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HHS Secretary Mike Leavitt Issues Blog Post on Proposed Regulation

August 7, 2008

HHS Secretary Mike Leavitt has been blogging since November of last year but rarely addresses the controversial issues in which he is involved, focusing instead on accounts of his travels around the globe. This changed today, when he published a post entitled “Physician Conscience” responding to criticisms that a proposed HHS rule could allow providers to define contraception as abortion. The rule is being framed as a physician conscience issue, in that healthcare providers and institutions receiving federal HHS funds could not discriminate against those unwilling to provide abortion services – under the current draft, many fear that this could include contraceptives under the definition of abortion.

Leavitt sidesteps this issue in his post, claiming that the rule is not intended to deal with contraceptives:

“An early draft of the regulations found its way into public circulation before it had reached my review. It contained words that lead some to conclude my intent is to deal with the subject of contraceptives, somehow defining them as abortion. Not true.

“The Bush Administration has consistently supported the unborn. However, the issue I asked to be addressed in this regulation is not abortion or contraceptives, but the legal right medical practitioners have to practice according to their conscience and patients should be able to choose a doctor who has beliefs like his or hers.”

He does not explicitly state, however, that he would exclude from the “legal right medical practitioners have to practice according to their conscience” the oral contraceptives and other items that critics have suggested might be affected. Regardless of intent, the regulation certainly could functionally allow the defining of contraceptives as abortion. Leavitt does not say that this language will be removed or clarified, but says only that if the regulation is issued, it will “be directly focused on the protection of practitioner conscience.”

This is not Leavitt’s first foray into physician conscience issues, nor the first time he has come down on the side of denying patient care in favor of provider ideology. In March of this year, Leavitt issued a letter to the American College of Obstetricians and Gynecologists protesting the organization’s own statement on physician conscience, and asking that the statement not be used to withdraw board certifications from physicians who object to providing abortion or other care. Anti-choice organizations had been protesting the statement for months, demanding that ACOG “repudiate and withdraw” their conscience statement. It is not clear if the uproar from anti-choice organizations such as the Family Research Council is responsible for the topic coming to Leavitt’s attention.

In the current blog post, he frames the newly proposed regulations by referring to this incident:

“Several months ago, I became aware that certain medical specialty certification groups were adopting requirements which potentially violate a physician’s right to choose whether he or she performs abortion. I wrote to the organizations in question, protesting their actions. Frankly, I found their response to be dodgy and unsatisfying. I sent another letter, more of the same.”

In fact, ACOG is not responsible for board certifications, and the actual certifying body responded that Leavitt “took two and two and came up with five.” They also affirmed that the statement could not compel any physician to provide services to which she or he objected. In other words, certification was never in danger if physicians refused to perform abortions.

I note that while Leavitt is concerned that “patients should be able to choose a doctor who has beliefs like his or hers,” he does not address the issue of patients actually being able to receive care from doctors. The ACOG statement to which he initially reacted is much more balanced, including the duty of physicians to provide scientifically accurate information, refer patients to other providers in a timely manner, and consider the effects in resource-poor areas, such as whether there are other providers able to fulfill the patients needs and requests. It only specifically demands provision of medical care in emergencies and when delays in such care would clearly negatively impact the health of the patient.

A central trouble with Leavitt’s explanation is that it is already possible for providers to refuse to perform abortions, but the regulation as written would considerably broaden the possible definitions of abortion, even so far as referring to public opinion surveys against leading medical opinion in supporting a definition that includes pre-implantation fertilized eggs. As Scott Swenson at RHRealityCheck explains regarding the proposed rule, that “Very quickly, the original intent of Sec. Leavitt becomes everyone’s right to withhold services because the person seeking it doesn’t believe exactly the same things as the person providing it.”

Additionally, many, many people have interpreted the draft to be a threat to healthcare provision, such as of contraceptives, and have acted to object. Numerous organizations have written to Leavitt to oppose the draft, including ACOG, the American Medical Association, the American College of Nurse Midwives, the American Academy of Pediatrics, and the American Academy of Family Physicians. ACOG called the draft “an affront to health professionals and to American women.” Clearly, quite a few educated people in healthcare clearly thought the draft was in fact problematic and could have the effects that Leavitt merely claims he didn’t “intend.”

Previous related posts:
Anti-Choice Organizations Respond to ACOG’s “Conscience” Statement – 12/17/07, at OBOS
Head of HHS Writes ACOG to Defend Physicians’ Right to Refuse Referrals on “Moral” Grounds – 3/21/08
HHS Attempts to Define Contraception as Abortion, Fertilized Egg as Human Being – 7/18/08
William Saletan on HHS Proposal – 8/5/08
Round-Up of Responses to Controversial HHS Proposal – 8/6/08, at OBOS

See also RHRealityCheck’s thorough coverage.

