The Assault on Womens Sexual and Reproductive Rights

[Kobi]

According to the Richmond Times Dispatch the bill should be voted on today.

The article contained some curious info:

"Del. Kathy J. Byron, R-Campbell, who sponsored the House's version of the bill, said numerous misconceptions about the bill are circulating, which is driving the negative attention surrounding it.

She said that both Planned Parenthood and federal abortion guidelines recommend the ultrasound as best practice to determine gestational age.

"The only way that they can determine the age of the fetus at an early age is by performing a trans-vaginal ultrasound, and they're already doing this procedure as a common procedure at Planned Parenthood," Byron said.

Byron said that providing a precise age builds on the state's existing informed consent law and helps ensure the safety of the woman.

"It's all well within our goal of making fully informed medical decisions," added Del. C. Todd Gilbert, R-Shenandoah.

Of course I went to the Virginia PP web site and this is what I found :

An abortion consultation appointment is required before the procedure can be scheduled. Please call any of our three offices to set up an abortion consultation appointment.

The following will be completed at the consultation appointment:

urine pregnancy test vaginal ultrasound pelvic exam discussion of the risks, benefits, alternatives, and a step-by-step review of what to expect during and after the procedure discussion of post abortion birth control options


So now I am confused. Is the legislature just legalizing what is already being done? Is PP giving mixed signals as to what the support vs what they actually do? Do different PP clinics have the ability to set different standards of care? If so, who sets the policies?

Puzzle it is. Must delve deeper.

[Kobi]

Corrected link for Virginia PP or just one of their clinics. Not sure.
Virginia PP

Boston might require abdominal but rarely transvaginal.

[Cin]

Originally Posted by Kobi

"The only way that they can determine the age of the fetus at an early age is by performing a trans-vaginal ultrasound, and they're already doing this procedure as a common procedure at Planned Parenthood," Byron said.

Just for the record if it's that early an age it's not a fetus it's an embryo. I think fetal development starts around 10 weeks. But anyway, what I found at the Planned Parenthood site was

Before the abortion procedure, you will need to

discuss your options
talk about your medical history
have laboratory tests
have a physical exam — which may include an ultrasound
read and sign papers

So I guess it's a possibility that an ultrasound may be needed. But it is not a given.

[Cin]

Laws Mandating Ultrasound Before Abortion Threaten Physician & Patient Rights
Margaret Polaneczky, MD

Part of me just shrugs my shoulders at the new laws being promulgated by state legislatures that require ultrasound prior to performing an abortion.

After all, in most practices, getting an ultrasound before doing an abortion is pretty much routine already. Doctors who do abortions don’t want to be surprised by an unexpectedly advanced gestational age, a uterine anomaly, an erroneous diagnosis or an ectopic pregnancy. Since most Ob-Gyns have an ultrasound machine in their office, the sono is fast and easy to do. Those docs who don’t have their own sono machines will refer out. And higher volume providers may employ a radiologist or sonographer to do the sonos in their practices.

So if we’re all doing ultrasounds anyway, what’s the big deal?

This is not about abortion – It’s about the practice of medicine and the rights of patients

The big deal is that patient and physician rights are being violated by legislators with an agenda that has nothing to do with the public health and everything to do with restricting access to a legal medical procedure.

We are not talking about a doctor ordering a radiologic test. We are talking about state legislators mandating that a patient undergo a medical procedure without her consent.

It’s not only invasion of privacy, and the physician-patient contract, it’s assault on the patient. It’s mandating that “as a component of informed consent”, a woman undergo a procedure without her consent. (Amendments that require the woman to consent for the ultrasound were voted down.)

HC 462 – The Virginia Ultrasound Law

Abortion; informed consent. Requires that, as a component of informed consent to an abortion, to determine gestation age, every pregnant female shall undergo ultrasound imaging and be given an opportunity to view the ultrasound image of her fetus prior to the abortion. The medical professional performing the ultrasound must obtain written certification from the woman that the opportunity was offered and whether the woman availed herself of the opportunity to see the ultrasound image or hear the fetal heartbeat. A copy of the ultrasound and the written certification shall be maintained in the woman’s medical records at the facility where the abortion is to be performed. This bill incorporates HB 261.

