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Contraception

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Science vs. Philosophy

R(obin) Alta Charo has once again been given a platform in the New England Journal of Medicine.

Poor Robin. She conflates ethics and philosophy with science. Although observing what “is” can lead to insight about which actions and manipulation lead to harm and which improve individual and group well-being, Science cannot prove or disprove philosophy, or determine what we “ought” to do.

Ms. Charo continues her career-long advocacy for elective, interventional abortion and against the inalienable human right not to be killed – all in spite of her assertion that she has no conflicts of interest in this essay. By declaring that Trump Administration appointees “embrace alternative science,” Robin makes her own gross scientific error. In addition to confusing “science” and philosophy, she bases much of her objection on an emphasis on “established pregnancies” and ignores the existence of the human embryo after fertilization but before implantation.

The very odd complaint about definitions of gestational age assumes that time varies according to when we start counting days.

Some state legislatures have tried to redefine pregnancy dating, shifting from the standard measure of time since last menses to time since probable fertilization. Such a definition falsely enhances the viability statistics for lower gestational ages and helps to bolster arguments for 20-week limits on abortion rights.

Again: Science is about what 《is,》 while ethics ought to be, not about true  《oughts.》

Texas’ Women’s Health, UT Study: Other than that*, the story was true.

*The authors of a study published in the New England Journal of Medicine admit to a narrow focus that ignored the multiple methods of funding Family Planning in Texas,  looking instead at a single type of “provider” – Title X clinics like Planned Parenthood (“PP”) – and a single source of funding for a specific set of services: long-acting reversible contraceptives such as the IUD and implants and injectables.

Yet, in typical fashion, the reports about the study claim much more. For example, the Texas Tribune has an article out, “Texas disavows Controversial Women’s Health Study,”  about the political fallout due to the skewed conclusions of the authors and the even more skewed editorializing in the media.

While the NEJM article (free article!) states in the “Methods” section that,

“After the exclusion, the provision of injectable contraceptives fell sharply in counties with Planned Parenthood affiliates but not in counties without such affiliates; subsequently, the numbers of claims in both groups of counties remained relatively stable during the next 2 years. In contrast, the provision of short-acting hormonal methods changed little in the two groups of counties in the quarter after the exclusion and declined steadily thereafter.” (Emphasis mine. )

the Tribune article reports that in answer to criticism,

Joseph Potter, one of the UT researchers who co-authored the study, said in an email that the paper addressed the “specific question” of how the exclusion of Planned Parenthood from the Texas Women’s Health Program affected women. Nothing raised in Traylor’s letter, he said, contradicted the researchers’ conclusions.

“We made no claims about access to reproductive health care as a whole in Texas,” he said, and he stood by the finding that claims for long-acting contraceptives fell after Planned Parenthood was excluded from the women’s health program.

The law in question, SB7, was passed with bipartisan support in 2011, a year when Texas, along with State budgets all over the Nation were tight. Although family planning was cut, no specific vendor was “excluded” and PP was not even mentioned in the legislation. Only because PP did not offer continuing, comprehensive care, that business would effectively be cut out.

The Obama Administration took great offense at our State’s attempt to take care of the whole woman and refused all Family Planning Title X money for Texas Medicaid.

Instead, Obama intervened to specifically direct $13 Million of Title X funds to a private organization,the Women’s Health and Family Planning Association of Texas (“WHFP”) which funds only Title X clinics, almost all of which are now Planned Parenthood businesses), so no money was lost even at PP.

The State Health Services no longer managed those Medicaid matching dollars once allowed by a special Medicaid waiver. Instead, State funding for the Family Planning programs and the Texas Women’s Health Program, was replaced by State dollars and directed toward programs and doctors that offer continuing, comprehensive care, such as Federally Qualified Health Centers (FQHC), State, County and local clinics and hospitals, and fee for service doctors that participate with Medicaid. Women could be diagnosed and treated for a much broader spectrum of health problems and their families were welcome at the same clinics.

Senator Jane Nelson, Chair of the Senate Finance Committee and sponsor of the Bill, objects to the implication by the NEJM that the authors were writing on behalf of the State. In her letter to the Executive Commissioner of Texas’ Department of Health and Human Services, Chris Traynor, Senator Nelson noted,

“This study samples a narrow population within the Texas Women’s Health Program (TWHP) — which represented only 33 percent of the overall number of women enrolled in our women’s health programs in Fiscal Year (FY) 2014. This ignores hundreds of thousands of women being served through the Expanded Primary Health Care Program; the Family Planning Program; and the 628,000 women of child-bearing age receiving full Medicaid benefits, 75 percent of which received contraceptive services in FY 14. Women often rotate in and out of our state programs, so we must look across our entire system to determine whether we are truly meeting their needs. Just because a claim for service was not submitted to TWHP does not mean a woman went without that service.
The study also creates an impression that fewer Texas women are accessing long-acting reversible contraceptives (LARCs). That’s simply not true. Across our state programs, there were more claims for LARCs in FY 2014 than there were in FY 2012 when Planned Parenthood was still a provider.”

In other words, women with private insurance and women who never had access to PP had similar numbers.

And another thing: Potter, a sociologist at UTAustin and the co-author quoted above, was the one who told the LA Times that,  “It’s not like there is a large, over-capacity of highly qualified providers of effective contraception out there just waiting for people to show up.”

On behalf of Texas’ Family Physicians, OB/Gyns, Pediatricians and Internists who accept traditional Medicaid and who had been unable to access the money in those competitive Title X grants awarded to PP, I’d like to inform him that yes, we have been waiting – for a chance to offer our patients this care.

But other than that ….

I say “fertilization,” you say “conception”

Forty years ago the words “fertilization” and “conception” meant the same thing to doctors, lawyers, and embryologists alike: the joining of the 23 chromosomes in the sperm with the 23 chromosomes in the oocyte (“egg”) to form a new complete, unique human organism. “Contraception” was defined as any method that worked before the existence of the embryo by preventing fertilization. These were the hormonal treatments and devices that prevent ovulation of the egg and condoms, diaphragms and sterilization that serve as “barriers” between the sperm and egg.   Drugs and devices that may or may not end the life of the embryo after fertilization were legally and correctly called “abortifacients.”

 

However, legalized abortion and the ability to accomplish fertilization through in vitro methods led to new legal definitions of “pregnancy” and “conception” as beginning at implantation rather than fertilization.   Even in vivo, healthy human embryos in healthy mothers were deprived of legal protection as human beings for at least the first 5 – 10 days of their lives, the window of opportunity for implantation when the developing embryo grows to hundreds of cells organized in 2 or 3 recognizable tissue layers and interact with the mother’s body in ways that may affect the timing of birth or risk of diabetes and other health concerns. Possible abortifacients that work after fertilization but before implantation were redefined as “emergency contraception.”

 

In spite of what you may have heard on the news, the June 30, 2014 Burwell v. Hobby Lobby decision by the Supreme Court of the United States (SCOTUS) didn’t deny birth control for anyone. Everyone may still purchase his or her own FDA-approved birth control.  SCOTUS simply ruled that the government can’t force some employers to buy things that they believe are immoral.

 

In fact, Hobby Lobby only asked to be exempt from purchasing insurance plans that paid for specific drugs and devices used for “emergency contraception.” Before the passage of the Affordable Care Act (“ObamaCare” or ACA), the company purchased insurance that included true forms of contraception, including,

  • Those that prevent ovulation by preventing the normal ups and downs of the hormones estrogen and progesterone, such asBirth-control pills with estrogen and progestin (“Combined Pill”),Birth-control pills with progestin alone (“The Mini Pill”),Birth control pills (extended/continuous use), Contraceptive patches, Contraceptive rings,Progestin injections, andImplantable rods

and

  • Those that act as “barriers” to fertilization by preventing the union of sperm and egg: Male condoms, Female condoms, Diaphragms with spermicide, Sponges with spermicide, Cervical caps with spermicide, Spermicide alone, Vasectomies, Female sterilization surgeries, and Female sterilization implants.