Added: I should add some kudos to Scott for asking Leavitt about this issue in person at an event at which the Secretary spoke about blogging. In a brief exchange over Skype, I told Scott good for him for asking the question, and observed that Leavitt never addresses concrete, controversial issues on his blog. Scott, I’m glad I was wrong in this case, and good for you! :)

Note: The Leavitt post changed URL sometime since this was posted. I have corrected it above and at OBOS. It was http://secretarysblog.hhs.gov/my_weblog/2008/08/physician-con-2.html (which now returns a 404 not found error) and is now http://secretarysblog.hhs.gov/my_weblog/2008/08/physician-con-3.html. There don’t appear to be any changes to the text, but I don’t have a captured copy for direct comparison. And… it’s changed again, on 8/14, to http://secretarysblog.hhs.gov/my_weblog/2008/08/physician-consc.html

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46 Comments leave one →
  1. August 8, 2008 8:17 am

    Many thanks for the kind words Rachel, and far more importantly for the EXCELLENT analysis. It is obvious that this story exploded in ways HHS never anticipated and they are trying to get a handle on it, but they’ve been exposed, and we all need to keep shining the bright light on them to make sure they don’t get away with this.

  2. August 8, 2008 10:56 am

    Thank you for keeping us updated on this. I don’t believe for one minute that this administration would not limit access to birth control if they thought they could get away with it. I agree with Scott, we need to keep this in the light and let them know people are watching.

  3. August 8, 2008 1:27 pm

    I actually have no problem with physicians refusing to do whatever their beliefs tell them they ought not. But if they are either providing general care, or practicing a specialty in which there are customary procedures they refuse to do, they had better advertise that big and loud, so that folks who care can avoid them. Same with pharmacists: I’m cool with Pharmacist A not filling some prescription for me, so long as Pharmacist A is never the only pharmacist in the shop.

  4. August 8, 2008 1:50 pm

    Nm, and it’s very rare for any offices to be that up front – I’ve yet to see any physician offices or pharmacies explicitly stating up front what parts of normal care they refuse to provide. I just don’t think it’s commonly done.

  5. August 8, 2008 3:34 pm

    Oh, I know. I’m just saying that they can have their “conscience clause” or whatever they want to call it, if we can have our protection from its potentially harmful effects.

  6. Kent Madin permalink
    August 9, 2008 12:58 pm

    Where does it end? If I feel that Muslims are agents of the devil and providing them housing is just encouraging them and making me a party to their evil nature, can I refuse to rent them an apartment?

    If I’m a clerk at a dime store can I refuse to sell children candy because I believe it is bad for them?

  7. onesillyme permalink
    August 10, 2008 11:36 am

    Kent-
    I’m sure, in practice, both of your examples have happened more than once. If the renter finds out what happened (and more problematically, can prove it), they have recourse. The outcome at the dime store depends on whether parents complain & the boss’s view of it.

    The difference with these regulations is that they rely, in part, for their justification on the professional status of doctors, pharmacists, etc. I’m a social worker with similar privilege and obligation.

    It is part of my professional obligation to “use my powers for good and not evil.” Fortunately, unlike many professions, social work has a deeply held value of client self-determination. This means that I think long and hard (and usually get a consult) before I decide my values trump those of the client.

    Paternalism makes my ovaries hurt…

  8. Janet Folger permalink
    August 13, 2008 1:08 pm

    What happened to the right to choose…life? Doctors entered the medical profession to SAVE LIVES and shouldn’t be forced out of it by the abortion extremists!

  9. Patricia Kanipe permalink
    August 13, 2008 1:12 pm

    PLEASE, PLEASE, PLEASE…PROTECT OUR DOCTORS WITH THE RIGHT TO MAKE THE SAME CHOICE THAT MOM’S CURRENTLY HAVE UNDER THE LAW. NO DOCTOR SHOULD BE FORCED TO ABORT A BABY. NO DOCTOR SHOULD HAVE TO REFER SOMEONE TO AN ABORTIONIST. AND LASTLY, NO DOCTOR SHOULD HAVE TO MOVE HIS/HER PRACTICE CLOSE TO AN ABORTIONISH FOR THE “CONVENIENCE” OF A MOTHER!!!

  10. deb weaver permalink
    August 13, 2008 1:14 pm

    We’re talking here about a Doctor CHOOSING to NOT kill a baby. Is this still America? It is amazing to me that this is even up for debate.

