Bush-era ‘conscience’ rule gets another look


Taking another step into the abortion debate, the Obama administration today will move to rescind a controversial rule that allows healthcare workers to deny abortion counseling or other family planning services if doing so would violate their moral beliefs, according to administration officials.

The rollback of the so-called conscience rule comes just two months after the Bush administration announced it late last year in one of its final policy initiatives.

The new administration’s action seems certain to stoke ideological battles between supporters and opponents of abortion rights over the responsibilities of doctors, nurses and other medical workers to their patients.


Seven states, including California, Illinois and Connecticut, and two family-planning groups have filed lawsuits challenging the Bush rule. They argue that it sacrifices the health of patients to the religious beliefs of medical providers.

The American College of Obstetricians and Gynecologists has reported cases, such as that of a Virginia mother of two who became pregnant after she was denied emergency contraception. In Texas, according to the group, a rape victim had her prescription for emergency contraception rejected by a pharmacist.

Supporters of the rule say it protects doctors from being forced to prescribe treatments including birth control pills.

President Obama -- a longtime supporter of abortion rights -- has been expected to reverse a number of Bush-era policies restricting access to family planning services.

But the new president has also been sensitive to the explosiveness of the reproductive rights issue.

Last month without official ceremony, Obama overturned a controversial ban on U.S. funding for international aid groups that provide abortion services.


The move by the Department of Health and Human Services to throw out the conscience rule is being made equally quietly as most of Washington focuses on the president’s blockbuster budget plan.

On Thursday officials stressed that before the administration finalizes the rollback, a standard 30-day comment period seeks input from people across the ideological spectrum.

“We believe that this is a complex issue that requires a thoughtful process where all voices can be heard,” said one official, who was not authorized to speak on the record about the policy change.

The officials said the administration would consider drafting a new rule to clarify what healthcare workers could reasonably refuse to do for their patients.

For more than 30 years, federal law has allowed doctors and nurses to decline to provide abortion services as a matter of conscience, a protection that is not subject to rule making.

In promulgating the rule last year, then-Health and Human Services Secretary Mike Leavitt said it was necessary to address discrimination in the medical field.


Leavitt criticized “the development of an environment in the healthcare field that is intolerant of individual conscience, certain religious beliefs, ethnic and cultural traditions, and moral convictions.”

But critics complained the language of the rule is overly broad, covering any “activity related in any way to providing medicine, healthcare and other service relative to health and welfare.”

Obama officials said the administration’s goal is to make the rule clearer rather than force doctors to provide abortions.

“The Bush provider-refusal regulation has created confusion about the scope and original intent of the law,” one official said.

“It went into effect in the last days of the Bush administration, claiming to bring clarity to current law. But instead it created much confusion. . . .

“Not only does it potentially make it harder for women to get the care they need, but it is worded so vaguely, that some have argued it could limit counseling, family planning, even blood transfusions and end-of-life care.”


If after 30 days of comments the administration throws out the Bush rule, it would have to begin a new rule-making process to enact a replacement.