The problem is that regulations written by the Obama Administration mandated that all insurances pay for all pregnancy “preventatives” approved by the FDA, including drugs and devices that may function after fertilization to end the life of the new human embryo:

  • Pills that mainly delay ovulation but may impair implantation and development of the placenta if fertilization takes place, such as over-the-counter Plan B and generic levonorgestrel tablets, and ella, which requires a prescription, and
  • Devices that mechanically and hormonally make the uterus inhospitable to implantation by the embryo, such as intrauterine devices like the copper-T, Mirena, and ParaGuard. These are inserted up to 5 days after unprotected intercourse to prevent implantation and then left in place to prevent fertilization and implantation for as long as 5-10 years.

 

 

Although the words we use do not change the fact that the human embryo is the same human life before implantation as after, they can change his or her legal status.

 

 

 

 

 

Wider impact of Hobby Lobby ruling? : SCOTUSblog

Remember, no one is forbidden to buy anything.  However, the US Government will not force people or their companies to pay for devices and drugs they believe are immoral.

 

The Affordable Care Act regulations issued by the federal government, however, required twenty different preventive methods or services, including sterilization and pregnancy counseling. Depending upon how lower courts now interpret the Hobby Lobby decision, companies that fit within the Court’s “closely held company” bracket and offer religious objections could be spared from having to provide any of those services through their employee health plans.

In three cases in which a federal appeals court had rejected the challenges to the mandate, the new Supreme Court orders told those courts to reconsider, applying Monday’s decision. The companies or their owners had taken those petitions to the Court.

On three petitions filed by the federal government, involving appeals court rulings rejecting the challenges by corporations. their owners, or both, the Justices simply denied review.

via Wider impact of Hobby Lobby ruling? : SCOTUSblog.

More on docs and conscience

Just after posting the article about Great Britain’s new official exclusion of pro-life doctors, I received an email from AAPLOG, the American Association of Pro-life OB/Gyns, referring to this article:

http://www.sciencedirect.com/science/article/pii/S2213560X14000034

“In medicine, the vast majority of conscientious objection (CO) is exercised within the reproductive healthcare field – particularly for abortion and contraception. Current laws and practices in various countries around CO in reproductive healthcare show that it is unworkable and frequently abused, with harmful impacts on women’s healthcare and rights. CO in medicine is supposedly analogous to CO in the military, but in fact the two have little in common.

This paper argues that CO in reproductive health is not actually Conscientious Objection, but Dishonourable Disobedience (DD) to laws and ethical codes.”

Read the rest for more about the “dishonorable doctors” who follow their consciences and well over 2000 years of “First, do no harm.”

Edited: BBN  to add corrected url,

UK: Doctors with consciences not welcome

The Royal College of Obstetricians and Gynecologists in Great Britain have determined that any nurses or doctors who oppose any form of contraception may not complete training and will not receive certification in the specialty:

Doctors who oppose morning-after pill on conscience grounds face qualifications bar

Guidelines confirm that doctors and nurses who oppose controversial emergency contraception on ‘moral or religious’ grounds cannot receive key specialist qualifications

This is very possible in the US. Take a look here at some fairly recent history of attempts to keep docs from practicing with a conscience.

American Academy of Family Physicians resignation

AAFPI wrote a very difficult letter today. I  resigned from the organization that is supposed to support Family Physicians in our education, practice management and good medical care of our patients. Instead, the American  Academy of Family Physicians too often strays toward forcing its members to be complicit with controversial policies such as condoning gun control and over-the-counter contraceptive drugs, and condemnation of “reparative therapy” for homosexual patients, even when those patients are unhappy with their sexuality. I write about my main conflicts and the “final straw” in the letter:

 

It is with great regret that I write this letter as notice that I have decided not to renew either my Texas or American Academy of Family Practice membership. While I am still a family doctor, neither the Texas Academy of Family Practice (TAFP) nor the American Academy of Family Practice (AAFP) represent my political or ethical views.

The political, social and ethical controversies were the main reason I remained in the Academy for the last few years since I left full time practice. I hoped that I could make a difference by volunteering my time and money as an active participant in the Texas Academy, the National Conference of Special Constituencies, the AAFP list serves, the Academy Legislative meetings in DC and our annual AAFP Congress of Delegates.

From the time of Hillary Clinton’s closed meetings on healthcare to the endorsement of the passage of the ACA before it was written, the political actions of the AAFP leaders has disappointed me in Washington, DC. Our practice hassle factors have grown and grown, too often with the blessings of – and sometimes due to the experiments with alternative methods of practice by – the Academy.

The AAFP advocated for elective abortion before I joined as a Student member and I accepted that the burden of persuasion was on those of us who disagreed.

However, the Academy’s decision to advocate for the redefinition of marriage in 2012 and the refusal to reconsider the extracted Resolution on marriage neutrality at the 2013 Congress of Delegates in San Diego were the final proof that there’s no tolerance for family doctors who hold conservative politics or traditional ethics in the Academy.

Unfortunately, our TAFP spokesperson to the 2013 AAFP Reference Committee on Advocacy misrepresented the Texas Delegation’s instructions from the Directors on marriage. As I remember the discussion and vote, the intention was to allow the Texas delegates wide latitude in voting on any final form of the Resolution.

I hereby resign from the Texas Academy of Family Physicians, the American Academy of Family Physicians and as a Fellow of the AAFP.

 

I waited to resign after nearly 30-year membership until the last minute before being dropped (for lack of paying my annual dues). There were several reasons for my hesitancy. For one thing, I didn’t want to be an undue influence on other members when they considered whether or not to write that hefty annual check to the Academy. For another, while I will continue to work with the AAFP and the Christian Medical and Dental Association to protect the right to life, marriage, the conscience rights of doctors within the profession of medicine and the specialty of Family Medicine, I do believe that it is important to work to persuade from within the organization. The biggest problem with finally writing the letter was that I was looking for a way to somehow keep my integrity while allowing the Academy to claim to represent me.

However, now that I’ve resigned, please consider sharing my letter with your family doctor. Many of them are unaware of the policies that our professional organizations push on good doctors of today and the students and residents who will be our doctors of tomorrow.

Texas Tribune interview with abortion-seeking couple

First, I hope and (am praying) Marni begins to love her child and allows her to live.

The Texas Tribune has published an interview with a couple whose baby’s life has been spared – at least for a few days – by Texas law.

Here’s the interview:

However, she found 2 alternatives within 2 days, so her rights are not at all infringed upon.

Marni is mistaken about the number of abortions in Texas every year. There were 66,000, not 80,000 abortions in 2012. 72,000 in 2011, 77,500 in 2010, 77,850 in 2009.

 

Marni specifically asks what sorts of “resources” the State and pro-life people have made available. She should have already known – and should ask their abortionist at her next appointment – about the Texas Woman’s Right to Know “Resource Directory.” She should have been given a copy at her first abortion consult appointment with Planned Parenthood. It’s also available online here.,  The file in pdf includes the information she asked about. The booklet lists agencies and assistance that’s available  from the State, County, and private organizations for pregnant women  in Travis County.

 

I’m not surprised that their comments are so political, and that John talks about politicians “shoring up their base,” etc., since that’s a common talking point for abortion advocates when they talk about pro-life politicians. I’m sure that someone at Planned Parenthood fed them the inaccurate statistics and coached them on the motives of people like me and the legislators who worked to protect life.

 

(I do have to wonder how Marni and John missed all the press leading up to the passage of HB2. You would think they’d have heard about Wendy Davis’ filibuster at least!)

 

Hopefully, when they see the way they’ve been misled about statistics, they will begin to understand that the prolife activists and politicians are as honest as we can be about our motives.