  11. August 13, 2008 1:16 pm

    Janet, nobody is forcing anybody out of the medical profession. There are already laws in place that allow physicians to conscientiously object to performing abortions. However, if a physician wants to take a stand against medical consensus and claim that contraceptives can be abortion and so not provide them, then yes, I think places like family planning clinics should be able to not hire them in the first place. This is not about extremists. The American Medical Association, ACOG, American Academy of Family Physicians, and numerous other professional medical organizations have objected to this proposal.

  12. Rebecca Stenson permalink
    August 13, 2008 1:17 pm

    I wish to give support to doctors to have the right to not perform abortions or any other procedure that they feel is harmful or against their beliefs.

  13. August 13, 2008 1:18 pm

    Patricia, same response, to you as well. Nobody is forcing anybody to move their practice. Leavitt completely misunderstood ACOG’s statement. ACOG simply asked that physicians, in choosing to refuse to provide legal care or referral to legal care, consider whether the woman they are refusing can reasonably find another provider nearby. There is a lot of deliberate obscuring/misunderstanding of the truth of the ACOG position and its effects out there, much of it originating from Leavitt himself.

  14. August 13, 2008 1:19 pm

    Sheesh. Repeat after me, people: doctors can already choose not to perform abortions. I don’t usually kill comments just because people are repeating untrue nonsense, but you all are tempting me.

  15. Joni permalink
    August 13, 2008 1:30 pm

    The same people that are screaming for a woman’s “right to choose” are the same one’s who want to refuse a doctor’s right to choose not to provide abortions. what a double-minded stance! If I want a tooth pulled instead of a root canal and a crown my dentist can refer me to someone who will pull the tooth because he does not want to do it. Why should it be any different for a woman wanting an abortion? There is no law forcing my dentist to provide me a service he chooses not to.

  16. August 13, 2008 1:35 pm

    The reading comprehension level is unusually low here today.

  17. deb weaver permalink
    August 13, 2008 1:58 pm

    OK, let’s look at the bigger picture. Those who are so strongly expressing their views regarding Doctors rights (even though their right to refuse to do an abortion may not be currently under threat)are expressing their frustration that ANY of this is an issue. Legal or not, the murder of pre-born human beings is not only offensive, it is the sign of a society that has devalued EVERY stage of life. Those of us that hold that view are very passionate about it,and will avail ourselves of every opportunity to stand for those who cannot speak for themselves.

  18. August 13, 2008 2:04 pm

    Deb, thank you – although we are going to have to agree to disagree on this one, your comment was something of a breath of fresh air.

  19. August 13, 2008 2:14 pm

    So are these commenters saying that I, an observant Jew, have the right to apply for a job at Hog Heaven, that I have the right to refuse to serve the barbecue there to any client because my religion forbids it, that in fact I have the right to put out the fire in the smoker because cooking pork is wrong, to throw the deliveries of uncooked meat into the trash, etc.? It sounds like it to me. And here I thought that the solution was for me not to work there, and that they ought to have the right not to hire me, or anyone whose beliefs would make it impossible to perform the tasks for which they want to employ me. Same with physicians, pharmacists, and other health care providers. They ought not to be forced to perform actions they find sinful, and no one needs to be forced to hire them if they won’t perform all the actions the employer wants.

  20. August 13, 2008 2:17 pm

    NM, for consistency’s sake, they should be, but I haven’t yet heard anyone do so.

  21. deb weaver permalink
    August 13, 2008 2:23 pm

    A) I assume that an observant Jew would probably not apply for work in an establishment that stands in direct conflict with his/her beliefs.
    B) An employer should ABSOLUTELY have the right not to hire someone that cannot benefit the company, due to their faith beliefs.
    and C) Are we really comparing the choice to sell or not sell pork to the choice to allow or not allow a child to live?
    If it’s wrong and wasteful to “throw the deliveries of uncooked meat into the trash”, how much more unacceptable is it to do just that to an unborn child. Therein, I believe lies the fundamental question, from which all the intellectual arguments spring.

  22. August 13, 2008 2:35 pm

    Point C is really a completely separate issue from the physician conscience issue, except that both examples represent something that particular groups of religious people would find morally reprehensible. What nm illustrates is that different religious groups have varying issues to which they might conscientiously object. How, then, are points A & B substantially different with regards to pork vs. abortion (or birth control, or blood transfusions, or any other thing which can be objected to on religious grounds)?