Do you see the legal precedent being made here?

Forget for a moment that this is about abortion.

Imagine instead that there is a law requiring you to get a chest x-ray before you can be treated for pneumonia. Or mandating that as a doctor, you order an MRI and show the patient the images before treating a headache. Or forcing a male patient to undergo a rectal exam before being treated for urethritis.

We’re not talking about whether or not these are things that are happening anyway as part of the current practice of medicine. We’re talking about a law requiring them to be done as a condition of treatment. The doctor must order the test and the patient must undergo the procedure. Or the doctor is breaking the law.

This is not just about abortion. Or women’s rights. Or Planned Parenthood.

It’s about the practice of medicine and the rights of our patients. It’s about physician-patient privacy and the authority of doctors to practice medicine without the fear of breaking the law.

All physicians and patients, whether they are male or female, pro-choice or pro-life, Republican or Democrat, should be outraged. Our medical societies and our patient advocacy groups - every single one of them, whether related to reproductive care or not – should be fighting these laws, and engaging physicians and patients everywhere to fight back. Publicly and vocally.

With the passage of Virginia HB 462, eight states now have laws mandating that a woman have an ultrasound prior to an abortion.

How soon before it’s your state? Or your specialty? Or your practice? Or your body?

[Kobi]

On a chilly winter day earlier this month, 120 college presidents--mostly of Protestant schools--from around the country met in Washington for an annual meeting sponsored by the Council of Christian Colleges and Universities, a group that represents 136 American schools and more than 400,000 students. One topic kept coming up in the discussions: How to combat President Barack Obama's proposed mandate for religious employers to provide health insurance that offers free contraception, a decision that would affect all of their institutions--and could violate some of their deepest-held beliefs.

During the conference, 25 of the presidents held a separate policy meeting to discuss the proposed directive, which was first established in the Affordable Care Act in 2010 and was upheld this year by the Department of Health and Human Services. The mandate, later softened by the Obama administration, would have required non-church religious institutions like schools and hospitals to offer health insurance plans that include free access to contraceptives and abortifacient drugs. Many of these presidents made trips to the offices of their representatives to urge them to fight against the decision.

Much of the news coverage of the battle over the contraception mandate focused on the outcry from the Catholic Church, but employers affiliated with Protestant denominations--especially religious colleges who offer insurance plans to students--waged an equally outspoken crusade against the decision. A coalition of more than 60 faith-based groups co-signed a letter to President Obama in December urging him to broaden exemptions to the mandate, and the council's president, Paul Corts, twice sent letters to the administration urging them to reconsider.

After the Obama administration first announced the mandate, colleges associated with Protestant churches and schools founded as expressly Christian institutions fought for exemptions, warning that the mandate could force them to deny health insurance to students who rely on the school's health care plans.

These critics say that many of the students who attend the schools are unmarried, so covering even preventive products would violate their religious teachings. Similarly, because some within the faith consider drugs like Plan B and Ella--which reduce the chance of pregnancy when taken after intercourse--to be abortion-inducing, the mandate caused problems even for coverage of married students and employees.

"You'd be teaching your students one thing and then providing services that you're teaching are wrong," Shapri LoMaglio, the director of government relations and executive programs at the council, told Yahoo News.

To quell concerns like these, Obama announced on Feb. 10 an "accommodation" for religious employers that would allow those employed by religious institutions to obtain free contraception as part of their employer health insurance, but said that the insurance companies would be required to pay for it, not the religious institutions.

In a statement after Obama's announcement, Paul Corts, the council's president, expressed skepticism that the accommodation plan would resolve the issue.

"Without seeing the final rule it is impossible to tell from the President's general statement if our specific religious liberty issues have been addressed," Corts said. "Therefore, we remain unaware of whether the religious exemption will encompass our schools and their student plans and eliminate all of the violations of conscience issues. We are anxious to get the details and will continue to work with the Administration to try to ensure that the religious liberty of our institutions is protected."

