Rule backs doctors opposed to abortion

Federal health officials announced tougher steps yesterday to protect doctors and other health care professionals from being fired or discriminated against for refusing to provide abortions for conscience or religious reasons.

A proposed rule, which is open for public comment for the next 30 days, reads that no one receiving federal funds can discriminate against employees who refuse to undergo training for abortions or provide referrals for abortions.

Institutions also cannot discriminate against physicians’ programs that do not train for the procedure, insurance companies for not providing abortion coverage and several other instances in which individuals or health care organizations may refuse to do abortions or sterilizations.

The wide-ranging regulation, which also covers training programs and research activities, restates three existing federal conscience statutes, Health and Human Services Secretary Michael O. Leavitt said Thursday.

“People should not be forced to say or do things they believe are morally wrong,” Mr. Leavitt said in a telephone press conference from China, where he is part of a U.S. delegation to the Beijing Olympics. “Health professionals should not be forced to provide services against their consciences.”

An HHS statement said an “intolerant” health care field “may discourage individuals from diverse backgrounds from entering health care professions.”

The agency was “concerned” that the public as well as many health care providers are “largely uninformed” about existing protections and criticized the American College of Obstetricians and Gynecologists as “appearing to disregard these laws” in a recent ethics opinion.

HHS also accused the American Board of Obstetrics and Gynecology (ABOG) of taking a similar tack, acting “to force physicians to either violate their conscience by referring patients for abortions (or taking other objectionable actions) or risk losing their board certification.”

A statement from ABOG President Dr. Norman Gant said the organization does not decertify doctors based on their abortion stances.

But Dr. Joxel Garcia, assistant secretary of HHS, said discrimination is common.

“Many health care providers routinely face pressure to change their medical practice - often in direct opposition to their personal convictions,” he said. “During my practice as an OB-GYN, I witnessed this firsthand. But health care providers shouldn’t have to check their conscience at the hospital door. This proposed rule will help ensure that doesn’t happen.”

However, the regulation, which defined several terms such as “workforce” and “individual,” did not define “abortion.” Despite questions from five reporters asking why, Mr. Leavitt simply said the procedure already had been defined in federal law.

“Nothing changes the patient’s right to any legal procedure,” he said. “This specifically applies to abortion and conscience. It does not seek to resolve any ambiguity in that area,” referring to birth control pills.

But many pharmacists believe that certain contraceptives - including the pill - are abortifacients.

“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.”

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