updated 12/18/2008 2:53:55 PM ET 2008-12-18T19:53:55

The Bush administration, in its final days, issued a federal rule reinforcing protections for doctors and other health care workers who refuse to participate in abortions and other procedures because of religious or moral objections.

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Critics of the rule say the protections are so broad they limit a patient’s right to get care and accurate information. For example, they fear the rule could make it possible for a pharmacy clerk to refuse to sell birth control pills or AIDS medication and face no ramifications from an employer.

Under long-standing federal law, institutions may not discriminate against individuals who refuse to perform abortions or provide a referral for one. The administration’s rule, issued Thursday, is intended to ensure that federal funds don’t flow to providers who violate those laws, Health and Human Services officials said.

“Doctors and other health care providers should not be forced to choose between good professional standing and violating their conscience,” said HHS Secretary Mike Leavitt.

The rule requires recipients of federal funding to certify their compliance with laws protecting conscience rights.

Raising awareness?
Despite multiple laws on the books protecting health care providers from participating in abortions or sterilizations, the administration argued that the rule was needed “to raise awareness of federal conscience protections and provide for their enforcement.”

But many groups described the rule as a last-minute push to make it harder for women to get services such as contraception or counseling in the event they are pregnant and want to learn all of their options.

Several medical associations as well as a group of 13 attorneys general were among the many thousands who wrote to the department to protest the rule after it was proposed. Opponents didn’t like the rule any better after it was finalized.

“In just a matter of months, the Bush administration has undone three decades of federal protections for both medical professionals and their patients, replaced them with a policy that seriously risks the health of millions of women, then tried to pass it off as benevolent,” said Nancy Northup, president of the Center for Reproductive Rights.

Abortion opponents hailed the regulation because they said the lack of regulation had resulted in confusion and a lack of awareness.

“This is a huge victory for religious freedom and the First Amendment,” said Tony Perkins, president of the Family Research Council.

The administration estimated the cost of complying with the rule at $43.6 million annually, which is spread throughout the hundreds of thousands of health providers subject to the rule — from hospitals and physician offices to medical schools and pharmacies.

Several lawmakers have promised to take up legislation that would overturn the rule once Congress reconvenes in January. Another option is for the Obama administration to issue new regulations that would trump it.

Making birth control more — not less — accessible is the best way to prevent unintended pregnancies and reduce abortion,” said Nita Lowey, D-N.Y.

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