29 August 2008

Comments Invited on HHS Rule on 'Conscience Clause'

The Department of Health and Human Services recently published the final version of a regulation [PDF] that supposedly aims to protect medical personnel’s right to conscience. (Secretary Michael Levitt writes about it in his blog.) Earlier versions of the rules contained a problematically broad, if not inaccurate, definition of abortion that could have easily been interpreted to include oral contraception.

As William Saletan points out, the latest version lacks that incendiary language, but it does not resolve the key problem: that pharmacists and medical providers may still refuse to provide basic oral contraception on the same grounds.

As an aside, according to the latest study on contraceptive usage by the Guttmacher Institute, a full 30 percent of American women regularly rely on oral contraceptives for family planning.

Unfortunately, the proposed regulations could open the door to pharmacists refusing to fill prescriptions for typical courses of oral contraception and/or denying emergency contraception to women across America.

Proponents argue that a "conscience clause" simply protects individuals from being forced to provide services that contradict their beliefs and that women can just as easily receive the medicine or care they need elsewhere.

Put aside the fact that this argument accepts that some women will be repaid with shame and inconvenience simply for taking responsibility for family planning. For vast numbers of women, it is not a question of going to a different pharmacy, it is a question of getting the care they need or not. The "other provider" argument applies only to areas where medical providers and pharmacies are numerous, and to women who have the means to reach them. For women and families in rural environments, or with limited means of transportation, one pharmacist's act of conscience can translate into another lengthy bus ride, or another $30 spent on gas to reach a pharmacy miles away.

Leavitt has dodged a number of pointed requests, from journalists and advocates, to clarify, once and for all, if the conscience provision outlined in the proposed regulation applies only to "abortion" as it is generally understood or if providers can invoke the provision to deny oral contraceptives to women as well.

The rule is open to public comment until Sept. 20th: let Secretary Leavitt know what you think about his vague terms and their potential impact on women and communities at consciencecomment@hhs.gov or at post online at regulations.gov.

The public deserves better than bureaucratic ambiguity on the matter, especially when the only thing that is clear is that many women will be denied the medical care they need if the rule is adopted as is.

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