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Caregiver opt-out rule may have wide impact

WASHINGTON — The Bush administration announced plans Thursday to implement a controversial regulation designed to protect doctors, nurses and other health care workers who object to abortion from being forced to deliver services that violate their personal beliefs.

The rule empowers federal health officials to pull funding from more than 584,000 hospitals, clinics, health plans, doctors' offices and other entities if they do not accommodate employees who refuse to participate in care they find objectionable on personal, moral or religious grounds.

"Health care workers should not be forced to provide services that violate their own conscience," Health and Human Services Secretary Mike Leavitt said.

The proposed regulation, which could go into effect after a 30-day comment period, was welcomed by conservative groups, abortion opponents and others as necessary to safeguard workers from being fired, disciplined or penalized in other ways.

Women's health advocates, family planning advocates, abortion rights activists and others condemned the regulation, saying it could create sweeping obstacles to a variety of health services, including abortion, family planning, end-of-life care and possibly a wide range of scientific research.

"It's breathtaking," said Robyn Shapiro, a bioethicist at the Medical College of Wisconsin. "The impact could be enormous."

The regulation drops the most controversial language in a draft version that would have explicitly defined an abortion for the first time in a federal law or regulation as anything that interfered with a fertilized egg after conception.

But both supporters and critics said the regulation remained broad enough to protect pharmacists, doctors, nurses and others from providing birth control pills, Plan B emergency contraception and other forms of contraception, and explicitly allows workers to withhold information about such services and refuse to refer patients elsewhere.

"The Bush administration's proposed regulation poses a serious threat to women's health care by limiting the rights of patients to receive complete and accurate health information and services," said Cecile Richards of the Planned Parenthood Federation of America. "Women's ability to manage their own health care is at risk of being compromised by politics and ideology."

Leavitt said he requested the new regulation after becoming alarmed by reports that health care workers were being pressured to perform duties they found repugnant.

He cited moves by two professional organizations for obstetricians and gynecologists that he said might require doctors who object to abortions to refer patients to other physicians who would perform them.

"People should not be forced to say or do things that they find morally wrong," Leavitt said.

A draft of the regulation that leaked in July triggered a flood of criticism from women's health activists, family planning advocates, members of Congress and others. Concern focused on fears the definition of abortion could be interpreted to include many forms of widely used contraception.

"Words in that draft led some to misconstrue the department's intent," Leavitt said Thursday.

Caregiver opt-out rule may have wide impact 08/21/08 [Last modified: Tuesday, November 2, 2010 1:37pm]

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