 

 

#Stand4Life Victories: Texas’ law upheld, ObamaCare contraception mandate struck

Victory on two levels! Many of Texas’ abortion facilities are closed today because they don’t have doctors with hospital privileges and today, the DC Court of Appeals ruled in favor of religious conscience rights, even for people who own businesses!

From The Hill, a blog out of Washington, DC:

A federal appeals court on Friday struck down the birth control mandate in ObamaCare, concluding the requirement trammels religious freedom.

The D.C. Circuit Court of Appeals — the second most influential bench in the land behind the Supreme Court — ruled 2-1 in favor of business owners who are fighting the requirement that they provide their employees with health insurance that covers birth control.

Requiring companies to cover their employees’ contraception, the court ruled, is unduly burdensome for business owners who oppose birth control on religious grounds, even if they are not purchasing the contraception directly.

“The burden on religious exercise does not occur at the point of contraceptive purchase; instead, it occurs when a company’s owners fill the basket of goods and services that constitute a healthcare plan,” Judge Janice Rogers Brown wrote on behalf of the court.

via Court strikes down mandate for birth control in ObamaCare | TheHill.

Senate Dems Sauntering Toward #HarryReidsShutdown #DCtime

Harry Reid is sauntering toward a Federal gov’t shutdown at midnight, tonight.

Even though the House passed a compromise Continuing Resolution (no longer defunding Obamacare, simply delaying it) just after midnight yesterday (Sunday) morning, Harry refused to allow the Senate to gather until 2PM, DC time, today (Monday).

Then, he made his motion to table the House CR. The motion passed along strict Party lines, 54-36. Then . . . might as well wait for it . . .  he announced “debate” until 4PM, DC time.

Compromise or computers: ObamaCare delay inevitable

 “But in some situations, you may see a redefinition of what ‘start’ means.” (Wall Street Journal quoting Obamacare consultant.)

President Obama and Democrats everywhere should be grateful to the Republicans for saving them from a huge embarrassment. Instead, the Dems continue to dig in, escalating their claims to have won a mandate on ObamaCare in 2012, in spite of the fact that the Republicans won enough seats in the House of Representatives to secure a strong majority.

House Republicans passed a new Continuing Resolution that compromises on Obamacare, by changing from refusing funding altogether to setting up a one year delay. Included in the Bill is a measure that would ensure that our military is paid in the event of a shutdown. The Bill also repeals the 2.3% tax on medical devices and the mandate that business owners with religious objections buy insurance that includes controversial “free” contraception.

The Wall Street Journal, in addition to reporting the redefinition of “start,” outlines the many ways that the Federal and State exchanges are not ready to launch Obamacare on October 1:

In the District [of Columbia], people who use the online marketplace will not immediately learn if they are eligible for Medicaid or for subsidies.

In Oregon, people will not initially be able to enroll in an insurance plan on the Web site.

In Vermont, the marketplace will not be ready to accept online premium payments until November.

In California, it could take a month for an insurer to receive the application of someone who applies for coverage on the exchange on Oct. 1.

. . . But as the launch nears, more delays are occurring. On Thursday, the administration announced a delay in the online shopping system for small businesses and confirmed that the Spanish-language site for signing up for coverage will be delayed until mid-October. Earlier in the week, officials said Medicaid applications will not be electronically transferred from the federally run exchange to states until November.

Freedom2Care: Now Secretary of Health and Human Services Kathleen Sebelius is not radical enough to work at Rite Aid

Conscience? More “Trust me, I’ll violate my conscience” news:

Tolerance. Diversity. Broad-mindedness. Those are the words.

Bullying. Discriminating. Compelling. Those are the deeds.

The contradictory words and deeds often come from one and the same individuals–and in a case I learned about today, companies. Turns out the words of tolerance, diversity and broad-mindedness only apply to those who comply with the dogma and submit to the will of the speakers.

Here’s an email I received this morning from a pharmacist member of the Christian Medical Association:

“Subject: Forced to resign over mandate to sell the morning after pill.

“Just to let you know that Rite-Aid corporation came out with a stricter policy on July 5, 2013 that requires all employees to accommodate the sale of the morning-after pill to all comers, of either gender and of any age.”

Read more via Freedom2Care: Now Secretary of Health and Human Services Kathleen Sebelius is not radical enough to work at Rite Aid.

While I don’t believe that Plan B is an abortifacient, I do believe it’s a powerful drug and that adolescents shouldn’t be able to buy it over the counter. I also find it hard to trust someone who will agree to go against their conscience!

Texas Still Fighting Funding to Planned Parenthood!

In spite of repetitive fraud, in spite of Texas’ laws prohibiting sending money to affiliates of abortionists, in spite of all our work.

Planned Parenthood clinics could be facing a legal fight that could keep them from receiving funding for impoverished Medicaid patients.

When the state passed the Women’s Health Program in 2005, legislators said the intent was to provide more family planning services, but not abortions, to low-income Medicaid patients.

State Sen. Bob Deuell said due to a loophole in the law, Planned Parenthood is part of the program, but thinks they shouldn’t be. As such, he has requested the attorney general clear up the matter.

*****

While Sen. Deuell admits he isn’t in favor of Planned Parenthood, he said his “goal is to provide comprehensive care and — abortion issue aside — the Planned Parenthood clinics don’t provide comprehensive care.”

It could take Attorney General Greg Abbott months to give his opinion.

In a brief HHSC officials sent to Abbott, they told him if the agency limits providers based on the way the law currently reads, the state risks violating Medicaid rules. State health officials said that could result in a loss of federal funding for the program.

via AG to rule on Planned Parenthood funding question – YNN – Your News Now.

Texas Planned Parenthood pays $4.3M (but media attacks Greg Abbott)

The $1.4 Million previously reported was the part that Texas will receive, not the total. Can you guess how the (very few) media reports (if you can find them) are playing the story?

From the July 30, Houston Chronicle:

Planned Parenthood Gulf Coast Tuesday settled a whistle-blower lawsuit that alleged the Houston nonprofit engaged in fraudulent Medicaid billing for $4.3 million – nearly $3 million more than was announced last week by Texas Attorney General Greg Abbott.

Yes, Planned Parenthood is quoted as claiming that the settlement for the AG’s finding that they are guilty of over $30M in fraud is “baseless” and simply a way to end harassment and to avoid turning over the (altered) medical records of patients. But the spin on the story is that Texas’ Attorney General, Greg Abbott, didn’t report the total and sent out his announcement before the settlement was signed by all parties.

My news search yields some op-eds and stories by Texas’ newspapers and a few more on pro-life sites.

Stories about PP closures and what to do if you need a doctor

What is PP doing with the $13 Million grant that the Obama Administration awarded them? Last March, the spokeswoman for the Women’s Health and Family Planning Association of Texas was crowing about the future use of the funds.

One thing it’s not doing is funding services in Bryan/College Station, Huntsville, and Lufkin, Texas.

In the meantime, everyone who is worried about low cost or free birth control and family planning should check into the Texas Women’s Health Program. For the most accurate and largest number of TWHP qualified doctors and clinics in your area, Texas’ Department of Health and Human Services has a search engine available here. More information, here. Use the “Advanced Search,” then choose Plan type:”Traditional Medicaid,” Provider type: “Specialist” (although this will actually bring up family physicians and other primary care docs). If you qualified at PP, you should qualify under this program, even if you don’t qualify for Medicaid. These docs give a 6 month or 12 month prescription, and the State will pay for screening, family planning.

“Planned Parenthood web ad blurs distinctions” (DMN Fact Check)

So, after telling us all these years that they don’t spend money from tax funds for their abortion business, Planned Parenthood is now saying that their facilities are often in the same buildings as the “separate” affiliates that don’t do abortions and that meeting the standards of an ambulatory care center will shut down both businesses.

Planned Parenthood operates 10 abortion clinics in the state that would be mandated to raise to the new standards. The abortion clinics, by law, are separate entities and must be separately funded from health centers where cancer screenings take place.

