The ISMA and the American Medical Association (AMA) have filed a legal brief urging the Indiana Court of Appeals to uphold a lower court injunction blocking the Indiana Department of Health (IDOH) from releasing terminated pregnancy reports (TPRs) to the public.  

Indiana law requires physicians to submit TPRs to IDOH every time they perform an abortion. These TPRs require the disclosure of more than 30 pieces of information regarding the patient, including the patient’s age, race, education level, county of residence, marital status, number of other children, date of last menses, and date of conception. TPRs also identify the treating physician.  

The ISMA and AMA’s amicus curiae (“friend of the court”) brief stems from a back-and-forth legal battle that began when Indiana’s near-total abortion ban took effect in 2023. IDOH had previously treated TPRs as public records that could be released pursuant to a public records request. With the new law dramatically reducing the number of abortions in Indiana, IDOH stopped releasing TPRs publicly out of concern that information in the reports could be used to identify patients. The South Bend anti-abortion group Voices for Life (VFL) filed suit. A judge upheld the new IDOH policy, but while a VFL appeal was pending, IDOH reached a settlement in which it agreed to release partially redacted TPRs. ISMA members Caitlin Bernard, MD, and Caroline Rouse, MD, then filed their own suit to block the release of TPRs.  After a lower court entered an injunction in favor of Drs. Bernard and Rouse, IDOH and VFL -- now on the same side of the dispute -- appealed.

In its brief to the Court of Appeals, ISMA raises two primary arguments.  First, the brief informs the Court of the importance of patient privacy to the physician-patient relationship.  Second, ISMA expresses concern about the effect on the health, safety, and well-being of physicians when they are identified and targeted as a result of public records requests like the type at issue here.  

The brief cites Indiana’s longstanding recognition of the common-law duty to keep a patient’s private health information confidential. The brief states the proposed release of TPRs conflicts not only with privacy laws but also the AMA Code of Medical Ethics, and warns the delivery of proper medical care is jeopardized if patients fear the health information they convey to their physicians will be made public.

“The patient-physician relationship is a covenant of trust,” the brief explains. “Absent trust, patients may delay or forgo treatment or misstate or omit vital information, diminishing personal health outcomes and impairing the health care system as a whole.”

The brief also argues the proposed release of TPR information would further jeopardize physicians’ personal safety and well-being. The brief points to an increasing frequency of harassment, threats, and violence toward health care workers, and notes VFL already posts photos on its website of physicians who have submitted TPRs in the past. The brief argues such websites and online forums do not promote government transparency but rather have the goal of “stigmatizing the care (physicians) provide, isolating them from their peers, and damaging their standing and reputation in the community.”

Upholding the injunction shielding TPRs from disclosure “is the only outcome that will preserve the sanctity of a patient’s private health information, the integrity of the patient-physician relationship, and the security of the medical profession,” the brief declares.

ISMA Resolution 24-17, approved while VFL’s lawsuit was still pending, directs ISMA to actively oppose legislative or regulatory attempts to publicly release TPRs.

Amicus briefs are filed by groups who are not themselves parties to a lawsuit, but who are positioned to offer helpful insight into the policy issues and practical consequences of the case. Amici must receive the Court’s permission to participate in a case; the Court of Appeals accepted ISMA’s brief on July 7. IDOH and VFL have until July 22 to submit any reply briefs.

The Court does not have a fixed timeline to rule on the appeal. ISMA will keep members apprised of developments in the case.