NEW YORK — In Congress and states nationwide,
anti-abortion activists are broadening efforts to support
hospitals, doctors and pharmacists who want to opt out of services
linked to abortion and emergency contraception.

A little-noticed provision cleared the House of Representatives
last week that would prohibit local, state or federal authorities
from requiring any institution or health care professional to
provide abortions, pay for them, or make abortion-related
referrals, even in cases of rape or medical emergency.

In Mississippi, a bill became law in July that admirers and
critics consider the nation’s most sweeping “conscience
clause.” It allows all types of health care workers and
facilities to refuse performing virtually any service they object
to on moral or religious grounds.

And in states across the country, anti-abortion organizations
and a group called Pharmacists for Life are encouraging pharmacists
to refuse to distribute emergency contraceptives, which they
consider a potential form of abortion.

“We’ve seen increasing organization and networking
to get more pharmacists to refuse to provide EC—not just in
the Bible Belt but all over,” said Gloria Feldt, president of
the Planned Parenthood Federation of America. “It’s
part of the anti-choice arrogance in which they believe they have
the right to impose their ideology on everyone else.”

Karen Brauer, president of Pharmacists for Life, was fired by
Kmart in 1996 for refusing to dispense a birth-control drug. She
believes momentum now favors her movement.

“More people, including pharmacists, are becoming informed
how certain drugs operate—and those who want to avoid ending
the life of a human being would avoid those drugs,” she
said.

Brauer, who lives in Lawrenceburg, Ind., and works at a
drugstore in Ohio, hopes more states will emulate Mississippi,
South Dakota and Arkansas by specifying that pharmacists, as well
as doctors, have the right to withhold services on moral grounds.
She does not believe there should be any obligation to refer
rebuffed customers to another pharmacist who would fill their
prescription.

“Forced referral is stupid,” she said. “If
we’re not going to kill a human being, we’re not going
to help the customer go do it somewhere else.”

At the federal level, abortion rights groups are alarmed by the
provision that cleared the House last week, broadening protections
for hospitals and insurers that seek to avoid any involvement with
abortions. The provision would prevent government officials from
using any coercive means to ensure abortion-related services are
available.

Two years ago, the House passed a bill with the same goals, but
it died in the Senate without a vote. Anti-abortion activists are
pleased because the revived proposal was sent to the Senate as part
of a broader appropriations bill and, at minimum, will go to a
House-Senate conference committee.

Opponents say the provision’s impact would be felt
primarily by low-income women who depend on federally subsidized
health care and use Roman Catholic hospitals. According to the
critics, the measure would enable hospitals to refuse to provide
abortions, or referrals, even if a pregnant woman had been raped or
was in critical medical condition.

“That the U.S. Congress would be so callous as to add this
kind of provision—that affects only poor women in the most
extreme circumstances—is outrageous,” said Frances
Kissling, president of Catholics for a Free Choice.

Kissling said she was heartened by developments in some
states—such as a California Supreme Court ruling that
Catholic Charities of Sacramento must provide birth control options
in its employee health plan. “But for women in conservative
states, that’s no help,” she said.

Mississippi’s new law provides sweeping immunity for
opting out of abortion and contraception services in a state where
many women seeking abortions already travel to Alabama or Tennessee
to obtain them.

“We have doctors who won’t even issue birth control
prescriptions,” said Nsombi Lambright of the American Civil
Liberties Union’s Mississippi branch. “It’s not
their job to impose their beliefs on others.”

In contrast, anti-abortion health professionals say it is their
beliefs that are embattled. Texas pharmacist Gene Herr, for
example, was fired this year by the Eckerd drugstore chain after
refusing to fill an emergency contraception prescription for a rape
victim.

“They were forcing me to do something that I see is
wrong,” Herr said.

The American Medical Association and American Pharmacists
Association support their members’ right to conscientious
refusal. However, the pharmacists’ group says patients also
have a right to obtain legally prescribed therapies.

Lourdes Rivera, who assists low-income patients as director of
the Los Angeles-based National Health Law Program, worries that
anti-abortion health providers are gaining too much leeway.

“Yes, we need to respect individual freedom of religion.
But at what point does it cross the line of not providing essential
medical care? At what point is it malpractice?” she asked.
“If someone’s beliefs interfere with practicing their
profession, perhaps they should do something else.”
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