Reproductive Rights Prof Blog

Italy Approves Use of Early Abortion Pill in Hospitals

BBC News: Abortion pill gets final approval in Italy:

The sale of the abortion pill RU486 has been given final approval in Italy, despite protests from the Vatican and the government in the Catholic country.

Unlike in other European countries, the pill, also known as mifepristone, will be administered solely in hospitals.

The pill was originally approved by the country's pharmaceuticals agency in late July, but the move prompted a parliamentary inquiry.

Italy was is one of the last European states to make it available.

Rep. Lois Capps Discusses Abortion and Health Care Reform on the Huffington Post

Huffington Post: Health Care Reform Is No Place for an Abortion Fight, by Rep. Lois Capps (D-CA):

When Congress began debating health reform earlier this year, I hoped our focus would remain on the central goal of improving access to affordable, quality health care rather than on divisive issues like end of life care or abortion. Let me begin by acknowledging that I am a strong supporter of a woman's right to choose and I make no apologies for my beliefs. However, I didn't believe that health reform legislation was the place to promote either a pro-choice or anti-choice agenda. The focus needs to be on getting insurance to the nearly 50 million Americans without it and ensuring stability of coverage for the rest of us...

Unfortunately, the Stupak-Pitts amendment that replaced my amendment during House Floor consideration goes well beyond the status quo and is in no way the simple extension of the Hyde amendment its proponents claim. It would result in a major step backwards for women's control over their reproductive lives.

We need to strike a balance on this issue so health reform isn't a casualty of divisive abortion politics. That's what my amendment did and that's what the Senate bill proposes. Congress would be wise to send the President a bill reflecting this common ground approach and I will work hard to see that happens.

Insurance Coverage for Abortion: What It Costs, and a Proposed Solution

This article is helpful in pointing out how little it costs insurance companies to cover abortion care.  However, it's discouraging that the author thinks it's so obvious that second-trimester abortions should not be covered. There are many reasons why women might seek an abortion in the second trimester.  Teenagers often are late to recognize the signs of pregnancy, or they are in denial.  Women with wanted pregnancies often do not learn of grave fetal anomalies until the second trimester.  Women should not be forced to pay out-of-pocket for second-trimester abortions, which can cost more than $1,000, when these procedures could be covered by their insurance plans.

Newsweek: Separate But Equal? Insurance, Abortion, and Politics, by Al Lewis:

Though the Nelson Amendment, which attempted to restrict federal insurance funds for abortion, failed in the Senate Tuesday, the issue of abortion's role in health care is far from settled. While the Senate version, if passed as now written, would allow federal funding, the House version, thanks to the Stupak amendment, does not even allow private purchase of a rider. Democrats are still divided on this issue, and without Democratic unity, health reform fails. Fortunately, the point of contention is not the thornier one of whether abortions should be legal, but rather how to accommodate both those who want to provide federal coverage and those who refuse to vote to earmark government funds to do so.

Both views can be accommodated by the simple step of establishing two insurance pools, one covering abortion and one not. Each would have the same premium, and people would sign up for the pool of their choice, depending on whether they wanted abortion coverage or not. To fully understand why this math works despite the extra cost of abortions, you must first understand abortion financing and rates in general. (What's the best way to take the passion out of the abortion fight? Turn it into an insurance equation)....

The Nelson Amendment and the Health Care Debate

Swampland (Time/CNN): The Health Reform Abortion Wars, Part Deux, by Amy Sullivan:

. . . On Monday, Nelson introduced an amendment that would prohibit the public option from covering abortion and would prevent private insurance plans that covered abortion procedures from receiving federal subsidies (bill text after the jump). It is virtually identical to the Stupak amendment that passed as part of a deal to get health reform through the House last month. But there is one important difference between the two.

Unlike the Stupak amendment, which garnered the support of 64 House Democrats, the Nelson provision will certainly not pass when the Senate considers it (probably Tuesday). The amendment would need 60 votes to pass, and pro-choice organizations count at least 41 senators who are solidly on their side. Each side is still playing their part, of course, with choice groups circulating frantic emails to their members about the "outrageous" Nelson amendment and a trio of key Catholic leaders sending a letter to senators to urge a "yes" vote on "an essential amendment." . . .

The full post includes the text of the Nelson Amendment.

ACLU Asks Court to Ensure Reproductive Health Care for Women Trafficked into U.S.

