Human Nature: Science, Technology, and Life.

Abortion? Don't Mention It.

In its final hours, the Bush administration implemented a regulation expanding the right of medical professionals to abstain from practices they find objectionable. On Friday, the Obama administration moved to "review" and eventually repeal the regulation. Organizations on all sides of the debate issued press releases responding to Obama's move. This table tells you everything you need to know about the politics of the fight:

1. Mentions of "abortion":

Christian Medical and Dental Association: 19
Family Research Council: 6
House Minority Leader John Boehner: 4
NARAL Pro-Choice America: 1
National Women's Law Center: 0
Center for Reproductive Rights: 0
Planned Parenthood Federation of America: 0

2. Mentions of "contraception" or "birth control":

NARAL Pro-Choice America: 3
Planned Parenthood Federation of America: 1
Center for Reproductive Rights: 1
National Women's Law Center: 1
House Minority Leader John Boehner: 0
Family Research Council: 0
Christian Medical and Dental Association: 0

To sum up: The liberal groups don't want to mention that the regulation involves abortion, and the conservative groups don't want to mention that it also covers the right to withhold birth control. Why? Just look at the polls. As Rachel Laser of Third Way astutely puts it, "If the president kept in place the conscience clause in regard to abortion but reversed it in regard to birth control, most Americans would agree that's common ground." And that's exactly what the Obama administration aims to do, according to a Health and Human Services official who spoke to Reuters:

The wording was vague enough to let health professionals invoke the conscience clause for things like contraceptives, family planning and counseling for vaccines and blood transfusions, the agency official said. ... "We recognize and understand that some providers have objections to providing abortions. We want to ensure that current law protects them," the official said. "But we do not want to impose new limitations on services ... like family planning and contraception that would actually help prevent the need for an abortion in the first place."

If Obama convinces the public that this is what he's doing, then politically, he'll be fine. And morally, he'll be well-justified.

The Morning-After Myth

David Savage, one of my favorite legal writers, has a good story in the L.A. Times about President Bush's plan to protect medical employees from punishment when they refuse to violate their consciences. The idea sounds good till you read the details: The rule bars "any entity" that gets federal money (e.g., private companies that happen to be funded in part by a grant) from disciplining any employee, including one "whose task it is to clean the instruments." Savage reports:

Proponents, including the Christian Medical Assn. and the U.S. Conference of Catholic Bishops, say the rule is not limited to abortion. It will protect doctors who do not wish to prescribe birth control or to provide artificial insemination, said Dr. David Stevens, president of CMA. "The real battle line is the morning-after pill," he said. "This prevents the embryo from implanting. This involves moral complicity. Doctors should not be required to dispense a medication they have a moral objection to."

Hey, I'm all for respecting moral objections. Doctors are entitled to their own ethical judgments, regardless of what the medical establishment says. But they're not entitled to such defiance when the judgments in question are scientific. And what Dr. Stevens says about the morning-after pill—that it "prevents the embryo from implanting"—is such a gross misrepresentation that it's amazing he's in charge of any medical association.

Let's get clear on two important points. First, "morning-after" does not mean "after-fertilization." To repeat what I wrote about this two years ago:

An egg loses its fertility within 12 to 24 hours. It takes sperm about 10 hours to reach the egg, and sperm can survive in the female reproductive tract for up to five days. If you want to get pregnant, you'd better send in the sperm before the egg shows up. But if you don't want to get pregnant, and the sperm are on their way or already there, you still have time to stop the egg.

Second, of all the ways in which a morning-after pill might block pregnancy, preventing implantation is the least plausible. Chemically, a morning-after pill is a form of oral contraception. Here are the facts:

The risk that oral contraception will prevent implantation of an embryo is purely theoretical. There is no documented case of such a tragedy, since we have no way to verify conception inside a woman's body prior to implantation without causing the embryo's death. Even theoretically, the risk is vanishingly small, since the primary effect of oral contraception is to prevent ovulation, and the secondary effect is to prevent fertilization. To classify oral contraception as abortifacient, one would have to posit a scenario in which the drug fails to block ovulation, then fails to block fertilization, and yet somehow, having proved impotent at every other task, manages to prevent implantation.

So what Stevens says is, at a minimum, a gross distortion. And it's a particularly evil distortion because it steers women away, not from abortion, but from the measure that is at that moment most likely to prevent them from later resorting to an abortion. If I ran a medical facility and found out one of my doctors was feeding patients that kind of propaganda, I'd fire him. And the government, particularly a government that calls itself conservative, has no business standing in my way.