Planned Parenthood officials acknowledged that, but said some abortion clinics and health centers are housed within the same buildings. She suggested that if it were too expensive to upgrade the abortion clinics, then it could also force a shut-down of the health care clinics in the same building.

Officials could not say how many of the 10 abortion clinics are adjacent or within the same building as health care centers.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund, responded by email and cited 55 health care centers already have been shuttered in Texas.

That assertion is based on legislative funding cuts from two years ago and is not related to the pending legislation.

And the previously closed health centers are not related to the assertion made in the advertisement.

Health centers that do not provide abortions would not be affected by the legislation.

via Fact check: Planned Parenthood web ad blurs distinctions | Trail Blazers Blog.

“No Cost” Contraception (Obama Administration fantasy)

The Obama Administration has published its final rule on health insurance coverage of contraception. “Religious employers” are supposed to be happy with the Obama decree that insurance companies will provide contraception “at no cost.”

We all know that there’s no such thing as “no cost.” Everyone will “share” the cost, since everyone will be forced to buy health insurance.

Here’s the letter, thanks to one of the Conscience groups I follow:

From:   Lauren Aronson
             Director, Office of Legislation
             Centers for Medicare & Medicaid Services
 
Re:       Administration Issues Final Rules on Contraception Coverage and Religious Organizations
 
Today, the Obama administration issued final rules that balance the goal of providing women with coverage for recommended preventive care – including contraceptive services prescribed by a health care provider – with no cost-sharing, with the goal of respecting the concerns of non-profit religious organizations that object to contraceptive coverage.  The final rules reflect public feedback received in response to the Notice of Proposed Rulemaking issued in February 2013. 
 
Today’s final rules finalize the proposed simpler definition of “religious employer” for purposes of the exemption from the contraceptive coverage requirement in response to concerns raised by some religious organizations.  These employers, primarily houses of worship, may exclude contraceptive coverage from their health plans for their employees and their dependents. 
 
The final rules also lay out the accommodation for other non-profit religious organizations – such as non-profit religious hospitals and institutions of higher education – that object to contraceptive coverage.   Under the accommodation these organizations will not have to contract, arrange, pay for or refer contraceptive coverage to which they object on religious grounds, but such coverage is separately provided to women enrolled in their health plans at no cost.  The approach taken in the final rules is similar to, but simpler than, that taken in the proposed rules, and responds to comments made by many stakeholders.
 
With respect to an insured health plan, including a student health plan, the non-profit religious organization provides notice to its insurer that it objects to contraception coverage.  The insurer then notifies enrollees in the health plan that it is providing them separate no-cost payments for contraceptive services for them for as long as they remain enrolled in the health plan. 
 
Similarly, with respect to self-insured health plans, the non-profit religious organization provides notice to its third party administrator that objects to contraception coverage.  The third party administrator then notifies enrollees in the health plans that it is providing or arranging separate no-cost payments for contraceptive services for them for as long as they remain enrolled in the health plan.  The final rules provide more details on the accommodation for both insurers and third party administrators.

 
To view the Final Rule: http://www.ofr.gov/OFRUpload/OFRData/2013-15866_PI.pdf
 
To view technical guidance on the temporary enforcement safe harbor visit: http://cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/preventive-services-guidance-6-28-2013.pdf
 
To view the self-certification form for eligible organizations visit: http://cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/index.html#Prevention
 
If you have any questions, please contact the CMS Office of Legislation. Thank you

American Academy of Family Practice quotes me on Plan B without restrictions

plan b packShould all girls “of child bearing age” be able to walk into the corner pharmacy and buy Plan B without ID, age restrictions or parental supervision? I don’t think so!

However, my professional organization, the American Academy of Family Practice, issued a statement this week advocating for just that. Our online newsletter included my comments in an article published today:

On the other hand, family physician Beverly Nuckols, M.D., of New Braunfels, Texas, said she has issues with the Academy statement because it is inconsistent with its own Family Medicine, Scope and Philosophical Statement.

“Family physicians not only treat the patient within the context of her family, we also strive to treat the whole patient — ‘biological, behavioral (and) social,'” Nuckols said. “In this case, the ‘disease’ we are trying to prevent is the high-risk behavior of unprotected sex. Parental involvement is vital to the health of children and is the best prevention for high-risk behavior, including adolescent sexual activity.

“The AAFP normally and correctly advocates parental involvement and intervention to prevent other high-risk activity, such as driving without a license, the use of guns without adult supervision, smoking, or overeating, etc.,” she said. “What is the rationale for treating adolescent sexual activity any differently than we would treat other risky behavior or preventable risk factor?”

Nuckols, who serves as chair of the Christian Medical & Dental Association’s Family Medicine Section, said she also has concerns about OTC Plan B One-Step because there are few controlled, randomized studies that prove levonorgestrel to be medically safe and effective for adolescents at the dosage given.

“The published data on emergency contraception don’t break out the numbers of adolescent girls, but the numbers appear to be low,” she said. “The closest I’ve found are small studies for treatment of menstrual disorders and inherited bleeding disorders by chronic use of oral or intrauterine levonorgestrel, with the youngest age at 14.”

via AAFP Disagrees With Justice Department Blockade of OTC Access to Plan B One-Step — AAFP News Now — AAFP.

(BTW, The author quoted my written statement, exactly, so any errors are mine.  I goofed in identifying myself to the author: Much to my relief, our CMDA Family Medicine Section elected a new Chair and I’m now the Past-Chair. I didn’t realize we had passed the turn-over date. Oh, and “data” really is plural, so “data … don’t” is not terrible grammar, just awkward.)

Plan B, Minors, and the Obama FDA Appeal

Just after I hit “publish” on yesterday’s effort to explain the mechanism of Plan B and why we still shouldn’t allow minor girls to buy it over the counter, I found the news that the Obama Administration has decided that the FDA will appeal the ruling by a New York Federal Judge Edward Korman that gave the FDA 30 days to remove all age restrictions on Plan B, the “morning after pill.” This will not change this week’s decision to move the age requirement down to 15 years of age, it is a good, if minor, move.

USA Today has an article that’s typical for those who object to the appeal, written by Cecile Richards, the former National president of Planned Parenthood (and the daughter of the late Texas Governor Ann Richards).

The comments on CBS News’ coverage of the appeal point out one big problem that teens who have unplanned sex may also have: the “emergency” aspect of “emergency contraception.” One person suggests that Plan B should be available in vending machines and restrooms, as condoms often are. Several readers are concerned that teens who have unprotected sex plan won’t ahead or be able to find a pharmacy open when they need it..

Obviously, the writer of that comment doesn’t understand that the pill can be useful up to 5 days — and is still very effective (if it’s going to be) for at least a day or two. As I responded, there is a difference between a condom and Plan B: the latter is ingested and will have an effect, however small, on the hormonal balance of whoever takes it. Condoms don’t make people nauseous or throw up!

Plan B appeal angers W.H. allies – Kathryn Smith – POLITICO.com

I didn’t expect this!

President Barack Obama’s administration on Wednesday angered allies in women’s groups by appealing a judge’s ruling that the morning-after pill must be available over the counter to girls of all ages.

The administration has argued that the pill should not be readily available to young teens, so the appeal is consistent with that position.

via Plan B appeal angers W.H. allies – Kathryn Smith – POLITICO.com.

Plan B and Minors (Updated!)

Update 5/02/13: The Obama Administration has decided to appeal the judge’s ruling that the age restrictions must be removed completely from Plan B sales.

Because of a ruling by a Court in New York on April 5, 2013 and the April 30, 2013 announcement that the Obama Administration has published its intent to allow 15 year olds to buy Plan B over the counter without a prescription or adult supervision, the news is full of the controversy about whether or not Plan B is an abortifacient because it kills the embryo or blocks implantation.

(How about that: she’s old enough to buy over the counter emergency contraception, but she’s still young enough for her parents to buy her insurance until she’s 26!)