  23. MomTFH permalink
    August 13, 2008 2:42 pm

    Thank you. I am furious about his response, and I wrote about it on another website, I think RH Reality check. Hard to keep track when I am so chatty. *eye roll*

    Anyway, I think it is dangerous to say that doctors and patients are somehow supposed to line up by belief systems. Can you imagine if this was applied to any other specialty than Ob/Gyn or any other belief than one that involved women’s sexuality? Emergency physicians treat gun shot wounds, regardless of what the patient was doing at the time of being shot, such as robbing a store or assaulting an officer.

    Prison doctors treat meth addicts’ teeth that they have rendered into dust by their drug habits, and treat child molesters and mass murderers with empathy and professionalism. My own uncle did surgery on Joe McCarthy!

    As for patients selecting their doctors by matching belief systems, do people ask their surgeon about her position on gun control, or birth control for that matter, before going under the knife? Does the anesthesiologist have to be a member of the same church?

    What if my internist would choose to ignore a DNR and try to force feed me if I was a terminal cancer patient? Should I present a list of case scenarios to my doctors? Because people who use federally funded clinics clinics (which is what this applies to) can really afford to shop around for doctors. *eye roll #2*

    As for the comments about doctors being forced to perform abortions, that is not what this proposed rule is about at all. OF course it is easy to support choosing not to be forced to do any procedure you don’t want to do as a physician or health care practitioner. It is hard enough to get trained on terminations, even in Ob/Gyn. Many medical schools don’t even have it in the curriculum. It is the single most common surgery in the United States, and is supported by the majority of the country.

    First trimester abortion, which accounts for more than 90% of terminations in the country, are hardly killing a baby. I wish people wouldn’t use such inaccurate and inflammatory language to distract from the real issues here. Doctors and 30% of the women in this country are not murderers. Of course infanticide is wrong. Back on topic, please.

    This rule attempts to guarantee federally funded jobs in public clinics and university clinics to people who will refuse to prescribe birth control, refuse to refer or counsel about reproductive options, refuse to refer or counsel about terminations, refuse emergency contraception, even to rape victims, and refuse to be part of any insertions of IUDs, and LAST OF ALL, refuse to perform any terminations.

    This has nothing to do with any health care practitioner who has a private practice. This has nothing to do with certification or accreditation (which is done by the USMLE, I think). This has to do with whether or not tax dollars should go to guaranteeing jobs to fringe activists in the front lines of the underserved. I say no. Let the Family Research Council and whoever else fund clinics that actually provide health care if these people need jobs. It is not the role of our local health departments and universities to guarantee the rights of fringe activists to purposefully place themselves in a position in which they will be forced to repeatedly refuse to provide adequate health care.

    It also attempts to inaccurately define the beginning of pregnancy as before implantation, which is not medically accepted. Also, it attempts to define a blastocyst as a human being, which is also medically inaccurate and legally troubling. If you all want to be accused of murder if you exercise too much or drink too much caffeine, then fine. I don’t. I would hate to have to fill out a death certificate, just in case, every time one of my patients has a heavy period.

  24. deb weaver permalink
    August 13, 2008 2:51 pm

    I do understand, on a purely intellectual level, how we could debate the merits of one religious belief vs. another and how they might be or not be accomodated by a society or government. That is one of the greatest attributes of the freedom of religion we enjoy in America. However, I find it hard to believe that we cannot ALL agree that the issue of the value of human life trumps all other issues. The bottom line to all of this discussion is simply this; is it or is it not the right of an individual/group/government to decide who can or cannot live, whether that life is in the womb, partially out of the womb, born in spite of a botched abortion, handicapped, vegetative, non-contributory to society, burdensome or just plain old and messy. If any one of those lives has any less intrensic value than any other life, or is less than an acceptable (by whom?) productive, functioning member of society, then we’re all in trouble, cause we may not be very agreeable when (not if) we fall into one of those categories.

  25. deb weaver permalink
    August 13, 2008 2:59 pm

    Mom TFH, If the target of a first trimester abortion is NOT a baby, what is it? A frog, a blob of nothing? Even the medical world has given up this argument. We have no problem, even in our textbooks, studying the progress of a preborn frog (tadbpole) through all of its stages of development. No one would argue that it is going to come out a frog.
    You are right, that 90% of abortions are 1st trimester, and have accounted for the loss of close to 40 million potential philosophers, teachers, doctors, moms, dads, engineers, dancers, musicians, artists, world leaders, etc.
    Well, I’ve enjoyed the discussion, and hope all sides have been given food for thought. Must away

  26. August 13, 2008 3:01 pm

    MomTFH, thank you for outlining that so clearly. Deb, someone else that I read put it very clearly recently, and I wish I could remember who said it, but the gist is that the “handicapped, vegetative, non-contributory to society, burdensome or just plain old and messy” do not specifically and totally depend on being attached to the organs of another human being for survival against that person’s will. As I have said before:

    I believe that there is an inescapable ethical and legal conflict inherent in any situation in which one being depends solely on the body and resources of another being for its existence, and this conflict is never more pronounced than when a fetus inhabits a woman’s body. To codify this conflict such that one party always necessarily wins seems to me a poor solution, whether the fully grown woman must always carry a pregnancy to term or a pregnant woman must always have an abortion.

