White House weakens conscience protections for health workers


WASHINGTON — The Obama administration has invalidated nearly all of the conscious clause protections for health workers implemented by the Bush administration. Health care workers can opt out of abortion procedures if they find it morally objectionable but cannot refuse to dispurse contraceptions.

The Department of Health and Human Services (HHS) issued a new regulation that rescinded safeguards for workers and entities who object on moral or religious grounds to providing, for instance, abortion-causing drugs or birth control, although it maintained long-standing, congressional safeguards for those who object to participating directly in the performance of abortions and sterilizations.

The result of the HHS revocation of a rule issued by the Bush administration in December 2008 is to empower federally funded state and local governments, hospitals and health plans to refuse to permit doctors, nurses, pharmacists and other workers to opt out of procedures and prescriptions that violate their convictions.

The change came despite a Feb. 11 letter sent to U.S. Secretary of Health and Human Services Kathleen Sebelius by 46 members of Congress. The representatives were seeking an explanation on why her department was seeking to repeal conscience protections for health care workers whose beliefs are often abused by supervisors.

Medical professionals should not be punished for holding to their beliefs, and they should not be forced to perform abortions against their conscience," said Matt Bowman, legal counsel for the Alliance Defense Fund. "Members of the House were justified in asking why the Obama administration would be seeking to repeal such protections."

Tony Perkins, president of Family Research Council, said the action was "a blow both to medicine and the right to practice one's deeply-held convictions."

One of the concerns expressed by foes of the new rule is the possibility of medical workers leaving their profession in order to avoid violating their consciences.

"Losing conscientious healthcare professionals and faith-based institutions to discrimination and job loss especially imperils the poor and patients in medically underserved areas," said J. Scott Ries, a Christian Medical Association vice president, in a written statement. "We are already facing critical shortages of primary care physicians, and the Obama administration's decision now threatens to make the situation far worse for patients across the country who depend on faith-based health care."

The head of a leading abortion-rights organization praised the new rule. It "reaffirms the principles of protecting the doctor-patient relationship by repealing the most onerous and intrusive parts" of the previous regulation, said Nancy Keenan, president of NARAL Pro-choice America.

The new HHS regulation was not a surprise. The administration indicated its intention to revoke the Bush-era rule in full or in part in March 2009, less than two months after President Obama took office. A 30-day comment period resulted in more than 300,000 responses, according to HHS. After its review of those comments, the department acknowledged Feb. 18 that nearly two-thirds were opposed to rescinding the Bush administration rule.

In issuing the new regulation, HHS said the December 2008 rule "caused confusion and could be taken as overly broad."

One provision retained in the new rule from the December 2008 regulation was the authorization of the Office for Civil Rights to investigate charges of violating conscience protections.

The new regulation would seem especially to threaten the liberty of pro-life pharmacists, who could be required to fill prescriptions for morally objectionable products, such as the Plan B "morning-after" pill, which can act as an abortifacient.

Plan B is basically a heavier dose of birth control pills. Under the regimen, a woman takes two pills within 72 hours of sexual intercourse and another dose 12 hours later. The drug, also known as "emergency contraception," works to restrict ovulation in a woman. It also can act after conception, thereby causing an abortion, pro-lifers point out. This mechanism of the drug blocks implantation of a tiny embryo in the uterine wall.

The Bush administration developed its rule after then-HHS Secretary Michael Leavitt became concerned about the willingness of the American Board of Obstetrics and Gynecology (ABOG) to protect 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 2008 to seek clarification it would not support controversial recommendations from a committee of the American College of Obstetricians and Gynecologists. That committee said physicians "with moral or religious objections" should refer women seeking abortions to doctors who will perform them. The 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.

The rule issued by the Bush administration placed into federal regulations congressional measures enacted in the 1970s through 2005 that "prohibit discrimination on the basis of one's objection to, participation in, or refusal to participate in, specific medical procedures, including abortion or sterilization," according to HHS at that time.

Congress has introduced several bills that will strengthen health care providers' conscience rights, Protect Life Act (H.R. 358), the No Taxpayer Funding for Abortion Act (H.R. 3), and the Abortion Non-Discrimination Act (H.R. 361).

BP and Christian Examiner staff report

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