There is quite a lot of evidence that Plan B does not interfere with the embryo if fertilization occurs and none that it does. If, as the evidence supports,  it doesn’t cause the death of the human embryo, before or after implantation, Plan B is not an “abortion pill.”

But it still shouldn’t be sold over the counter to minors.

I don’t know anyone who thinks it’s healthy for 12, 14 or 15 years olds to have sex – whether boys or girls. While Texas does have the “Romeo and Juliet” defense ( when there’s no force, both are over 14 years old, opposite sex and within 3 years of the same age), 15 year olds can’t legally consent to sex. Texas law deems it a “crime of indecency” to have sex with a minor under 17.  Our State has also decided that 15 year olds can’t drink alcohol, can’t buy tobacco or Sudafed, and they usually can’t get a driver’s license.

We do this to protect them, because we know that they are not prepared to make good decisions. Their brains are not mature enough and they don’t have the experience and knowledge to adequately judge the difference between immediate gratification and future benefit. The fact is that most parents are their children’s best protectors and advocates. We are legally responsible for our children, but we are also morally responsible for them. We love them and don’t want them to hurt!

Parents need – and have the right – to know what our dependent children are doing and what medicines they are taking. By changing these regulations, the Federal government is moving between the parent and child — a much more sacred relationship than “a woman and her doctor.”

There is very strong evidence from good scientific experiments published in the last 10 years that Plan B does not interfere with the implantation or development of an embryo.

Plan B only works, when it works, by preventing fertilization for 4-5 days in the middle of the month – before ovulation – it delays ovulation so there is no egg to fertilize and by preventing the sperm from getting to the egg.

Plan B is a high dose of progesterone, the main hormone produced by the ovaries during the second half of a woman’s monthly cycle. Before ovulation, Progesterone or Plan B delays ovulation (the release of the egg from the ovary) and makes it difficult for the sperm to get to the egg.  At or after ovulation,   progesterone appears to slow the sperm’s travel to the egg (prevents fertilization) In nature, this prevents fertilization of an old egg – and its effect is one of the signs used by women who use “Natural Family Planning.”   Progesterone normally encourages the development of the lining of the womb after ovulation. In fact, doctors sometimes give Progesterone to women who have repeated miscarriages.

 It wouldn’t be ethical to conduct experiments on women who are ovulating and having sex, because those women might be carrying a human embryo that hasn’t implanted or who could be harmed. While it is true that there have been no experiments on women who might be pregnant, there are good studies which were done on ovulating women who have their tubes tied or who agree to abstain from sex during the experiment. Then, they were studied by checking repeat exams, blood work, ultrasounds and biopsies of the womb.  No evidence that Plan B interferes with implantation or damages the embryo has been found.

Current evidence is that Plan B decreases the risk of pregnancy for those women who take it properly, Plan B cuts the risk of pregnancy by 50- 70%. At the population level, it does not decrease either the pregnancy rate or the abortion rate. In fact, even women who have the pills in their medicine cabinet – who don’t have to pay $45 when they have unprotected sex – don’t use the pills consistently. This is true in countries like Scotland, the UK and Jamaica where teen girls can obtain the medication without a prescription or are provided the medication in advance of need.

I am a pro-life doctor who, like Texas law, believes that the individual begins at fertilization. I spend much of my time advocating for laws that protect the human right not to be killed and for traditional medical ethics. Yes, I am a Christian , but I prefer to make my arguments from the science side because I’m convinced that science will prove me right in the long run. After all, the “Nature’s Creator “ cited in the Declaration of Independence created science!

For the science, see these articles:

Added 8:00 PM 5/2/13 One of the best and oldest. I can email a copy of the entire article to anyone who needs it http://www.contraceptionjournal.org/article/S0010-7824%2805%2900045-4/abstract

This is Leticia Van De Putte, the pro-abort racist

Lest we forget, as Senator Zaffirini reminded us this afternoon, Leticia Van de Putte is a rabid advocate for Planned Parenthood. And, here’s who she was in 2003, when she ran away with the other Democrats to thwart the will of the voters of Texas on redistricting. (Edit –  She’s the one who suggested to the 82nd Legislature that traditional marriage would be strengthened if the State passed a law requiring all marriages to include “some sex.” — clarified for context. BBN)

Here’s the story I wrote in 2003, published online at the time by the Washington Dispatch and on FreeRepublic.com

Racism in Texas Politics? Exclusive commentary by Beverly Nuckols

Aug 7, 2003

From the Op-Ed pages of the Houston Chronicle on August 6, 2003:

To paraphrase one of the greatest civil rights activists of the 20th century, “We are sick and tired of being sick and tired.” Fannie Lou Hamer uttered these infamous words during her crusade in the 1960s and 1970s to encourage political participation and the right to vote by African-Americans, Hispanics and other minorities.

“We and our fellow senators are in Albuquerque, N.M., because the same important issue faces the citizens and state of Texas.”

These words were written by three Houston Democrats: State Senators Rodney Ellis, Mario Gallegos and John Whitmire. They are members of a mixed-race, single-party gang of eleven Texas State Senators who fled across the border to Albuquerque, New Mexico in order to shut down the legislative process of Texas by denying the State Senate a quorum. The group, alternately called the “Killer D’s,” “Chicken D’s,”or “AlbuTurkeys”, panicked Monday afternoon, July 28th, and left the Austin Capitol Building to board two private jets provided by wealthy Texas businessmen, David Rogers, whose family owns the First National Bank of Edinburg, and Greg LaMantia, a partner in L&F Distributors for Anheuser-Busch in McAllen. They have set up camp in $150 to $200 per day rooms and suites at the Marriott Pyramid. The Chair of the 2004 Democratic Convention, who just happens to be New Mexico’s Governor Bill Richardson, immediately sent State Troopers to provide round-the-clock protection so that the Senators would be safe to make statements such as this to the media. Virtually every news article printed, and most of the television or radio reports, about the attempted-coup-by-flying-the-coop quote the flock of eleven about the races of the voters in Texas, but never a word is said about the racial diversity of their own group, much less about the divisive nature of their comments.

Senator Leticia Van de Putte, who is the current Senate Democratic Caucus, former Chair of the Texas Senate Hispanic Caucus and the apparent gang leader of the runaways, engaged in similar rhetoric when I met with her at her hotel hideout on Sunday, August 3. (I drove and stayed in a much cheaper room in the same hotel.) Senator Van de Putte admitted that her constituency in the Bexar County area will not be touched by any of the proposed redistricting maps, because the Hispanic population is protected under Civil Rights laws and locked in by court rulings. However, the Senator with the Dutch surname repeatedly talked about her interests as “Hispanic” “Latino” and “minority,” while using the term, “Anglo” to represent those who oppose her and/or any group of people that she believed I would support. The Senator didn’t know that her use of the word “Anglo” would offend me, because of her own bias. She also doesn’t know how proud I am of my Cherokee ancestry, which gave me a great ability to tan instead of sunburn, and which made my eyes as dark as hers. And she evidently prefers to ignore the fact that 44% of Hispanic voters voted for the brown-eyed Republican Governor Rick Perry in 2002.

And then later, The Fort Worth Star-Telegram contains this little tidbit:

Sen. Rodney Ellis, D-Houston, recalled that in 1993, Senate Democrats were pushing a resolution to have state judges elected from Texas House districts rather than running in countywide elections. At the time, the House had a solid Democratic majority while Republicans were winning countywide elections in many urban areas.

When the resolution came up for a vote in the Senate, most of the Republicans had left the floor, which left the body short of the 21 members it needed for a quorum.