ACLU News Release: ACLU Asks Court On Thursday To Ensure Reproductive Health Care For Women Trafficked Into The United States:

BOSTON -- On Thursday, December 3, 2009, the American Civil Liberties Union will ask the U.S. District Court of Massachusetts to allow a legal challenge to proceed against the Department of Health and Human Services (HHS).  The ACLU filed the case earlier this year against HHS for permitting the United States Conference of Catholic Bishops (USCCB) to use taxpayer money to impose religiously based restrictions on reproductive health services in the U.S. government's trafficking victims program.

Since April 2006, HHS has awarded USCCB from $2.5 million to $3.5 million annually to make grants to organizations that provide direct services to trafficking victims under the federal Trafficking Victims Protection Act.  HHS did this knowing that USCCB prohibits, based on its religious beliefs, grantees from using any of the federal funds to provide or refer for contraceptive or abortion services, even though the Trafficking Victims Protection Act contains no such restrictions.

In an attempt to block the legal challenge, HHS has argued that the ACLU of Massachusetts cannot bring the lawsuit.  On Thursday, the ACLU will demonstrate in court that the Constitution permits federal taxpayers to challenge this misuse of public dollars.

The ACLU's brief is available at: http://www.aclu.org/reproductive-freedom/aclu-massachusetts-v-michael-o-leavitt-et-al-complaint

Catholic Church to Deny Communion to Spanish Politicians Who Voted to Liberalize Abortion Laws

Reuters: Pro - Abortion Bill Spanish Politicians Sinful - Church:

MADRID (Reuters) - The Catholic Church will deny communion to Spanish members of parliament who have voted in favour of a bill to make abortion more readily available, the spokesman of Spain's Bishops' Conference said on Friday.

"This is a warning to Catholics, that they can't vote in favour of this and that they won't be able to receive communion unless they ask forgiveness," Juan Antonion Martinez Camino told a news conference.

"They are in an objective state of sin," he said.

The government-sponsored bill, which passed the first of a series of votes in parliament on Thursday, will allow abortion until the 14th week of pregnancy and, in cases of extreme foetal deformity, at any time in the pregnancy.

Catholic Church on Abortion and Marriage Equality

NPR: Catholic Church Stokes Political Debate On Abortion, Gay Marriage:

An Irish Catholic congressman is entangled in a very public battle with a Catholic Archbishop. Rep. Patrick Kennedy, a Democrat from Rhode Island, says he was told not to take communion because of his views on abortion rights. The controversy illustrates a larger debate about the Catholic Church's priorities and core values. For more on the subject, guest host Jennifer Ludden talks with Frances Kissling, former president of Catholics for Choice, the Rev. Harry Jackson, pastor of Hope Christian Church in Beltsville, Md., Professor Stephen Schneck, director of the Institute for Policy Research & Catholic Studies at The Catholic University of America.

Rep. Kennedy Denied Communion Due to his Stance on Abortion

NY Times: Kennedy Barred From Communion by Bishop, by Ian Urbina:

Widening a growing rift, Rep. Patrick J. Kennedy, a Rhode Island Democrat, said on Sunday that the Roman Catholic bishop of Providence had instructed him to refrain from receiving communion because of the congressman’s stance on abortion.

Rep. Kennedy said that Bishop Thomas J. Tobin “instructed me not to take communion and said that he has instructed the diocesan priests not to give me communion,” according to The Providence Journal, which first reported the article....

The allegation by Rep. Kennedy, a Democrat in his eighth term, is the most recent escalation in a bitter and unusually personal dispute between the men that began after the lawmaker criticized the nation’s Catholic bishops for threatening to oppose an overhaul of the health care system unless it tightened restrictions on publicly financed abortion....

Afghan Mullahs Get a Lesson on Birth Control

NY Times: Broaching Birth Control With Afghan Mullahs, by Sabrina Tavernise:

MAZAR-I-SHARIF, Afghanistan — The mullahs stared silently at the screen. They shifted in their chairs and fiddled with pencils. Koranic verses flashed above them, but the topic was something that made everybody a little uncomfortable.

“A baby should be breast-fed for at least 21 months,” said the instructor. “Milk is safe inside the breast. Dust and germs can’t get inside.”

It was a seminar on birth control, a likely subject for a nation whose fertility rate of 6 children per woman is the highest in Asia. But the audience was unusual: 10 Islamic religious leaders from this city and its suburbs, wearing turbans and sipping tea.

The message was simple. Babies are good, but not too many; wait two years before having another to give your wife’s body a chance to recover. Nothing in Islam expressly forbids birth control. But it does emphasize procreation, and mullahs, like leaders of other faiths, consider children to be blessings from God, and are usually the most determined opponents of having fewer of them.

