed about 20 years ago and involves harvesting cells from the bloodstream rather than in bone. Called "apheresis," the procedure requires the donor to undergo five days of drug injections to stimulate production of specialized blood cells. Then the donor sits in a recliner for several hours while the blood is filtered through a machine that extracts the specialized cells.

"Congress could not have had an intent to address the apheresis method when it passed the statute, because the method did not exist at that time," Judge Andrew Kleinfeld wrote for the court. "We construe 'bone marrow' to mean the soft, fatty substance in bone cavities, as opposed to blood, which means the red liquid that flows through the blood vessels."

Kleinfeld said it may be time to apply a new label to the process.

"It may be that 'bone marrow transplant' is an anachronism that will soon fade away, as peripheral blood stem cell apheresis replaces aspiration as the transplant technique, much as 'dial the phone' is fading away now that telephones do not have dials," Kleinfeld wrote.

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Obama healthcare law issues before high court

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By James Vicini

Tue Oct 25, 2011 5:27pm EDT

n">(Reuters) - Six cases involving President Barack Obama's healthcare overhaul legislation are pending before the Supreme Court as part of the legal battle over the law's fate.

The following key issues have emerged in the legal briefs recently filed in the cases stemming from Obama's signature and most controversial domestic achievement that involved the biggest reform of the healthcare system in nearly 50 years:

INDIVIDUAL INSURANCE MANDATE

The most important issue involved whether the Congress exceeded its power by requiring that all Americans buy health insurance or pay a penalty. The law aims to provide more than 30 million uninsured Americans with coverage.

The Obama administration in its Supreme Court appeal argued that Congress could enact this provision, called the individual mandate, under its powers in the U.S. Constitution to regulate interstate commerce. The mandate is due to take effect in 2014.

Congress adopted the law to address a national crisis of health insurance costs rising beyond the reach of millions of Americans and coverage denied to millions more, Solicitor General Donald Verrilli, a former White House lawyer, said in a brief.

Opponents of the law, including 26 of the 50 states, argued that Congress exceeded its powers. They said the law dramatically expanded the federal government's power and argued that the provision should be struck down as unconstitutional.

Former Bush administration Solicitor General Paul Clement, who represents the states, called the law "an unprecedented legislative initiative" that seeks "to force individuals to engage in commerce so that the federal government may regulate them."

WHAT HAPPENS TO THE REST OF THE LAW?

In a broader issue, the states and the National Federation of Independent Business -- a lobbying group for small businesses -- said the entire healthcare law must fall if the mandate is declared unconstitutional.

The federation and states contend that the individual mandate is at the heart of the law, a carefully crafted compromise, and new insurance regulations and other provisions cannot survive on their own.

The administration disagreed. It said it would be wrong to strike down all other provisions of the law, especially those unrelated to the mandate, such as the requirement that insurers provide coverage for young adults.

The administration said a few key provisions, including one that will bar insurers from refusing to issue coverage to a person because of a pre-existing medical condition, could not be separated from the mandate.

EXPANSION OF MEDICAID ON THE STATES

The states also challenged the expansion of Medicaid, a federal-state partnership that provides health care to poor Americans. They argued that Congress unconstitutionally forced the expansion on the states by threatening to withhold billions of dollars in funds from states that refuse to cooperate.

The administration said the provision expanding Medicaid eligibility to cover individuals with income up to 133 percent of the federal poverty level was a valid exercise of Congress's power to set the terms in appropriating federal funds.

MUST THE PENALTY BE IMPOSED FIRST?

The Obama administration and some opponents of the law asked the court to address whether lawsuits challenging the mandate are barred because the penalty for not obtaining individual insurance has yet to be imposed.

At issue is a federal law aimed at preventing lawsuits from tying up tax collection and whether the challenges can only be decided after taxpayers actually begin paying the penalty for not purchasing insurance.

The administration said the law, the Anti-Injunction Act, did not require dismissal of the challenges to the mandate. But the administration said the Supreme Court should consider the issue and consider appointing a lawyer to make that argument.

ARGUMENTS LIKELY IN MARCH

The Supreme Court next month is expected to consider the various appeals, to officially agree to take up the law, and it could clarify the issues to be decided.

The next steps would be for legal briefs to be filed, the scheduling of oral arguments, most likely in late March, and a ruling expected by the end of June.

