"It's unconscionable that the Bush administration, while promising a smooth transition, would take a final opportunity to politicize women's health," said Cecile Richards, president of Planned Parenthood.
Despite the controversy, HHS Secretary Mike Leavitt said he intends to issue the rule as a final regulation before the Obama administration takes office, to protect the moral conscience of persons in the healthcare industry. Abortion-rights advocates are just as insistent that the rights of a patient come first.
If the regulation is issued before Dec. 20, it will be final when the new administration takes office, HHS officials say. Overturning it would require publishing a proposed new rule for public comment and then waiting months to accept comments before drafting a final rule.
Abortion-rights advocates think it might be easier to get Congress to reject the rule. Sen. Hillary Rodham Clinton (D-N.Y.), before being nominated Monday for secretary of State, and Sen. Patty Murray (D-Wash.) have said they would move to reverse it.
The HHS proposal has set off a sharp debate about medical ethics and the duties of healthcare workers.
Last year, the American College of Obstetrics and Gynecology said a "patient's well-being must be paramount" when a conflict arises over a medical professional's beliefs.
In calling for limits on "conscientious refusals," ACOG cited four recent examples. In Texas, a pharmacist rejected a rape victim's prescription for emergency contraception. In Virginia, a 42-year-old mother of two became pregnant after being refused 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.
"Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients [or] negatively affect a patient's health," ACOG's Committee on Ethics said. It also said physicians have a "duty to refer patients in a timely manner to other providers if they do not feel that they can in conscience provide the standard reproductive services that patients request."
