New Hampshire Attorney General Kelly Ayotte (R) on Friday asked U.S. District Judge Joseph DiClerico to reject requests from abortion-rights advocates to invalidate a law (HB 763) that requires physicians in the state to notify by certified letter a parent or guardian of a minor who is seeking an abortion at least 48 hours before performing the procedure, the Concord Monitor reports (Timmins, Concord Monitor, 12/30/06). The law also bars parents from forbidding the procedure, and the notification requirement could be bypassed by a judge if a doctor determines that the minor's life is in danger. Planned Parenthood of Northern New England; the American Civil Liberties Union; the Concord Feminist Health Center; the Feminist Health Center of Portsmouth, N.H.; and Manchester, N.H.-based ob-gyn Wayne Goldner in November 2003 filed the lawsuit challenging the constitutionality of the law. DiClerico and the 1st U.S. Circuit Court of Appeals subsequently struck down the entire law. Ayotte appealed the lower courts' ruling to the U.S. Supreme Court, saying that the judicial bypass clause in the measure, combined with other state laws that allow doctors to act in an emergency, protect a woman's health. The Supreme Court in January 2006 unanimously ruled that the lower courts should not have invalidated the entire measure and ordered lower courts to review the legislative intent regarding exceptions to the law for medical emergencies. NARAL Pro-Choice America in October 2006 filed a friend-of-the-court brief with DiClerico saying that Ayotte essentially is asking the judge to rewrite the law -- a function that the group says should be left to the state Legislature. The brief also said that "[a]lthough it may seem counterintuitive, the New Hampshire Legislature probably would have preferred no parental involvement law at all to one with a health exception" (Kaiser Daily Women's Health Policy Report, 10/5/06).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Articles and news on abortion facts, abortion myths, safety of abortions, legal and/or economic barriers, surgical abortion, medical abortion, abortion after 12 weeks, post-abortion issues, abortion and the law, ethics of abortion, parental consent.
February 28, 2007
New York Times Magazine Did Not Show Enough 'Vigor' For Accuracy And Fairness In Part Of Article On El Salvador Abortion Law,Opinion Piece Says
Although an April 9, 2006, New York Times Magazine article "provided a broad and intriguing look" at El Salvador's abortion law, "[a]ccuracy and fairness" in regard to a "key example" in the story "were not pursued with the vigor Times readers have the right to expect," Byron Calame, the Times' reader representative, writes in the New York Times. According to Calame, the article stated that a "few" women in El Salvador were serving 30-year prison terms for having had abortions. It also included an account of how a woman named Carmen Climaco received a 30-year prison sentence after having an abortion at 18 weeks' gestation, Calame writes. According to Calame, "it turns out that trial testimony convinced a court in 2002 that Climaco's pregnancy had resulted in a full-term live birth and that she had strangled the 'recently born'." The court found her guilty of "aggravated homicide," Calame writes, adding that the article's author, Jack Hitt, "suggested that the 'truth' was different." Hitt "never checked" the ruling "while preparing for his story" and said "no editor or fact checker ever asked him if he had checked the court document containing the panel's decision," Calame writes. He also addresses the Times' response to reader complaints about the story. "Articles on topics as sensitive as abortion need an extra level of diligence and scrutiny," Calame writes, adding, "Exceptional care must be taken in the reporting process on sensitive articles such as this one to avoid the slightest perception of bias" (Calame, New York Times, 12/31/06).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Massachusetts Gov. Romney Forms Presidential Campaign Committee; Criticized By DNC For Past Abortion Statements
The Democratic National Committee on Wednesday criticized Massachusetts Gov. Mitt Romney (R) for statements he made about abortion while in office and during previous senatorial campaigns, the Los Angeles Times reports. Romney, who officially leaves office Thursday, filed papers with the Federal Election Commission on Wednesday to form a presidential campaign exploratory committee (Gerstenzang, Los Angeles Times, 1/4). Since Romney first ran for U.S. Senate in 1994, he has acknowledged that his position on abortion has changed from supporting abortion rights to saying that he would prefer to have Roe v. Wade -- the 1973 Supreme Court decision that effectively barred state abortion bans -- overturned. Romney, during his election campaign for the U.S. Senate, in 1994 said, "I believe that abortion should be safe and legal in this country," adding, "I believe that since Roe v. Wade has been the law for 20 years, we should sustain and support it." When he ran for Massachusetts governor in 2002, Romney promised to "preserve the status quo" on abortion rights in the state and oppose any changes to state laws that restricted or