President Bush fires off a final insult to women on his way out the door

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A married woman is in a gynecologist's office seeking birth-control information. Unbeknownst to her, the doctor is a religious fundamentalist who believes women should be fruitful and multiply. Instead of writing her a prescription, he tells her birth control is dangerous and hands her a Bible with a relevant passage highlighted.

A college student calls the campus health clinic for information about Gardasil, which immunizes against the human papillomavirus that causes cervical cancer. But the secretary thinks protecting young women against sexually transmitted diseases gives them a green light to be promiscuous. So she refuses to make the appointment.

A rape victim goes to the hospital seeking treatment. Instead of offering her the Plan B morning-after pill that prevents pregnancy, as state law requires, the staff fails to mention it, or tells her that they're all out or that no such remedy exists.

Medically unethical? Criminally negligent? Try legally protected, as of next week.

On that date and beyond, health-care workers who have moral objections to any kind of treatment or procedure can refuse to provide it, or refer patients to a place where such services are available, or even tell them about it.

In theory, this means that someone whose religion frowns on blood transfusions or psychotropic drugs could refuse to mention or offer them. In reality, we all know the real target of this absurd regulation is reproductive health services, the whipping girl of the Bush administration for the past eight years.

The new regulation, euphemistically dubbed the "Provider Conscience Rule," is George W. Bush's parting sop to the religious right as he leaves the White House.

I, for one, would love to know how his wife and daughters feel about it. Not that they'd ever be forced to seek care from someone they didn't know well and trust implicitly. But many women and girls in this country are at a disadvantage in that regard, and they will be the ones who suffer.

Thanks to this rule, anyone along the chain of care from secretary or clerk to nurse, doctor or pharmacist, can refuse assistance, information or treatment to a woman seeking birth control, the morning-after pill, protection against sexually transmitted diseases, an abortion or related help. They will be permitted to mislead or misinform women of the options legally available to them.

If you're considering an abortion for any reason, this rule will trump your constitutional right to obtain one. If you're trying to have safe, responsible sex that prevents pregnancy or HIV, this rule will allow health care workers to block your path.

Not for long, one hopes. Barack Obama will be sworn in as president two days after this travesty goes into effect. No doubt he'll move to undo it, but that could take months, and a lot of mischief can occur in the interim.

And so we see one more time that health care no longer exists for the welfare of the patients. Now it's for the comfort of the providers. And why not? The medical industrial complex thinks it exists for bricks and mortar, profits and power. The insurance industry thinks it exists for squeezing subscribers and denying claims. This is just one more interest group taking precedence over those seeking care.

The new rule is a solution in search of an injustice. Apparently, the dispensing of condoms, the morning-after pill and the like has exacted a tragic toll on health-care workers who've been forced to actually do their jobs.

It's totally unfair that they should have to consider the required tasks before accepting a position. Why should someone who objects to, say, in-vitro fertilization have to forgo working at a clinic that provides in-vitro fertilization? Why can't they still take the job, decline to do it and, if the employer doesn't like it, file a charge of discrimination?

Who wanted this rule? Not the American Medical Association, or the American Nurses Association, or the American Hospital Association, whose members will be among the newly protected class. A host of critics from these and other groups have denounced it as unnecessary, overly broad, confusing, irresponsible, a barrier to care and, as has been the case with so much Bush policy, fantasy-based.

To that list, I would add misogynist. All the snide remarks about Sarah Palin's five kids and Hillary Clinton's ankles pale in comparison to the novel theory that females seeking reproductive health-care information or treatment are in no position to judge whether they deserve to get it.

No, this little gem was tailored to the extreme-right groups that helped Republicans lose the support of the American people in November. Tony Perkins of the Family Research Council called it "a huge victory." Which pretty much seals it as a disaster for women.

Will the "conscience rule" mean an insurance adjuster could deny coverage for amniocentesis because it might reveal chromosomal abnormalities and raise the possibility of abortion? Could it go so far as to allow a truck driver to refuse to deliver a shipment of condoms? The truth is, no one knows how people will interpret its vague guidelines, and that means a litigation boom is bound to follow.

And while it's very nice of the outgoing administration to create a new sub-specialty for the legal profession, it would be so much better if they dropped this rule where it belongs on their way out the door -- in the trash heap of misogynist history.

Sally Kalson is a columnist for the Post-Gazette ( skalson@post-gazette.com , 412 263-1610).


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