在担任德克萨斯州总检察长期间，肯·帕克斯顿曾发表过多次声明，纪念那些他认为属于“国家悲剧”的事件。
Early in his tenure as Texas attorney general, Ken Paxton issued a statement commemorating what he believed was a national tragedy.
“5000多万失踪人员的空缺永远无法填补，”他在2016年说道。当时正值罗诉韦德案（Roe v. Wade）判决43周年——该判决保护了堕胎权利，长期以来一直阻碍着禁止早期妊娠堕胎行为的努力（因为大多数堕胎行为都发生在这一阶段）。
“It’s impossible to fill the void of more than 50 million missing human beings,” he said in 2016. He was marking the 43rd anniversary of Roe v. Wade, the Supreme Court ruling that protected abortion rights — and had long stood in the way of efforts to ban terminations in early pregnancy, when most abortions occur.
在接下来的几年里，帕克斯顿不断试探法律的界限，并最终取得了他人未能实现的成就：2021年，他成功推动了德克萨斯州立法机构制定的几乎全面禁止堕胎的法案。尽管罗诉韦德案仍然有效，美国最高法院还是允许该法案生效。
Paxton spent the years that followed testing Roe’s limits and ultimately prevailed where others had failed: In 2021, he defended a near-total abortion ban that Texas legislators had designed to evade conventional legal challenges. The U.S. Supreme Court allowed it to take effect while Roe remained in force.
次年，当最高法院推翻了罗诉韦德案的裁决后，帕克斯顿仍继续推动限制堕胎的政策，探索新的手段来扩大德克萨斯州相关法规的适用范围。他成功对抗了拜登政府，并与那些支持堕胎权利的州发生了冲突；他的策略后来也被其他州采纳或进一步扩展。
After the justices overturned Roe the following year, Paxton kept pushing, pursuing new ways to extend the reach of Texas’ restrictions. He prevailed against the Biden administration, picked fights with states that protect abortion access and pioneered strategies that his peers later adopted or expanded.
尽管帕克斯顿的任期因个人丑闻及滥用职权的行为而受到来自各政治派别的批评，但无论是批评者还是支持者都承认，他作为该州最高法律官员的最大成就就是推动了堕胎限制政策的实施。
While Paxton’s tenure as attorney general has drawn criticism from across the political spectrum for his personal scandals and alleged misuse of the office, detractors and allies alike agree that his signal achievement as the state’s top legal official has been advancing restrictions on abortion.
仔细审视他的政绩可以发现一个明显的规律：他总是不遗余力地试探法律的极限，并运用创新的法律手段来实现自己的目标。
A close look at his record shows a clear pattern in his successes: He relentlessly tests the limits of the law and employs novel legal strategies to advance his goals.
如果帕克斯顿在美国参议院选举中获胜，他在全国范围内的影响力将会发生巨大变化。作为德克萨斯州总检察长，他此前大多能够独立行使职权；如果他在11月的选举中获胜，他将成为美国参议院的一员——而在这个机构中，大多数立法提案都需要60票才能通过（以克服阻挠议事程序）。不过，那些见证过他成功的人认为，这或许是一个新的机遇……“他可以利用自己在德克萨斯州为某些法律辩护时所积累的影响力，来推动美国参议院的立法工作，”德克萨斯价值观组织（Texas Values）的政府关系主管玛丽·伊丽莎白·卡斯尔（Mary Elizabeth Castle）说道。该组织是一个支持全国性堕胎禁令的基督教倡导团体。
Paxton’s national role as an anti-abortion warrior would change if he wins his U.S. Senate race. As Texas attorney general, he has been able to act largely on his own authority. If he prevails in November, he would become one of 100 senators in a chamber where most legislation needs 60 votes to overcome a filibuster. But allies who have witnessed his victories see an opening. “He’ll have the ability to use some of the laws that he’s defended in Texas as influence to draft legislation in the U.S. Senate,” said Mary Elizabeth Castle, director of government relations at Texas Values, a Christian advocacy group that supports a national abortion ban.
法律专家和各方倡导者都认为，他可能会加入那些向美国食品药品监督管理局（FDA）施压、要求撤销对堕胎药物米非司酮（mifepristone）批准决定的同事们的行列。
Legal experts and advocates on both sides expect he could join colleagues who are pressuring the Food and Drug Administration to revoke its approval of the abortion drug mifepristone.