“They didn’t leave the state; they just left the Senate,” Ellis recalled. “But they did succeed in shutting the place down, even if it was just for a day. I remember somebody asking me if it was like the Killer Bees (the nickname for the Senate Democrats who fled for four days in 1979), and I said it was more like the Killer WASPs.” (emphasis mine)

As a citizen of the State of Texas and an American, I am sick and tired of the racist comments and views of the eleven Democrat rogues who have run away to New Mexico in an act of extortion against the Governor and Lieutenant Governor who are only responding to the will of the voting majority. These cowardly partisans seem determined to divide the State along racial lines and blur their own political agenda. They have waged a campaign in the media to deliberately imply that the State’s redistricting effort is an attempt to take the votes from certain racial groups. In fact, the actions of the Democrats – now and in May when 51 Democrats hired buses to take them to Ardmore, Oklahoma – steal the power of the votes of the majority of Texans: those who voted for the Legislators who did show up for work when they were supposed to.

Beverly B. Nuckols, MD is a pro-life pro-human rights Family Practitioner from New Braunfels, Texas. Beverly can be contacted by writing to feedback@washingtondispatch.com

Texas Medical Association wants you to pay for elective abortions @texmed @texasallianceforlife #pro-life #tcot

Not all of the members of Texas Medical Association agree with the TMA on this.

The San Antonio Express News published an editorial August 9th, by O. Ricardo Pimentel, entitled, “Texas tries to get between you, your doctor:”

For them, the issue isn’t abortion; it’s about the doctor-patient relationship, patient health and the ability to put everything on the table that needs to be discussed. Even if it’s abortion.

In a recent letter to the state, the Texas Medical Association, joined by other medical groups, said Texas is about to embark on a plan for providing medical care to low-income women that will impose a “gag order” on discussing abortion even on doctors working with patients not in the program.

Other groups, weighing in during the public comment period on proposed state rules, have similar concerns.

It’s a plan, they say, that will ensure not enough doctors for this program willing to provide care, including family planning services. And this, they say, will guarantee more unintended pregnancies, more abortions and more illness that might have been prevented for low-income women.

Among those also commenting on the rules were the Center for Public Policy Priorities, and leaders of Planned Parenthood entities in the state, South Texas groups among them.

Trust me, for everyone who is mentioned above, it’s about abortion. The law doesn’t stop anyone from discussing or even promoting true contraception that doesn’t end the life of our youngest children of tomorrow.

And it is about “elective abortions:” those that are performed on health babies in healthy mothers. We’re not talking about the more controversial abortions in cases of rape and incest, much less in the cases of congenital disorders that are “not compatible with life outside the womb and certainly not in cases where the mother’s life is in danger. Since when do elective abortions “need to be discussed?

How difficult is it to understand that Texas taxpayers should not pay for “promotion” of abortion? Or that we most certainly do not want our State tax funds to go to doctors who perform elective abortions on healthy babies and healthy mothers?

While I don’t speak for the Society, I am an elected delegate for my County Medical Society to the TMA House of Delegates and I believe that most of our members would agree with me on this. I am very much in favor of restricting payment from our limited State funds to only those doctors and organizations that provide comprehensive and continuing medical care for the whole woman and her whole family. With Texas Family Doctors, Internal Medicine Docs, Pediatricians and OB/Gyns reeling from the lack of increasing fees from Medicare and decreases in Medicaid funding, why not help keep them in business by adding the availability of billing the State for screening tests like pap smears, exams for breast masses, diabetes and high blood pressure?

In fact, that’s what the Legislature decided: that money would be prioritized. First come the comprehensive care docs, hospitals, and county and city clinics. Planned Parenthood is never mentioned, although there is a section of the law that absolutely prohibits the State from contracting with anyone who “promotes” abortion *if there are other qualified providers available.*

Texas DHS has already identified more than enough doctors and clinics that qualify under the law. These doctors can actually treat the diseases for which the Texas Women’s Health Plan screens. Our Texas Legislature made a wise decision when they agreed that it doesn’t make sense to send our few dollars to a clinic that treats a very narrow medical spectrum in an intermittent manner.

And the law has already saved human lives: Austin city and Travis County taxes once paid for 400 elective abortions each year. A year ago, the law achieved what the taxpayers who protested this use of their money couldn’t do: Austin and Travis County health clinics were forced to stop funding those abortions.
If you have a family doctor, consider a polite call to his or her front desk asking them to let the TMA know their views on using Texas’ tax funds to support Planned Parenthood and other abortion providers.

You might also consider contacting Texas Alliance for Life and/or you local Crisis Pregnancy Center to let them know that you support their efforts to keep your State (and federal) tax funds from paying for the ending of lives of our Texans of tomorrow.

Action: Women Speak 4 OURSELVES @WomenSpeak2012 #tcot #pro-life

Based on the Declaration of Independence, the Constitution of our United States is designed to secure our rights to life, liberty and property for every human being, not just the ones who can speak out. Those of us who can speak, should join in the effort to protect the rights of all, including the unborn children of tomorrow, male and female, and everyone who objects to government-sponsored efforts to end their lives. The recent Obama mandate that infringes on the First Amendment protection of the right of free exercise of religion and their on-going efforts to force Texas to fund Planned Parenthood with State taxes is in direct violation of the Bill of Rights.

I received an email tonight from the group, “Women Speak for Themselves” asking for comments on next Saturday’s Washington, DC rally sponsored by pro-abortion, anti-family and anti-First Amendment rights groups:

This Saturday, on the National Capitol lawn, Think Progress (a George Soros funded group) is hosting a “We Are Women” rally. Soros’ group, along with some of their co-sponsors, the usual—the National Organization of Women, Planned Parenthood, and the National Women’s Political Caucus—along with some more peculiar groups—Rock The Slut Vote, The National Center for Transgender Equality, and the Reformed Whores entertainers, among others—have a specific goal in mind.

“Our mission,” their website reads, “is to bring national attention to the ongoing war on women’s rights…”

Not surprisingly, the language on their website gives the appearance that they’re claiming to speak for all women on matters of healthcare, family, and freedom…which makes this just the type of event at which we need to make our voices heard! And so, here’s where YOU come in.

Prior to the rally, we’ll be releasing a statement to the press, informing them that there are women with alternative views on these matters, should the press wish to include us in the discussion. We’d like to add YOUR voices to that statement.

Send us a brief statement (2-3 sentences), articulating why as a woman you stand for and believe freedom includes protection for life, family, and/or religion. Be sure to include your full name, city and state, and your occupation, if you’d like—along with permission for us to include your information and quote in our press release.

If you’re not sure where to start, feel free to use our two sets of talking points for ideas (though your statement need not be solely focused on the HHS mandate), and try to stay focused on why you’re FOR our view of women’s freedom, as opposed to AGAINST the view of women’s freedom being put forth by Soros and cohorts.

Thanks for your help with this….I look forward to your statements!

My best to you,
Helen

http://womenspeakforthemselves.com/
https://www.facebook.com/WomenSpeakForThemselves
https://twitter.com/womenspeak2012

P.S. I’m told some pro-lifers will be gathering at the North Capitol Lawn on Saturday, to hold a counter protest. The rally starts at 11am, I believe, so feel free to head on over, with signs and pro-life gear, if you’d like to be a joyful example of the alternative.

 

I wish I could attend the counter protest, but I’m committed to a meeting for the Christian Medical and Dental Association that day. If you can attend, please do. Either way, send a message to http://womenspeakforthemselves.com/ or @womenspeak2012!

2010 RPT (original) Platform “Strengthening Families, Protecting Life and Promoting Health”

Here is the original 2010 platform – I’ve only copied the section that was disputed. The 2010 Platform was used by the 2012 Temporary Platform Committee as a beginning for our new 2012 Platform of the Republican Party of Texas. (At least for now, the entire 2010 document is online at the Tarrant County Republican Party website. The 2012 Platform is here at the RPT website.) (Thank you Tarrant County Republican Party!)

I’ve noted amended portions in red and deleted wording in blue. You can see the final version of this section here and the version proposed by my sub-committee is here.