It is an attitude that Afghanistan can no longer afford, in the view of the employees of the nonprofit group that runs the seminars, Marie Stopes International. The high birthrate places a heavy weight on a society where average per capita earnings are about $700 a year. It is also a risk to mothers. Afghanistan is second only to Sierra Leone in maternal mortality rates, which run as high as 8 percent in some areas. . . . 

The Stupak Amendment's Effects on Abortion Access

The Huffington Post: Why the Stupak Amendment Is A Monumental Setback for Abortion Access, by Jessica Arons:

If you thought that just because abortion is a constitutional right and part of basic reproductive health care it would be available in the reformed health insurance market known as the Exchange, think again. The Stupak Amendment, passed Saturday night by the House of Representatives after a compromise deal fell apart, potentially goes farther than any other federal law to restrict women's access to abortion.

The claim that it only bars federal funding for abortions is simply false. Here's what the Stupak Amendment does . . . .

Abortion Rights Opponents Influence Health Care Reform

NY Times: For Abortion Foes, A Victory in Health Care Vote, by David D. Kirkpatrick & Robert Pear:

A restriction on abortion coverage, added late Saturday to the health care bill passed by the House, has energized abortion opponents with their biggest victory in years — emboldening them for a pitched battle in the Senate.

The provision would block the use of federal subsidies for insurance that covers elective abortions. Advocates on both sides are calling Saturday’s vote the biggest turning point in the battle over the procedure since the ban on so-called partial birth abortions six years ago.

Both sides credited a forceful lobbying effort by Roman Catholic bishops with the success of the provision, inserted in the bill under pressure from conservative Democrats.

The provision would apply only to insurance policies purchased with the federal subsidies that the health legislation would create to help low- and middle-income people, and to policies sold by a government-run insurance plan that would be created by the legislation.

Abortion rights advocates charged Sunday that the provision threatened to deprive women of abortion coverage because insurers would drop the procedure from their plans in order to sell them in the newly expanded market of people receiving subsidies. The subsidized market would be large because anyone earning less than $88,000 for a family of four — four times the poverty level — would be eligible for a subsidy under the House bill. Women who received subsidies or public insurance could still pay out of pocket for the procedure. Or they could buy separate insurance riders to cover abortion, though some evidence suggests few would, in part because unwanted pregnancies are by their nature unexpected.

House Passes Health Care Bill with Abortion Restrictions

NY Times: Abortion Was at Heart of Wrangling, by David M. Herszenhorn & Jackie Calmes:

It was late Friday night and lawmakers were stalling for time. In a committee room, they yammered away, delaying a procedural vote on the historic health care legislation. Down one floor, in her office, House Speaker Nancy Pelosi desperately tried to deal with an issue that has bedeviled Democrats for more than a generation — abortion...

Her attempts at winning them over had failed, and Ms. Pelosi, the first woman speaker and an ardent defender of abortion rights, had no choice but to do the unthinkable. To save the health care bill she had to give in to abortion opponents in her party and allow them to propose tight restrictions barring any insurance plan that is purchased with government subsidies from covering abortions.

The restrictions were necessary to win support for the overall bill from abortion opponents who threatened to scuttle the health care overhaul.

“If enacted, this amendment will be the greatest restriction of a woman’s right to choose to pass in our careers,” said Representative Diana DeGette, Democrat of Colorado, one of the lawmakers who left Ms. Pelosi’s office mad.

Representative Rosa DeLauro, Democrat of Connecticut, said the bill’s original language barring the use of federal dollars to pay for abortions should have been sufficient for the opponents. “Abortion is a matter of conscience on both sides of the debate,” Ms. DeLauro said. “This amendment takes away that same freedom of conscience from America’s women. It prohibits them from access to an abortion even if they pay for it with their own money. It invades women’s personal decisions."

L.A. Times: House Votes for Ban on Abortion Subsidies, by Kim Geiger:

Reporting from Washington - In a last-minute compromise seeking to secure a majority vote for a healthcare overhaul, House Democratic leaders agreed Saturday to essentially exclude abortion coverage from their bill except for insurance policies paid exclusively with private money.

The amendment, offered just prior to the vote on the healthcare bill, passed 240 to 194.

The compromise won immediate support from the U.S. Conference of Catholic Bishops, which urged Catholics to "lend their full-throated support" to the Democrats' healthcare bill.

"The bishops' stamp of approval means that this bill is unambiguously pro-life and we will vigorously oppose those who suggest otherwise," the conference said in a statement Saturday.

In a letter to Congress, the National Right to Life Committee described the vote on the amendment as "the most important House roll call on federal funding of abortion" in more than a decade. . . .

