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Kathleen Sebelius (Associated Press)

Weakened protections

Healthcare | The Obama administration strikes elements of conscience protections for pro-life medical providers

WASHINGTON-After nearly two years of warnings, the Obama administration is moving forward with plans to weaken federal regulations designed to protect pro-life medical providers.

The Department of Health and Human Services (HHS) announced Friday that it is striking elements of a 2008 Bush administration order that bolstered the ability of medical caregivers to refuse participation in procedures they find morally objectionable. The changes do not go as far as the administration originally intended or as conservatives feared: wiping out protections in their entirety. But, according to Matt Bowman of the Alliance Defense Fund, it "leaves the how and if of enforcement of conscience protections completely under the discretion of an agency which says it agrees with Planned Parenthood."

The new regulations, which go into effect in 30 days, lower the priority of conscience protections, stating that such rights should be trumped by other issues like patient access. Calling the 2008 protections "unclear and potentially overbroad in scope," the Obama administration is changing elements of the conscience protection regulation largely dealing with contraception.

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This new rule ignores the evidence that many controversial emergency contraception prescriptions promoted by abortion advocates, such as the Plan B drug, can sometimes act as an abortion drug, according to J. Scott Ries, a physician and vice president with the Christian Medical Association (CMA).

"They are pulling the rug out from under faith-based providers," Ries said.

HHS argues that the original 1973 law codifying conscience protections to medical providers who refuse to perform abortions for religious reasons remains in place. But Ries said President George W. Bush's 2008 executive order was needed because of the advancement of medical technology and pharmaceuticals, noting that the elimination of some of the 2008 enhanced protections, as the Obama administration is doing, places pro-life doctors inside a 21st century medical world armed only with an out-dated, four-decade-old law. Those pro-life providers who decline to prescribe controversial contraceptives likely will be stripped of any federal protections if their decisions put their jobs in jeopardy, Ries fears.

Under the new changes, medical providers also may come under attack for refusing either to refer patients to abortion providers or to include the abortion option while counseling.

"These new rules have intentionally inserted ambiguities that weaken these protections," said Ries, adding that they also could be applied to other medical procedures such as end of life issues.

The change comes a little more than two years after the Obama White House, soon after the president's inauguration, announced its intentions to rescind the entire federal regulation that Bush established in his final days in office.

That initial notification met with controversy and resistance. A public comment period on the proposed rescission brought about 300,000 responses, with twice as many comments opposed to the rescission than in favor of it.

HHS said the delays in its ruling were caused by the need to devote time and resources to other agency priorities-most likely the 18-month battle over healthcare overhaul.

On Feb. 11 of this year, just a week before the administration announced it was altering the protections, 46 members of the House sent a letter to Kathleen Sebelius, the secretary of HHS, to express "serious concern" that the department may not fully enforce federal conscience laws.

The congressional letter cited several ongoing incidences as proof of their concern: a nurse with New York's Mount Sinai Hospital forced against her conscience to participate in an abortion and a complaints over applications for Vanderbilt's nurse residency program that include a pledge to participate in abortions.

Even though the changes still allow victims to file complaints, the Obama administration has already established a pattern of not aggressively pursing conscience protection cases, according to Bowman.

Ries adds that during the last two years, CMA has collected numerous accounts where "conscience protections have been trounced": doctors being forced to refer abortion services, an OB-GYN doctor losing a job for refusing to consul patients about abortion, medical resident students having their positions put in jeopardy for not participating in abortion training.

The changes have medical professionals of faith concerned that the weakened civil rights will drive pro-life individuals out of the profession and discourage pro-life students from pursuing careers in certain types of medicine.

Reis, who travels the country speaking at medical schools as vice president of CMA's campus ministries, said many students tell him, "I am not going to risk losing my moral integrity."

The repercussion for medical access could be devastating-about one in five faith-based providers work in poor and underserved areas, according to a CMA survey.


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