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HHS Attempts to Define Contraception as Abortion, Fertilized Egg as Human Being

July 18, 2008

I’ve been dealing with some sick kitty issues this week, so haven’t had time to properly address a proposed rule for the Department of Health and Human Services that addresses “conscience” clauses which allow healthcare providers to refuse services and information based on their personal religious or moral beliefs. Here’s the “quick” overview, with links to additional explanatory posts on the topic at the end.

The proposed rule explains how recipients of HHS funds already cannot discriminate (such as in hiring practices) against employees “who participate in health service programs or research activities funded in whole or part by the Department who refuse to perform certain medical services, including sterilization, abortion, or research activities.”

What’s new in the proposed rule is that it essentially says, because some people think that “life” begins when sperm and egg meet, and so consider contraception to be abortion, even though the medical & scientific community does not support or agree with that view, we’re going to accept what people “believe” as a medical definition. It would allow contraception to be defined as abortion for these purposes. It says:

Abortion: An abortion is the termination of a pregnancy. There are two commonly held views on the question of when a pregnancy begins. Some consider a pregnancy to begin at conception (that is, the fertilization of the egg by the sperm), while others consider it to begin with implantation (when the embryo implants in the lining of the uterus).17 A 2001 Zogby International American Values poll revealed that 49% of Americans believe that human life begins at conception. Presumably many who hold this belief think that any action that destroys human life after conception is the termination of a pregnancy, and so would be included in their definition of the term “abortion.” Those who believe pregnancy begins at implantation believe the term “abortion” only includes the destruction of a human being after it has implanted in the lining of the uterus.

[so on and so forth, equating a couple of medical dictionaries with the opinions of the American Medical Association and the British Medical Association]

The Department proposes to define abortion as “any of the various procedures—including the prescription and administration of any drug or the performance of any procedure or any other action—that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation.”

Did you catch that? “a human being after it has implanted…” “life of a human being…whether before or after implantation” No reliance on implantation to define a pregnancy, even though “pregnancy” cannot be detected prior to implantation and a great percentage of fertilized eggs fail to implant, medically meaning that the woman was. not. pregnant. Implication that a fertilized egg is a “human being,” regardless of whether it ever would/could implant. So the Department of Health and Human Services is suggesting that every time a woman menstruates – oops, there might be a human being in there, ladies. This would also mean that workers at HHS-funded clinics could refuse to offer Plan B or other oral contraceptions, given the belief in the possibility that these drugs might (but are not scientifically proven to) occasionally interfere with implantation. They could also presumably refuse to offer IUDs. Recipients of HHS funds also could not refuse to hire individuals who refused to provide these healthcare services.

“Recipients” is pretty broad – the proposed rule references any:

“organization receiving financial assistance directly from the Department awarding agency to carry out a project or program. The term includes public and private institutions of higher education, public and private hospitals, commercial organizations, and other quasi-public and private nonprofit organizations such as, but not limited to, community action agencies, research institutes, educational associations, and health centers. The term may include foreign or international organizations (such as agencies of the United Nations) which are recipients, subrecipients, or contractors or subcontractors of recipients or subrecipients at the discretion of the Department awarding agency.”

It looks like this could include places like community health clinics, and Planned Parenthood.

Some less rushed posts on the issue (let me know if I’m missing any good ones):

I should also note that HHS head Mike Leavitt has a blog, but you won’t see information on this on there, just like it didn’t mention it when he went after ACOG on regarding their statement on conscientious refusal (and completely got the facts wrong).

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17 Comments leave one →
  1. DRF permalink
    July 18, 2008 4:29 pm

    A medical worker of any kind who believes that contraception is wrong “because it is really an abortion” needs to be corrected, not coddled. If a job requires performing or referring abortion services, and a person is, for any reason, not able to perform that job, then the person should be reassigned or dismissed and replaced with someone who can.

    Speculation dressed up as fact, contraception dressed up as abortion… I shouldn’t be surprised. We have fools dressed up as politicians.

  2. July 19, 2008 7:28 am

    I agree with the conclusions of this post, but I think some of the specific arguments could be refined. For example, defining pregnancy as a condition that can be tested for is not useful here: a number of trace proteins in the woman’s blood indicate the presence of an embryo prior to implantation. The one that has received the most study is early pregnancy factor.

    To my understanding, a fertilized egg is different from a skin cell or a blood cell because it is a complete entity unto itself, a “being”. Embryo and fetus are the preferred scientific terms, but when one is talking about the entire gestational period the phrase “embryos and fetuses” gets rather awkward very quickly. I think “human being” is an acceptable substitute phrase. To me, what is at question here is the personhood of the embryo, not its humanness or distinctness from other cells found in the human body. I would be upset if the government was defining an embryo as a human person; it doesn’t bother me to see it called a human being.

    In IVF, where the study subjects are infertile couples and the embryos are subject to extensive manipulation, about 75% of embryos fail to implant. The studies I’ve read of healthy subjects suggest that implantation failure runs closer to 20-25% in that population. However, having a fifth of a human population die in a specified time period doesn’t logically make every life in that population worthless. There are countries in our modern world where 20% of children die of illness before they are five years old: that doesn’t mean a person there who accidentally runs over a child should not feel remorse. There are good arguments for not placing a high value on the life of early embryos, but I don’t believe their death rate is one of them.

    To me, the biggest problem here is that HHS is letting an effect of contraceptives that is not intended, may never happen, and if it happens at all is rare, to drive this policy. Insertion of an IUD may cause an infection, or the IUD may perforate the uterus and cause complications in the abdominal cavity, and the woman may die. OCs increase the risk of blood clots, and some women who have this complication die. But fear of these rare complications causing the death of human persons is not seen as justification for denying these products; fear of other rare complications causing the death of what some consider to be human persons should equally not be allowed to carry this much weight.

    Does the current rule about non-discrimination for refusal to perform abortions and sterilizations apply to community clinics and Planned Parenthood? If not, does the language of this new proposed rule apply it more broadly? Or is that language similar but the fear is the rule would be interpreted to apply more broadly?

  3. July 19, 2008 10:52 am

    Lyrl, thanks for your comment – I do work from an assumption that the folks inserting “human being” into this language are implying personhood, not simply looking for a catch-all term. Based on my reading, I do think that the non-discrimination language would apply to community clinics and Planned Parenthood. They don’t specifically name those, but the language of who would be covered is extremely broad.

  4. MomTFH permalink
    July 19, 2008 1:39 pm

    There should be a pingback for this post, but I don’t see it…here is the link.

    http://momstinfoilhat.wordpress.com/2008/07/19/head-exploding-quietly/

  5. Zoe Morosini permalink
    August 28, 2008 1:55 pm

    So…let me get this straight…if “any of the various procedures—including the prescription and administration of any drug or the performance of any procedure or ANY OTHER ACTION (my caps) —that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation” will be considered abortion, if the fertilized egg doesn’t implant naturally and is expelled through the normal ACTION of LIVING MY LIFE, I am guilty of having performed an abortion on myself???????

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