A woman apparently high on several drugs when she had an abortion almost certainly couldn't have made a rational decision about her health care, two Ohio State University medical experts say. Dr. Brad Lander, a psychologist and clinical director of addiction medicine at the OSU Wexner Medical Center, said he could not comment specifically on the case of a 31-year-old woman who received an abortion last year at a Dayton-area abortion clinic.

A woman apparently high on several drugs when she had an abortion almost certainly couldn't have made a rational decision about her health care, two Ohio State University medical experts say.

Dr. Brad Lander, a psychologist and clinical director of addiction medicine at the OSU Wexner Medical Center, said he could not comment specifically on the case of a 31-year-old woman who received an abortion last year at a Dayton-area abortion clinic. The case is the subject of complaint filed by the Ohio Deparment of Health and Dayton Right to Life with the State Medical Board.

Lander, an expert on the impact of narcotic drugs on the brain, said a person under the influence is "not really in their right mind. They have a distorted view of whatever information. Making an important decision when you're high or intoxicated is not a good idea." He said any one of three narcotic drugs the woman reportedly took would have made it difficult if not impossible to think clearly.

Dr. Ryan R. Nash, director of the OSU Center for Bioethics and Medical Humanities, agreed. He called the decision to proceed with an elective abortion under the circumstances "troubling," likely unethical and possibly illegal.

"The basis for informed consent by patients is the right of refusal," Nash said. "The patient has the right to say 'no' right up until the time of the procedure. It's ethically obligatory."

Even if the woman consented on the first day when she came to the clinic, she should have been given the opportunity to consent 24 hours later, as required by Ohio law, Nash said. There is no record the woman was asked for or gave consent on her second visit to the clinic, the health department found.

Officials at the Women's Med Center in suburban Dayton decided it was best to perform the abortion in June 2015 before sending her to the hospital for treatment of the probable drug overdose. Not performing the abortion, clinic doctors said, could have triggered a miscarriage or live premature birth because the woman already was dilated by the abortion procedure.

Even before this case, the state health department was trying to close the Women's Med Center because it lacks a transfer agreement with an area hospital, as required by law. In the past five years, about half of Ohio's abortion clinics have closed as Republicans repeatedly tweaked state law.

The state health department found that a friend who drove the woman to the clinic told the staff she had taken "two Soma (a muscle relaxer), and several Percocet (a narcotic painkiller), and probably both Suboxone (a drug to ease cravings for opiates) and perhaps some heroin on her way in."

The department report said the woman could not walk, hold her head up, or have a coherent conversation on her second visit.

Abortion supporters pushed backed against the accusations.

"The anti-choice minority is up to their usual tricks by distorting, misstating facts and twisting rationale in an attempt to brainwash the public," a spokesperson at the abortion clinic said.

Even though the health department considers its case against the clinic over the abortion open, NARAL Pro-Choice Ohio Deputy Director Jaime Miracle noted that nothing has happened in 10 months.

"In October of 2015, ODH notified the clinic that its patient consent policy needed to be clarified. The clinic immediately made the clarification and ODH accepted the revision. Since the document was sent to ODH last October, ODH has not objected to it, indicated that it has found any deficiencies in the policy, or suggested any punishment to be levied against the clinic," she said in a release.

ajohnson@dispatch.com

@ohioaj