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USA: Don’t let the Bush administration take away women’s right to reproductive health care

Sunday 10 August 2008

[(Under the guise of rules to protect antiabortion nurses and doctors from discrimination the Bush administration is once again pandering to the religious right wing to dramatically undermine womens rights to reproductive health care. Posted below are a short selection of critical commentary, resources and a report from the mainstream media)]

#1.

Stealth Assault on Reproductive Rights

by Katha Pollitt
(Published in: The Nation, 4 August 2008)

When pro-choicers accuse anti-choicers of being anti-contraception they’re often taken as crying wolf — even though no anti-choice organization explicitly endorses birth control and despite the prominent anti-choice role of the Catholic Church, which explicitly bans contraception. After all, goes the complacent point of view, most women, and most couples, use some form of birth control. Opposition to it seems like something out of Margaret Atwood’s The Handmaid’s Tale, a novel whose futuristic vision of women’s subjection to rightwing Christian patriarchs no less a shrewd social critic than Mary McCarthy found preposterous when she reviewed it in the New York Times Book Review in 1986.

The Bush Administration seems bent on giving Atwood material for a sequel. Last month, Health and Human Services issued a draft of new regulations which would require health-care providers who receive federal funds to accept as employees nurses and other workers who object to abortion and even to most kinds of birth control. This rule would cover some 500,000 hospitals, clinics, and other medical facilities— including family planning clinics, which would, absurdly, legally be bound to hire people who will obstruct their very mission. To refuse to hire them, or to fire them, would be to lose funds for discriminating against people who object to abortion for religious or —get this — moral beliefs.

This represents quite an expansion of health workers’ longstanding right not to be involved in abortion. And, incidentally, this respect for moral beliefs only goes one way. A Catholic hospital has no corresponding obigation to hire pro-choice workers or accomodate their moral beliefs by permitting them to offer emergency contraception to rape victims or hand out condoms to the HIV positive; a “crisis pregnancy center” would not have to hire pro-choice counsellors who would tell women that abortion would not really give them breast cancer or leave them sterile. Only anti-choicers, apparently, have moral beliefs that entitle them to jobs they refuse to actually perform.

There are several disturbing elements to this story. One is that even as it fades into history, the Bush Administration is catering to the anti-choice movement’s larger agenda of making contraception harder to obtain. What Bush can’t give them legislatively, he’ll provide administratively, in bits and pieces, under cover of granting workers rights of conscience (the only workers’ rights he seems to care about). Remember when it seemed just plain bizarre that a pharmacist could refuse to fill a woman’s prescription for emergency contraception or even the Pill? Now pharmacists have that explicit right in four states, and possibly in five more.

Bureaucratic rules and regulations may seem arcane— how many nurses who think the Pill “kills babies” want to work in family-planning clinics? Actually, they have far-reaching effects. For example, the HHS regulations could invalidate state laws requiring hospitals to offer emergency contraception to rape victims. Moreover, the importance of regulations goes way beyond the actual number of people they affect directly. They shape both how we think of rights and how we decide what normal behavior is. As it becomes more accepted for health care workers to inflict their moral judgments on patients, and customers, the burden shifts onto women seeking care. Instead of asking “what gives the pharmacist the right to refuse to fill her prescription?” and “Why should a birth-control clinic be forced to employ a nurse who won’t give out the Pill?” the question becomes “why can’t she go to another drugstore or come back to the clinic another day”?

As the blogger Amanda Marcotte argues, antichoicers know they can’t ban contraception, but they can redefine it as a lifestyle drug, a luxury, rather than a medical necessity that gets a lot of credit for modern women’s good health and longevity. Amazingly, Bill O“Reilly is not the only person who thinks health insurance plans should pay for Viagra but not for the Pill. If you can’t afford birth control, just don’t have sex, you hussy! The next Administration may not find it so easy to turn this mindset around, and if McCain wins, I doubt it will even try. McCain himself, as I’ve noted before, has a longstanding record of votes against abortion and birth control — 125 out of 130 votes in Congress and Senate. The man has a O% rating from NARAL. That he is widely regarded as a”moderate" on reproductive rights is truly incredible.