    In your scenario, the fetus always wins rights to the body over the will of the woman, and that does in fact make a decision about whose life is more intrinsically valuable.

  27. deb weaver permalink
    August 13, 2008 3:04 pm

    Rachel, in your response, the mother is inconvenienced, the child is dead. I know, I had an abortion 30 years ago.

  28. MomTFH permalink
    August 13, 2008 3:04 pm

    It is a blastosphere, it is an embryo, it is a fetus. It changes depending on the day after fertilization.

    Providing adequate health care, including birth control and abortion, saves millions of lives. Lack of access to abortion is the 3rd leading cause of maternal mortality in countries that restrict abortion. Most of these women had children at home, who are 4 times for likely to die if she is dead.

    Life is sacred. Implantation of a bundle of cells is not.

  29. MomTFH permalink
    August 13, 2008 3:09 pm

    Deb, I don’t think you are a murderer, and I don’t think your doctor does either, and I don’t think your doctor was one. I am glad you had the freedom to choose to end your pregnancy at that time. Can you imagine if you were arrested and given capital punishment 30 years ago?

    Even though most women do not feel overwhelming grief or guilt over their decisions, it sounds like you have grief and guilt. As I said, more than 30% of the women around you have had abortion. Thank you for being brave enough to say you have had one, since many people feel ashamed to share this. I am sorry you have such confused feelings about what you went through, but that is not what federal health policy is or should be based on.

  30. August 13, 2008 3:47 pm

    B) An employer should ABSOLUTELY have the right not to hire someone that cannot benefit the company, due to their faith beliefs.

    Well then, why do you support regulations that make it impossible for an employer to refuse to hire an employee on this basis?

    C) Are we really comparing the choice to sell or not sell pork to the choice to allow or not allow a child to live?

    In my religion, a blastocyst and an embryo are only potentially human, and a fetus doesn’t get a soul until halfway through gestation. But even a potentially human fetus, with a soul, has only one of the souls involved; the woman in the case has one too, and my religion considers her life, her health (including mental health) to trump the well-being of the as-yet-unlived life of the fetus she’s carrying. This is not even optional for us; when there is a choice, the woman’s life must take precedence. Please don’t assume that your religious beliefs have a thing to do with those of others, let alone with science. An embryo is not a child.

    Now, clearly, the solution to this conundrum is to make such painful choices as rare as possible. Which, in part, entails not making it impossible for institutions that distribute birth control to decline to hire persons who won’t prescribe or distribute it, which is the topic of the post under discussion.

  31. MomTFH permalink
    August 13, 2008 6:51 pm

    Thank you. The best way to prevent abortions is to support birth control. And, this proposed rule does the opposite of that.

  32. Toni permalink
    August 19, 2008 8:56 pm

    My God! Bush is certainly pushing the status of women back to the barefoot and pregnant days! No access to contraception and his engineering of our economy’s flop will get the job done if we let him! (Who will be able to afford shoes?) Who do Bush and Leavitt think they are? Women’s personal lord and saviour?

  33. Toni permalink
    August 20, 2008 1:58 pm

    Given the power to do so, “pro life” proponents would deny us our God-given right of self-determination. They would deny us our Gift of Choice. “Remember: No-choice is a choice where someone else does the choosing. That’s another name for Slavery.”

    “The ultimate tyranny in a society is not control by martial law. It is control by psychological manipulation of consciousness, through which reality is defined so that those who exist within it do not realize they are in prison.” ~ Barbara Marciniak
    My choice, my God-given self determinism is not rightfully owned by you. To count as rational, a belief must be freely chosen. A belief is freely chosen if it is chosen without duress. Postulating an immensely complicated argument to explain an immensely complicated opinion, doesn’t actually explain anything and is self-refuting.
    Since an anthropological view of the contents of a pregnant womb suggests to some an independent life form, and a true independent life form (i.e. born) cannot survive in a womb environment, the anthropological view of the contents of a pregnant womb is self-refuting.
    We might also develop an interesting discussion in when human life begins by considering a Bible verse found in IThessalonians 5:23. This verse indicates that a human being is spirit, soul and body. “… your whole spirit and soul and body …”

    In pondering the biblical fact as given above that a human being is spirit and soul and body, not just one or the other, but all three, one may conjecture that an “unborn” is not a human being according to the Bible. To be a human being one must possess a spirit and soul and body. Spirit and soul and body are not the same. Let us look at each as defined by the Greek word translated for each one. The above passage is found in the New Testament, and as such, the English translation given in the Bible comes from Greek.