increased access to abortion. Romney in 2004 while studying human embryonic stem cell research said he experienced an awakening that led him to believe "the sanctity of life had been cheapened" by the Roe decision (Kaiser Daily Women's Health Policy Report, 12/21/06). According to Democrats, Romney in February 2006 said, "I've never used either title, pro-life or pro-choice, in the past. I said I don't favor abortion." In October 2006 Romney said, "I call myself firmly pro-life" (Los Angeles Times, 1/4). "While Mitt Romney says he's not a multiple-choice candidate, his record shows that he has routinely changed his position on everything from abortion to taxes, making it difficult to know where he stands," DNC spokesperson Stacie Paxton said (Johnson, AP/San Diego Union-Tribune, 1/3). Kevin Madden, Romney's communications director, said, "If the DNC is after us, we must be doing something right" (Los Angeles Times, 1/4).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Wisconsin Right To Life, Residents File Lawsuit Challenging State Judiciary Electoral, Recusal Rules
Wisconsin Right to Life and eight state residents on Friday filed a lawsuit in a U.S. District Court in Madison, Wis., challenging state rules that prohibit judicial candidates from making public comments on issues, such as abortion, and that require judges to recuse themselves from cases on which they have taken sides publicly, the AP/CBS 5 reports (AP/CBS 5, 1/2). Wisconsin Right to Life is suing the Wisconsin Judicial Commission and the state Office of Lawyer Regulation, alleging that the rules prohibit judicial candidates from expressing their views on "cases, controversies and issues" that are likely to come before them and that they are unconstitutional because they violate candidates' constitutional rights to free speech and association, the Wisconsin State Journal reports. The suit says the group was unable to use its survey in 2006 -- which asked judicial candidates questions concerning their positions on issues, such as abortion -- because six of the seven candidates declined to answer, citing the state Supreme Court rules. According to the brief, "It is in the public interest for citizens to know about the views on disputed political and legal issues espoused by judicial candidates, that they might make an educated decision in casting their vote in the upcoming elections." The suit said that while the goal of the rules is to maintain an impartial judiciary, the result is the opposite, adding, "Since it is apparent that judges and judicial candidates have views on disputed legal or political matters, there is also a danger that silence inspires the suspicion that they are hiding their views to mask their impartiality or bias." The heads of the state judicial commission and state lawyer regulation office declined to comment and said they have not seen the lawsuit and request for injunction (Hall, Wisconsin State Journal, 1/3). According to the AP/CBS 5, the lawsuit asks a federal judge to rescind the rules before the April elections, which include a contest for state Supreme Court, three unopposed state appeals court races and several county judge elections (AP/CBS 5, 1/3).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
China's Henan Province Bans Sale Of Drugs For Medical Abortion
China's Henan province on Monday banned the sale of drugs for medical abortions in coordination with the province's efforts to maintain gender balance among infants, Xinhua/China Daily reports. People who violate the law could receive fines of between $385 and $2,564 and risk having their illegal profits seized by the state, and a pregnant woman who undergoes an abortion illegally could face a fine of $256. According to Xinhua/China Daily, local government sources said the ban could be seen as a measure to support regulations prohibiting sex-selective abortion in the province. Under those regulations, which took effect on Monday, abortion is permitted only if the fetus has a serious hereditary disease or severe birth defect, if continuation of gestation will damage the health or life of the pregnant woman, or if the pregnant woman is divorced or widowed (Xinhua/China Daily, 1/3). A 2000 census found that the ratio of infant boys to infant girls in Henan was about 118 boys for every 100 girls. The worldwide ratio is about 107 boys to 100 girls (BBC News, 1/3). According to the Henan Population and Family Planning Commission, the direct cause of the imbalance was gender identification with "advanced technology" and abortions of female fetuses (Xinhua/China Daily, 1/3). Sex-selective abortion is banned nationwide, but physicians who help people determine a fetus' sex for nonmedical reasons generally face only administrative penalties (Kaiser Daily Women's Health Policy Report, 8/3/06).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Oklahoma Lawmaker Files Bill That Will Reinstate Antiabortion Laws If Roe Is Overturned