Another dangerous feature of the proposed rules is that they redefine contraception as abortion. Standard medical authorities define abortion as something that takes place after you become pregnant, that is, after a fertilized egg implants in your womb and sets off a cascade of physical changes in your body. The HHS draft changes all that. It defines abortion as “any procedures, including prescription drugs, that result in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation.’” According to these rules, you can have an “abortion” without even being pregnant. (The Pill,emergency contraception, and the IUD mostly work by preventing ovulation and fertilization, but anti-choice advocates argue that they prevent implantation, and it is not yet possible to say with 100 percent certainty that this never, ever happens.) These are the knots we get tied up in when religious ideology replaces sound science.

Don’t let the Bush administration take away women’s right to get legal reproductive health care in a timely and respectful fashion. Support Hillary Clinton and Patty Murray, who are leading the fight in the Senate by emailing your senators here . Better yet, send them a real letter, on paper. As for Congress, So far only 104 Representatives —fewer than one in four —have signed a letter protesting the changes. Call or write yours and demand that they join you in the 21st century.

UPDATE: More info, including lists of Senators and Representatives who’ve signed on to letters opposing the new regulations here.

#2.

Mamma Mia, here Bush goes again

#3.

Bush aims attacks on women, cutting birth control

by Kathy Durkin
(Published in: Workers World, July 26, 2008)

The Bush administration is at it once again. Determined to further undermine women’s reproductive rights and health care, it is once again colluding with the religious right. This time their attack is not only on the right to abortion but on the right to birth control, too.

If implemented, the entire health-care system would be affected.

In mid-July, a Department of Health and Human Services (HHS) draft memorandum came to public view that proposed ominous new regulations to undercut contraceptive services and reproductive health care. All hospitals, clinics and medical schools that receive HHS grants and provide family planning services would have to hire employees even if these individuals oppose abortion or birth control. The health-care providers would have to swear in writing to comply with this policy to obtain HHS funding.

This affects almost every U.S. hospital, as nearly all receive public funding. States could lose federal grants if they required health-care entities or individuals to provide abortion and birth control services.

The regulations include another dangerous provision: Abortion is redefined in such an overly broad way as to include many popular and effective forms of prescription birth control, including pills, patches, intrauterine devices and even emergency contraception. The document deliberately misnames them “abortifacients†(abortion-causing) when, in fact, they are birth control methods.

By proposing these rules, the administration is clearly aiding virulent anti-choice institutions and individuals in the health-care industry, whose sinister goals are to deny women their fundamental right to birth control and comprehensive reproductive health services.

If the regulations go through, the HHS would be legally protecting anti-choice health corporations and staff members who oppose prescription birth control. HHS would also punish, by withdrawing federal funds, any health-care provider who doesn’t go along. (Anti-choice providers can already refuse to provide abortions or referrals, even in rape cases.)

Thus federal funds meant for family planning programs and reproductive health care could be used by health-care providers who oppose these very services! This could have a very deleterious effect on tens of millions of women—if government-funded health institutions, HMOs or health insurance plans refuse to provide birth-control services, information or referrals.

These regulations represent a particularly serious attack on the health and well-being of millions of low-income women who utilize Title X family planning programs or who are covered by Medicaid; both are under the aegis of HHS. Medical centers contracted by Medicaid or their employees could deny contraceptives to women covered by this program—who total 12 percent of women of reproductive age.

Title X is the only federal program solely devoted to funding family planning and related reproductive health care services. Its 4,400 health centers annually assist five million young, low-income and uninsured women, including many from oppressed communities. Services are usually free or subsidized. (www.plannedparenthood.org)

Family planning program providers would lose federal funds if they didn’t strictly adhere to HHS rules, leaving millions of low-income women in the lurch, at a time of increasing economic crisis. With growing unemployment, no health insurance or loss of existing coverage, soaring food and fuel prices, more women than ever will need government-funded health care, including family planning services.

In its remaining days in office, the Bush gang is trying to push back women’s reproductive rights as far as it can. The HHS proposals are intended to undercut laws and access to birth control and abortion that have been guaranteed. This access was won by decades of struggle by women’s and health care groups and advocates.