    According to Abingdon’s Strong’s Exhaustive Concordance of the Bible, “spirit” as used in the biblical verse cited above comes from the Greek “nveuya pneuma,” which means a current of air, i.e. breath (blast) or breeze;”

    “Soul” used in the parameter described above, comes from the Greek “psuche” which means “breath,” i.e. (by implication) spirit (the animal sentient principle only): thus distinguished on the one hand from spirit (as given above) which is the rational and immortal soul; and on the other in which there is mere vitality, even of plants.

    “Body,” again following the above parameter, “cupa soma” the body (as in a sound whole) used in a very wide application.

    What conclusions can we draw from spirit and soul and body?
    Firstly, with the use of “and,” it indicates all three must be present. An “unborn” does not breathe. It does have mere vitality. It does not have a sound, whole body. Therefore, biblically speaking, an “unborn” is not a human being.

    Biblically speaking we have established that an “unborn” is not a human being and we have established that seen anthropologically, an “unborn” cannot be seen as a human being.
    Since an “unborn” is not a human being, there can be no murder.

  34. Tara permalink
    August 22, 2008 9:44 am

    To momTFH, are you a mother? Are you the biological mom?

    Do you know that the baby has a heartbeat and other organs during the first trimester?

    Do you know that by the time a mother usually finds out that she is pregnant her child already has a heartbeat? When you choose to stop this baby’s heart you took the life out of it and stopped a beating heart. That is called MURDER.
    You are kidding yourself if you think otherwise and disillusioned of all reality and conscience. Please tell me you are not that out of touch and heartless…….but i guess you are if you think that stopping a beating heart isn’t murder. Where does the unborn child get a right to live?

    It can not speak but i guarantee it would say “Please give me a chance to live like you do mommy. I don’t want to die, please don’t take my life away mommy!”

    It isn’t about our life, it’s about NOT TAKING AWAY ANOTHERS TO LIVE………even one that can’t speak for themselves.

  35. August 23, 2008 7:44 pm

    Dear Good People,

    In the past, 20th century catholics believed in the “moment of conception”,as new human life. Fertilization of the egg was considered to be the actual moment of “ensoulment”.
    And they initially frowned on artificial insemination and required, it was essential to have natural sexual union of a man and a woman as God intended to create new human life. Modern reproductive health care and medicine have moved beyond those old religious restrictions and limitations. I do not think many Catholics today believe any women or couple who use a fertility clinic are mass murderers. Do YOU? At the clinic, several of her eggs are placed with sperm in glass tubes and tested. The best fertilized ones are then implanted in her womb or frozen for another monthly reproductive cycle and the other inferior surplus embryos(examined for genetic deficits or gender preference)have been totally discarded as medical waste for the past thirty years. Is that legally or religiously considered murder today? Of course not.

    So I am asking how can any people continue to believe it murder now to salvage and use these leftover test tube laboratory samples in scientific medical stem cell research that might help save other lives of existing human beings? I don’t think so, how about YOU? A human embryo has no brain cells, this mass of cells may split again and start to become two or three,twins even triplets may begin to evolve in the following two weeks. We know that no early implanted embryo has any brain cells, so it can not think or reflect on its own existence or lack thereof. Modern human philosphy is based on the theory that I think, therefore I am. An early embryo has no mind, no soul and no social desire or ability to place a guilt trip on any woman for its’s own life for that matter. We can and often do as intelligent human beings become more consistent in our thinking and choose to change some of our former traditional conceptual thinking based on religious belief sytems passed down to by our ancestors with increasing scientific knowledge and as public awareness increases. We think it over and gradually we adopt new ways of thinking, The world is not flat, infertile women can have children if they choose and new beliefs emerge as medical science moves forward the edges of our human knowledge and understanding from generation to generation.
    It is not easy to change our deeply held personal beliefs, but human autopies were formerly prohibited by religious and secular laws. Some doctors who wanted to study human anatomy on human corpses were punished by civic and religious laws in the last century. In todays world most of us believe autopsies are good for medical research and some even volunteer to donate our usable human organs to save other lives or to study after we are brain dead. I think the majority of us have begun to realize that embryonic stem cell research is essential to advance medical science for the common good.

