WASHINGTON The Bush administration has issued a rule affirming the right of doctors and other health care providers to refuse to participate in abortion and other medical procedures to which they object.
The Department of Health and Human Services announced the new regulation Dec. 18. The rule will take effect 30 days after its publication Dec. 19 in the Federal Register, which means it will be in force when President-elect Barack Obama is sworn in Jan. 20.
In the wake of the announcement, abortion-rights advocates called on the Obama administration to overturn the new HHS regulation.
The regulation makes clear institutions that receive certain HHS funds as well as employees of such institutions are protected from discrimination. Recipients of such HHS funds must verify their compliance with laws safeguarding the conscience rights of health care providers.
The rule impacts more than 580,000 hospitals, nursing homes, medical schools, doctors' offices and other recipients. Noncompliance could result in the withholding of federal funds from those entities.
"Doctors and other health care providers should not be forced to choose between good professional standing and violating their conscience," HHS Secretary Michael Leavitt said in a written release. "This rule protects the right of medical providers to care for their patients in accord with their conscience."
Pro-life advocate applauded the new regulation.
Tony Perkins, president of Family Research Council, described the new rule as "a huge victory for religious freedom and the First Amendment. No one should be forced to have an abortion, and no one should be forced to be an abortionist.
"This is also a victory for the right of patients to choose doctors who decline to engage in morally objectionable practices," Perkins said in a written statement.
Abortion rights advocates, who already had decried the pending regulation, lambasted it after it was finally issued.
"We are shocked that the Bush administration chose to finalize its midnight regulation and to take this parting shot at women's health and ignore patients' rights to receive the critical health care services and information they deserve," Cecile Richards, president of Planned Parenthood Federation of America, said in a written statement. "From day one, this administration has made ideology and politics a priority over patients' rights and needs, and this regulation is no different."
HHS said the regulation is needed to provide "awareness of, and compliance with," federal laws enacted during the last three decades that were intended to protect the conscience rights of doctors and other health care workers. Those laws include prohibitions on discrimination by federal, state and local governments against institutions or individuals, including those who refuse to take part in or train for performing abortions, as well as to make referrals for the procedures.
Though critics attacked the rule as an eleventh-hour move, HHS had been working on the regulation throughout much of 2008. The department issued a proposed rule in August and held a 30-day comment period.
The rule developed after Leavitt expressed concern about the willingness of the American Board of Obstetrics and Gynecology (ABOG) to safeguard the freedom of conscience of pro-life physicians. ABOG provides certification and recertification for obstetricians and gynecologists in the United States.
Leavitt wrote ABOG in March to seek clarification that the board would not support controversial recommendations from a committee of the American College of Obstetricians and Gynecologists (ACOG). The ACOG committee said last November physicians "with moral or religious objections" should refer women seeking abortions to doctors who will perform them. The ACOG committee even said pro-life doctors should locate their practices near physicians who will do abortions.
ABOG's response to his request "was dodgy and unsatisfying," Leavitt said in an Aug. 21 post on his weblog at the HHS website.
Doctors inside and outside HHS confirmed pro-life medical workers already are pressured to compromise their moral and religious beliefs.
"Many health care providers routinely face pressure to change their medical practice often in direct opposition to their personal convictions," HHS Assistant Secretary of Health Joxel Garcia said in a written release. "During my practice as an OB-GYN, I witnessed this firsthand. Fortunately, Congress enacted several laws to that end, but too many are unaware these protections exist."
The Christian Medical Association (CMA) reported 41 percent of its members said in a survey they had been "pressured to compromise Biblical or ethical convictions."
"Medical students have been reporting to us that they are deciding not to pursue careers in obstetrics and gynecology for fear of coercion to do abortions," CMA Senior Vice President Gene Rudd said in a written statement. "Obstetricians are already being forced out of the profession because of soaring malpractice insurance costs. Forcing yet more obstetricians out of the profession simply for following the Hippocratic Oath and other medical ethical standards would only further harm patient access."
Among medical organizations opposing the new HHS regulation are the American Medical Association, American Psychiatric Association, American Nurses Association and ACOG.