The rules as proposed by HHS also threaten state laws requiring drugstores to fill contraceptive prescriptions. And they endanger state requirements that hospitals provide emergency contraceptives to sexual-assault survivors, which the ultra-right has been furiously trying to undo.

The Bush administration explains this reactionary document as a “freedom of conscience proposal.†This is similar to the so-called “religious freedom†claim by right-wing pharmacists who refuse to fill birth-control requests, including for emergency contraception. At the core, these practices blatantly discriminate against millions of women whose own beliefs, reproductive rights and health care would be further denied.

No wonder women’s and reproductive rights’ organizations and health advocacy groups are up in arms about the proposed HHS rules.

Cecile Richards, president of Planned Parenthood Federation of America, stresses, “At a time when more and more families are uninsured and under economic assault, we find our healthcare system is in crisis and our president taking steps to deny access to basic care.

“Th[ese] proposed rule[s] will put women’s access to birth control and the information they need to make health-care decisions at risk. ...women’s ability to manage their own healthcare is at risk of being compromised by politics and ideology.†(www.plannedparenthood.org)

Mass pressure is needed now to stop the Bush administration from implementing these anti-woman proposals. Women’s, reproductive justice and health care advocacy organizations are calling for strong opposition to these attacks. They urge messages be sent to the White House, President Bush, HHS Secretary Michael Leavitt and Congress demanding that the regulations be stopped.

To send emails, go to www.plannedparenthood.org and www.naral.org.
Articles copyright 1995-2008 Workers World. Verbatim copying and distribution of this entire article is permitted in any medium without royalty provided this notice is preserved.

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#4.

Workers’ Religious Freedom vs. Patients’ Rights
Proposal Would Deny Federal Money if Employees Must Provide Care to Which They Object

by Rob Stein
- Washington Post Staff Writer
- Thursday, July 31, 2008; Page A01
(Published in: Washington Post, 31 July 2008)

A Bush administration proposal aimed at protecting health-care workers who object to abortion, and to birth-control methods they consider tantamount to abortion, has escalated a bitter debate over the balance between religious freedom and patients’ rights.

The Department of Health and Human Services is reviewing a draft regulation that would deny federal funding to any hospital, clinic, health plan or other entity that does not accommodate employees who want to opt out of participating in care that runs counter to their personal convictions, including providing birth-control pills, IUDs and the Plan B emergency contraceptive.

Conservative groups, abortion opponents and some members of Congress are welcoming the initiative as necessary to safeguard doctors, nurses and other health workers who, they say, are increasingly facing discrimination because of their beliefs or are being coerced into delivering services they find repugnant.

But the draft proposal has sparked intense criticism by family planning advocates, women’s health activists, and members of Congress who say the regulation would create overwhelming obstacles for women seeking abortions and birth control.

There is also deep concern that the rule could have far-reaching, but less obvious, implications. Because of its wide scope and because it would — apparently for the first time — define abortion in a federal regulation as anything that affects a fertilized egg, the regulation could raise questions about a broad spectrum of scientific research and care, critics say.

“The breadth of this is potentially immense,” said Robyn S. Shapiro, a bioethicist and lawyer at the Medical College of Wisconsin. “Is this going to result in a kind of blessed censorship of a whole host of areas of medical care and research?”

Critics charge that the proposal is the latest example of the administration politicizing science to advance ideological goals.

“They are manipulating the system by manipulating the definition of the word ’abortion,’” said Susan F. Wood, a professor at George Washington University who resigned from the Food and Drug Administration over the delays in approving the nonprescription sale of Plan B. “It’s another example of this administration’s disregard for science and medicine in how agencies make decisions.”

The proposal is outlined in a 39-page draft regulation that has been circulated among several HHS agencies. The FDA has not objected, but several officials at the National Institutes of Health said that the agency had expressed serious concerns.

“This is causing a lot of distress,” said one NIH researcher who spoke on the condition of anonymity to describe internal discussions. “It’s a redefinition of abortion that does not match any of the current medical definitions. It’s ideologically based and not based on science and could interfere with the development of many new therapies to treat diseases.”