Legal experts said it was impossible to predict how the court might rule. A decision by the nine-member court, closely divided with five conservatives and four liberals, could come down to Chief Justice John Roberts and Justice Anthony Kennedy, who often casts the decisive vote, they said.

The Supreme Court cases are Thomas More Law Center v. Barack Obama, No. 11-117; National Federation of Independent Business v. Sebelius, No. 11-393; U.S. Department of Health and Human Services v. Florida, No. 11-398; Florida v. Department of Health and Human Services, No. 11-400; Virginia v. Sebelius, No. 11-420; and Liberty University v. Geithner, No. 11-438.

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Top court considers California Medicaid cuts

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WASHINGTON | Mon Oct 3, 2011 1:50pm EDT

WASHINGTON (Reuters) - The Supreme Court opened its new term on Monday and considered whether Medicaid recipients and medical providers may sue California for cutting reimbursement rates in the healthcare program for low-income Americans.

The justices heard arguments in a case that centered on the plan by California's lawmakers in 2008 to slash Medicaid payments to doctors, hospitals and other medical providers to help reduce the state's massive budget deficit.

The providers sued to stop the cuts from taking effect on the grounds it would violate federal law. The cash-strapped state said the 10 percent cuts would save more than $700 million.

Washington attorney Carter Phillips, representing those who challenged the cuts, argued before the Supreme Court that an appeals court in California correctly ruled in blocking the cuts for violating federal law.

California Deputy Attorney General Karin Schwartz and Deputy Solicitor General Edwin Kneedler, who argued on behalf of the Obama administration, said only the government can enforce the federal law and private citizens have no right to sue.

After the arguments, the Supreme Court took the case under advisement, with a ruling expected early next year.

Medicaid, administered by the states with partial reimbursements from the federal government, can account for a third of a state's spending. It provides health insurance to more than 55 million people.

The 2009 economic stimulus plan boosted the rates of reimbursements for states, with the caveat that they not cut Medicaid spending. As that money ends, though, so does the requirement and states are eager to find new places for savings as their revenues remain well below pre-recession peaks.

The housing bust, financial collapse and economic recession created the largest drop in states' revenues since the 1980s, and California has been particularly hard hit.

Earlier this month, the state reported its August revenue was $65 million below forecast, which could force California to slash spending more. It recently closed a $10 billion budget gap with cuts and expectations of improving revenue.

Even though the recession officially ended more than two years ago, states had to cut spending and hike taxes to a close a total of about $100 billion in budget gaps for the fiscal year that started in July. Many states targeted Medicaid payment rates.

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Safe drug-injection site can stay: Supreme Court of Canada

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A poster shows how to use a syringe safely inside a safe injection site for drug addicts on Vancouver, British Columbia's eastside August 23, 2006.

Credit: Reuters/Andy Clark

By David Ljunggren

OTTAWA | Fri Sep 30, 2011 11:14am EDT

OTTAWA (Reuters) - Vancouver's Insite clinic, the only such safe-injection site for drug addicts in North America, can stay open, the Supreme Court of Canada ruled on Friday in a landmark defeat for the federal government.

The country's top court, slapping down the Conservative government with some harsh language, ruled unanimously that closing the site would threaten the lives of drug users and therefore violate their human rights.

The government, which is pushing a tough-on-crime agenda, said keeping Insite open made a mockery of laws designed to stamp out illegal drug use. The Health Department had said it would not extend a special exemption to drug laws that allowed the site to operate.

The court said such a decision would break the principles of fundamental justice and was arbitrary, ordering the health minister to maintain the exemption.

"It is also grossly disproportionate: the potential denial of health services and the correlative increase in the risk of death and disease to drug users outweigh any benefit that might be derived from maintaining an absolute prohibition on possession of illegal drugs on Insite's premises," it ruled.

Insite operates in Vancouver's poor Downtown Eastside district, one of the most deprived urban areas in Canada. The clinic was set up in 2003 to allow intravenous drug users to shoot up in a place that had medical supervision.

A study in the Lancet medical journal this year said the site had cut drug overdose deaths by 35 percent in the area. Police and local officials had campaigned for it to stay open.

The site's operators - who argued that drug addiction was a disease - said that, before the site opened, drug users were regularly dying of overdoses on the streets. The Downtown Eastside has around 4,600 intravenous drug users.

