some thoughts on the new dhhs regulations
I know, I know. It has been covered to death. But I was reading some of the endless news stories that cross my desk every day, and getting increasingly frustrated at the whole idea behind this. For those of you who are out of the loop, here’s the background. A couple weeks ago some draft regulations, ostensibly written to clarify the “right to conscience” of health care workers, were leaked from the Department of Health and Human Services. According to the Secretary, Michael Leavitt: "An early draft of the regulations found its way into public circulation before it had reached my review. It contained words that lead some to conclude my intent is to deal with the subject of contraceptives, somehow defining them as abortion. Not true."
The words he’s referring to defined abortion as anything that interfered with the implantation of a fertilized egg, which could potentially include such simple contraceptives as the IUD and the pill. I’m a little fuzzy on the science here (for a really good blog on the science behind contraception, check out rh reality check). According to US policy, health care workers have a right to refuse to perform or be trained to perform abortions. The obvious problem with this back-door redefinition of abortion is that health care workers (including insurance companies and pharmacists) could then also claim that they have a right to refuse to provide birth control. How the hell that would reduce abortions, I leave to you to explain to me, ‘cause I don’t get it. In the latest draft, that specific language has been removed, but the term abortion remains undefined, leaving the door open to future attempts to expand the definition. And I believe that’s intentional - Sec. Leavitt’s been making the rounds painting us all as histrionic, easily riled feminists, and belittling our concern about a legitimate problem with US policy. My favorite quote? Comes from his blog, and I do really think that this shows his general lack of respect for the other side: "I'm delighted to announce that with the help of Planned Parenthood, my blog -- for the first time -- received more visits than my teenage son's MySpace page."
I took some time to read the newest draft of the regulations (available for public comment on the DHHS website), and I’m curious about what I think might be the more insidious idea - that the health care practitioner’s “right to conscience” out-weighs the patient’s right to treatment. There’s a lot of language in all of the policies and amendments and laws that set this precedent that tends towards neutrality. As such, they talk a lot about the fact that patient’s right to care will not be compromised, because they can access services somewhere else. I’m not sure I buy it. these regulations govern federally funded health services. Access to birth control, and information about it, is especially necessary at federally funded health service centers, which are supposed to catch the people who fall through the cracks of our broken private health industry. Plus, the “right to conscience” clause is usually interpreted to mean that health care practitioners can refuse not only to provide access to abortion, but also to provide information about abortion or referrals to other health providers who do perform abortions. I think that does and will continue to compromise the patient’s right to care. Abortions are, currently at least, legal. A federally funded health care provider should not be allowed to refuse to provide information about legal health procedures. You may not want to do it, you may think it’s wrong, but you should at least suck it up, recognize that you’re in a service industry, and say “I won’t do that, but if you’re looking for more information you can ask that guy down the hall.” I don’t think that infringes on the right to conscience, and I think the ability of a health care provider to tell his or her patient that “I won’t do it, and I won’t help you find anyone who will, or who will even talk to you about it,” is not only a breach of a patient’s right, but also of the medical code of ethics.
Then we get to the issue of pharmacists. When emergency contraception became available in the states, there was a lot of noise about the pharmacist’s right to refuse to provide it. Personally, I think it’s bunk. I don’t think pharmacists have a right to refuse to provide medication. That’s their job. There are religions that don’t believe in medication at all, and so those people who subscribe to those religions DON’T BECOME PHARMACISTS. Generally. I would expect. Similarly, if you have a problem providing an FDA-approved drug in a federally-funded pharmacy, I think it might be time to find a new job. Go work in a pharmacy that shares your moral code. But those organizations that think that they should be allowed to deny contraceptives to women merely because it’s against their belief system shouldn’t be eligible for federal funding. Note the disappointed quote from the irritatingly named Pharmacists for Life International, reacting to the change in language in the new regulation:
"This is not going to help any individual pharmacist very much," said Karen Brauer, president of Pharmacists for Life International. "If it says anything that is not a surgical abortion is not an abortion, a pharmacist will not be protected by this." "Hundreds" of pharmacists have been fired for refusing to provide contraceptives, she added.
I repeat, she whines that “hundreds” of pharmacists have been fired for flat-out refusing to perform their job. As well they should be, I would think. And, again referencing the rh reality check blog, CONTRACEPTION IS NOT ABORTION. Period. Contra = against, caption=conception. Contraceptives prevent you from conceiving. That’s why they’re called contraceptives. They don’t terminate an existing pregnancy. Pregnancy, as defined by every legitimate medical authority in the world as beginning at implantation. Not fertilization. Which is what contraceptives prevent. It’s fairly simple logic.
But logic is not the problem here. As many better bloggers than I have pointed out many, many times, the pro-life movement is not against abortion. They are against women’s control over their own bodies. Period. Any rational or logical movement to reduce the numbers of abortions in the world (which most of us want to do, oddly enough) would be PRO-contraception. We would (and do!) celebrate contraception and information about it as a method of preventing unwanted pregnancies. And pharmacies and health clinics that do receive federal funding shouldn’t be forced to hire people who refuse to perform part of their job. There is no other issue or industry where you can walk into an interview, state outright that you will refuse to perform part of the job, and then sue for discrimination when you’re not hired. That’s ridiculous. And here’s where I go into the conspiracy theory thing - I can easily see anti-choice activists (you know, the same people who shoot doctors and blow up clinics in defense of “life?”) organizing themselves to march into clinics, refuse medical treatment to people, refuse to provide referrals, then scream their heads off about discrimination in order to make sure federal funding doesn’t continue to go to clinics that provide a full range of legal medical services and information to their clients. And that is bone-chilling, to me.