州和联邦层面的反堕胎活动人士也在努力为胎儿争取法律权利；这些努力可能会对避孕措施和体外受精（IVF）等生殖医疗服务产生影响。帕克斯顿（Paxton）曾公开表示自己是体外受精技术的坚定支持者，但最近他表示自己愿意接受那些旨在防止受精卵被浪费的法规。
Anti-abortion activists at the state and federal level are also trying to secure legal rights for fetuses, which could have implications for reproductive care like birth control and in vitro fertilization. Paxton, who has called himself a strong supporter of IVF, recently said he was open to restrictions intended to prevent the loss of fertilized eggs.
他的诉讼行为也引发了一些问题，这些问题预计将会由最高法院来裁决：例如，一项要求医院为紧急情况中的患者提供救治的联邦法律是否优先于各州的堕胎禁令；是否应该将胎儿视为具有独立权利的“患者”并赋予其紧急医疗救助权；以及各州在追究那些向禁止堕胎的州的患者开具堕胎药物的医生时，能采取多严格的措施。
His litigation has also raised questions that experts expect the Supreme Court to confront, including whether a federal law, which mandates hospitals provide stabilizing care to patients having an emergency, overrides state abortion bans; whether to treat a fetus as a separate patient that has its own emergency care rights; and how far states can go in pursuing out-of-state doctors who prescribe abortion medication to patients in states where it’s banned.
在本次竞选活动中，堕胎问题远不如帕克斯顿的道德操守问题那么受关注。他的民主党对手詹姆斯·塔拉里科（James Talarico）表示，自己支持恢复联邦层面的堕胎权利，并认为自己的基督教信仰要求废除帕克斯顿所捍卫的那些“极端”法律——正是这些法律迫使许多女性不得不离开德克萨斯州去寻求紧急堕胎服务。
During the current race, abortion has played a far smaller role than questions about Paxton’s ethics. His Democratic opponent, James Talarico, has said that he supports restoring a federal right to abortion and that his Christian faith calls for an end to “extreme” laws that Paxton has defended and that have forced women to flee the state for emergency abortion care.
最近，帕克斯顿几乎不再公开谈论堕胎问题；尽管他本人曾主张实施比许多德克萨斯人更严格的堕胎限制措施。
Lately, Paxton has said little about abortion — an issue on which he has defended restrictions more stringent than many Texans say they want.
然而，那些关注帕克斯顿如何将德克萨斯州的法律影响力扩展到其他州的人，都在密切关注他的参议院竞选活动。
But those who have watched Paxton extend the reach of Texas law beyond its borders are paying close attention to his Senate bid.
堕胎提供者珍妮弗·维拉维森西奥博士表示，她感到被迫两次搬迁家庭，前往对医生提供强有力法律保护、以抵御州外诉讼的州，部分原因是担心帕克斯顿正在为针对像她这样的提供者制定蓝图。
Dr. Jennifer Villavicencio, an abortion provider, said she has felt compelled to move her family twice to states with strong laws shielding doctors from out-of-state litigation, partly out of concern that Paxton is creating a blueprint for targeting providers like her.
“想到这或许即将来到美国参议院，我感到非常沮丧和害怕，”她说。
“It’s very disheartening and scary to think that it’s maybe coming to the U.S. Senate,” she said.
在罗伊诉韦德案被推翻之前，帕克斯顿成功捍卫了一项近乎全面的堕胎禁令。
Paxton successfully defended a near-total abortion ban before Roe v. Wade was struck down.
2015年帕克斯顿成为得州司法部长时，他对堕胎的立场毫无歧义。
When Paxton became Texas attorney general in 2015, there was no ambiguity about where he stood on abortion.
他在反堕胎活动家的家庭中长大，娶了一位来自基督教学院的甜心，她为自己被收获这一事实感到自豪，并表示她的生母“选择了生命”。她为帕克斯顿竞选助力，但他自身也有相当的资历。他作为州参议员时共同赞助的一项法律禁止了孕20周后几乎所有的堕胎。
Raised by an anti-abortion activist, he married his sweetheart from a Christian college, who spoke proudly about the fact that she was adopted, saying her birth mother “chose life.”She campaigned for Paxton, but he had his own bona fides. A law he’d co-sponsored as a state senator banned almost all abortions after 20 weeks.