Oklahoma state Rep. Mike Reynolds (R) on Wednesday filed a bill (HB 1014) that would reinstate the state's antiabortion laws if the U.S. Supreme Court overturns Roe v. Wade -- the 1973 Supreme Court decision that effectively barred state abortion bans -- the Tulsa World reports. Reynolds said the new composition of justices on the Supreme Court increases the chances that Roe will be reconsidered. "This legislation will ensure the state of Oklahoma acts immediately to save the lives of the unborn if we are given the choice," he added. Linda Meek, executive administrator of Reproductive Services of Tulsa, on Wednesday said that the organization will provide services for women seeking abortions as long as the procedure is legal, adding, "If Roe v. Wade is overturned, we will deal with it at that time." According to Meek, if Roe is overturned and a bill such as the measure introduced by Reynolds is passed, women most likely would go out of state for abortions or resort to "back-alley abortions" (Hinton, Tulsa World, 1/4).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
64% Of Portuguese Voters Favor Lifting Abortion Ban, But High Abstention Rate Might Invalidate Referendum, Poll Says
About 64% of Portuguese voters said they favor lifting the country's ban on abortion, according to a poll released Thursday by Portuguese newspaper Correio da Manha and the pollster Aximage, Reuters reports (Reuters, 1/4). Abortion is illegal in Portugal except when necessary to protect the life or health of a woman or if a woman becomes pregnant as a result of rape. The Portuguese Parliament in October 2006 approved a government proposal to hold a national referendum aimed at decriminalizing abortion in the first 10 weeks of pregnancy. The Portuguese Constitutional Court the following month ruled 7-6 in favor of allowing the referendum, and Portuguese President Anibal Cavaco Silva then approved the referendum, scheduled for Feb. 11. The referendum will ask voters: "Do you agree with the decriminalization of the voluntary interruption of pregnancy, in the first 10 weeks, in a legally authorized health establishment?" (Kaiser Daily Women's Health Policy Report, 11/17/06). The poll also found that 27.3% of the 502 people surveyed said they would vote to uphold the current law. According to the poll, 56.8% of voters are expected to cast a vote on the referendum. Half of the electorate must vote for a referendum to be valid, according to Portuguese law. "It isn't yet clear, but there is a risk of the 'yes' camp winning but voter turnout being less than 50%," pollster Jorge de Sa said (Reuters, 1/4). Officials say that about 10,000 women annually in Portugal are treated at hospitals for complications caused by illegal abortions (Kaiser Daily Women's Health Policy Report, 11/17/06).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Potential Jurors Asked About Views On Abortion In Federal Trial Of Convicted Murderer Kopp
Jury selection for the federal trial of James Kopp -- who in 2003 was convicted of murdering Buffalo, N.Y., abortion provider Barnett Slepian in 1998 -- began on Thursday, the AP/Long Island Newsday reports. According to the AP/Newsday, about 100 potential jurors were questioned about their views on abortion and knowledge of Slepian's murder (Thompson, AP/Long Island Newsday, 1/4). Kopp in 2003 was convicted under state second-degree murder charges and sentenced to 25 years to life in prison for Slepian's murder. In the upcoming trial, he faces charges of violating the federal Freedom of Access to Clinic Entrances Act. The federal charges could carry a sentence of life in prison without parole. Kopp's former attorney, John Humann, had filed a motion to suppress Kopp's confession to the murder despite Kopp's objection. Kopp subsequently made a request to represent himself, which U.S. District Judge Richard Arcara granted in May 2006. Arcara also has ruled that Kopp cannot discuss his antiabortion views or offer abortion-related photographs or testimony during the trial because they are irrelevant (Kaiser Daily Women's Health Policy Report, 12/11/06). Kopp, who is representing himself, and the prosecutors will use questionnaires filled out by the potential jurors to make the jury selection. Opening statements in the case are expected to begin on Tuesday, the AP/Newsday reports (AP/Long Island Newsday, 1/4).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
New York Times Issues Editor's Note About Article On El Salvador Abortion Law
The New York Times on Sunday issued an editor's note about an April 9, 2006, New York Times Magazine article about El Salvador's abortion law (New York Times, 1/7). Byron Calame, the Times' reader representative, in a column published last week wrote that although the article "provided a broad and intriguing look" at the law, "[a]ccuracy and fairness" in regard to a "key example" in the story "were not pursued with the vigor Times readers have the right to expect." The article included an account of how a woman named Carmen Climaco received a 30-year prison sentence after having an abortion at 18 weeks' gestation, Calame writes. According to Calame, "it turns out that trial testimony convinced a court in 2002 that Climaco's pregnancy had resulted in a full-term live birth and that she had strangled the 'recently born'." The court found her guilty of "aggravated homicide," Calame writes, adding that the article's author, Jack Hitt, "suggested that the 'truth' was different." Hitt "never checked" the ruling "while preparing for his story" and said "no editor or fact checker ever asked him if he had checked the court document containing the panel's decision," Calame writes (Kaiser Daily Women's Health Policy Report, 1/3). According to the note, Climaco was sentenced in a case "initially thought to be an abortion but was later ruled to be a homicide," adding that a picture caption with the article "misstated the facts of the ruling." The editor's note says that the Times "should have obtained the text" of the court's ruling before publishing the article, but it "did not vigorously pursue the document until details of the ruling were brought to the attention of editors" in late November 2006. Climaco is appealing the ruling and the Times continues to investigate the case, the note says (New York Times, 1/7).