The words he’s referring to defined abortion as anything that interfered with the implantation of a fertilized egg, which could potentially include such simple contraceptives as the IUD and the pill. I’m a little fuzzy on the science here (for a really good blog on the science behind contraception, check out rh reality check). According to US policy, health care workers have a right to refuse to perform or be trained to perform abortions. The obvious problem with this back-door redefinition of abortion is that health care workers (including insurance companies and pharmacists) could then also claim that they have a right to refuse to provide birth control. How the hell that would reduce abortions, I leave to you to explain to me, ‘cause I don’t get it. In the latest draft, that specific language has been removed, but the term abortion remains undefined, leaving the door open to future attempts to expand the definition. And I believe that’s intentional - Sec. Leavitt’s been making the rounds painting us all as histrionic, easily riled feminists, and belittling our concern about a legitimate problem with US policy. My favorite quote? Comes from his blog, and I do really think that this shows his general lack of respect for the other side: "I'm delighted to announce that with the help of Planned Parenthood, my blog -- for the first time -- received more visits than my teenage son's MySpace page."
I took some time to read the newest draft of the regulations (available for public comment on the DHHS website), and I’m curious about what I think might be the more insidious idea - that the health care practitioner’s “right to conscience” out-weighs the patient’s right to treatment. There’s a lot of language in all of the policies and amendments and laws that set this precedent that tends towards neutrality. As such, they talk a lot about the fact that patient’s right to care will not be compromised, because they can access services somewhere else. I’m not sure I buy it. these regulations govern federally funded health services. Access to birth control, and information about it, is especially necessary at federally funded health service centers, which are supposed to catch the people who fall through the cracks of our broken private health industry. Plus, the “right to conscience” clause is usually interpreted to mean that health care practitioners can refuse not only to provide access to abortion, but also to provide information about abortion or referrals to other health providers who do perform abortions. I think that does and will continue to compromise the patient’s right to care. Abortions are, currently at least, legal. A federally funded health care provider should not be allowed to refuse to provide information about legal health procedures. You may not want to do it, you may think it’s wrong, but you should at least suck it up, recognize that you’re in a service industry, and say “I won’t do that, but if you’re looking for more information you can ask that guy down the hall.” I don’t think that infringes on the right to conscience, and I think the ability of a health care provider to tell his or her patient that “I won’t do it, and I won’t help you find anyone who will, or who will even talk to you about it,” is not only a breach of a patient’s right, but also of the medical code of ethics.
Then we get to the issue of pharmacists. When emergency contraception became available in the states, there was a lot of noise about the pharmacist’s right to refuse to provide it. Personally, I think it’s bunk. I don’t think pharmacists have a right to refuse to provide medication. That’s their job. There are religions that don’t believe in medication at all, and so those people who subscribe to those religions DON’T BECOME PHARMACISTS. Generally. I would expect. Similarly, if you have a problem providing an FDA-approved drug in a federally-funded pharmacy, I think it might be time to find a new job. Go work in a pharmacy that shares your moral code. But those organizations that think that they should be allowed to deny contraceptives to women merely because it’s against their belief system shouldn’t be eligible for federal funding. Note the disappointed quote from the irritatingly named Pharmacists for Life International, reacting to the change in language in the new regulation:
"This is not going to help any individual pharmacist very much," said Karen Brauer, president of Pharmacists for Life International. "If it says anything that is not a surgical abortion is not an abortion, a pharmacist will not be protected by this." "Hundreds" of pharmacists have been fired for refusing to provide contraceptives, she added.
I repeat, she whines that “hundreds” of pharmacists have been fired for flat-out refusing to perform their job. As well they should be, I would think. And, again referencing the rh reality check blog, CONTRACEPTION IS NOT ABORTION. Period. Contra = against, caption=conception. Contraceptives prevent you from conceiving. That’s why they’re called contraceptives. They don’t terminate an existing pregnancy. Pregnancy, as defined by every legitimate medical authority in the world as beginning at implantation. Not fertilization. Which is what contraceptives prevent. It’s fairly simple logic.
But logic is not the problem here. As many better bloggers than I have pointed out many, many times, the pro-life movement is not against abortion. They are against women’s control over their own bodies. Period. Any rational or logical movement to reduce the numbers of abortions in the world (which most of us want to do, oddly enough) would be PRO-contraception. We would (and do!) celebrate contraception and information about it as a method of preventing unwanted pregnancies. And pharmacies and health clinics that do receive federal funding shouldn’t be forced to hire people who refuse to perform part of their job. There is no other issue or industry where you can walk into an interview, state outright that you will refuse to perform part of the job, and then sue for discrimination when you’re not hired. That’s ridiculous. And here’s where I go into the conspiracy theory thing - I can easily see anti-choice activists (you know, the same people who shoot doctors and blow up clinics in defense of “life?”) organizing themselves to march into clinics, refuse medical treatment to people, refuse to provide referrals, then scream their heads off about discrimination in order to make sure federal funding doesn’t continue to go to clinics that provide a full range of legal medical services and information to their clients. And that is bone-chilling, to me.