类似的20周禁令在全国范围内逐渐确立，因为数十年的法院裁决不断削弱罗伊案，但尚未有州成功在孕六周时就实施禁令。十几个州曾尝试通过法律，禁止在能检测到心脏活动时进行堕胎，但这些法律一个接一个地被法院阻止。
Similar 20-week bans had taken root across the country as decades of court rulings chipped away at Roe, but no state had managed to enforce a ban as early as six weeks. More than a dozen tried, passing laws that prohibited abortion when cardiac activity could be detected. One after another, they were blocked by judges.
然后，在2021年，得州律师乔纳森·米切尔与立法者合作，起草了一项旨在抵御类似挑战的法律。与其让州官员执行他们的“心跳法”，新法——被称为参议院第8号法案（Senate Bill 8）——允许公民起诉他们怀疑正在提供堕胎服务的医生。若胜诉，可获得最高1万美元的赔偿。
Then, in 2021, a Texas lawyer named Jonathan Mitchell worked with legislators to craft a law that would withstand similar challenges. Instead of having state officials enforce their “heartbeat law,” the new act, referred to as Senate Bill 8, allowed citizens to sue physicians they suspected were providing abortions. The law offered up to $10,000 if they won.
当堕胎提供者和乔·拜登总统的政府分别在联邦法院对该法律提出挑战时，帕克斯顿办公室主张，州官员无法被命令停止执行该法律，因为他们本来就没有权力这样做。只有私人公民才能这样做。
When abortion providers and President Joe Biden’s administration separately challenged the law in federal court, Paxton’s office argued that state officials couldn’t be ordered to stop enforcing it because they had no power to do so in the first place. Only private citizens could.
“由于行政官员被明确禁止执行SB 8，”他的办公室在致最高法院的信中写道，“联邦法院无法发布禁令。”最高法院同意帕克斯顿不能被起诉，理由是“请愿人未能指出总检察长在SB 8方面拥有的任何执法权力，而联邦法院可能禁止他行使该权力。”该法律继续生效，成为罗伊案之后首个可执行的六周禁令。随后，爱达荷州和俄克拉荷马州的立法者通过了类似的法律。
“Because the executive officials are expressly prohibited from enforcing SB 8,” his office wrote to the Supreme Court, “there is nothing for a federal court to enjoin.”The Supreme Court agreed that Paxton couldn’t be sued because “the petitioners have not identified any enforcement authority the attorney general possesses in connection with S. B. 8 that a federal court might enjoin him from exercising.”The law remained in effect, becoming the first enforceable six-week ban under Roe. Legislators in Idaho and Oklahoma subsequently passed similar laws.
对于在圣安东尼奥计划生育协会工作的萨姆·迪克曼博士而言，其影响显而易见：“我将不得不要么完全改变我所提供的医疗类型，要么离开这个州，”他说。他选择了后者，搬到了蒙大拿州，在那里堕胎在胎儿具备存活能力之前是合法的，大约是24周。
For Dr. Sam Dickman, who worked at a San Antonio Planned Parenthood, the implications were clear: “I was going to need to either entirely change the type of medicine I was providing or leave the state,” he said. He opted for the latter, moving to Montana, where abortion is legal until viability, or roughly 24 weeks.
德克萨斯州禁令生效后几天，乔塞利·巴尼卡在经历流产时到达休斯顿的一家医院。她怀孕17周，胎儿的头部顶住了她已经扩张的宫颈。由于这种情况使她面临高感染风险，医学专家表示医生本应主动提出加速分娩或清空子宫；胎儿不具备存活能力，妊娠的丧失是不可避免的。但胎儿的心脏仍在跳动。
Days after the Texas ban took effect, Josseli Barnica arrived at a Houston hospital in the midst of a miscarriage. She was 17 weeks pregnant and her fetus’s head was pressed up against her dilated cervix. Because the situation put her at high risk of developing an infection, medical experts said doctors should have offered to speed up delivery or empty her uterus; the fetus was not viable, and losing the pregnancy was inevitable. But the fetus’s heart was still beating.
巴尼卡向丈夫转述了她所说的医护人员告诉她的话：“他们必须等到没有心跳为止，”他对《普罗公共》用西班牙语说道。“给她做堕胎将是犯罪。”巴尼卡等待了40小时，她的子宫暴露在细菌中。
Barnica relayed to her husband what she said her medical providers had told her: “They had to wait until there was no heartbeat,” he told ProPublica in Spanish. “It would be a crime to give her an abortion.”For 40 hours, Barnica waited, her uterus exposed to bacteria.