While the Obama administration was still considering how to apply the health care law's mandate to religious groups, several presidents from Protestant colleges sent letters to their representatives and posted them on Regulations.gov, a government site that gathers public comments on rules before they are implemented. Of the schools in the Council of Christian Colleges and Universities, at least 12 submitted comments urging the administration to expand the mandate or eliminate it all together. If churches were exempt, they argued, why aren't institutions that base their bylaws on the same faith-based principles?

"The Department of Health and Human Services hardly seems like the appropriate place for such a determination to be made," wrote Mark Benedetto, the president of the University of Sioux Falls in South Dakota, a school founded by Baptists in 1872. "I am concerned that the regulations as written will violate the conscience of our institution as it relates to the health care plan that we offer to our students--the exemption is for employer plans, as written it does not appear to also include the student plans. Not only would this force our institution to violate our religious convictions by offering emergency contraceptives to our students, it would put us in the awkward position of offering a health care plan to our employees that is consistent with their religious convictions while offering another to our students that violates their religious convictions."

Some schools have already made the decision to revoke insurance to students not covered by their parents. A spokesman from Colorado Christian University, an interdenominational school in Denver that has filed a lawsuit opposing the rule, said students will be forced to seek insurance options elsewhere if the administration does not change course.

"This plan will not be offered in the future if it must be compliant with the administration's mandate thereby forcing American citizens to either compromise their beliefs or go without," said Ron Benton, the school's assistant vice president for administrative services.

http://news.yahoo.com/blogs/ticket/n...232819956.html

[Kobi]

(Reuters) - Can a state require a pharmacy to stock and dispense emergency contraception - even when the owner considers the drug immoral?

That's the question at the heart of a long-running legal battle in Washington state, expected to be decided Wednesday with a ruling from U.S. District Court in Seattle.

It's the latest twist in a contentious national debate over the role of conscience in the workplace.

In recent weeks, the debate has been dominated by religious groups fighting to overturn a federal mandate that most health insurance plans provide free birth control. But the battle extends far beyond insurance regulations.

Asserting conscientious objections, nurses in New Jersey have said they would not check the vital signs of patients recovering from abortions. Infertility specialists in California would not perform artificial insemination on a lesbian. An ambulance driver in Illinois declined to transport a patient to an abortion clinic.

In the Washington case, a family-owned pharmacy in Olympia declined to stock emergency contraception, which can prevent pregnancy if taken within 72 hours of unprotected sex. Co-owner Kevin Stormans says he considers the drug equivalent to an abortion, because it can prevent implantation of a fertilized egg. His two pharmacists agree.

Their decision to keep the drug off their shelves came under fire in 2007, when the state Board of Pharmacy enacted a rule requiring pharmacies to stock and dispense all time-sensitive medications in demand in their community. In the case of the Olympia pharmacy, that includes emergency contraception, said Tim Church, a state Department of Health spokesman. The pharmacy's owner and employees filed suit to block the mandate.

"All our family wants ... is to serve our customers in keeping with our deepest values," Stormans said in a statement issued by his attorneys.

The state argues that it has a compelling interest in protecting the right of patients to legal medication

The conscience debate has implications for a vast number of patients. A 2007 New England Journal of Medicine study found that 14 percent of doctors do not believe they are obligated to tell patients about possible treatments that they personally consider morally objectionable. Nearly 30 percent of physicians said they had no obligation to refer patients to another provider for treatments they wouldn't offer themselves. A more recent study, published last week in the Journal of Medical Ethics, echoed the finding on referrals.

And abortion and contraception aren't the only medical services at issue. Physicians also may object to following directives from terminally ill patients to remove feeding tubes or ventilators, said Kathryn Tucker, director of legal affairs for Compassion & Choices, an advocacy group that backs physician-assisted suicide.

A FAMILIAR DIVIDE

The arguments for and against expanded conscience rights fracture along familiar lines.

