Rules Let Health Workers Deny Abortions

The Bush administration has proposed stronger protections for health-care workers who refuse to participate in abortions, issuing a sweeping regulation that could also undercut access to birth-control pills and other forms of contraception.

The new rules, which could take effect after a 30-day comment period, threaten state governments with a cutoff in federal funding if they force medical personnel to perform, assist in or refer patients to abortion services.

But supporters and opponents of abortion rights said the regulation is ambiguous enough to affect contraception services, including the so-called morning-after pill.

An earlier draft of the regulation had defined abortion to include contraceptive pills, as well as the intrauterine device, which can prevent a fertilized egg from implanting in the womb. The 42-page document issued Thursday doesn't include that definition.

"This regulation is not about contraception. It's about abortion," said Mike Leavitt, secretary of the Department of Health and Human Services.

But Mr. Leavitt acknowledged that some medical providers may want to "press the definition" and make the case that some forms of contraception are tantamount to abortion.

Karen Brauer, president of Pharmacists for Life, said she expects members of her group will do exactly that. "It would be pretty excellent," she said, if states lost federal funding over laws requiring pharmacists to fill birth-control prescriptions.

Activists on both sides of the debate said that hospitals, insurers and HMOs may be able to use the regulations to challenge other state laws, such as requirements that insurers include contraception as part of prescription-drug benefits. Or the federal government could force states to change those laws as a requirement for federal funding. "We fear that's possible," said Roger Evans, director of litigation for Planned Parenthood.

If the regulation passes, his group would try to convince the federal government that it has "gone awry," he said. If that fails, he added, the group will consider litigation to block the regulation.

From the other side of the issue, Casey Mattox, an attorney with the Christian Legal Society, expressed strong support for the regulation. "It's about time," he said.

The religious right -- a key ally of Republicans in this election year -- has long pressed for more restrictions on abortion and contraceptive access. John McCain, the likely Republican presidential nominee, has repeatedly said he would enact "pro-life" policies, including expanded protections of life in the womb, if elected. He hasn't signaled his stance on this regulation and declined to comment when asked about an earlier draft.

Barack Obama, expected to accept the Democratic presidential nomination next week, signed a letter opposing that draft. If he were to win the White House, he could reverse the regulation.
It is unclear how many women might be affected if the regulation takes effect as written.

Catholic hospitals account for more than 10% of the nation's emergency rooms, and many would like to be freed from state mandates requiring them to offer emergency contraception to victims of sexual assault.

Studies have shown that state laws requiring insurance companies to cover contraception have significantly expanded access for women. But it isn't known whether those insurers would remove birth control from their coverage plans if those state mandates expired.

The Department of Health and Human Services wouldn't comment on any state laws or how they might be affected.

Mr. Leavitt stressed that the regulation "does not affect the rights of patients" to obtain "any legal procedure."

But it could make access to those procedures more difficult. Institutions and individuals opposed to abortion need not refer patients to other providers, Mr. Leavitt said. That could leave some patients stranded, especially women in isolated areas, or those who need quick access to the morning-after pill.

The number of abortions in the U.S. has dropped steadily over the past two decades and now stands at about 1.2 million a year. More than a third of American women live in counties with no abortion provider.

Opponents of the regulation said they were most concerned about the prospect that some federally funded clinics, which serve mostly low-income women, could assert a right to refuse to prescribe or even discuss birth-control pills with their patients.

"This raises very serious questions about contraceptive access," said Louise Melling, director of the American Civil Liberties Union's Reproductive Freedom Project.

Mr. Leavitt has been intensely lobbied about this regulation for weeks, since a draft was leaked by opponents of the Bush administration. Earlier this week, the Planned Parenthood Action Fund and MoveOn.org Political Action delivered 325,000 signatures of protest to Mr. Leavitt.
Other strong criticism came from the American Medical Association and the American College of Obstetricians and Gynecologists. Dozens of members of Congress raised objections as well.
In the face of this criticism, Mr. Leavitt wrote a blog post distancing himself from the draft, suggesting that he might not issue any regulation at all.

Thursday, however, he signaled his desire to go forward, citing the need to protect medical professionals. Their right to refuse to perform -- or inform patients about -- certain procedures is "a fundamental freedom," he said, "something every American values."

Pro-lifer attacked at Santa Ana abortion clinic

A California abortionist could face prosecution over an incident at an abortion clinic in Santa Ana.

A pro-life prayer warrior was at the clinic taking pictures. According to Cheryl Sullinger of Operation Rescue, the man was attacked at the end of the day.

"As he was leaving the clinic the abortionist got angry and attacked him, punched him, choked him," Sullinger explains. "He was knocked to the ground. He received lacerations and other injuries."

While on the ground, the unidentified pro-lifer yelled for help. "The police were summoned, and the abortionist was arrested and charged with assault and battery," Sullinger adds.

There were several witnesses to the incident. The owner of the clinic was arrested recently and faces 28 charges, including performing abortions without a license.

Court revisits partial-birth abortion case

WASHINGTON (BP)--A federal appeals court has provided hope that Virginia's ban on partial-birth abortion may withstand its scrutiny after all.

The Fourth Circuit Court of Appeals has decided the full court will reconsider a May decision by a three-judge panel that the state prohibition on the gruesome late-term abortion procedure is unconstitutional. On July 28, the court voted 6-4 for the rehearing, according to the Alliance Defense Fund (ADF).

Oral arguments before the court are tentatively set for the period of Oct. 28-31, said Virginia Attorney General Bob McDonnell, who requested the full court hear the case.

A divided, three-judge panel of the Fourth Circuit invalidated the state prohibition on "partial birth infanticide" May 20, saying it went beyond a 2003 federal law and unconstitutionally restricted the right to abortion. The decision came only 13 months after the U.S. Supreme Court affirmed the Partial-birth Abortion Ban Act, a 2003 federal measure that prohibits an abortion technique that involves the killing of a nearly totally delivered baby usually in at least the fifth month of pregnancy.

The same three-judge panel, also in a 2-1 vote, had rejected the Virginia law in 2005.

The U.S. Supreme Court, after its 2007 ruling upholding the federal law by a 5-4 vote, returned the case from the Fourth Circuit to the appeals court for reconsideration in light of its opinion regarding the federal ban. That did not prevent the three-judge panel from striking it down again.

"Virginia has legitimately chosen to protect innocent life from a terrible procedure, and the court is right to revisit the decision against Virginia's law," ADF senior counsel Jordan Lorence said in a written statement. ADF has funded friend-of-the-court briefs in the case. "The decision of the three-judge panel conflicts significantly with the Supreme Court's ruling over a year ago [upholding the federal ban].

"The abortionists pursuing this case show an obsessive devotion to abortion that they think trumps reasonable public policy decisions."

A partial-birth abortion, as typically performed, involves the feet-first delivery of an intact baby until only the head is left in the birth canal. The doctor pierces the base of the infant's skull with surgical scissors before inserting a catheter into the opening and suctioning out the brain, killing the baby. The technique provides for easier removal of the baby's head.

The case is Richmond Medical Center v. Herring. The Fourth Circuit is based in Richmond, Va.