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During a discussion of abortion in the final presidential debate, Republican John McCain shocked millions of Americans with his sneering remarks and derisive air quotes when it came to the "health of the mother."  Now as he prepares to leave office, President George W. Bush is making that condescension towards American women the law of the land.  His eleventh hour so-called "right of conscience" regulation would allow health care workers of all stripes to refuse to provide abortion services, artificial insemination procedures and even birth control.

Following on recent Justice Department policy enabling faith-based charities receiving federal funds to discriminate in hiring, the controversial HHS rule would dramatically broaden the ability of individual health care providers to refuse "to participate in any procedure they find morally objectionable."  As the Los Angeles Times detailed, the last minute regulation soon to be finalized by Health and Human Services Secretary Mike Leavitt could significantly curtail access to reproductive services for Americans:

For more than 30 years, federal law has dictated that doctors and nurses may refuse to perform abortions. The new rule would go further by making clear that healthcare workers also may refuse to provide information or advice to patients who might want an abortion.

It also seeks to cover more employees. For example, in addition to a surgeon and a nurse in an operating room, the rule would extend to "an employee whose task it is to clean the instruments," the draft rule said.

The implications for the nation's 4,800 hospitals, 234,000 doctor's offices, 58,000 pharmacies and thousands of other "entities" receiving federal funds are dramatic and draconian.  As the American College of Obstetrics and Gynecology detailed, the new regulation would threaten the well-being, and in some cases the lives, of American women.  In the future, these examples of withheld emergency health care services cited by ACOG would become frighteningly commonplace:

In Texas, a pharmacist rejected a rape victim's prescription for emergency contraception. In Virginia, a 42-year-old mother of two became pregnant after being refused emergency contraception. In California, a physician refused to perform artificial insemination for a lesbian couple. (In August, the California Supreme Court ruled that this refusal amounted to illegal discrimination based on sexual orientation.) And in Nebraska, a 19-year-old with a life-threatening embolism was refused an early abortion at a religiously affiliated hospital.

But while the American Medical Association and the American College of Obstetrics and Gynecology stress that a "patient's well-being must be paramount" in seeking to limit so-called "conscientious refusals," groups like the U.S. Conference of Catholic Bishops and the Christian Medical Association see the proposed rule as broadly extending well beyond abortion.  As Dr. David Stevens, president of CMA, put it:

"The real battle line is the morning-after pill.  This prevents the embryo from implanting. This involves moral complicity. Doctors should not be required to dispense a medication they have a moral objection to."

As Dr. Stevens suggests, the Bush administration and its allies on the religious right are now fighting by other means the war against emergency contraception like Plan B.  Having finally lost in 2006 the battle to keep over-the-counter Plan B out of the hands of American women, the White House is trying another tack.  And just as in the case of the FDA's stonewalling, Senators Hillary Clinton (D-NY) and Patty Murray (D-WA) plan to fight back.

Sadly, that could take some time.  As President Obama prepares to take over in Washington, undoing George Bush's regulatory assault on women's reproductive rights won't be quick or easy.  If the rule is issued before December 20th, it could take months for the administrative law process and public comment period to be concluded by President Obama.  As a result, health care advocates led by Murray and Clinton will likely look to action by Congress early next year.

This last gasp attack on access to reproductive services is just one of the parting gifts from George W. Bush.  Of course, it could have been much worse.  He could have been passing the baton to President John McCain.

** Crossposted at Perrspectives **

Originally posted to Jon Perr on Tue Dec 02, 2008 at 11:50 AM PST.

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Comment Preferences

  •  Since these are executive orders (5+ / 0-)

    can't they be overturned easily? Isn't the Obama team already reviewing executive orders to overturn immediately? I know this is true in family planning that requires "abstinence only" advice.

  •  I diaried about this a few weeks ago when it was (16+ / 0-)

    proposed, and it's just horrifying. I believe that any health care provider is obligated to treat the patient, not their conscience.

    "One of the things Ive used on the Google is to pull up maps. Its very interesting to see, Ive forgot the name of the program, but you get the satellite."-GWB

    by GirlZero on Tue Dec 02, 2008 at 11:55:25 AM PST

  •  This is political BS (6+ / 0-)
    Like many right-wing maneuvers, this "right of conscience" change will sound reasonable to many. For 30 years, doctors have been able to excude themselves from abortions (which most people don't have a problem with) and this "sounds" the same.

    But it's not.  Especially given that doctor's have taken an oath to protect their patients and most doctors I know will go to extraordinary lengths to make sure people get the care they need (even if they don't provide it themselves).

    This is a topic worthy of discussion. There are people who have moral issues. But debate it in congress. In the open, where all sides can be heard. This 11th hour behind closed-doors BS shows that the people in charge today have no morals.

