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HHS publishes proposal to rescind 'rule of conscience'
New rule would reverse policy supported by Bush
At the urging of the Obama administration, a policy to rescind the so-called "rules of conscience" for health care providers means that battle lines have been drawn once again over the question of when life begins — among other moral and scientific questions in reproductive health.
The proposed rule would reverse a policy that took effect Dec. 18, 2008, as pushed forward by the Bush administration after a three-month review period that began in August.
The rule was published Tuesday, March 10, in the Federal Register. And as noted in the statutory background of the proposed rescission rule, "Several provisions of federal law prohibit recipients of federal funds from coercing individuals in the health care field into participating in actions they find religiously or morally objectionable."
Several organizations, including Planned Parenthood Federation of America (PPFA) in New York, had filed suit against the Bush policy PPFA was among the organizations recently that applauded the Obama administration's initiative to rescind the rules of conscience.
"This proposed rule clearly states that the Obama administration is committed to putting patients' care first," said Cecile Richards, president of PPFA, in a news release. "As was made clear at the White House Summit on Health Care … we should be working together to increase, not hinder, access to care.
"Patients, especially low-income women, deserve access to complete and accurate health care information and services, and [this] action shows that this administration understands and will meet this need. This is a commonsense fix."
Calling the Bush administration's policy "a dangerous rule" on its web site, the American Civil Liberties Union (ACLU) in Washington, DC, noted that the Bush rule "must be rescinded."
"We are pleased that the Obama administration recognizes that this rule was essentially the Bush administration's parting shot against women's health and warrants careful review," said Caroline Frederickson, director of the ACLU Washington Legislative Office, in a news release. "The rule jeopardizes patients' access to important reproductive health services, especially for low-income and uninsured women who rely on federally funded health centers for care."
Jennifer Dalven, deputy director of the ACLU Reproductive Freedom Project, said in the release that "The Obama administration has taken the first step toward rescinding this rule that fails to properly balance protections for individual religious liberty and patients' access to health care."
For some, moral questions continue
David Stevens, MD, MA (ethics), CEO of the Christian Medical and Dental Associations (CMDA) in Bristol, TN, which has 16,000 members, disputes the notion that the rules of conscience were something "cooked up by the Bush administration."
He says that the Obama proposed rescission rule "actually rescinds all regulations" that would protect physicians from discrimination by institutions or other physicians if they exercise actions based on moral beliefs, such as refusing to perform abortions or sterilizations.
Instead of being a Bush-driven policy, Stevens notes, "There are laws that have been on the books protecting right of conscience going clear back to the Church Amendments, which actually happened in the '70s."
The Church Amendments followed the decision of Roe vs. Wade in 1973."
"[The amendments] said very clearly that you can't force people to participate in abortions and other things . . . that they have opposition to," Stevens says.
He also points to an AMA statement that says, "We affirm that neither physicians, hospitals, nor hospital personnel can be held to perform any act violating personally held moral principles."
That statement, according to Stevens, was last affirmed in 1997 by the AMA.
"The problem is, and what brought this to the forefront, is a number of abortion groups — Planned Parenthood and the ACLU — have had very well funded abortion access projects, whose goal is to get health care providers to participate in abortions," Stevens says. "And they've been fairly successful."
There is a 30-day public comment period for the rule of conscience rescission proposal. That comment period ends April 9, 2009.
Planned Parenthood, in a news release on the Obama administration's decision, urged supporters to comment on the rule and show their support for the proposed rule.
"Planned Parenthood is using the latest technology to get the word out and encourage supporters to comment on the rule, including text messaging, social networking, and Twitter," according to the release.