Recovered heroin addict Dean Wilson, a member of the board of the users' group, jumped in the air, whooped loudly and clenched his fists in delight when told of the ruling.

"This just substantiates what I've been saying for a long time, that what we've been doing is the right thing. This has nothing to do with the law-and-order platform, this has to do with gold standard medical intervention for a group of very very ill people," he told reporters.

Heroin and cocaine addicts receive clean needles to inject themselves with their own drugs under supervision by a nurse. They can then stay in a special "chill-out" room before returning to the streets.

Federal Health Minister Leona Aglukkaq will comment on the court ruling later Friday, a spokesman said.

The Conservatives, who won a majority in the May general election, plan to push through tougher laws on crime and open new prisons - moves that critics say are expensive and will put many more people in jail.

"They always took this political ideological partisan position," said Libby Davies, a legislator for the opposition New Democrats, whose parliamentary constituency includes the Downtown Eastside.

"I want to say to them: Have you now understood, have you learned the importance of what Insite is about? ... There have been no deaths from overdoses inside Insite," she said.

The case name is Attorney General of Canada et al. v. PHS Community Services Society, et al. (Case no: 33556).

(Reporting by David Ljunggren; editing by Rob Wilson)

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Obama's healthcare law appealed to Supreme Court

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Opponents of the proposed U.S. health care bill are pictured during a rally outside the U.S. Capitol Building in Washington, March 21, 2010.

Credit: Reuters/Jason Reed

By James Vicini

WASHINGTON | Wed Sep 28, 2011 6:43pm EDT

WASHINGTON (Reuters) - The Obama administration on Wednesday asked the U.S. Supreme Court to back the centerpiece of Barack Obama's sweeping healthcare overhaul -- the requirement that all Americans have health insurance.

The appeal was largely expected as a high court ruling against the law could be a fatal blow to the president's signature domestic policy achievement and could have major implications for his re-election bid.

The same day the administration filed its appeal, 26 states and a major business group urged the justices to strike down the entire law, which would have a far-reaching impact on future healthcare coverage for Americans and company costs.

The case is likely to be heard and decided in the Supreme Court's upcoming term that begins next week and lasts through June 2012. A ruling is likely in the midst of the campaign for the November 2012 elections.

The administration and the opponents of the law called for a quick ruling by the high court to resolve uncertainty affecting the federal government, states and companies about the law's key provisions that are taking effect.

The 26 states and National Federation of Independent Business argued in their appeals the entire law should be invalidated because Congress exceeded its powers requiring that Americans buy health insurance or face a penalty.

The Obama administration filed its own appeal in which the Justice Department argued the so-called individual mandate, due to take effect in 2014, was constitutional and said the issue was appropriate for Supreme Court review.

"Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act and the Voting Rights Act, and all of those challenges failed," the Justice Department said.

"We believe the challenges to Affordable Care Act ... will also ultimately fail and that the Supreme Court will uphold the law," the department said in a statement.

White House adviser Stephanie Cutter said the administration asked the Supreme Court to hear the case "so that we can put these challenges to rest and continue moving forward implementing the law to lower the cost of health care and make it more secure for all Americans."

At issue was a ruling by a U.S. appeals court in Atlanta in August that declared unconstitutional the individual insurance requirement but refused to strike down the entire law.

That decision conflicted with rulings by other appeals courts that have upheld the law or have rejected legal challenges, including a lawsuit by the state of Virginia that was dismissed earlier this month on procedural grounds.

The law, passed by Congress and signed by Obama in 2010 after a bruising political battle, is expected to be a major issue in the 2012 elections as Obama seeks another four-year term. Republican presidential candidates oppose it and Republicans in Congress have pushed to repeal the law.

EXPANDING COVERAGE

Obama, a Democrat, has championed the law as a major accomplishment of his presidency and as a way to try to slow soaring healthcare costs while expanding health insurance coverage to the more than 30 million Americans without it.

The Supreme Court long has been expected to have the final word on the law's constitutionality. The dispute has important legal, political and financial implications for companies in the healthcare field.

Florida Attorney General Pam Bondi said the states sought Supreme Court review of their lawsuit.

"This healthcare law is an affront on Americans' individual liberty and we will not allow the federal government to violate our constitutional rights," she said.

