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Birth Control Fears Addressed
HHS Chief Says Draft Rule Is Not Redefining Abortion

By Rob Stein
Washington Post Staff Writer
Saturday, August 9, 2008

Health and Human Services Secretary Mike Leavitt has denied that a controversial draft regulation would redefine common birth control methods as abortion and protect the rights of doctors and other health-care workers who refuse to provide them.

In a statement posted on his blog on Thursday, Leavitt appeared to try to allay fears that the proposed regulation would create sweeping new obstacles to women seeking a variety of commonly used contraceptives, such as birth control pills and the Plan B emergency contraceptive.

"An early draft of the regulation found its way into public circulation before it had reached my review," Leavitt said. "It contained words that lead some to conclude my intent is to deal with the subject of contraceptives, somehow defining them as abortion. Not true."

Leavitt's statement, however, failed to alleviate concerns among members of Congress, family planning advocates, women's health activists and others.

"It does not alleviate my concerns at all," said Jill Morrison of the National Women's Law Center, noting that a major section of the draft regulation titled "The Problem" cites state laws designed to make sure that women have access to birth control pills and Plan B. "I will wait to see if a 'clean' version of the rule is released for publication in the Federal Register, and then I will believe it."

The draft regulation would deny federal funding to any hospital, clinic, health plan or other entity that does not accommodate employees who want to opt out of participating in care that runs counter to their personal convictions.

The proposal has been welcomed by conservative groups, advocates for religious freedom and others. But the draft has triggered widespread concern that it would restrict access to contraceptives as well as inhibiting scientific research, perhaps permitting discrimination against gay men and lesbians, and even interfering with end-of-life care.

In his blog, Leavitt said the request for a possible regulation was prompted by concerns that health-care workers were being forced to perform services that they found objectionable.

"The Bush Administration has consistently supported the unborn. However, the issue I asked to be addressed in this regulation is not abortion or contraceptives, but the legal right medical practitioners have to practice according to their conscience and patients should be able to choose a doctor who has beliefs like his or hers."

According to the language in a draft of the regulation that leaked last month, the rule would apply to anyone who participates in "any activity with a logical connection to a procedure, health service or health service program, or research activity. . . . This includes referral, training and other arrangements of the procedure, health service, or research activity."

Kathryn Tucker, director of legal affairs for Compassion & Choices, which advocates for physician-assisted suicide, said she remains concerned that the regulation could apply to health-care workers who refuse to participate in a variety of end-of-life care, including the withdrawal of unwanted feeding tubes and ventilators.

One section of the draft regulation defines abortion as "any of the various procedures -- including the prescription, dispensing and administration of any drug or the performance of any procedure or any other action -- that results in the termination of life of a human being in utero between conception and natural birth, whether before or after implantation."

The Planned Parenthood Federation of America, NARAL Pro-Choice America and other groups said the draft regulation is so broad that they remain alarmed.

"Until the regulation removes the re-definition of abortion and it clearly states that it deals solely with abortion (and not with any other procedure, nor with any refusals based on the nature of the patient, such as single or gay), I would not be satisfied," R. Alta Charo, a lawyer and bioethicist at the University of Wisconsin wrote in an e-mail. "There is no reason to extend any benefit of the doubt to this administration when it comes to reproductive rights or the civil rights of gay people."

Sens. Hillary Rodham Clinton (D-N.Y.) and Patty Murray (D-Wash.) sent a letter to Leavitt yesterday requesting a meeting about the draft regulation. "We remain concerned by the regulations' potential to create barriers for women seeking health care, to jeopardize federal programs that provide family-planning services and to disrupt state laws securing women's access to birth control," they wrote.

Christina Pearson, an HHS spokeswoman, refused to elaborate on the statement. In his posting, Leavitt said the agency was "still contemplating if it will issue a regulation or not. If it does, it will be directly focused on the protection of practitioner practice."

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