Reproductive Rights Prof Blog

Thaddeus Pope on Religious Refusals and Health Care

Thaddeus Mason Pope (Widener University Law School) has posted Legal Briefing: Conscience Clauses and Conscientious Refusal on SSRN. Here is the abstract:

This issue’s “Legal Briefing” column covers legal developments pertaining to conscience clauses and conscientious refusal. Not only has this topic been the subject of recent articles in this journal, but it has also been the subject of numerous public and professional discussions. Over the past several months, conscientious refusal disputes have had an unusually high profile not only in courthouses, but also in legislative and regulatory halls across the United States.

Healthcare providers’ own moral beliefs have been obstructing and are expected to increasingly obstruct patients’ access to medical services. For example, some providers, on ethical or moral grounds, have denied: (1) sterilization procedures to pregnant patients, (2) pain medications in end-of-life situations, and (3) information about emergency contraception to rape victims. On the other hand, many healthcare providers have been forced to provide medical treatment that is inconsistent with their moral beliefs.

There are two fundamental types of conscientious objection laws. First, there are laws that permit healthcare workers to refuse providing – on ethical, moral, or religious grounds – healthcare services that they might otherwise have a legal or employer-mandated obligation to provide. Second, there are laws directed at forcing healthcare workers to provide services to which they might have ethical, moral, or religious objections. Both types of laws are rarely comprehensive, but instead target: (1) certain types of healthcare providers, (2) specific categories of healthcare services, (3) specific patient circumstances, and (4) certain conditions under which a right or obligation is triggered.

For the sake of clarity, I have grouped recent legal developments concerning conscientious refusal into eight categories: (1) abortion: right to refuse; (2) abortion: duty to provide; (3) contraception: right to refuse; (4) contraception: duty to provide; (5) sterilization: right to refuse; (6) fertility, HIV, vaccines, counseling; (7) end-of-life measures: right to refuse; and (8) comprehensive laws: right to refuse.

Center for Reproductive Rights Files Federal Lawsuit Challenging Lousiana Clinic Licensing Law

Women's Health Policy Report (National Partnership for Women & Families): Center For Reproductive Rights Files Lawsuit Against La. Clinic Licensing Law:

The New York-based Center for Reproductive Rights on Monday filed a federal lawsuit against Louisiana over a new law that gives state health authorities expanded authority to suspend or revoke abortion clinics' licenses and immediately close clinics if they determine that violations pose health or safety threats to patients, the AP/WWLTV reports. The suit argues that the law is unconstitutional and vague. . . .

New YouTube Channel to Provide Support for Gay and Lesbian Teens

Mashable/Social Good: Dan Savage Creates YouTube Channel to Help Gay Teens, by Samuel Axon:

Sex advice columnist and gay rights activist Dan Savage has launched a YouTube channel called “It Gets Better.” He’s soliciting videos from fans who want to provide support and encouragement to gay teens who face adversity, discrimination and bullying in high school.

Savage announced the new channel today in episode 205 of his podcast. He’s also hinted on his blog that further explanation will come in the next issue of his sex advice column “Savage Love.” The channel was created after Indiana teenager Billy Lucas committed suicide in response to bullying from his classmates, who assaulted him with epithets and told him to go home and kill himself because he was gay. . . .

Anti-Choice Groups Spread Misinformation About New Emergency Contraceptive, Ella

NARAL: Blog for Choice: Fight Back Against Anti-Choice Attacks on Ella®:

You've probably already heard about ella®, the new type of emergency contraception (EC) that the FDA approved last month. ella® can prevent unintended pregnancy up to five days after sex. If a primary form of birth control fails, like a condom breaks, ella® can help.

It's no big surprise that the folks at Family Research Council, an extreme anti-choice and anti-gay organization, are already on the warpath against ella®. They have a long history of trying to confuse people into thinking that EC causes abortion (and, let's be clear, that's a big lie).

This time, the Family Research Council has banded together with other anti-choice groups like Americans United for Life and Concerned Women for America. A key part of their plot to block women's access to ella® is getting anti-choice activists to spread misinformation about the medication to pharmacists. They want to take away women's choices by convincing pharmacists not to stock this important contraceptive. . . .