    If preachers and other good people would stop trying to legally enforce their own inconsistent personal belief of when a real person is alive inside another woman’s body this will remain a free country. Why be more consistent with the currently known facts of human reproductive biology in the here and now instead of blindly denying our knowledge with old concepts that do not hold water. Advising others on the meaning, purpose and/or existence of human life from “the womb to the tomb” based on personal philosophies must not include restricting criminalizing or eliminating individual freedom of choice to control our own family size and our own bodies in todays world.
    The morning after pill MIFEPPEX, an early option for emergency contraception and early termination of an unwanted pregnancy in the first trimester 50 to 60 days is legal and safe and effective in this country and it has actually reduced crime from domestic violence, child abuse and reduced the number of drug deformed brain damaged newborns. To use religion to take advantage of our lack of scientific knowledge with an emotional appeal that is not reality is intrinsically evil.

    But if you insist on personifying an unborn fetus, what about the drug addicted ones already in great physical danger and pain? Some are living in denial and/or poverty? Are they restless, angry and crying all the time in the womb? Are they hoping they will never be born to this unhealthy unwed woman and/or the violent man who might continue to abuse and neglect them both instead of protecting and nurturing them?

    Do you see how unreal your own imaginative and emotional guarantee is? What if daily life the way Mommy lives is deplorable? Are you ready to take full responsibility for that child’s entire future yourself? It is not our job to judge others and so before you do, try raising a newborn child released suddenly from a drug dependent womb.
    GBYAY Anne

  36. Separationist permalink
    August 26, 2008 11:52 am

    This is for all of those “religious” people commenting and insisting that abortion is murder. (If you don’t believe in abortion, don’t have one, but don’t attempt to legislate to prevent the rest of us from being able to obtain a medical precedure when necessary.)

    After Roe v. Wade was decided, numerous religious groups came out with statements supporting (and some opposing) the decision. Over the years since that time, groups have made other statements further defining their beliefs. I think it safe to say that all of these groups would say that the life of the mother is primary. And many would say that the health, mental state, and other things would be legitimate reasons for having a legal abortion. Some specify that there should be consultation with a spiritual guide. Some make it very evident that having an abortion is a last choice and requires serious deliberation.

    In any event, the following have indicated support for choice:

    American Baptist Churches
    United Methodist Church
    Presbyterian Church (USA)
    United Church of Christ
    Episcopal Church
    American Jewish Congress
    Unitarian Universalist Association
    Church of the Brethren
    Union of American Hebrew Congregations (now under the name of Union of Reformed Judaism)
    Christian Church (Disciples of Christ)
    Lutheran Church in America
    YWCA National Board

  37. August 26, 2008 1:56 pm

    You can add to that list the Rabbinical Assembly (the international body of Conservative Jewish rabbis). Between them and the URJ, that’s the overwhelming majority of rabbis, serving the overwhelming majority of Jews, in the US.

  38. Gabe permalink
    August 26, 2008 5:40 pm

    Rachel, thank you for the bit about the relative value of human lives. I’ve been wrestling with that one for a while, and I think you found the point of it.

    Toni, please don’t confuse laws controlling actions with laws controlling beliefs. No one’s beliefs are being threatened here. This newly defined law (which I also oppose) would make it illegal to fire someone for not acting. Much like we don’t outlaw believing that some adult should be killed, only acting on that belief.

    The problem is that not acting in this circumstance could include lying to a patient about medical options or refusing to send them to someone else, even if the patient is in danger. This violates the current terms of their employment in medicine. As they already have the option of not acting, provided they allow the patient to find someone who will, I don’t think this law will do what Leavitt claims to want. If Leavitt didn’t intend to write regulations affecting reproductive health and the definition of abortion, I wish he would rewrite the regs to explicitly not include them.

  39. August 26, 2008 8:19 pm

    Thanks, Gabe, I appreciate that.

  40. Nancy Fisher Stein permalink
    August 28, 2008 11:11 am

    I am the mother of three daughters and the grandmother of one girl.

    They need all the proction now available to them, plus more. It is still to limited.

    Stop this change.

    Nancy Fisher Stein

  41. Elizabeth permalink
    August 28, 2008 12:03 pm

    I am an obstetrician, so let me shed some light on several issues from a medical point of view.

    First, altho I am pro-choice, I have never performed an abortion. I was not trained to do them. Some ob-gyn residency programs do, some don’t.