STRENGTHENING FAMILIES, PROTECTING LIFE AND PROMOTING HEALTH

PROTECTING INNOCENT HUMAN LIFE

Party Candidates and the Platform on Protecting Innocent Human Life– We implore our Party to support, financially or with in-kind contributions, only those candidates who support protecting innocent human life. Further, we strongly encourage the State Republican Executive Committee to hear and recognize the longstanding and overwhelmingly consistent voice of the grass roots and revise its by-laws to make this action binding on our Party.

Partial Birth Abortion– We oppose partial birth abortion. We recommend that Congress eliminate from all federal court jurisdictions all cases involving challenges to banning Partial Birth Abortion.

Right To Life – All innocent human life must be respected and safeguarded from fertilization to natural death; therefore, the unborn child has a fundamental individual right to life which cannot be infringed. We affirm our support for a Human Life Amendment to the Constitution and to make clear that the Fourteenth Amendment’s protection applies to unborn children. We support the Life at Conception Act. We oppose the use of public revenues and/or facilities for abortion or abortion–related services. We support the elimination of public funding for organizations that advocate or support abortion. We are resolute regarding the reversal of Roe v. Wade. We affirm our support for the appointment and election of judges at all levels of the judiciary who respect traditional family values and the sanctity of innocent human life. We insist that the U.S. Department of Justice needs to prosecute hospitals or abortion clinics for committing induced labor (live birth) abortion. We are opposed to genocide, euthanasia, and assisted suicide. We oppose legislation allowing the withholding of nutrition and hydration to the terminally ill or handicapped. Until our final goal of total Constitutional rights for the unborn child is achieved, we beseech the Texas Legislature in consideration of our state’s rights, to enact laws that restrict and regulate abortion including:

1. parental and informed consent;
2. prohibition of abortion for gender selection;
3. prohibition of abortion due to the results of genetic diagnosis
4. licensing, liability, and malpractice insurance for abortionists and abortion facilities;
5. prohibition of financial kickbacks for abortion referrals;
6. prohibition of partial birth and late term abortions; and
7. enactment of any other laws which will advance the right to life for unborn children.

Sonograms – We urge the Texas legislature in its next biennial session to enact legislation requiring a sonogram be performed and offered as part of the consent process to each mother seeking an elective abortion.

Harassing Pregnancy Centers– We urge legislation to protect pregnancy centers from harassing ordinances to require pregnancy centers to post signs in violation of their Constitutional rights. We further oppose any regulation of pregnancy centers in Texas which interfere with their private, charitable business.

Choose Life – We ask the Legislature to provide Texans opportunity to purchase “Choose Life” license plates.

Parental Consent– We call on the Legislature to require parental consent for any form of medical care to minors. We urge electoral defeat of judges who through judicial activism seek to nullify the Parental Consent Law by granting bypasses to minor girls seeking abortions. We support the addition of a legislative requirement for the reporting of judicial bypasses to parental consent on an annual basis to the Department of State Health Services and such reports shall be made available to the public. Further, we encourage the Congress to remove confidentiality mandates for minors from family planning service programs operating under Title X of the Public Health Services Act and Medicaid.

Protection of Women’s Health– Because of the personal and social pain caused by abortions, we call for the protection of both women and their unborn children from pressure for unwanted abortions. We commend the Texas Legislature for the passage of the Woman’s Right to Know Act, a law requiring abortion providers, prior to an abortion, to provide women full knowledge of the physical and psychological risks of abortion, the characteristics of the unborn child, and abortion alternatives. We urge the state government and the Department of State Health Services to ensure that all abortion providers are in compliance with this informed consent law and to ensure that all pregnancy centers and other entities assisting women in crisis pregnancies have equal access to the informational brochures created by the Department of State Health Services.

Alternatives to Abortion– We urge the Department of State Health Services to provide adequate quantities of The Woman’s Right to Know Resource Directory to anyone that works with pregnant women.

RU 486 – We urge the FDA to rescind approval of the physically dangerous RU-486 and oppose limiting the manufacturers’ and distributors’ liability.
Morning After Pill– We oppose sale and use of the dangerous “Morning After Pill.”


Gestational Contracts– We believe rental of a woman’s womb makes child bearing a mere commodity to the highest bidder and petition the Legislature to rescind House Bill 724 of the 78th Legislature. We support the adoption of human embryos and the banning of human embryo trafficking.

Unborn Child Pain Protection – We support legislation that requires doctors, at first opportunity, to provide to a woman who is pregnant, information about the nervous system development of her unborn child and to provide pain relief for her unborn if she orders an abortion. (Language added here to prohibit abortions after 20 weeks.)

Unborn Victims of Violence Legislation– We urge the State to ensure that the Prenatal Protection Law is interpreted accurately and consider the unborn child as an equal victim in any crime, including domestic violence.

Abortion Clinics – We propose legislation that holds abortion clinics to the same health regulations as other medical facilities and that subjects clinics to the same malpractice liabilities. We oppose any public funding for Planned Parenthood or other organizations/facilities that provide, advocate or promote abortions.

Abortion Requirements for Hospitals– We propose legislation that entitles hospitals to refuse to perform abortions because government has no moral authority to require such an abortion.

Conscience Clause– We believe that doctors, nurses, pharmacists, any employees of hospitals and insurance companies, health care organizations, medical and scientific research students, and any employee should be protected by Texas law if they conscientiously object to participate in practices that conflict with their moral or religious beliefs, including but not limited to abortion, the prescription for and dispensing of drugs with abortifacient potential, human cloning, embryonic stem cell research, eugenic screenings, euthanasia, assisted suicide, and the withdrawal of nutrition and hydration. We call on the Texas Legislature to pass legislation to strengthen and clarify the current conscience clause in the Occupational Code to include the above-mentioned persons and practices. We further encourage legislation that requires hospitals and clinics to inform all health care personnel of their right to refuse to become involved in abortion or euthanasia, and their protection from prosecution and retaliation under Texas law.

Fetal Tissue Harvesting – We support legislation prohibiting experimentation with human fetal tissue and prohibiting the use of human fetal tissue or organs for experimentation or commercial sale. Until such time that fetal tissue harvesting is illegal, any product containing fetal tissue shall be so labeled.

Stem Cell Research– We oppose any legislation that would allow for the creation and/or killing of human embryos for medical research. We encourage stem cell research using cells from umbilical cords, from adults, and from any other means which does not kill human embryos. We oppose any state funding of research that destroys/kills human embryos. We encourage the adoption of existing embryos. We call for legislation to withhold state and/or federal funding from institutions that engage in scientific research involving the killing of human embryos or human cloning.

Human Cloning– Each human life, whether created naturally or through an artificial process, deserves protection. We confirm that somatic cell nuclear transfer (SCNT) is the process by which a human being is cloned, and that SCNT creates a unique human being with the same properties of a human embryo created through the union of sperm and egg. We seek a ban on human cloning for reproductive purposes (where a cloned human embryo, created through SCNT, is implanted in a womb and the human clone is birthed). We also seek a ban on research cloning (where a cloned human embryo, created through SCNT, is created, grown in the laboratory, and then destroyed when its stem cells are extracted for research purposes). Furthermore, criminal penalties should be created and experimenters prosecuted who participate in the cloning of human beings. No government or state funding should be provided for any human cloning.

Patient Protection– We support patients’ rights by calling on the state legislature to amend the Advance Directive Act to establish due process of law and ensure that a physician’s decision to deny life saving treatment against the patient’s will or advance directive is not due to economic or racial discrimination or discrimination based on disability. We also support the passage of legislation to amend the Advance Directive Act by requiring hospitals intending or threatening to withdraw life-sustaining treatment against the patient’s wishes or their advance directive to continue all treatment and care for such patients pending transfer to another facility.

Gene Manufacturing – We support a ban on research that alters human DNA in living human beings at any stage of life, including the altering of artificial, manufactured, and natural genes and chromosomes.

First Amendment on Life Support

“More sparingly should this praise be allowed to a government, where a man’s religious rights are violated by penalties, or fettered by tests, or taxed by a hierarchy. Conscience is the most sacred of all property.” John Madison, “Property,” National Gazette, March 29, 1792.

