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Wednesday, September 03, 2008


Federal Ambiguity on Abortion Vs. Contraception
By Paul Hsieh @ 1:37 AM PermaLink

William Saletan of Slate has recently posted a couple of informative updates on the Bush administration's attempt (or lack thereof) to define abortion.

The context is the proposed new law that would grant special protections for religious health care workers who chose not to provide abortion care or information to patients out of reasons of "conscience". In effect, the new law would forbid employers from firing such workers and enforce this by threatening the employer with loss of federal funding.

Leaving apart the fact that such issues should be settled by private contract (as nicely argued by Thomas Bowden of the Ayn Rand Center for Individual Rights in their recent press release, "Let Doctors Protect Conscience by Contract"), this proposed law has spawned a controversy over what exactly constitutes an "abortion" in the eyes of the federal government.

As Saletan documents in his first piece from 8/28/2008, "Contraceptive Fudge", the initial definition was:
...[A]ny of the various procedures -- including the prescription, dispensing 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
However, this was dropped after protest from physicians and reproductive rights advocates who correctly noted that this would include some forms of birth control that are not generally regarded as "abortion" -- including IUDs and sometimes birth control pills.

Saletan also points out that a number of religious advocacy groups have already argued that "hormonal contraception is abortion", including Pharmacists for Life International, Christian Legal Society, and Concerned Women for America, and that the current definition still leaves the door open for this interpretation.

When others have asked Health and Human Services Secretary Michael Leavitt to clarify this point, he has been cagey. In Saleton's second piece from 8/29/2008, "Contraceptive Fudge: Addendum", he notes the following statement by Leavitt:
But when pressed about whether the regulation would protect health-care workers who consider birth control pills, Plan B and other forms of contraception to be equivalent to abortion, Leavitt said: "This regulation does not seek to resolve any ambiguity in that area. It focuses on abortion and focuses on physicians' conscience in relation to that."
Secretary Leavitt is trying to have it both ways. While claiming this would not "change a patient's right to a legal procedure", his deliberate characterization of this issue as one of "ambiguity" is leaving the door open for the conflation of popular forms of birth control with abortion, and thus preparing the way for future restrictions of birth control in the name of restricting abortion.

Saletan also explicitly supports the private contract approach to the "conscience" issue, and I applaud his principled stance:
As a pharmacist, you have every right to refuse to fill contraceptive prescriptions. But your customers have every right to boycott your store, and your employer has every right to fire you. If you don't like your employer's policy, open your own pharmacy.
He also notes that federal government is soliciting citizens' opinions on this issue. You can e-mail them at: consciencecomment@hhs.gov.

Here's a slightly edited version of the comment I sent them:
The US government needs to be completely clear and unambiguous as to whether it regards standard forms of contraception such as birth control pills and IUDs as forms of "abortion", if they result in the expulsion of an egg that has already been fertilized but not yet undergone implantation.

Rather than fudging this issue and calling it an "ambiguity", it must let practicing physicians such as myself know whether restrictions on abortion will also entail restrictions on these other forms of contraception.

If the Bush administration wants to call those "abortions", then please be up front about it and say so. If the administration does not consider those to be "abortions", then say so and clear the air. To straddle the fence does a grave disservice to millions of men and women, and also leads to the concern that there is a hidden agenda amongst some in the government to also include restrictions on these forms of birth control when they propose future restrictions on abortions.

Paul Hsieh, MD
You too can let the Feds know what you think!

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Comments on "Federal Ambiguity on Abortion Vs. Contraception"
Wednesday, September 3, 2008 at 6:36:01 mst
Comment ID: #1
Name: h-man
E-mail: h_blend(at)hotmail.com

"The regulation could strip federal funding from employers or institutions that fire a doctor, nurse, pharmacist or other health professional who refuses to provide abortion care or information"

So now the position is that the government must fund these activities?


Wednesday, September 3, 2008 at 11:33:39 mst
Comment ID: #2
Name: Doug H.
E-mail: radiotheatre[at]gmail[dot],com

h-man, that is not the context at all. The point of the paragraph is to illustrate the social and ethical engineering done by the government through economic incentives and by coercion. While related in principle, the morality of whether various medical institutions receive or do not receive federal funding is ultimately a separate issue.


Wednesday, September 3, 2008 at 12:53:28 mst
Comment ID: #3
Name: Tony Donadio
E-mail: tdonadio(at)optonline.net

h-man wrote: "So now the position is that the government must fund these activities?"

It shouldn't, no. But as long as government *is* going to fund such things, then it must do so objectively, fairly, without ideological prejudice. Discriminatory funding of this kind establishes ideology (in this case, religion, and contrary to the first amendment).


Wednesday, September 3, 2008 at 22:19:10 mst
Comment ID: #4
Name: IchorFigue

I'm not sure if you've noticed yet, but ARC is currently taking part in another website debate on abortion.
http://www.opposingviews.com/questions/should-abortion-be-legal

The setup has them split up in pairs of 2 vs 2, kinda weird, but interesting.


Thursday, September 4, 2008 at 4:33:49 mst
Comment ID: #5
Name: Paul Hsieh
E-mail: paul(at)geekpress(dot)com
URL: http://www.geekpress.com

To echo Tony's comment, it's very similar to the debate over, say, welfare. The government should not run any sort of welfare state at all to provide food stamps for people under a certain income. But given that it currently does, it would be wrong to cut off such stamps for all Italian-Americans (or pick any other ethic group), while keeping the food stamp system intact for every other ethnic group.

If such a cutoff were part of a principled even-handed reduction of the overall welfare state, then that would be one thing and could be supported.

But to single out a particular ethnic subgroup and cut off government funding only for them would be to enshrine into law a form of ethnic discrimination. That would not be reduction of statism, but a worsening in a new way. Under that change, the incorporation of bad principles into law would become even worse, even if the total dollar expenditures by the government might actually be slightly less.


Thursday, September 4, 2008 at 5:52:03 mst
Comment ID: #6
Name: Steve D'Ippolito, Persecuted Minority

"it would be wrong to cut off such stamps for all Italian-Americans (or pick any other ethic group..."

Whew! That was getting too dangerously close to "Italian-Polish-Russian Jewish-Left Handed Americans" for my comfort.


Thursday, September 4, 2008 at 6:07:20 mst
Comment ID: #7
Name: Steve D'Ippolito

On a more serious note, I wrote the following rant:

http://forum.objectivismonline.net/index.php?showtopic=13656&pi ...

...on Objectivism Online, and then saw the website debate that IchorFigue referenced--it illustrated my point perfectly. Because the National Abortion Federation fails to take on the "pro-life" premise that the embryo and fetus are human beings, their arguments fall flat.

The pro-legal-abortion position as presented by most abortion-rights groups will ultimately *fail* if it does not correct this tendency. I could title this "Why we are still losing the war!"

ARC does not make this mistake.


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