DALLAS (AP) — A Texas medical panel on Friday rebuffed calls to list specific exceptions to one of the most restrictive abortions bans in the U.S., which physicians say is dangerously unclear and has forced women with serious pregnancy complications to leave the state.

The head of the Texas Medical Board also said that wider issues surrounding the law — such as the lack of exceptions in cases of rape or incest — were beyond the authority of the 16-member panel, twelve of whom are men. Only one member of the board is an obstetrician and gynecologist.

“We can only do so much,” said Dr. Sherif Zaafran, the board’s president.

The public meeting dealt new discouragement and anger to opponents who have urged courts and Texas lawmakers for nearly two years to clarify exceptions to the state’s ban. In December, Kate Cox, a mother of two from Dallas, sued the state for the right to obtain an abortion after her fetus developed a fatal condition and she made multiple trips to an emergency room.

Cox wound up leaving the state for an abortion before the Texas Supreme Court, whose nine justices are all elected Republicans, ruled that she had not shown her life was in danger. The court, however, called on the state medical board to offer more guidance.

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Zaafran said that that while the board has some discretion as far as helping to define what the law says they don’t have discretion in rewriting it, which would be up the Legislature. He and other members of the board were appointed by Republican Gov. Greg Abbott, who signed the ban in 2021.

The board’s proposed guidelines on exceptions to Texas’ ban on abortion from the moment of fertilization, issued Friday, advise doctors to meticulously document their decision-making when determining if continuing a woman’s pregnancy would threaten her life or impair a major bodily function, but otherwise provide few specifics.

While anti-abortion advocates praised language leaving the question of whether or not to perform an abortion at a reliance on doctors’ “reasonable medical judgment,” some doctors, attorneys and women who have left the state for abortions said more needed to be done to shield doctors from prosecution for performing abortions under the medical exceptions.

“You’ve got people who are scared to death,” said Steve Bresnen, an attorney who petitioned the board for guidance. “They are facing death and they are scared to death and we think you can do more than it seems that your proposed rule would do. In that sense, we’re disappointed.”

“Even though you don’t feel like you can do something about criminal exposure, that’s not right,” he said.

A doctor convicted of providing an illegal abortion in Texas can face up to 99 years in prison, a $100,000 fine and lose their medical license.

Zaafran said the board decided against listing specific medical conditions that might apply because there would be too much nuance depending on each case.

“You can have two conditions but two very different circumstances, including where it may have happened. Was it an area where you could not transfer the mother to an area of higher level of care?” he said. Advancements in medicine also could change the effect of certain conditions, he added.

Rebecca Weaver, the legislative director at Texas Right to Life, the state’s largest anti-abortion group, expressed satisfaction that the guidelines aren’t “weakening the strength of our laws,” and that the board chose “not to list out circumstances but defer to reasonable medical judgment.”

“Texas’ pro-life laws clearly permit physicians to intervene when a pregnant woman’s life or major bodily function is in jeopardy because of her pregnancy,” she said.

A period now opens for the public to comment on the board’s proposed guidelines.

After the U.S. Supreme Court end abortion rights in June 2022, vaguely worded bans in some Republican-controlled states have caused confusion over how exceptions should be applied.