In Congress and states nationwide, anti-abortion activists are broadening efforts to support hospitals, doctors and pharmacists who — citing moral grounds — want to opt out of services linked to abortion and emergency contraception.
A little-noticed provision cleared the House of Representatives last week that would prohibit local, state or federal authorities from requiring any institution or health care professional to provide abortions, pay for them, or make abortion-related referrals, even in cases of rape or medical emergency.
In Mississippi, a bill became law in July that admirers and critics consider the nation’s most sweeping “conscience clause.” It allows all types of health care workers and facilities to refuse performing virtually any service they object to on moral or religious grounds.
And in states across the country, anti-abortion organizations and a group called Pharmacists for Life are encouraging pharmacists to refuse to distribute emergency contraceptives, which they consider a potential form of abortion.
“We’ve seen increasing organization and networking to get more pharmacists to refuse to provide EC — not just in the Bible Belt but all over,” said Gloria Feldt, president of the Planned Parenthood Federation of America. “It’s part of the anti-choice arrogance in which they believe they have the right to impose their ideology on everyone else.”
Karen Brauer, president of Pharmacists for Life, was fired by Kmart in 1996 for refusing to dispense a birth-control drug. She believes momentum now favors her movement.
“More people, including pharmacists, are becoming informed how certain drugs operate — and those who want to avoid ending the life of a human being would avoid those drugs,” she said.
Brauer, who lives in Lawrenceburg, Ind., and works at a drugstore in Ohio, hopes more states will emulate Mississippi, South Dakota and Arkansas by specifying that pharmacists, as well as doctors, have the right to withhold services on moral grounds. She does not believe there should be any obligation to refer rebuffed customers to another pharmacist who would fill their prescription.
“Forced referral is stupid,” she said. “If we’re not going to kill a human being, we’re not going to help the customer go do it somewhere else.”
At the federal level, abortion rights groups are alarmed by the provision that cleared the House last week, broadening protections for hospitals and insurers that seek to avoid any involvement with abortions. The provision would prevent government officials from using any coercive means — such as a funding cutoff or permit denial — to ensure abortion-related services are available.
Poor women most affected?
Two years ago, the House passed a bill with the same goals, but it died in the Senate without a vote. Anti-abortion activists are pleased because the revived proposal was sent to the Senate as part of a broader appropriations bill and, at minimum, will go to a House-Senate conference committee.
Opponents say the provision’s impact would be felt primarily by low-income women who depend on federally subsidized health care and use Roman Catholic hospitals. According to the critics, the measure would enable hospitals to refuse to provide abortions, or referrals, even if a pregnant woman had been raped or was in critical medical condition.
“That the U.S. Congress would be so callous as to add this kind of provision — that affects only poor women in the most extreme circumstances — is outrageous,” said Frances Kissling, president of Catholics for a Free Choice.
Kissling said she was heartened by developments in some states — such as a California Supreme Court ruling that Catholic Charities of Sacramento must provide birth control options in its employee health plan. “But for women in conservative states, that’s no help,” she said.
Mississippi’s new law provides sweeping immunity for opting out of abortion and contraception services in a state where many women seeking abortions already travel to Alabama or Tennessee to obtain them. “We have doctors who won’t even issue birth control prescriptions,” said Nsombi Lambright of the American Civil Liberties Union’s Mississippi branch. “It’s not their job to impose their beliefs on others.”
In contrast, anti-abortion health professionals say it is their beliefs that are embattled. Texas pharmacist Gene Herr, for example, was fired this year by the Eckerd drugstore chain after refusing to fill an emergency contraception prescription for a rape victim.
“They were forcing me to do something that I see is wrong,” Herr said.
The American Medical Association and American Pharmacists Association support their members’ right to conscientious refusal. However, the pharmacists’ group says patients also have a right to obtain legally prescribed therapies.
Lourdes Rivera, who assists low-income patients as director of the Los Angeles-based National Health Law Program, worries that anti-abortion health providers are gaining too much leeway.
“Yes, we need to respect individual freedom of religion. But at what point does it cross the line of not providing essential medical care? At what point is it malpractice?” she asked. “If someone’s beliefs interfere with practicing their profession, perhaps they should do something else.”