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Kansas AG Morrison Voices Concerns About Security Of Medical Records Of Women Who Underwent Late-Term Abortions
Kansas Attorney General Paul Morrison (D) after being sworn in to the office on Monday said he is concerned the medical records of 90 women and girls who in 2003 underwent late-term abortions subpoenaed by former Attorney General Phill Kline (R) might have been copied, the AP/Wichita Eagle reports (Hanna, AP/Wichita Eagle, 1/8). Kline in 2004 subpoenaed the records of the women and girls who received late-term abortions at Comprehensive Health, which is operated by Planned Parenthood of Kansas and Mid-Missouri in Overland Park, Kan., and Women's Health Care Services in Wichita, Kan., saying there is probable cause that each record contains evidence of a felony. The state Supreme Court in February 2006 ruled that Kline can seek access to the records but that he must return to Shawnee County, Kan., District Court Judge Richard Anderson and present his reasons for seeking the subpoenas. Anderson turned over the records to Kline's office in November 2006 after removing information that would identify individuals (Kaiser Daily Women's Health Policy Report, 12/4/06). Kline last month filed 30 misdemeanor charges against Women's Health Care Services owner George Tiller for allegedly performing 15 illegal late-term abortions in 2003 on patients ages 10 to 22 without properly reporting the details to the state. Kline hired attorney Don McKinney to be special prosecutor in the case (Kaiser Daily Women's Health Policy Report, 1/2). A Sedgwick County, Kan., district judge last month dismissed the charges on a jurisdictional issue at the request Sedgwick County District Attorney Nola Foulston (D), and McKinney filed an appeal to the state Supreme Court. Morrison, who defeated Kline in the November 2006 election, said he does not plan to withdraw McKinney's request. According to the AP/Eagle, the evidence against Tiller includes records from 60 patients who visited Women's Health Care Services (AP/Wichita Eagle, 1/8).
Morrison Fires McKinney, Reaction
Morrison on Tuesday sent a letter to McKinney ordering him "to cease and desist of any further activity" in regard to the Tiller case, the AP/Forbes reports (Hanna, AP/Forbes, 1/9). Morrison said he will demand McKinney return the medical records and any copies he might have made. "I do have concerns about how many copies have been made of [the medical records] and who's got possession of them," Morrison said. He added that his office will give the allegations against Tiller "a really good review" no matter how the state Supreme Court rules on McKinney's appeal. Tiller's attorneys have said the allegations are unfounded (AP/Wichita Eagle, 1/8). "Morrison said he would fire me because I was not a 'neutral third party;' that's a smoke screen," McKinney said adding, "Nobody is neutral about aborting late-term babies. A special prosecutor isn't supposed to be neutral, he's supposed to prosecute the defendant." Kline in a statement Tuesday said Morrison "fired an independent prosecutor with a well-respected legal career and terminated the contract that provided that prosecutor with independent authority." McKinney's last day as special prosecutor will be Saturday (AP/Forbes, 1/9).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Human Rights Advocates In Nicaragua Call On Supreme Court To Declare Country's Abortion Ban Unconstitutional
Some human rights advocates in Nicaragua on Monday called on the Supreme Court to declare the country's abortion ban unconstitutional, Reuters AlertNet reports (Reuters AlertNet, 1/9). Nicaragua's Asamblea Nacional, the national Legislature, in October 2006 voted 52-0 with nine abstentions and 29 not present to pass a bill that bans abortion in all cases, and President Enrique Bolanos in November 2006 signed the measure into law. According to the law, women convicted of having an illegal abortion and those convicted of assisting them receive mandatory six-year prison sentences. The law eliminates exceptions to the country's abortion ban that allow the procedure in the case of rape or when three physicians certify a woman's health is at risk. The Center for Constitutional Rights in Nicaragua had said it planned to file appeals to the Nicaraguan human rights council and the country's Supreme Court saying that the ban violates a woman's right to life (Kaiser Daily Women's Health Policy Report, 11/28/06). Human rights advocates have said the Supreme Court should declare the ban unconstitutional because it violates "fundamental rights and principles," according to Reuters AlertNet. The Supreme Court has not set a date or time frame to issue a ruling on the case (Reuters AlertNet, 1/9).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Some Georgia Antiabortion Group Leaders Not Focusing On Bill That Would Ban Abortion In All Cases