    Second, I have practiced in 5 different states. In every case, patients who wished to terminate their pregnancies were referred to a clinic devoted to abortions (often Planned Parenthood). This arrangement seems to work well. So there is really no issue of a doctor being “forced” to perform an abortion.

    Third, just some terminology: (there is a post above which is essentially correct). The sperm meets the ovum at the end of the fallopian tube resulting in FERTILIZATION and the cells start dividing. One division takes place about every 24 hours. It takes 6-7 days for the dividing cells to get to the uterus and embed themselves in the lining. At this point the cells have formed a hollow ball called a BLASTOCYST. (It is only at this point that a pregnancy can be determined by a blood test.) From the blastocyst the EMBRYO develops. During the embryonic phase all the organ systems begin to develop and, yes, the heart beats, circulating blood, but the embryo looks like a lima bean not a human being. After the 8th week, when all the organ systems have started, the proper term is FETUS. The developing pregnancy is a fetus until it is born, when it is termed a NEONATE or INFANT.
    BABY is a lay term full of emotion. When you see it used, watch out.

    Fourth: Ob-Gyns are certified by the American Board of Obstetrics and Gynecology, which is based in Dallas. Certification is by written and oral examinations. The Board does not care whether you do abortions or not. (ACOG – the American College of Obstetricians and Gynecologists, located in Washington, is our professional organization, into which you are inducted and are then termed a “Fellow”.)

    Fifth: there are so many good forms of birth control that it is a real shame for a woman to get pregnant unless she wants to be. It is birth control which is the question here. Birth control could only be confused with abortion if you believe that an embryo or an early fetus is the equivalent of a human being. It is clear from these postings that some people do, but they cannot be allowed to set the laws for the majority of us.

    Sixth: yes, I am the mother of 2 children who were wanted before they were conceived.

  42. LetYourLifeSpeak permalink
    August 28, 2008 1:20 pm

    Ms. Anne McGinnis Breen,

    I want to thank you for your well-expressed, reality-based, and non-judgemental insights. I could not have better expressed my views.

    As a physician, I took a an oath to do no harm. This means that if I do not have the expertise to manage a persons care, or I do not choose to perform a procedure for whatever reason (it’s irrelevant why), I am STILL morally, ethically obligated to fully inform my patient of all medically accepted options for managing the condition, and to refer him/her to the care of the best physician available who can provide those services. I am morally and ethically bound to ensure that ANY patient (of any creed, of any color, of any personal background) who comes to me for care is ABLE TO RECEIVE IT, one way or another, JUST AS IF THAT PATIENT HAD CHOSEN ANY OTHER PHYSICIAN. The same must be expected, in my opinion, for ANY provider of health services, including allied professionals such as pharmacists and nurses.

    Any gynecologist/OB who oversteps those bounds by imposing his/her own beliefs over medically accepted care is, in my firm opinion, committing fraud unless he/she clearly informs patients of his/her personal limitations and provides an opportunity to opt out. Furthermore, if I must choose between my personal convictions against a procedure and the medical decision of the patient, THE PATIENT WINS. The patient controls his/her body. Always. Never me. And should I ACCEPT the care of the patient, I am obligated as his/her personal health advocate to find his/her the care needed.

    I am also morally and ethically bound by whatever belief systems I may hold to avoid doing whatever is morally abhorrent to me, and not to accept employment or payment from those who expect me to do it. I don’t have to take anyone’s money if I don’t want to do what they say. And they have a right to deny me pay or employment if I do not meet their expectations. I have no right to expect special treatment for my “higher” moral convictions. I have free will.

    This said, to be clear on my own stance as a woman, wife, mother of a future wife and husbands (of whatever gender preference), and an American, I believe in the fundamental right of every individual to control of their own body and to follow their own moral compass. I love babies dearly, but it is clear to me that no one has the right to force anyone to carry a fetus to term any more than force anyone to abort. This decision is a fundamental right of the person whose body is intimately involved, and only she can say what path is right for her and this fetus at this time in her life. Some men may not like the idea that they must defer their choice in the matter, but that’s Biology 101. They had the choice not to impregnate a woman to begin with. If it’s not your womb, you don’t get final say.

  43. marlene murrin permalink
    September 24, 2008 9:19 am

    As a former RN and a Christian, I strongly support any health care worker’s right to refuse to perform any procedure or provide any service that they object to on moral grounds.

  44. September 24, 2008 11:01 am

    Health care workers already have that right. This proposed regulation doesn’t suggest changing it. Instead, it forces employers to hire featherbedding employees who will not provide the health care the employer desires to give patients, and who will be willing to lie to patients about what their health-care options are.

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