Religious liberty advocates argue that protecting an individual's right to heed his conscience is a core American value. They advocate broad laws that would shield most anyone in the health-care field from doing any work he or she deems objectionable, even if it's several steps removed from the actual act of terminating a pregnancy or supplying emergency contraception.

Under this view, a translator could refuse to convey family-planning information to a patient; a custodian could refuse to clean the operating room after an abortion; a billing clerk could refuse to process insurance claims for birth-control pills.

Conscience is, by definition, a highly individual value set; neither an employer or the state should "get to define the conscience" of an individual worker, said Matt Bowman, an attorney with the Alliance Defense Fund, a conservative non-profit law firm focused on religious liberty.

Bowman recently represented a dozen nurses who sued a New Jersey hospital over a requirement that they tend to abortion patients before and after surgery.

One of those nurses, Fe Esperanza Racpan-Vinoya, said even a routine blood pressure check would be abhorrent to her if the patient was in for an abortion. "Absolutely," she said, "there's a big difference" between a patient in for an abortion and one in for an appendectomy.

The hospital, University of Medicine & Dentistry of New Jersey, settled the case in late December. It pledged to hire new staff so nurses with objections wouldn't have to help with abortion patients, except in emergencies.

RETAINING PEOPLE OF FAITH

Religious liberty advocates say they worry that narrowing conscience rights will drive people of faith out of medical professions. "The government cannot single out people with conscientious objections ... and seek to exclude them from the public square," said Eric Kniffin, legal counsel for the Becket Fund for Religious Liberty, which represents the pharmacy in the Washington case.

But women's groups and other patient advocates argue that expansive opt-out clauses create workplace chaos and risk patient harm. They worry about rural patients, where there may be just one pharmacist or gynecologist within 100 miles.

"It leads to one group of people imposing their religious belief on the public health of everyone else, and that's just unacceptable," said Susan Berke Fogel, an attorney with the National Health Law Program, which advocates for family planning access.

Paige Gerson, a dietician in the Kansas City suburbs, experienced the sting of a doctor citing conscience objections several years ago, when she called her gynecologist early one Saturday seeking an emergency contraceptive. The doctor on call declined to prescribe it or refer Gerson to another doctor.

"I was in disbelief," Gerson said. "I absolutely felt she was judging me." She drove into the city to get help from Planned Parenthood.

COURT RULINGS VARY

Case law on conscience rights is a confusing patchwork.

Federal law offers clear protections for doctors and nurses who don't want to participate in abortions.

Nearly every state has similar "conscience clause" laws in place for abortion. A number go further still -- 17 states allow health-care providers to refuse to sterilize patients on moral or religious grounds, and 13 states permit providers to refuse to prescribe or dispense contraceptives, according to the Guttmacher Institute, a family planning research group.

The broadest conscience protection of all is in Mississippi, where state law allows nearly anyone connected with health-care service to refuse to participate in nearly any procedure.

State and federal courts, however, have signaled a wariness to extend such broad protections.

Letting citizens freely opt out of civil laws by citing their religious beliefs would effectively "permit every citizen to become a law unto himself," Justice Antonin Scalia warned in a 1990 decision curtailing the rights of workers to claim religious freedom exemptions.

In 2008, the California Supreme Court cited that ruling in deciding that infertility doctors were wrong to deny a lesbian artificial insemination on religious grounds. Their denial ran afoul of a California law barring discrimination based on sexual orientation, the court found.

On the other hand, some courts have signaled strong support for religious freedom protections.

A state court in Illinois last spring overturned a regulation, similar to the Washington rule, that required pharmacies to carry and dispense emergency contraception.

And late last month, the 6th Circuit Court of Appeals in Cincinnati ruled in favor of a graduate student studying for a counseling degree who said she couldn't counsel clients on same-sex relationships because of her religious belief that such relationships were wrong. The university expelled her, citing intolerance; she sued, claiming religious discrimination. The appeals court said she should get a trial.

"A reasonable jury could conclude that professors ejected her from the counseling program because of hostility toward her speech and faith," the court wrote. "Tolerance is a two-way street."

http://ca.news.yahoo.com/debate-over...231341506.html