Since a copy of the document leaked earlier this month, outside advocates and scientists have voiced growing alarm that the regulation could inhibit research in areas including stem cells, infertility and even such unrelated fields as cancer.

Dozens of members of Congress have sent letters of protest to HHS Secretary Mike Leavitt, as have scores of major medical and health groups that say their supporters have sent Congress, the White House and HHS thousands of letters protesting the proposal.

HHS officials declined to discuss the draft, saying it is in the very early stages of review. But HHS issued a statement that reads in part:

“Over the past three decades, Congress has passed several anti-discrimination laws to protect institutional and individual health care providers participating in federal programs. HHS has an obligation to enforce these laws, and is exploring a number of options.”

The draft states that numerous cases have been reported of health-care workers being “required to violate their consciences by providing or assisting in the provision of controversial medicine or procedures.” It adds that many states have recently passed laws requiring health plans to pay for contraception, pharmacists to fill prescriptions for birth control, and hospitals to offer Plan B to women who have been raped.

“In general, the Department is concerned that the development of an environment in the health care industry that is intolerant of certain religious beliefs, ethnic and cultural traditions, and moral convictions may discourage individuals from underrepresented and diverse backgrounds from entering health care professions,” the document states.

The regulation would require any entity receiving HHS funding to certify that it does not discriminate against organizations or individuals who do not want to provide services they consider objectionable.

The most controversial section defines abortion as “any of the various procedures — including the prescription, dispensing and administration of any drug or the performance of any procedure or any other action — that results in the termination of life of a human being in utero between conception and natural birth, whether before or after implantation.”

That definition would include most forms of hormonal birth control and the IUD, which most major medical groups believe do not constitute abortion because they primarily affect ovulation or fertilization and not an embryo once it has implanted in the womb.

The regulation would apply to anyone who participates in “any activity with a logical connection to a procedure, health service or health service program, or research activity. . . . This includes referral, training and other arrangements of the procedure, health service, or research activity.”

If the administration decides to adopt the regulation, it would undergo public comment and further review before becoming final.

Critics argue that the broad definitions of abortion and the types of workers who could object would cover everyone from the top doctor at a hospital to the janitor.

Cecile Richards of the Planned Parenthood Federation of America said, “At a time when access to health care is at an all-time low, the idea that the Bush administration would be creating more barriers is frankly incredible.”

The regulation could trump dozens of state laws that require health plans to cover birth control, pharmacists to fill prescriptions for contraceptives, and hospitals to offer emergency contraception to women who have been raped, critics said.

“You could imagine a group of people with less than honorable intentions seeking to get hired at a family planning clinic with the specific objective of obstructing access. Under this regulation, there is little you could do about it,” said Jill Morrison of the National Women’s Law Center.

Others said the rule could have additional implications, including justifying discrimination against gays, single women or others seeking health care.

“As soon as you have a definition in one part of federal law, it can become the inspiration for the reinterpretation of other statutes,” said R. Alta Charo, a lawyer and bioethicist at the University of Wisconsin at Madison.

Supporters dismissed such predictions.

“This would essentially simply require people to comply with laws that they have been required to comply with for decades,” said M. Casey Mattox of the Christian Legal Society’s Center for Law and Religious Freedom. “That does not mean any organization or state can’t keep doing exactly what it’s been doing. It means they have to make room for people who have sincere moral or ethical concerns about doing something.”

Conservative groups including the U.S. Conference of Catholic Bishops, Concerned Women for America and the Catholic Medical Association said the regulation is needed.

David Christensen of the Family Research Council said: “Health-care professionals should not be forced to engage in an action that they see is the taking of a human life. Federal funds shouldn’t be used for that kind of pressure.”

Christensen and others said the regulations spell out legitimate differing views about what constitutes abortion and when life begins.

Richard S. Myers, a law professor at Ave Maria School of Law in Ann Arbor, Mich., said: “Religious freedom is an important part of the history of this country. People who have a religious or moral belief should not be forced to participate in an act they find abhorrent.”