New conscience clause may hinder reproductive health care

As Rachel Maddow reports, the Bush Administration is seeking to add a broad new “right of conscience” ruling that would permit medical facilities, doctors, nurses, pharmacists and other healthcare workers to refuse to participate in any procedure they find morally objectionable, including abortion and possibly even artificial insemination and birth control. Rachel Maddow interview on reproductive rights ruling

For more than 30 years, federal law has dictated that doctors and nurses may refuse to perform abortions. The new rule would go further by making clear that healthcare workers also may refuse to provide information or advice to patients who might want an abortion. This ruling is being interpreted so broadly by the outgoing head of Health and Human Services that reproductive health advocates say that it could encompass the workers who clean the instruments, as well as pharmacists, counselors and others.

The “morning-after” pill, a form of emergency contraception is the target of much of the pro-life movement’s ire.  The pill prevents an embryo from implanting in the uterus.

As written, the ruling could apply to nearly 600,000 workers including 58,000 pharmacies. While abortion is a difficult subject and President-elect Obama has characterized in that way, he has also said that he would support a woman’s right to choose.  Following his election, President Obama could overturn this ruling but would have to post new regulations, open the proposed regulation for public comment for a number of months and then issue a final ruling.

Of course, every person has the right to their own view on abortion, contraception, and other forms of family planning. However, if that viewpoint infringes on the health and safety of a patient, then the issue moves from one of medical ethics to one quite literally at times of life and death.

The American College of Obstetrics and Gynecology (ACOG) called for limits on the “conscience clause” and cited several of examples of problems with the clause. In one case, a Texas pharmacist rejected a rape victim’s prescription for emergency contraception. In California, a physician refused to perform artificial insemination for a lesbian couple. (In August, the California Supreme Court ruled that this refusal amounted to illegal discrimination based on sexual orientation.) And in Nebraska, a 19-year-old with a life-threatening embolism was refused an early abortion at a religiously affiliated hospital.

President-elect Obama has already promised to overhaul the healthcare system in this country. As he does so, I hope that he will ensure that reproductive health and family planning care are affordable and accessible to women and men in the U.S. It is unfortunate that in its waning days, the Bush Administration is trying once more to undermine that goal.

Congolese Women Bear the Unbearable

I’ve worked as a Pennsylvania-certified sexual assault and domestic violence counselor since I was nineteen years old. I’ve counseled women as young as fifteen who have been assiduously cheated by the United States justice system, wandering through the remainder of their lives helpless and destroyed.  I’ve witnessed the way sexual violence breaks a woman’s spirit. But I’ve only done work in the United States, where victims have access to free counseling services and medical attention.  Across the globe, in war-ridden communities in the Democratic Republic of the Congo, women are forced to make do, to piece themselves back together and reintegrate back into society, without such resources.

In the Democratic Republic of the Congo, rape is an inescapable reality.

Policymakers in the Western world tremble in fury each time news of an honor killing or gang-rape in the Muslim world reaches their ears. Three years ago, when former Pakistani President Pervez Musharraf banned gang-rape victim Mukhtar Mai from leaving the country so she wouldn’t “blacken her country’s reputation,”  Washington erupted in rage. Condoleezza Rice personally ordered the travel ban reversed. Mai was vindicated.

The U.S. government has taken similar actions in Saudi Arabia, and other Middle Eastern countries. But why have our policymakers not exercised the same resolve to aid women in the DRC, a country with the highest rate of sexual assault in the world? Up to 70 percent of Congolese women are estimated to have been raped at some point in their lives.

Stories of their ordeals are nothing short of horrifying. Many women are reported to have bullets shot into their vaginas, others raped by multiple soldiers. Still others are sexually assaulted using tree-branches and bayonets. Rape in the Congo has evolved into a war strategy, utilized by various rebel groups to force their enemies into submission.

Last fall, Vice-President-elect Joe Biden co-sponsored the International Violence Against Women Act, a bill that will provide one billion dollars over the course of five years in U.S. aid to international programs that deal with sexual violence.

Both President-elect Barack Obama and Vice President-elect  Joe Biden have demonstrated their commitment to supporting the I-VAWA and providing aid to the women of the Democratic Republic of Congo. President-elect Barack Obama personally wrote a letter defending the legislation and rebutting a group’s claim that the I-VAWA is an example of anti-male, anti-family propaganda. He also wrote a letter to Condoleezza Rice, urging her to take action on behalf of the rape victims languishing in this central African country.

So, while it remains to be seen how the Obama team addresses violence against women in the DRC, perhaps there is hope. It would be a shame if our concern for victims of sexual assault and domestic violence continued only to extend to countries of geopolitical and strategic interest.