Although several political watchers have said a bill (HB 1) recently introduced in Georgia that would ban abortion in the state under all circumstances is unlikely to pass, it "underscores the balancing act" Republicans in the state General Assembly "must strike" between social conservatives and moderates, the Atlanta Journal-Constitution reports. State Rep. Bobby Franklin (R), sponsor of the bill, has introduced similar measures in each of the past three legislative sessions, and none have reached a vote in the state House. According to the Journal-Constitution, some antiabortion group leaders say they support the measure but are focusing on other legislation. Pat Chivers, spokesperson for the Roman Catholic Archdiocese of Atlanta, said, "There needs to be some changes on the U.S. Supreme Court before there would be a consideration" of Franklin's bill. Dionne Vann, executive director of NARAL Pro-Choice Georgia, said the group is "not too worried" that Franklin's bill would become law, adding, "But we are concerned and keeping an eye on the fact that a growing number of representatives are jumping on the bandwagon for whatever reason." Franklin -- who held a news conference, informal hearing and prayer vigil with supporters of the measure on Tuesday -- said he believes the legislation would pass "if it comes to the House floor." The archdiocese and Georgia Right To Life are supporting a proposed measure that would require a pregnant woman to undergo an ultrasound and view images of the fetus before having an abortion. A similar measure did not pass last year (Campos/Jacobs, Atlanta Journal-Constitution, 1/10).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Federal Appeals Court To Rehear Case Challenging South Dakota Abortion Counseling Law
The 8th U.S. Circuit Court of Appeals in St. Louis on Tuesday announced the full court on April 11 will hear arguments in a lawsuit challenging a 2005 South Dakota law (HB 1166) that would require abortion providers in the state to tell women before performing the procedure that it would "terminate the life of a whole, separate, unique, living human being," the AP/Yankton Daily Press & Dakotan reports (Brokaw, AP/Yankton Daily Press & Dakotan, 1/10). The law, which was signed by Gov. Mike Rounds (R) in March 2005 and was scheduled to take effect in July 2005, requires physicians to fully inform women about risks, consequences and alternatives to abortion, such as adoption, at least two hours before performing the procedure. The law also says that women have a relationship with the fetus until birth and that the state has an interest in protecting that relationship. Planned Parenthood of Minnesota-North Dakota-South Dakota in June 2005 filed suit requesting that the law be blocked because it violates doctors' free speech rights by requiring them to provide inaccurate and ideological information to women seeking abortion. U.S. District Judge Karen Schreier in July 2006 issued a temporary injunction blocking enforcement of the regulation and said the state cannot violate abortion providers' First Amendment rights by requiring them to "espouse the state's theology." A three-judge panel of the 8th Circuit Court in October 2006 ruled 2-1 to uphold Schreier's ruling and sent the case back to her for a final opinion (Kaiser Daily Women's Health Policy Report, 10/31/06). According to the AP/Yankton Daily Press & Dakotan, the state argues that the law would not restrict access to abortion and that the required information is accurate and supported by science (AP/Yankton Daily Press & Dakotan, 1/10).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Many Congressional Democrats Seek Middle Ground On Abortion, Other Issues, New York Times Reports
Democratic congressional leaders say they are "committed to governing from the center" and are hoping "to bring that philosophy to bear on some of the most divisive social issues in politics, like abortion," the New York Times reports. Many Democrats are seeking "common ground" on such issues, according to the Times. Their "moves toward consensus building ... reflect their effort to adjust to a new political reality" -- their majority is "slimmer than it was the last time they were in power" and the country has "grown more conservative on abortion and other social issues," the Times reports. One example of how the "legislative debate has shifted" is that the last time the Democrats controlled Congress, one of the biggest abortion debates was over whether the procedure should be covered in the national health plan proposed by the Clinton administration, the Times reports. Now, abortion-rights supporters are focusing on "far more modest goals," according to the Times. For instance, some Senate Democrats in this congressional session have reintroduced a bill that seeks to reduce the number of abortions in the U.S. by expanding access to contraception, family planning and sex education and providing financial support to new parents. "I can tell you what I expect," Douglas Johnson, legislative director of the National Right to Life Committee, said, "I think the Democratic leadership will seek to advance the policy agenda of the hardcore groups but do so under the cover of deceptive rhetorical campaigns" (Toner, New York Times, 1/16).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Abortion-Related Legislation Recently Introduced In Indiana, Texas, Virginia, Wyoming