几天后来，她因败血症死亡。医学专家告诉《普罗公共》她的医生没有遵循正确的护理标准，且巴尼卡的死亡是可以避免的。
She died days later of sepsis. Medical experts told ProPublica her doctors did not follow the proper standard of care and that Barnica’s death was preventable.
在一份声明中，为她提供治疗的医院连锁机构HCA Healthcare表示：“我们的责任是遵守适用的州和联邦法律法规”，并称医生会行使其独立判断。
In a statement, HCA Healthcare, the hospital chain that treated her, said “our responsibility is to be in compliance with applicable state and federal laws and regulations” and said that physicians exercise their independent judgment.
帕克斯顿阻止了针对紧急堕胎护理的联邦指导，其影响远超德克萨斯州。
Paxton blocked federal guidance for emergency abortion care, with consequences far beyond Texas.
2022年6月24日最高法院推翻宪法赋予的堕胎权后，帕克斯顿在中午解散了他的工作人员以示庆祝。他随后将该日指定为带薪办公假日——“生命神圣日”。
When the Supreme Court overturned the constitutional right to abortion on June 24, 2022, Paxton dismissed his staff at noon to celebrate. He would later designate the date as a paid office holiday, Sanctity of Life Day.
德克萨斯州立法机关为此做好了准备，颁布了一项法律，该法在罗诉韦德案被推翻后不久生效。该禁令威胁医生若实施堕胎将面临最高99年的监禁。但随后出现了帕克斯顿所称的联邦试图阻挠州法的举动。
The Texas Legislature had prepared for the occasion, passing a law that went into effect shortly after the overturning of Roe. The ban threatened doctors with up to 99 years in prison if they performed an abortion. But soon came what Paxton framed as a federal attempt to thwart the state law.
拜登政府向实施堕胎禁令的州的医生发布备忘录，称联邦紧急护理法保护他们的医疗判断，“不论州内的限制如何”。当时的联邦卫生与公共服务部部长表示，医生有义务遵守《紧急医疗治疗与积极分娩法》（Emergency Medical Treatment and Active Labor Act，简称EMTALA）。该法要求接受联邦资金的医院对每一位到院患者进行筛查并提供稳定治疗。
The Biden administration issued a memo to doctors in states with abortion bans saying that a federal emergency care law protected their medical judgment, “regardless of the restrictions in the state.”The federal Health and Human Services secretary at the time said doctors had an obligation to follow the Emergency Medical Treatment and Active Labor Act, better known as EMTALA. The law requires hospitals that accept federal funding to screen and stabilize every patient who arrives.
对于出现严重子痫前期等并发症的患者——这是一种可能致命的妊娠相关血压紊乱——稳定患者可能需要进行堕胎，即使该州禁止堕胎，指南中如此指出。“医生必须提供该治疗，”指南将“必须”二字加粗。
For those with complications such as severe preeclampsia, a potentially fatal, pregnancy-related blood pressure disorder, stabilizing a patient might require performing an abortion, even if the state forbids it, the guidance said. “The physician must provide that treatment,” it said, bolding the word “must.”
帕克森提起诉讼，指控州政府试图利用联邦法律“把全国每一家急诊室都变成随时接受堕胎的诊所”。
Paxton sued, accusing the administration of an attempt to use federal law “to transform every emergency room in the country into a walk-in abortion clinic.”
他辩称，EMTALA 法的制定是为了确保医院不会在未对无保险患者进行治疗的情况下将其赶回街头，而不是为了凌驾州法律。他进一步提出，依据 EMTALA，医生可能需要考虑“未出生婴儿的生命”。六位法律专家对《公共新闻》表示，这一论点是新颖的。
He argued EMTALA was created to make sure hospitals didn’t dump uninsured patients back on the street without treatment, not to override state laws. He took the argument a step further, suggesting that under EMTALA, doctors might need to consider “the life of the unborn child.”The argument was novel, six legal experts told ProPublica.
“他基本上是起诉联邦政府，以保护德克萨斯州强迫孕妇在健康受到威胁时仍不得堕胎的权利，”匹兹堡大学法学院教授格里尔·唐利说。“我记得当时想，‘哇，这真是激进。’” 医学团体警告称患者可能会死亡。
“He’s basically suing the federal government to protect Texas’ right to force pregnant women to not get abortions, even when their health is threatened,” said Greer Donley, a law professor at the University of Pittsburgh. “I remember thinking, ‘Wow, that’s radical.’”Medical groups warned patients would die.