Legal experts have said the nine-member Supreme Court, with a conservative majority and four liberals, most likely will be closely divided on whether the individual mandate requiring insurance purchases exceeded the power of Congress.

The Obama administration earlier this week said it decided against asking the full U.S. Appeals Court for the 11th Circuit to review the August ruling by a three-judge panel of the court that found the insurance requirement unconstitutional.

That decision cleared the way for the administration to go to the Supreme Court.

The states in their appeal also argued the law's expansion of Medicaid, a federal-state partnership that provides health care to low-income Americans, was unconstitutionally coercive, forced upon the states.

A senior Justice Department official told reporters that political considerations played no role in moving for Supreme Court review. The official said it was important to get a ruling soon so planning for the far-reaching law can proceed.

(Additional reporting by Jeremy Pelofsky and Karen Pierog in Chicago; Editing by Mary Milliken and Bill Trott)

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Obama healthcare law headed for Supreme Court

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President Barack Obama is pictured as he delivers remarks on the need to provide states with relief from key provisions of the No Child Left Behind education policy, at the White House in Washington September 23, 2011.

Credit: Reuters/Jason Reed

By James Vicini

WASHINGTON | Mon Sep 26, 2011 6:00pm EDT

WASHINGTON (Reuters) - The Obama administration on Monday cleared the way for the U.S. Supreme Court to decide in its 2011-12 term the president's signature healthcare law that requires Americans to buy insurance or face a penalty.

A Justice Department spokeswoman said it decided against asking the full U.S. Appeals Court for the 11th Circuit to review the August ruling by a three-judge panel of the court that found the requirement unconstitutional.

The decision not to seek review by the full appeals court will likely speed up consideration of the matter by the high court in its 2011-12 term that begins next week. A ruling could come by late June, in the middle of the presidential campaign.

The Supreme Court has long been expected to have the final word on the legality of the individual mandate, a cornerstone of President Barack Obama's healthcare law. A big uncertainty has been over when the court would decide the issue.

The law's fate before the nine-member court, closely divided with a conservative majority and four liberals, could come down to two Republican appointees, Chief Justice John Roberts and Justice Anthony Kennedy, legal experts have said.

The law, adopted by Congress in 2010 after a bruising battle, is expected to be a major political issue in the 2012 elections as Obama seeks another four-year term. All the major Republican presidential candidates oppose it.

Obama, a Democrat, has championed the individual mandate as a major accomplishment of his presidency and as a way to try to slow soaring healthcare costs while expanding coverage to the more than 30 million Americans without it.

The 11th Circuit appeals court, based in Atlanta, ruled by a 2-1 vote last month in favor of 26 states and others who challenged the mandate for exceeding the power of Congress.

The Obama administration could have asked the full U.S. 11th Circuit Court of Appeals to reconsider its decision. But that could have pushed back any Supreme Court ruling to its 2012-13 term.

The 2-1 ruling conflicted with other appeals courts that have upheld the law or have rejected legal challenges, including a lawsuit by the state of Virginia which was dismissed on procedural grounds.

A U.S. appeals court based in Cincinnati ruled Congress had the power to adopt the individual mandate, which takes effect in 2014. The losing side in that case, the Thomas More Law Center, already appealed to the Supreme Court in July.

The administration has steadfastly maintained its belief that the law will survive judicial scrutiny and be upheld by the Supreme Court. The states that have challenged the law have argued it went beyond Congress' authority to require coverage.

(Additional reporting by Jeremy Pelofsky; Editing by Doina Chiacu and Eric Walsh)

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Court hears child heart unit row

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27 September 2011 Last updated at 09:49 GMT The hospital has described the consultation as unlawful The Royal Brompton Hospital is starting a legal challenge over what it says was "deeply flawed" consultation which it claims has led to its children's heart surgery unit facing closure.

It says the shutting down of the unit would put the viability of the whole hospital at risk.

The hospital in Chelsea, west London, has the largest specialist heart and lung centre in the UK.

A judicial review over the consultation begins later at the High Court.

Its challenge, which is expected to be heard over three days, is against the consultation process launched by the Joint Committee of the Primary Care Trusts of England as part of a national review aimed at streamlining paediatric congenital cardiac surgery services (PCCS) around the country.

It is believed this is the first legal challenge of its kind to be brought by one NHS body against another.