Colorado Nominee for U.S. Senate Is Attacked for His Opposition to Abortion in Cases of Rape and Incest

Denver Westword: Ken Buck: Opponents rally rape and incest survivors to decry his abortion policy, by Michael Roberts:

Abortion is seldom a major debating point in campaigns these days -- not because it's deemed an unimportant issue, but because most people already have made up their minds on the subject.

It's an interesting twist, then, that the Campaign for a Strong Colorado, which opposes Republican senate nominee Ken Buck, is putting the topic front and center at news conferences today featuring survivors of rape and incest.

The reason, says campaign executive director Ellen Dumm, is Buck's opposition to abortion even for rape and incest victims. . . .

Religious Conservatives Urge GOP Not to Lose Focus on Social Issues

Politico: Social conservatives warn Republicans not to abandon social issues, by Abby Phillip:

Leaders of the religious right are warning Republicans not to abandon social issues in a document that is expected to be an outline of the party’s governing agenda if it regains control of Congress.

Some have compared the document, being drafted by the GOP’s congressional leadership, to former House Speaker Newt Gingrich’s groundbreaking 1994 “Contract With America.” But religious conservatives are worried that their bread-and-butter social issues — opposition to abortion and gay marriage, and support for religious liberty — will be left behind on the Republicans’ path to power, an effort to draw support from social moderates.

NOW: Affordable Health Care Act Will Eliminate Private Coverage for Abortion Care

NOW: Anti-Abortion Rights Model Guidelines Released: NOW Intensifies Call for Obama to Live Up to Campaign Promises, Statement of National Organization for Women President Terry O'Neill: 

Late last night, the Office of Management and Budget and the Department of Health and Human Services released pre-regulatory model guidelines for the implementation of the anti-abortion rights provisions tacked on to the Affordable Care Act in order to secure the votes of a handful of religious fundamentalists serving in Congress.

NOW remains clear that women in the United States have fewer abortion rights today than we did one year ago, and that the situation will be dramatically worsened by the time health insurance exchanges are up and running in 2014. Forcing health insurers who participate in exchanges to segregate funds for abortion care perpetuates grave injustice to women; insults those paying into plans -- young, old, women, men, as well as payroll account administrators -- with a burdensome monthly "two-check" requirement; and will lead to the end of private coverage for abortion care, even for women with the luxury to afford their own insurance premiums.

Today 87 percent of employer-based insurance plans cover abortion care; those that choose to continue that coverage while participating in exchanges will be subject to annual cost audits, new layers of internal and administrative controls and the potential for harassment from state health insurance commissioners. It is no surprise that a George Washington University study has predicted that one outcome of the Affordable Care Act will be the virtual elimination of private coverage for abortion care -- legal medical care accessed by one in three women in this country.

NJ Gov. Christie's Refusal to Fund Family Planning Leads to Closure of Planned Parenthood Clinic

North Jersey.com: NJ family planning clinic closed after cutbacks: 

Cuts in state funding have led Planned Parenthood of Southern New Jersey to close a family planning clinic in Cherry Hill.

The decision came a day after Democrats in the New Jersey Senate on Monday failed to override Gov. Chris Christie's veto of a bill that would have provided $7.5 million for 58 clinics around the state.

Christie said the state didn't have the money. . . .

The Devastating Toll of the Hyde Amendment

Center for Reproductive Rights: Hyde: The Status Quo Is Not OK:

Mexico Deeply Divided On Abortion

Reuters: Mexico abortion sentences reveal social collision, by Caroline Stauffer:

Women seeking abortions in Mexico steal away to the country's liberal capital, escaping their home states where the practice is condemned and illegal.

Authorities in almost all of Mexico's conservative states have fought back against Mexico City's abortion policies, among the most permissive in largely Catholic Latin America, by making examples of specific women and tightening laws. . . .

Crisis Pregnancy Centers Serve Up Anti-Choice Rhetoric and Pizza

Ms. Magazine: Want a Pizza with That Pap Smear? Oh, and We’re Anti-Choice, by Alexandra Tweten:

Question: Guess what genius new advertising tactic certain crisis pregnancy centers (CPCs) are using to get women in the door to their fake clinics?