然而，联邦法官在去年八月站在帕克森一边，2024 年一月，第五巡回上诉法院确认了该裁决。
But a federal judge sided with Paxton that August, and the 5th U.S. Circuit Court of Appeals affirmed the decision in January 2024.
该裁决的影响不仅是阻止州政府在德克萨斯执行其对 EMTALA 的解释。
The ruling did more than keep the administration from enforcing its EMTALA interpretation in Texas.
它还禁止联邦政府对两家加入帕克森诉讼的反堕胎医学组织——美国反堕胎产科妇科医师协会和基督教医学与牙科协会——提起诉讼。这实际上免除了它们遵循联邦指南的义务，无论其工作地点在哪里。该裁决亦立即为另一个州争取执行本州堕胎禁令提供了诉讼素材。
It barred the federal government from pursuing cases against members of two anti-abortion medical organizations that had joined Paxton’s suit as plaintiffs, the American Association of Pro-Life Obstetricians and Gynecologists and the Christian Medical & Dental Associations. This effectively exempted them from having to follow the federal guidance, regardless of where they worked. It also served as immediate litigation fodder for another state fighting to enforce its own abortion ban.
爱达荷州在法院的成功程度不及德克萨斯州。拜登政府提起诉讼，主张该州的禁令与《紧急医疗治疗与劳动法案》（EMTALA）相冲突，结果爱达荷在下级法院和上诉法院均败诉，使其禁令在紧急情况下实际上被冻结，医生被指示遵循联邦指南。
Idaho had not had the same success in court as Texas. After the Biden administration sued, arguing the state’s ban conflicted with EMTALA, Idaho lost in lower and appellate courts, leaving its ban effectively frozen in emergency cases, with doctors instructed to follow the federal guidance.
但帕克斯顿（Paxton）于2024年1月2日在第5巡回法院的胜诉为爱达荷的禁令注入了生机。该裁决与第9巡回法院在爱达荷的判决相冲突，形成了联邦上诉法院之间常见的分歧，通常会由最高法院介入解决。
But Paxton’s 5th Circuit win on Jan. 2, 2024, gave Idaho’s ban a lifeline. The ruling conflicted with the 9th Circuit’s decision in Idaho, creating the kind of disagreement between federal appeals courts that the Supreme Court often steps in to resolve.
次日，代表爱达荷的律师向最高法院请求介入，称帕克森的成功表明他们“很可能获胜”。与此同时，他们请求法院解除对禁令的冻结。
The following day, attorneys representing Idaho asked the high court to do just that, saying Paxton’s success showed they were “likely to prevail.”In the meantime, they asked the court to unfreeze the ban.
2024年1月5日，最高法院允许爱达荷在案件审理期间全面执行其禁令。
On Jan. 5, the Supreme Court allowed Idaho to fully enforce its ban while the case proceeded.
据美国国家公共广播电台（NPR）报道，紧急科医生开始犹豫何时可以合法进行堕胎，圣卢克健康系统（St. Luke’s Health System）首席医师吉姆·苏扎（Dr. Jim Souza）在一次新闻电话会议上说：“她的败血症程度是否足以让我进行这项堕胎，而不冒入狱并失去执照的风险？”在随后三个月里，圣卢克——该州最大的医院系统——表示不得不将六名患者空运出州外进行堕胎。
Emergency doctors began hesitating over when they could legally provide abortions, Dr. Jim Souza, chief physician at St. Luke’s Health System, said on a press call at the time, according to NPR. “Is she septic enough for me to do this abortion and not risk going to jail and losing my license?”In the three months that followed, St. Luke’s, the state’s largest hospital system, said it had to airlift six patients out of the state for abortions.
在德克萨斯州，ProPublica 已记录了孕期紧急情况女性所面临的后果。
In Texas, ProPublica has documented the consequences for women experiencing pregnancy emergencies.
ProPublica 先前报道，当特拉·沃克（Tierra Walker）当年晚些时候在圣安东尼奥寻求治疗时，她出现了子痫前期，最终因该病去世。参与她治疗的90名医生中，没有一人向她提供终止妊娠的选项，即使她询问这样做是否能保障她的安全。
When Tierra Walker sought care later that year in San Antonio, she developed preeclampsia and ultimately died from it, ProPublica previously reported. None of the 90 physicians involved in her care offered her the option of terminating her pregnancy, even after she asked if doing so might keep her safe.