    It's kind of funny, but when Jesus came 2000 years ago, he seemed to only pick fights with the lawmakers.  The had become obsessed with the law and had forgotten about love.

    How little has changed.

    The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me' MT 25:40

    by Ed G on Tue Dec 02, 2008 at 12:05:33 PM PST

  •  whether it can be easily undone or not... (6+ / 0-)

    ...isn't really the concern.  

    The concern is that it will place President Obama and the Democrats in a position of HAVING to do something about it.  If they take this bait and undo these sorts of dastardly, last minute changes, Obama and the democrats will be providing ammo to the repubs in the next election cycle.  

    Can't you just hear it now?  "Obama voted to force doctors to perform abortions!!!!!!"  Yeah, I can even hear Palin screeching that out on a stump somewhere, doncha know.  Also.    

    It's kind of like strategic retreat.  Yeah, you may withdraw your forces from this village so that you can regroup and mount a stonger defense in the next village, but, before you leave, you dump rat poison down the village drinking water well so you'll have fewer enemies to fight when you do make your next stand.  

    •  I can only speak for myself.... (0+ / 0-)

      and my experience but in years of working in ERs across the country (mainly in the southeast US) I have never once been faced with someone seeking an abortion and only a handful in need of immediate contraception.

      So I am not sure what nurses this would really effect.  Most ers dont do abortions and dont actually dispense medications only scrips.  Same goes for physicians.  

      How many abortions occur outside of clinics?  Does anyone have these numbers?

    •  putting aside the topic of abortion for a moment. (0+ / 0-)

      i know of people in most every industry who come across situations where their conscience and the job assigned to them conflict. some people suck it up and feel awful later on, some pass along the assignment to someone who isn't conflicted and some get up and leave.

      most OBGYNs, for example, do not perform abortions. as long as individuals have convenient, affordable access to the health services they need I have no problem with individuals referring their patients to someone else.  i just think physicians are in better situations to make those judgments than others in the healthcare field, which is why this new regulation is particularly frightening.

      any topic where there are such deep-seated views should have been raised in the light of day via Congress, and not some 11th hour out-of-sight edict.

      The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me' MT 25:40

      by Ed G on Tue Dec 02, 2008 at 12:46:07 PM PST

      [ Parent ]

    •  Not really (0+ / 0-)

      It is not anyone's job to provide a specific service to a specific person.  In other words, it is not a doctor's job to treat anyone unless and until the doctor agrees to do so.  Nor is it a doctor's job to provide any treatment that the patient may request.

  •  Did he smirk when he signed it? (2+ / 0-)

    Oh, George!


    Never sold your soul?


    Then, tell me, please,
    tell the truth whole:

    What's the smirk for?


    - Caneel

    Against silence, which is slavery. -- Czeslaw Milosz

    by Caneel on Tue Dec 02, 2008 at 01:00:55 PM PST

  •  what if it conflicts with a state law? (0+ / 0-)

    They should leave it up to the states to have restrictions like these. I don't know why the federal government needs to be involved if the patient visit doesn't happen "across state lines".

    In a democracy, everyone is a politician. ~ Ehren Watada

    by Lefty Mama on Tue Dec 02, 2008 at 01:20:33 PM PST

  •  i wrote them during the public comment period. (2+ / 0-)

    Noticed they didn't take my thoughts, feelings and rights to health into account.

    Hey, I'm only a woman.  Right?  It's not like I matter, or outnumber men, or outlive them.

    Another kick in the teeth.  Guess all I can say to these people is "fuck you".

    A bunch a times.  Real loud and up close.


    "What you see isn't necessarily what you'll get."

    by mechboots on Tue Dec 02, 2008 at 03:24:46 PM PST

  •  Now i might get burned for this (0+ / 0-)

    but this is where being pro-life across the board pops up in my mind.

    Now while i don't support the hammer approach to abortions, i'd rather see a system created that helps women chose to have kids rather than ever need to consider abortion.

    It still taps my catholicness that a doctor who takes an oath to do no harm might be forced to do what they see as harm.

    Honestly as liberal catholic as i am i'm sick of having to tight rope walk this blasted issue, when i talk about this around center and center-right Catholics they don't think i'm doing my faith correctly, and with my leftist views on everything else sometimes my fellow lefties will look at me after i talk about this like i'm a monster or something.

    We have a health and support crisis in this country, we need a system, not a better system but a system period. I feel if we make a better country a more stable one, issues like abortion will in some manner fix itself.

    bloody hard to talk about wedge issues....

    •  Believe me, (4+ / 0-)

      I would have WAY preferred that my contraceptive worked. Cause not being in a situation where all the choices stink is way preferable.

      One important element to decrease abortion is to improve the general lot of the working poor and middle class. A certain percentage of abortions are, "I cannot afford a/another child." Abortions will still happen, even in the best world we can manage to create. I agree that it would be better if we could avoid it getting to that point.