Could it be … listing themselves under “clinics” and “abortion” in the Yellow Pages? No, they’ve been doing that for ages. Could it be CPCs on wheels, you ask? Nope. Already tried that.

Answer: Crappy pizza. Yes, CPCs are luring women with cheap food.

The Pregnancy Resource Center of St. Cloud, Minn. has placed a coupon in the back of (my alma mater) St. Cloud State University’s 2010/11 student agenda book shilling a free small Little Caesars Pizza along with $10 STD, HIV and pap tests.

CPCs are using increasingly imaginative advertising techniques in order to preach religious fundamentalist anti-choice politics and lies. Relying on deceptive advertising to get women in the door, CPCs often obscure their religious ties. The St. Cloud center’s website, preghelp.com cites no mention of the center’s religious orientation. However, a visit to the Pregnancy Resource Center of St. Cloud yields religious anti-choice brochures and questions about patients’ religions. . . .

In China, Mothers Seek Help of "Confinement Ladies" After Birth

USA Today: More moms in China readopt confinement after childbirth, by Kathy Chu:

HONG KONG — When Noelle Leung learned she was pregnant, the first person she called was her doctor. The second was a confinement lady.

So-called confinement ladies are highly sought after in Hong Kong and other parts of Asia as experts who can guide women through what's believed to be a critical month after birth.

According to traditional Chinese medicine, the month after giving birth is when new mothers are especially vulnerable to health problems, so they're not supposed to go outside, take a bath, brush their teeth or do anything else that could allow "bad wind" into their bodies.

Today, the rules of confinement, called cho yuet, are being rewritten to adapt to the realities of life. Relatives used to care for new mothers and their babies, but today's changing needs are spawning alternatives, such as confinement ladies and postpartum hotels. . . .

Studies Yield Conflicting Information On Connection Between Birth Control Pills and Breast Cancer

Slate: The Pill-Breast Cancer Connection, by Florence Williams:

Last summer, in a study of more than 50,000 African-American women, Boston University epidemiologist Lynn Rosenberg found a 65 percent increase in a particularly aggressive form of breast cancer among those who had ever taken the birth-control pill. The risk doubles for those who had used the contraceptive within the past five years and had taken it for longer than 10 years.

This unwelcome news doesn't fit well into the wave of coverage of the pill's 50^th anniversary. A Newsweek columnist gushed that the pill "did more good for more people than any other invention of the 20^th century." In a cover story, Time magazine extolled the pill as "the means by which women untied their aprons, scooped up their ambitions and marched eagerly into the new age." (True. Thanks, pill!) A commemorative MSN.com piece flatly asserted earlier this year that "taking the pill has no impact on breast cancer risk."

Rosenberg's findings question that assertion. . . .

U.S. Conference of Catholic Bishops' Letter Asks HHS Not to Include Birth Control Pills or Sterilization as "Preventive Services" in New Health Care Regs

Modern Healthcare: Bishops stress birth-control stance to HHS, by Joe Carlson:

Catholic hospitals do not offer contraceptives or sterilizations to their patients as a matter of conscience, but American bishops say that regulations under debate in the healthcare reform law scheduled to go into effect Thursday could force religious healthcare providers to offer the services to their own employees.

HHS officials are finalizing the regulations on the specific services that group health insurance plans will be required to offer to consumers as “preventive services” under the Patient Protection and Affordable Care Act. The reform law requires private health plans to cover evidence-based preventive services and to eliminate any cost-sharing requirements for them.

The July 14 interim final rule defining the services included coverage of chronic disease screenings, prenatal care and routine doctor visits for infants and children, but left open the question of what services will be required under preventive health services for women.

In a six-page letter hand-delivered to HHS, the U.S. Conference of Catholic Bishops urged the federal rule-makers to reject calls to define family planning services such as contraceptive pills and sterilization as “preventive services” because family-planning efforts do not aim to cure disease. “To prevent pregnancy is not to prevent a disease,” the bishops  wrote. . . .