她的家属于9月起诉帕克森，并将州医疗官员及数家医疗机构列为被告，指控德克萨斯的堕胎限制以及沃克所接受的护理导致了她的死亡。帕克森未对诉讼作出回应，也未对请求置评的询问作出回应。
Her family sued Paxton in September, along with state medical officials and several healthcare providers, alleging that Texas’ abortion restrictions and the care Walker received led to her death. Paxton has not responded to the suit and did not respond to a request seeking comment.
ProPublica 已确认至少还有另外两名孕妇在德克萨斯州死亡，她们在专家称本应得到适当急救的情况下未获救治。帕克斯顿未对她们的死亡作出公开评论，也未回应 ProPublica 对此的提问。我们的分析还发现，州内因妊娠并发症就医的患者的结局正在恶化。帕克斯顿的法律胜诉的影响可能并不止于此。
ProPublica has identified at least two other pregnant Texas women who died without what experts said was appropriate emergency care. Paxton has not publicly commented on any of their deaths and did not respond to ProPublica’s questions about them. Our analysis also found worsening outcomes across the state for patients experiencing pregnancy complications. The reach of Paxton’s legal victory may not end there.
最高法院仍未解决巡回法院裁决之间的冲突。它在爱达荷州案件中拒绝介入，且在唐纳德·特朗普总统上任后，其政府撤回了诉讼并取消了 EMTALA 指导意见。
The Supreme Court still hasn’t resolved the conflict between the circuit rulings. It declined to do so in the Idaho case, and after President Donald Trump took office, his administration dropped the suit and rescinded the EMTALA guidance.
但法律专家对 ProPublica 表示，最高法院尚未解决帕克斯顿诉讼提出的核心问题：EMTALA 是否优先于州堕胎法，以及在母亲健康受到威胁的情况下，胎儿是否也拥有紧急治疗权利，从而可能与母亲的利益冲突。
But legal experts told ProPublica the Supreme Court has yet to resolve core questions that Paxton’s litigation raised: whether EMTALA preempts state abortion laws and whether a fetus also has a right to emergency treatment that could conflict with the mother’s interests in cases where her health is at risk.
为防止未来裁决产生不利影响，一个名为 All* Above All 的生殖权利倡导组织正推动州级立法，以保障紧急医疗。该组织主席 Nourbese Flint 说：“我们正看到眼前的混乱和困惑。”
To guard against future rulings, a reproductive rights advocacy group called All* Above All is pushing state-level legislation to safeguard emergency care. “We’re seeing the chaos right now and the confusion,” said its president, Nourbese Flint.
帕克斯顿尝试以更广泛的新方式追究堕胎提供者。其他州正效仿他的做法。
Paxton tested expansive new ways to pursue abortion providers. Other states are following his lead.
2023 年 12 月 7 日，奥斯汀的一名州法官作出裁决，帕克斯顿随即采取行动试图阻止该裁决。
On Dec. 7, 2023, a state judge in Austin issued a ruling that Paxton immediately moved to stop.
一名 31 岁的母亲 Kate Cox 想要获得堕胎许可。她怀孕 20 周，胎儿被诊断为 18 三体综合征，这是一种会导致绝大多数出生婴儿死亡的遗传疾病。
A 31-year-old mother named Kate Cox wanted permission to get an abortion. She was 20 weeks pregnant and carrying a fetus diagnosed with trisomy 18, a genetic condition that kills the vast majority of babies born with it.
德克萨斯州不允许对致命胎儿异常进行堕胎，但 Cox 的医生辩称，如果她被迫生下孩子，可能会危及她再次怀孕的能力。此举亦存在医学风险：Cox 已经通过剖宫产生育了两个孩子，且每次手术后并发症的风险都会增加。
Texas doesn’t allow abortions for fatal fetal anomalies, but Cox’s doctor argued that if she was forced to give birth, it could imperil her ability to get pregnant again. It was also medically risky: Cox had already had two children by cesarean section, and the chances of complications increase with each procedure.
