Laura Berman

Keep the choice in hands of patients

The latest salvo in the long-running abortion wars pits health care workers with strong religious and moral beliefs against women needing care.

In this new wrinkle, the "right-to-choose" is being applied by the Bush administration to the rights of nurses, doctors, even receptionists who are conscientious objectors to some procedures, from abortion to vasectomy, tubal ligation, and potentially some contraception methods.

In Michigan, this pitched battle has been going on for years. But last week, the federal Health and Human Services Department cut to the chase by proposing a new rule that will apply to virtually all health care entities -- from hospitals to medical schools to clinics.

Far-reaching implications

It's so broad that family planning groups, in particular, are concerned they'll be required to change hiring practices or lose government funding. Planned Parenthood of South and Mid-Michigan, for example, gets $3 million annually in federal and state funding.

"We're worried that a rape victim won't be told she can get emergency contraception because the attending nurse has a moral objection to that," says Lori Lamerand, the CEO of Planned Parenthood.

The 42-page rule will cost $45 million to implement, according to government documents, and require health care providers to certify they don't discriminate against employees whose religious or moral beliefs conflict with some procedures.

Even as it seemingly empowers doctors, nurses and others on the front line of health care, it also potentially creates a worrisome danger zone for all health care providers.

"It's throwing a monkey wrench into the works," says Donna Crane, the policy director for ProChoiceAmerica.

Both sides take issue

Even anti-abortion groups recognize the potential for problems. "We want individual conscience rights to be honored, but we're also concerned about the employers," says Ed Rivet, the legislative director for Right to Life of Michigan.

In Michigan, Rebekah Warren, D-Ann Arbor, is sponsoring a bill that would require rape victims to be told about emergency contraception. Rivet backs other legislation that, he says, creates a process for the employee to opt out.

The federal rule empowers personnel -- but doesn't clearly describe how far their moral imperative extends.

As an example, the regulation would protect an employee whose job is "cleaning instruments" from an objectionable procedure.

How would a hospital weed out a noninstrument cleaning assistant? Or the obstetrician who refuses to allow a woman with two children to opt for a tubal ligation after delivery?

When your moral conscience is deemed more important than my medical emergency, we are all in trouble.