Last Thursday, George W. Bush’s administration shrugged off any pretense of restraint and launched a transparent attack on women’s health by proposing regulations that would allow health care organizations and individual health care providers who receive federal funding to refuse to provide information about abortion.
In so doing, the president gave a gift to the religious right and at the same time delivered a parting shot at the women he claimed his middle initial — W — was supposed to “stand for.”
The new regulation purports to clarify three acts of Congress which allow individuals and organizations to refuse to perform or assist in performing abortions if doing so violates their religious or moral beliefs. However, it goes far beyond defending a medical worker’s right to refuse to perform an abortion — it also secures his or her right to refuse to “refer for, or make other arrangements for, abortions.” In other words, a worker at a women’s clinic, perhaps the only one for several hundred miles, can refuse to perform an abortion and refuse to refer the patient to someone who will.
A previous draft of the rule included a provision defining many common forms of birth control, such as the pill, as abortion. While this definition is not included in the current draft, the wording of the proposed rule we now have from the administration is vague enough to allow a health care worker to attempt to establish a conscience exception to providing hormonal birth control.
In fact, U.S. Department of Health and Human Services Secretary Michael Leavitt was quoted in the Aug. 22 Wall Street Journal saying “that some health workers might want to ‘press the definition’ of abortion and argue that some forms of contraception are abortion.”
How would this work in practice? A woman comes to a health center in, say, Bangor for a pregnancy test. Her test comes back positive; she is three weeks pregnant. Under these circumstances, the responsible reaction from a nurse practitioner is to provide all the information available describing the patient’s pregnancy options. This is called “comprehensive options counseling” and would include information about where to access prenatal care, what resources are available to women seeking to place their infant for adoption, and information regarding abortion.
Under the new rule, a nurse practitioner could omit information about abortion when discussing options with a pregnant woman, or the nurse practitioner could flat out refuse to provide any information on abortion, even at the patient’s request.
And what would be the impact on Maine Family Planning? Title X, the federal family planning program that helps support Maine’s 44 clinics throughout the state, requires family planning staff to provide comprehensive options counseling and referral to pregnant women, including information about and referrals for abortion services. The Bush administration’s new regulation would make it possible for a family planning staff member to refuse, on the basis of personal moral conviction, to provide a referral to a patient seeking an abortion.
The rule protecting the conscience of the health care provider inflicts unconscionable harm on a patient who is trying to make an informed decision about her options. It also puts the family planning clinic in the highly unusual position whereby complying with one federal regulation — the conscience excuse — puts a clinic in conflict with its Title X obligations and therefore at risk for losing its federal funding.
What is perhaps most remarkable about this proposed regulation, which runs 42 pages, is the utter absence of any mention of the patient — the woman or teenager who visits a health care provider expecting to receive information and care that’s legally available. If she doesn’t get that care because the health care provider disapproves of the choices or the circumstances that led her to the provider in the first place, what happened to the rights of the patient?
No, the letter “W” does not stand for “Women” as we were told repeatedly during George Bush’s two election campaigns. Instead, it stands for the ongoing war on women that Bush has waged for the last eight years and continues even into the final days of his presidency.
George A. Hill is president and CEO of the Family Planning Association of Maine.