在特拉维斯县地区法院法官批准她的请求的当天，帕克斯顿采取了法律专家告诉《ProPublica》他们从未见过其他州检察长采取的步骤：他向科克斯的医生拥有接诊特权的三家医院发送信函，威胁如果该医生实施法官称她可能进行的堕胎，将采取法律行动。他写道，法院命令并未使医院、医生或其他任何人免于因违反德州堕胎法而承担民事和刑事责任。
The day a Travis County district court judge granted her request, Paxton took a step legal experts told ProPublica they had not seen another state attorney general take: He sent letters to three hospitals where Cox’s doctor had admitting privileges, threatening legal action if the doctor performed the abortion a judge said she could have. The court order, he wrote, did not insulate hospitals, doctors or anyone else from civil and criminal liability for violating Texas’ abortion laws.
与此同时，他将此案上诉至德州最高法院，称科克斯并未面临法律例外所涵盖的那种生命威胁。如果立法者想为致命胎儿异常设定例外，他说，他们本可以这么做。
At the same time, he appealed the case to the Texas Supreme Court, saying that Cox did not face the kind of threat to her life that fell under the law’s exception. If legislators had wanted to write an exception for fatal fetal anomalies, he said, they would have done so.
“德州立法机关并不打算让法院成为获取堕胎许可的旋转门，”他说。
“The Texas Legislature did not intend for courts to become revolving doors of permission slips to obtain abortions,” he said.
德州最高法院同意帕克斯顿的观点，推翻了下级法院的裁决。到那时，科克斯已经在州外寻求堕胎。
The Texas Supreme Court agreed with Paxton and reversed the lower court’s ruling. By that time, Cox had sought an abortion out of state.
“那真的非常可怕，”科克斯对《ProPublica》说。“我们在我的案件中看到德州会追究医生的责任。”帕克斯顿也是首位——迄今唯一——在本州因违反堕胎禁令而对提供者进行刑事起诉的检察长。
“It was incredibly scary,” Cox told ProPublica. “We saw in my case that Texas will go after doctors.”Paxton was also the first — and, so far, the only — attorney general to criminally prosecute a provider in his state for violating an abortion ban.
根据法院文件，调查人员收到匿名线报，称一家为低收入、西班牙语患者提供服务的医疗诊所正在进行堕胎，该诊所由持证助产士玛丽亚·罗哈斯（Maria Rojas）管理。
According to court documents, investigators got an anonymous tip alleging that abortions were being performed at a medical clinic that catered to low-income, Spanish-speaking patients, managed by Maria Rojas, a licensed midwife.
罗哈斯被逮捕并被指控无证行医及违反州堕胎禁令。帕克斯顿还动议暂时关闭该诊所及她运营的其他诊所，直至案件在法庭上审理完毕。她被捕数月后，帕克斯顿宣布已逮捕并起诉另外八名诊所工作人员，指控他们无证行医。
Rojas was arrested and charged with practicing medicine without a license and violating the state’s abortion ban. Paxton also moved to temporarily shut down the clinic and others she ran while the case progressed through court. Months after her arrest, Paxton announced he had arrested and indicted eight other clinic staffers for practicing medicine without a license.
罗哈斯对所有指控均表示不认罪。她的律师指责帕克斯顿的办公室调查工作存在严重疏漏，并指出：至少有一起被检察官视为“堕胎”行为的案件，实际上只是对患者流产症状的常规治疗而已。
Rojas has pleaded not guilty to the charges. Her attorneys have accused Paxton’s office of a shoddy investigation and argued that at least one case prosecutors were treating as an abortion was actually the management of a patient’s miscarriage.
虽然审判尚未安排，但今年夏天一家上诉法院推翻了关闭这些医疗诊所的裁决，认为州政府未能提供足够的证据来支持这一临时禁令的合法性。帕克斯顿表示他将对这一裁决提出上诉。法院并未对罗哈斯是否真的实施了非法堕胎行为作出任何判定。在追查这些医生的过程中，帕克斯顿的行动并未止步于州界。
A trial has not yet been scheduled, but an appeals court this summer overturned the order shuttering the clinics, finding the state had not presented sufficient admissible evidence to justify a temporary injunction. Paxton said he is appealing the ruling. The court did not rule on whether Rojas had actually performed illegal abortions. Paxton has not stopped at the state border in his pursuit of doctors.
2024年12月，帕克斯顿起诉了纽约市的玛格丽特·卡彭特医生，指控她在通过远程医疗方式为居住在达拉斯北部郊区普莱诺的患者提供医疗服务并开具堕胎药物时违反了多项德克萨斯州法律。他认为，由于该患者位于德克萨斯州，卡彭特应受该州禁止堕胎的法律约束，且在该州行医必须持有相关执照。
In December 2024, he sued Dr. Margaret Carpenter, a New York-based physician, accusing her of violating multiple Texas laws when she treated a patient via telehealth who lived in Plano, a suburb north of Dallas, and prescribed her abortion medication. Because the patient was based in Texas, he argued, Carpenter was subject to laws there that banned abortion and required a license to practice in the state.
