With a new administration about to take office, the news that the Bush administration moved ahead with a dangerous and ideological federal regulation might seem like a non-issue. This rule change institutes a broad Health and Human Services refusal clause that allows HHS-funded doctors, health care workers and even volunteers to deny patients health care information and services based on their own personal beliefs rather than professional standards of care.
It is widely perceived as a change that targets access to safe and legal abortion when in fact it is so broad that it applies to any medication or procedure. This is why both the American Medical Association and the American Hospital Association strongly opposed this deceptive regulation. Considered a "midnight rule" by the outgoing Bush Administration, there is no quick fix for the incoming Obama administration. This rule change will be a challenge to overturn and it may take months - jeopardizing patient access to health care and services across the country.
In the meantime, this change allows any health care employee to refuse to treat or to refer any individual receiving any service. This refusal might include: patients seeking treatment for depression, HIV-infected individuals seeking anti-retroviral medications or men with erectile dysfunction seeking Viagra, etc. More realistically, women's health care will be the hardest hit: women denied access to contraceptives, sexual-assault victims denied emergency contraception that could prevent an unintended pregnancy, or women experiencing a miscarriage who are denied care in the emergency room. The impact of this regulation is almost unimaginable given its scope, but the bottom line is that it jeopardizes all health care services and the health of men, women, children and families.
Nothing in this regulation requires an employee to notify a supervisor or employer of his/her intent to refuse to provide a service, nor is there any provision to protect access for all patients, regardless of an objecting individual. A clear example would be access to emergency contraception for a rape victim. The same employee can indiscriminately base his/her objection on their understanding of the individual or the case rather than a personal objection to the therapy itself. In small towns - like those here in Montana - knowing the victim versus the assailant could mean the difference between receiving emergency care or not. The broad permissiveness under this new HHS regulation is unconscionable and an irrational response to accommodating true conscientious objections.
These scenarios may sound far-fetched, but keep in mind that there are currently pharmacists in Montana who refuse to fill birth control prescriptions based on their personal beliefs. In Broadus, for example, the only pharmacist in town will not dispense contraceptives, so women are forced to drive 80 miles to fill their prescriptions. That is precisely why this rule change is particularly onerous in a state like Montana, which covers a large geographic area and has a shortage of health care providers. If you are a patient who is denied access to a medical procedure or medication in an isolated, rural part of the state, you don't have many options.
Despite receiving more than 200,000 comments in opposition to this disastrous rule, including from the American Medical Association, the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, the Bush administration chose to issue the HHS regulation anyway.
At Planned Parenthood of Montana, our commitment to quality health care remains strong, and we will work to overturn this rule change and to expand - not limit - the right of all Montanans to have equal access to vital health care and information.
Stacy C. James of Billings is CEO for Planned Parenthood of Montana.