The compromise amendment, offered Saturday by Rep. Bart Stupak (D-Mich.), in effect bans abortion coverage by all plans that are purchased using taxpayer dollars. Abortions could still be obtained by policyholders who pay their entire premiums without government assistance or by individuals receiving federal subsidies in the event of rape, incest or danger to the mother's life.

Abortion rights advocates say the result would be a "de facto ban" on abortion in insurance plans sold under the new exchanges that would be created in the bill, because so many of the customers using the exchanges would be getting subsidies.

Politics vs. Religion in Debate Over Abortion and Health Care Reform

Religion Dispatches: Politics, Not Religion, At Heart of Health Care Reform Wrangle on Abortion, by Sarah Posner:

As the House of Representatives health care reform bill edges closer to a vote, anti-choice Democrats continue their threats to hijack the bill over abortion funding. These members-and their supporters-are the very constituency Democrats have been urged to placate on abortion-related issues. That strategy, misguided to begin with, seems even more so as the "pro-life" Democrats are trying to bring down their own party's signature legislative initiative.

As part of Democrats' re-tooling in the post-"values voters" election of 2004, they tried to be more "friendly" to religion. A big part of that strategy included making anti-choice Democrats feel more "welcome" in the party by being less doctrinaire on choice, and acknowledging the claimed heartfelt religious belief at the core of these Democrats' position.

But now some of these Democrats, who claim to be pro-life, are playing politics with health care reform, aligning themselves more closely with the anti-choice hard right and the U.S. Conference of Catholic Bishops (USCCB) than their own party. They insist that efforts to ensure that no public funds will be used to cover abortion services are insufficient. This game-playing is not about public funding of abortion, already outlawed in the Hyde Amendment (which bars federal funding from being used to pay for abortions for low-income women under Medicaid and other programs). Indeed, the House bill already incorporates Hyde through its own amendment authored by pro-choice California Democrat, Rep. Lois Capps.

Instead, these Democrats, led by Rep. Bart Stupak of Michigan, are pushing for an amendment to restrict womens' access to abortion. And that's not theology, it's politics. . . . 

Philippine Congress Considers Measure to Expand Access to Birth Control

NY Times: Birth Control Bill Has Enemies in Philippines, by Carlos H. Conde:

Abortion is illegal in the Philippines, though birth control and related health services have long been available to those who can afford to pay for them through the private medical system. But 70 percent of the population is too poor and depends on heavily subsidized care through the public health system. In 1991, prime responsibility for delivering public health services shifted from the central government to the local authorities, who have broad discretion over which services are dispensed. Many communities responded by making birth control unavailable.

More recently, however, family planning advocates have been making headway in their campaign to change this. Legislation before the Philippine Congress, called the Reproductive Health and Population Development Act, would require governments down to the local level to provide free or low-cost reproductive health services — from condoms and birth control pills to tubal ligation and vasectomy. It would also mandate sex education in all schools, public and private, from fifth grade through high school.

Rep. Patrick Kennedy Criticizes Catholic Church Over Health Care Reform Stance

Boston Globe: Kennedy spars with church on abortion, by Milton J. Valencia:

The late Senator Edward M. Kennedy seemed to mend his differences with the Catholic Church just before his death. But less than two months later, his youngest son has plunged into a firestorm of controversy with the church.

In strong rhetoric, US Representative Patrick Kennedy of Rhode Island and Bishop Thomas J. Tobin of the Providence Diocese have exchanged nasty comments over abortion and proposals for a health care overhaul in Washington, D.C. Kennedy is a strong supporter of health care overhaul, even if it includes public funding for abortion services, while the Catholic Church opposes the abortion component.

In a statement released yesterday, Tobin lashed out at Kennedy, a son of one of the nation’s most prominent Catholic families, for incendiary remarks the congressman made in an interview about abortion.

Kennedy, speaking in support of a public option for a proposed universal health care plan, told Catholic News Service in an article posted Thursday that he found it perplexing that the church would oppose the health insurance plan.

Bernard Dickens on Religious Refusals to Provide Medical Care

Bernard Dickens (University of Toronto Faculty of Law) has posted Legal Protection and Limits of Conscientious Objection: When Conscientious Objection is Unethical on SSRN.  Here is the abstract:

The right to conscientious objection is founded on human rights to act according to individuals' religious and other conscience. Domestic and international human rights laws recognize such entitlements. Healthcare providers cannot be discriminated against, for instance in employment, on the basis of their beliefs. They are required, however, to be equally respectful of rights to conscience of patients and potential patients. They cannot invoke their human rights to violate the human rights of others.