由于卡彭特未对诉讼作出回应，帕克斯顿因此胜诉。然而，德克萨斯州未能追回超过10万美元的罚款及诉讼费用；纽约州的一名法院工作人员以“保护法律”（即保护在纽约州合法提供堕胎服务的医疗机构的法律）为由，拒绝执行该判决。自罗诉韦德案（Roe v. Wade）被推翻以来，至少有22个州通过了此类“保护法律”，其中纽约州的法规最为严格。卡彭特既未回应相关询问，也未公开评论此事。
Carpenter didn’t respond to the suit, so Paxton won by default. But Texas was unable to collect on more than $100,000 in civil fines and court fees that resulted; a New York county clerk refused to the judgment, invoking a “shield law” that protects providers of abortion care that is legal in New York from certain out-of-state investigations, prosecutions and judgments. At least 22 states have passed shield laws since Roe was overturned, and New York’s is among the strongest. Carpenter did not respond to a request seeking comment and has not publicly responded to the case.
一名纽约州法官驳回了帕克斯顿要求执行该判决的诉讼，但帕克斯顿并未放弃，今年又向特拉华州和加利福尼亚州的多家向德克萨斯州邮寄堕胎药物的医疗机构和组织提起了另外两起民事诉讼。
A New York judge dismissed Paxton’s case seeking to enforce the judgment, but Paxton didn’t give up, filing two more civil suits this year against practitioners and organizations in Delaware and California that mail abortion medication to Texas.
另外三位州检察长也已扩大了这一策略。上个月，路易斯安那州检察长莉兹·穆里尔（Liz Murrill）——在帕克斯顿起诉她后对卡彭特提出刑事指控（并在纽约遭遇类似阻碍）——与阿肯色州和阿拉巴马州的检察长一起，对州外堕胎药提供者提起了大规模联邦民事诉讼。该案列出了帕克斯顿曾追诉的部分相同提供者；这些提供者已对诉讼提出挑战。这三位检察长另行向最高法院提交了一项单独行动，请求法院废除纽约、马萨诸塞州和加利福尼亚州的“盾牌法”。
Three other state attorneys general have now expanded on the strategy. Last month, Louisiana Attorney General Liz Murrill — who brought criminal charges against Carpenter after Paxton sued her (and has faced similar obstacles in New York) — joined the attorneys general of Arkansas and Alabama in filing a sweeping federal civil suit against out-of-state providers of abortion pills. The case names some of the same providers Paxton pursued; they have challenged the suits. The three attorneys general filed a separate action directly with the Supreme Court asking it to strike down shield laws in New York, Massachusetts and California.
帕克斯顿已超越医生，转而针对帮助患者获取堕胎的其他实体。加州大学戴维斯分校的堕胎史学家、法学教授玛丽·齐格勒（Mary Ziegler）称他是“在扩大被视为罪魁祸首或帮凶网络方面的创新者”。他向向德克萨斯州运送堕胎药物的组织发送了停止侵权函；随后阿拉巴马州检察长也采用了类似手段。帕克斯顿还起诉本州的城市，阻止它们拨款帮助女性前往他州堕胎——州议会随后通过法律禁止此类资助。
Paxton has moved beyond doctors to target other entities that help patients obtain abortions. Mary Ziegler, an abortion historian and professor of law at University of California, Davis, called him “an innovator in terms of broadening the network of people who were seen as culprits or aiders or abettors.”He sent cease-and-desist letters to organizations that ship abortion medication into Texas; the attorney general of Alabama subsequently used similar tactics. And Paxton sued cities in his state to stop them from disbursing funds to help women travel for abortions — a move the Legislature followed with a law banning such funding.
在今年早些时候对圣安东尼奥市取得法律胜利后，该市被迫终止10万美元的项目，帕克斯顿作出誓言：“我将始终竭尽全力，防止激进分子操纵制度谋杀无辜的婴儿。”
Following his legal victory against the city of San Antonio early this year, in which it was forced to end the $100,000 program, Paxton made a vow: “I will always do everything in my power to prevent radicals from manipulating the system to murder innocent babies.”