Abortion Brought to Forefront in Michigan Governor's Race

Detroit Free Press: Bernero takes on Snyder over abortion issue, calls foe 'extreme', by Chris Christoff:

Democratic gubernatorial candidate Virg Bernero cranked up the abortion issue in the campaign today, saying while he believes in a woman’s right to choose, his Republican opponent Rick Snyder and Snyder’s running mate Rep. Brian Calley, R-Portland, hold “extreme” views against abortion that would jeopardize women’s rights and health.

Bernero, joined by his running mate, Southfield Mayor Brenda Lawrence, said Snyder’s opposition to abortion in cases that threaten a woman’s health shows insensitivity to women’s rights.

They were endorsed by Planned Parenthood, the state’s leading advocate for abortion rights. . . .

Colorado GOP Candidate for US Senate Reverses Support for Fetal Personhood Amendment

The Denver Post: Buck softens stance on abortion and "personhood", by Allison Sherry:

As a Republican primary candidate, Ken Buck took absolutist positions on abortion and "personhood" — declaring that if elected to the U.S. Senate he would sponsor a constitutional amendment to ban abortion and backing a proposed state law that would outlaw some common forms of birth control.

Now, faced with televised attacks from incumbent Sen. Michael Bennet over those strident views, Buck is painstakingly trying to modify positions that may not match the beliefs of the unaffiliated moderates who will ultimately decide the contest. . . .

Anti-Abortion Advocates Attack Ohio Anti-Abortion Democrats for Backing Health Insurance Reform

The Plain Dealer: Ohio anti-abortion Democrats take flak over vote on health care bill, by Sabrina Easton:

Months after backing a controversial health insurance reform bill that critics said might open the door to taxpayer-funded abortions, anti-abortion Democrats in Congress, including three Ohioans, face attack campaigns over their votes.

In Cincinnati last month, International Right to Life Federation founder John C. Willke published a letter in the Cincinnati Enquirer that criticized Rep. Steve Driehaus' vote for the bill. Angry Catholics accosted the congressman at church festivals. The anti-abortion Susan B. Anthony List denounced him at a Fountain Square rally in front of a bus painted with his photo and the words "Sold Out." . . .

Rep. Chris Smith's Op-Ed Opposes Including Abortion as Part of Reproductive Health in UN Millenium Development Goals

Wash. Post Op-Ed: Abortion does not further children's health, by Chris Smith:

An army of health activists and world leaders will gather at the United Nations this week to review the eight Millennium Development Goals agreed to at the start of the century and to recalibrate and recommit to more effectively achieve them by 2015. The overarching and noble goal is reducing global poverty. But the most compelling and achievable objectives -- huge reductions in maternal and child mortality worldwide -- will be severely undermined if the Obama administration either directly or covertly integrates abortion into the final outcome document. . . .

Under New Law, Nebraska Abortion Providers Must Report Gestational Age of Fetus

CNBC: Neb. abortion docs to file fetus' age with state:

Nebraska doctors will soon be required to report an aborted fetus' gestational age to the state as part of a first-of-its-kind law that will ban abortions starting at 20 weeks based on assertions that fetuses feel pain at that stage of development.

The age information has so far been optional on reports doctors are required to file with the state detailing each abortion, and Nebraska's two abortion clinics don't volunteer it. That has made it difficult for state lawmakers — and abortion opponents — to get a clear picture of Nebraska's abortion business and the potential impact of state laws. . . .

"Defanged" Version of HIV Used to Treat Rare Blood Disorder

The Los Angeles Times: HIV virus used to cure a genetic blood disorder, by Thomas H. Maugh II:

For the second time, researchers have used the HIV virus in gene therapy to cure a severe genetic disease, this time the blood disorder beta-thalassemia, which causes life-threatening anemia.

French researchers had previously used a "defanged" version of the virus that causes AIDS to cure two boys with the rare disorder adrenoleukodystrophy, which was at the heart of the popular movie "Lorenzo's Oil." Beta-thalassemia is a much more common disease, and although the new research involved only one patient, it suggests that this approach could have wide applicability. . . .