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Our decision to take legal action has been taken with deep regret”

End Quote Bob Bell Royal Brompton and Harefield NHS Foundation Trust Bob Bell, the Royal Brompton and Harefield NHS Foundation Trust's chief executive, said: "Our decision to take legal action has been taken with deep regret.

"But the gravity of the consequences for patients of this deeply flawed consultation process left us no other option."

The decision to grant a judicial review was made following a hearing in July.

At that hearing, Alan Maclean QC, for the trust, said the joint committee was proposing under the "Safe and Sustainable" consultation on the future of children's heart surgery in England to reduce the number of centres in London from three to two.

Robust review

He said it was now clear that the Royal Brompton centre was going to be "ditched" following an "unfair and unlawful" consultation exercise "shot through with legal error".

But Neil Garnham QC, for the joint committee, said there had not yet been a final decision that the number of PCCS centres in London would be reduced from three to two.

The three-centre solution "has plainly not been excluded and the joint committee is proceeding with an open mind", said Mr Garnham.

Views in favour of retaining the Royal Brompton's services would be properly considered.

Teresa Moss, director of the NHS' Specialised Commissioning team, said: "Safe and Sustainable do not accept the allegations made today by the Royal Brompton.

"We will present our own case later this week when we provide evidence in court demonstrating that the principles and processes of the review are robust."

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Woman wins court order against 1972 Idaho abortion law

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By Laura Zuckerman

SALMON, Idaho | Fri Sep 23, 2011 11:35pm EDT

SALMON, Idaho (Reuters) - An Idaho woman prosecuted for terminating her own pregnancy with abortion pills she ordered online won a temporary court order on Friday barring enforcement of the decades-old law under which she was charged.

But the federal judge in the case also rebuffed her separate bid to block a newly enacted state law that bans abortions after 20 weeks of pregnancy unless there is proof the woman's life is in danger.

On that issue U.S. District Judge B. Lynn Winmill ruled that Jennie Linn McCormack, 33, lacked legal standing to seek a temporary restraining order against Idaho's new "fetal pain" abortion law because she was no longer pregnant and could not demonstrate imminent harm from the statute.

Her lawsuit is believed to be the first federal court case challenging any of several late-term abortion bans enacted in Idaho and five other states the past two years, based on controversial medical research suggesting a fetus feels pain starting at 20 weeks of gestation.

McCormack's lawyer, Richard Hearn, said he would press to establish his client's standing at a future hearing on the new law, which was passed by the Republican-led Legislature and signed by Republican Governor Butch Otter in April.

The suit, filed by McCormack in August, stems from a criminal charge brought against the Pocatello mother of three -- and later dismissed for lack of evidence by a judge -- under a 1972 Idaho law making it a felony for a woman to end her own pregnancy.

Because that criminal case could technically be refiled against her, Winmill ruled that McCormack did have standing to seek a court order against further enforcement of the measure.

He also ruled that McCormack was likely to succeed on the merits of her claim that the 40-year-old statute poses an unconstitutional barrier to her rights to seek an abortion.

Although the temporary restraining order he granted technically applies only to Bannock County prosecutors, Hearn said it would in effect keep the law from being enforced anywhere in the state for the time being.

Such an occurrence seems unlikely. County Prosecuting Attorney Mark Hiedeman said the case he brought against McCormack marked the first time in his 27 years as a prosecutor that he had ever invoked the 1972 statute. He also said he was not sure it was ever applied elsewhere in Idaho.

The two-pill abortion medication known as RU486 has been legally available in the United States since 2000, and by 2008 accounted for about one-fourth of U.S. abortions performed before nine weeks gestation, according to the Guttmacher Institute, an abortion rights think tank.

As approved by the Food and Drug Administration, the two drugs -- mifepristone and misoprostol -- can be obtained from a physician and are not available in pharmacies. The medication is generally indicated for pregnancies of less than eight weeks.

Prosecutors said McCormack terminated her own pregnancy using abortion pills she obtained from an online distributor at between 20 and 21 weeks on December 24, 2010. Hearn has said she believed she was getting the pills from a legitimate medical provider.

Similar late-term abortion bills were adopted this year in four other states besides Idaho -- Alabama, Indiana, Kansas and Oklahoma. All were modeled after the "fetal pain" bill enacted last year in Nebraska, according to abortion rights advocates.

(Writing by Steve Gorman; Editing by Peter Bohan)

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