    •  I understand where you are coming from (3+ / 0-)

      but your wording here 'help women choose to have kids' raises my hackles.

      The emphasis should never be on 'help women choose to have kids' it should only be 'never put them in a situation where they have to choose'. The support apparatus should be in place so that accidental pregnancy is rare and when it does occur, the options are there, one way or another. This includes decent sex ed and easily obtainable contraceptives, including Plan B and other so-called abortion pills that simply prevent an egg from implanting. If the woman does choose to continue the pregnancy, options for health care and early childhood care should also be available.

      For some of us, it is never a choice. For personal reasons, I will never choose to have children and that choice is as valid as any other. Not to bite your head off, but the idea that all women should 'choose to have children' is a hot button for me. The emphasis should be for women to live their lives the way they choose, not the way society thinks they should live.

      •  I expected to get bitten at (0+ / 0-)

        now this might be me, but i'm all on with the no sex till marriage thing, maybe it's because i've never been able to get a date in my 23 years i think that way but for a guy like myself it does work.

        Now this is my most conservative aspect, but to me if two people choose to have sex, then they also chose to chance having a kid. This means both the man and the woman have to be ready for that chance.

        Of course i'm 23, male, and a barely social nerd, so what do i know about this stuff, other than the raw technical side of it.

        -Gabe who likes reasoned discussion and knows that he's dancing in a minefield at the moment.

        •  YOUR interpretation of sex should not (0+ / 0-)

          decide other people's options.

          And I can see why, with your attitudes, no one will go out with you.

          The last time we mixed religion and politics people got burned at the stake.

          by irishwitch on Wed Dec 03, 2008 at 05:36:00 PM PST

          [ Parent ]

        •  YOU (0+ / 0-)

          would force a woman to bear her rapist's child.  THAT is the effect of these regs.

          The last time we mixed religion and politics people got burned at the stake.

          by irishwitch on Wed Dec 03, 2008 at 05:37:26 PM PST

          [ Parent ]

          •  Would i? (0+ / 0-)

            i said two consenting people, in rape there is a lack of consent.

            and in my own defense, i've never really tried to get a date, and it's not like i go around telling people my views on sex, my lack of dates has more to do with my lack of social contact, i'm a nerd that tends to drive away most girls.

            as far as politics my biggest issues are tech and labor related, i try not to get involved in issues like this because as i said before their minefields.

            did i ever say people should follow the rules i do??

            What do i think will reduce abortion the most?
            -better health care
            -a better econ
            -better eduction both sexual and formal

            some people who are pro-choice are just as quick to attack people who are anti-choice as anti-choice forces are to attack people are pro-choice.

            -gabe, who stepped on a mine.....

    •  Ex-Catholic here: (0+ / 0-)

      Someone else's religious views should not have a deleterious effect on my health.  It is ONE thing to refuse to perform an anortion--but to refuse to give a referral is absolutely wrong. DItto birth control.

      And any OB/Gyn OWES it as a fiduciary duty to his ptients to tell them up front when they call tomake their appointment the first time what they won't do.  Maybe they should have a recorded message the possible patient could listen to the first time they call. SO it ties up their line. They'll live. But MANY health policies only cover one Gyn visit a year--no one should have to waste it on a doc who won't handle contraception.

      The last time we mixed religion and politics people got burned at the stake.

      by irishwitch on Wed Dec 03, 2008 at 05:35:07 PM PST

      [ Parent ]

  •  unconstitutional (1+ / 0-)
    Recommended by:

    For faith based charities to even recieve government funds is a serious outrage and a threat to the seperation of church and state that has been so vital to this ongoing democracy experiment. Anyone that thinks otherwise should read Madisons (remember him . . . he WROTE the constitution) to Edward Livingston. This beautiful letter should be required reading in every high school in the nation.

    Obama supports faith based charities: he too, should read the letter & the eloquent explanation given by James Madison.

  •  What if (0+ / 0-)

    if offends a health care provider's conscience to provide any form of health care treatment for Republicans?  Just asking.

    "Honey, the clue box is right there!" - Contestant on The Amazing Race

    by Tara the Antisocial Social Worker on Wed Dec 03, 2008 at 07:35:52 AM PST

  •  ANother case of clear religiously based (0+ / 0-)

    discrimination   is this doctor who refused to treat a child with an ear infection because her mother didn't meet his dress code!!!!  If left up to me, he wouldn't have a medical license left, and any church which claims to follow Jesus would refuse to accept him as a member unless he repents.

    What's next?  Can Christian doctors refuse to treat anyone who isn't the Right Kind of Christian?

    The last time we mixed religion and politics people got burned at the stake.

    by irishwitch on Wed Dec 03, 2008 at 05:31:21 PM PST

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