“In purity and holiness I will guard my life and my art.” Hippocratic Oath, approximately 400 BC.

“Refusals based on moral disapprobation, however, are not typical of medical ethics” R. Alta Charo, ”Health Care Provider Refusals to Treat, Prescribe, Refer or Inform: Professionalism and Conscience.” February, 2007.

Fully enjoying the protections of the First Amendment themselves, the New England Journal of Medicine has published yet another editorial, “Warning: Contraceptive Drugs May Cause Political Headaches,”  by Robin Alta Charo, J.D., denouncing conscience and those of us who abide by ours. I suppose that she thought it was the right thing to do.

The Journal does not offer background on Ms. Charo’s previous editorials on the subject, including the notorious 2005 “The Celestial Fire of Conscience.” The editors don’t include any  note – any “warning’ – that she was part of the political Obama transition team. Ms. Charo did not mention any of these possible conflicts of interest in her “disclosure form,” available online.

Charo’s entire argument relies on readers’ agreement that the argument is about “public policy and contraception.” It is vital to her argument since, as she quotes Georgetown University theologian Tom Reese, “If the argument is over religious liberty, the bishops win.” Because, if we understand that the issue relates to “an establishment of religion,” Congress cannot legitimately pass, and the Executive Branch may not enforce, any law that infringes on the free exercise of religion.

Charo would instead have us focus on “public institutions, public places, and public duties.” Although hospitals and universities serve the public by providing healthcare and education, they are still owned by private, religious entities. In addition, the Obama Administration’s “accommodation” – the suggestion that the institution’s insurance company provide contraception free of charge to the ensured who want it – becomes much more complicated in light of the fact that most large religious hospitals and universities privately self-insure rather than enter into the market to buy first dollar coverage from a third party insurance company.

Charo’s essay is political appeal to emotion and half-truths, full of the “partisan sound bites and slogans” she denounces. However, not even the lie about mandatory transvaginal ultrasounds compares with her earlier error of logic in warning that the institutions could withhold “ordinary salary.” I don’t know of any religious organization that considers agreed-upon salary for agreed-upon service as inherently sinful. Keeping a promise, like that in the First Amendment or a contract with an employee is sacred to those of us with a conscience.

The Constitution demands that Congress “shall make no law” limiting religious freedom. The attempt by the Obama Administration to write regulations that require religious institutions to engage in acts that are contrary to long-standing, organized tenets of that religion goes directly against the First Amendment and cannot be justified.

Planned Parenthood “affiliates” and the Texas Women’s Health Program

Today, the Austin Chronicle, the local “alternative” news source, has yet another article “Perry continues assault on women’s healthcare,” claiming that Governor Perry and the Commissioner of Health and Human Services Suehs have acted – seemingly on their own – to shut down the Texas Women’s Health Program (more info here) in order to spite the poor underdog, Planned Parenthood.

Today’s statement is that “The new regulation signed by Suehs – redefining “affiliate” to mean that Planned Parenthood clinics not providing abortions are deemed affiliated with those clinics that do – conflicts with federal law, as confirmed last week by U.S. Health and Human Ser­vices Secretary Kathleen Sebelius.”

Actually, the Attorney General ruled on the definition of “Affiliate.” The Secretary must follow the law passed last Spring by the 82nd Texas Legislature.

It’s not surprising – in fact it’s common sense – that subsidiary corporations are considered “affiliates” by the State, since they are members of the Planned Parenthood Federation of America.  The annual report of PPFA calls these facilities their “medical affiliates.” The President of PPFA, Cecile Richards, shown above with Texas Senator Jeff Wentworth at a Planned Parenthood of San Antonio and South Texas event, visits these subsidiaries in her official duties.

(Photo from the 2009 Annual Report of Planned Parenthood of San Antonio and South Texas)

“Women Speak for Themselves” up to 4 pages

The list of women who have asked to co-sign the open letter to President Obama and Secretary Sebelius is still growing. Have you signed up?
There’s a button on the top of the page, just fill in your name and State, more information is optional. You, too, can say,

Here We Are!

Texas Governor Perry Pushes Back (Family Planning, Women’s Health and PP)

Governor Rick Perry is pushing back against the Obama Administration’s threat to kill our Texas Women’s Health Program due to law passed by the Legislature last June. The Governor’s office has produced 4 new videos (one of which includes me) explaining that the State is prepared to ensure that women are able to access continuing comprehensive care under these programs.

If you only have time for one, watch Carol Everett’s video in which she relates that the Commissioner of Health and Human Services has identified 2500 doctors willing to participate with the Well Woman Program and Texas’ Family Planning, even in rural areas where there has never been a Planned Parenthood clinic. There are also videos from former Waco PP Executive Director Abby Johnson, Texas Alliance for Life’s Executive Director Joe Pojman, Ph.D., and me.

The videos can be viewed at the Governor’s YouTube page and via the Office of the Governor website. They are the beginning of a series of announcements and news releases in hopes of convincing the Obama Administration and Secretary Sebelius to preserve these programs. Time is short as the current Medicaid waiver is due to expire at the end of March.

Stop and think about it: What the media is reporting as a single crisis is really the effect of two separate events. One is the cut in funding to Family Planning that went into effect in October,  along with many other cuts that were made in order to balance the State budget according to the Texas Constitution while paying for Medicaid for children and education.  The second is what is happening in a few clinics that are partners with other clinics that do abortions and are panicking because they are about to lose State funds.

Where are the reports about the thousands of providers who have agreed to see patients under both these programs?

The media is also acting as though the law prohibiting anyone who performs or refers to abortions, or who is a business partner with an abortion provider is brand new or that the Governor got up one morning and changed the law. No, the House and Senate of the 82nd Texas Legislature deliberated for months on Medicaid funding, including the best way to provide care under the Family Planning Title X funds and the Medicaid funded Women’s Health Program. They continued the old prohibition on funding affiliates.

The only change is that the Attorney General has clarified that “affiliates” include organizations that are part of the same national corporation.

The media and President Obama also ignore that the legislature won’t meet until January, 2013, so there is no way to change the law that appropriates State Tax funds.

Don’t say I didn’t warn you: I was nervous as I could be and I spent too much time giving a list of my credentials. But if you’re brave, here’s my video.

Update on Texas, Contraception, and Women Who Vote (and blog)

Over the weekend, there were more op-eds published in online magazines and newspapers all over the Internet championing women’s “right” to contraceptives and nearly everyone of them tied that “right” to the “right” to obtain an abortion. Search the news on “Texas contraception politics” and you’ll find a few dozens of articles published repeatedly in newspapers across the Nation. They often begin discussing cuts in State funding for contraception and move straight to the theme that mean old Republicans in Texas just don’t want to pay for abortions.

Yes, we don’t want to pay for abortions or support corporations that do them. That is our “choice.”

However, the reality is that Texas Legislators had no choice other than to cut spending. Where is the money going to come from?

Texas also cut money to train resident doctors – the future family doctors, OB/Gyns and pediatricians because there was not enough money. But I don’t see any articles on “The war against physician workforce.”

The only way to raise money would be to raise taxes. In order to raise taxes, we would have to have a vote to change our Constitution. I, for one, would vote “no.”

Everyone – including the Obama Administration – ignores the fact that Texas’ part-time Legislature will not meet again until January 2013, so there won’t be a chance to change the funding until after the November election.

Please notice the hateful tone of many of the blogs, op-eds and especially the readers’ comments and letters to the editors. And note that they always focus in on abortion – and that even the National articles narrow in on Texas. The truly mean comments claim that Republicans hate women. Some articles are even titled, “. . . War on Women,” and “When States Abuse Women.” One of the “War on Women” articles was published in the UK’s Guardian.

Women vote in Texas. We believe that life begins at fertilization and that every human being is endowed by our Creator with the right to life.

And we sure don’t have extra money to pay higher taxes. How hard is that concept to understand?

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