There are legal limits to conscientious objection. Laws in some jurisdictions unethically abuse religious conscience by granting excessive rights to refuse care. In general, healthcare providers owe duties of care to patients that may conflict with their refusal of care on grounds of conscience. The reconciliation of patients' rights to care and providers' rights of conscientious objection is in the duty of objectors in good faith to refer their patients to reasonably accessible providers who are known not to object.

Conscientious objection is unethical when healthcare practioners treat patients only as a means to their own spiritual ends. Practitioners who would place their own spiritual or other interests above their patients' healthcare interests have a conflict of interest, which is unethical if not appropriately declared.

Professor Dickens has also published an op-ed, Unethical Protection of Conscience: Defending the Powerful against the Weak, in the American Medical Association's journal, Virtual Mentor:

In “The Personal is Political, the Professional is Not: Conscientious Objection to Obtaining/Providing/Acting on Genetic Information,” Joel Frader and Charles L. Bosk make a compelling argument that the invocation of personal conscience violates medical professional ethics. They believe that provisions like those in new federal legislation and regulations that prohibit discrimination against health care professionals who refuse to provide services or referrals on religious or moral grounds violate medical ethics.

The rules on protection of conscience issued by the federal Department of Health and Human Services (DHHS) were given legal effect January 20, 2009, as a final gesture of the Bush administration, and are now under review by the Obama administration. They were proposed under three laws: the Weldon Amendment, named after former Representative Dave Weldon (R-FL), which amends the HHS Appropriations Act; section 245 of the Public Health Service Act, signed by President Clinton in 1996; and the Church Amendments, named after former Senator Frank Church (D-ID), and enacted following the Supreme Court’s 1973 decision in Roe v. Wade to ensure that physicians and hospitals were not required to perform abortions or sterilizations as a condition of receipt of federal funds. At least seven states and two abortion-rights groups are in federal court claiming that the Bush administration provisions are unconstitutional on the grounds that they interfere with state laws guaranteeing access to abortion-related and comparable health care services.

The protection that the federal provisions offer is glaringly at odds with the self-sacrifice that has characterized the four historically reputable professions, namely medicine, religious ministry, the profession of arms, and the law. . . . 

Religious Refusals Asserted in Ever-Wider Range of Medical Scenarios

USA Today: Conscience clauses not just about abortion anymore, by Adelle M. Banks:

WASHINGTON — Faced with a request to give an unmarried female patient a prescription for birth control pills, Dr. Michele Phillips looked to her conscience for the answer.

"I'm not going to give any kind of medication I see as harmful," said Phillips of San Antonio. The drugs would not protect her patient from "emotional trauma from multiple partners," Phillips reasoned, or sexually transmitted diseases. "I could not ethically give that type of medication to a single woman."

After the evangelical Christian refused to write the prescription, she resigned her position. She now does contract work at a faith-based practice that permits her to "prescribe according to my ethical values."

U.S. Bishops Threaten to Withdraw Support for Health Care Reform Over Abortion

USA Today: Bishops may pull health care support over abortion, immigrants, by Kevin Eckstrom:

WASHINGTON — The nation's Catholic bishops have threatened to pull their support for health care reform unless their concerns about abortion and access for immigrants are addressed by lawmakers.

The U.S. Conference of Catholic Bishops, which supports universal access to health care as a "basic human right," had been supportive of efforts to reform the health care system, but is concerned about taxpayer-funded abortions.

Spain's Plans to Liberalize Abortion Laws Draw Protesters

BBC NEWS: Big Anti-Abortion Rally in Spain

More than a million people are said to have taken part in a march in Madrid to oppose government plans to liberalise Spain's abortion law.

Several dozen centre-right opposition party joined the demonstration, which was backed by Roman Catholic bishops.

Socialist Prime Minister Jose Luis Rodriguez Zapatero wants to introduce abortion on demand.

At present, a pregnancy can only be terminated in mainly Catholic Spain under specific circumstances. . . .

Polish Court Awards Damages Against Catholic Magazine for Vilifying Polish Woman Who Sought Abortion

BBC News: Award for Poland abortion woman:

A Polish court has awarded $11,000 (7,400 euros) in damages to a woman likened to a child killer by a Catholic magazine for wanting an abortion.

The article also compared abortion to the experiments of Nazi war criminals at Auschwitz.

Alicja Tysiac had been warned by doctors when she became pregnant that she could go blind if she had her baby.

But she was denied an abortion - illegal in most cases in Poland - and her eyesight subsequently deteriorated.

(By the way, how about this article's headline?  "Abortion woman?")

See also: Catholic News Agency: Catholic weekly in Poland fined for questioning 'award' granted to woman who sought illegal abortion.