The following highlights recent news of state actions on abortion-related legislation.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Abortion Regulations
- Indiana: Two bills (SB 135, SB 172) recently introduced in the state General Assembly would require abortion providers to tell women seeking an abortion that life begins at conception and that a fetus can feel pain, the Indianapolis Star reports (Ruthhart, Indianapolis Star, 1/13). In addition, the bills would require that women seeking abortion receive written notice about adoption and potential physical risks 18 hours before the procedure. Betty Cockrum, president and CEO of Planned Parenthood of Indiana, said the two bills infringe on the doctor-patient relationship and impose religious beliefs on pregnant women (AP/Wabash Plain Dealer, 1/14). Mike Fichter, executive director of Indiana Right to Life, said such information is "critical" for women seeking abortion (Indianapolis Star, 1/13). A similar bill passed last year in the state House but was not approved in the state Senate. Supporters of the legislation have said it has a better chance to pass this year (AP/Wabash Plain Dealer, 1/14). According to the Star, other abortion-related legislation introduced in the General Assembly includes: a bill (HB 1282) that would require clinics to give women information both orally and in writing prior to an abortion; a measure (SB 117) that would allow pharmacists to refuse to fill prescriptions for birth control devices or for medications that would result in an abortion; legislation (SB 194) that would allow physicians who perform abortions to have admitting privileges in the country the procedure is performed and that would allow the patient to be told where she could receive follow-up care from the physician; and a bill (SB 221) that would allow the state Department of Health to create physical specifications for so-called "birthing centers" and abortion clinics that clinics would have to meet by July 2011 (Indianapolis Star, 1/13).
- Texas: State Sen. Dan Patrick (R) last week filed a measure that would ban abortion in the state if Roe v. Wade, the 1973 Supreme Court decision that effectively barred state abortion bans, was overturned, the Dallas Morning News reports. "Many of us on the pro-life side and even those on the pro-choice side believe it is a matter of time before Roe v. Wade is overturned," Patrick, a radio talk-show host who was sworn into office on Jan. 9, said, adding, "I want to have a law on the books in Texas that clearly says if Roe v. Wade is overturned, there will be no abortions in Texas." A companion bill has been filed in the House by Rep. Warren Chisum (R). The Texas Senate requires a two-thirds vote to agree to consider a bill before it can come up for debate (Stutz, Dallas Morning News, 1/11).
- Virginia: The state General Assembly is considering several bills involving abortion and pregnancy in 2007, including a total ban on the procedure if the U.S. Supreme Court overturns Roe v. Wade -- the 1973 Supreme Court decision that effectively barred state abortion bans -- the Washington Post reports (Craig, Washington Post, 1/15). The legislation banning abortion would provide an exception when the life of the pregnant women is threatened (Washington Post, 1/15). Gov. Tim Kaine (D) has said he would veto any bill that outlaws abortion, the Post reports (Craig, Washington Post, 1/15). Other legislation under consideration would require parental consent before a minor can receive contraceptives; require clinics that perform abortions to be licensed by the state and abide by requirements for ambulatory surgery centers; and make coerced or forced abortions a misdemeanor or felony if committed by the father. In addition, lawmakers are considering bills that would change the state feticide law -- which makes the unlawful killing of a fetus by someone other than the woman a felony -- to include the women carrying the fetus; allow the state to charge a pregnant women with a felony if she misuses controlled substances; and compel the state to study reasons why women receive abortions (Washington Post, 1/15).
- Wyoming: A bill (HB 144) recently introduced in the state Legislature would require abortion providers in the state to tell women seeking an abortion about alternatives to the procedure and to inform women about the potential risks and side effects of abortion, including "increased risks of breast cancer," the AP/Jackson Hole Star Tribune reports. The legislation, called the "Woman's Right to Know Act," also would require doctors to explain to a woman the anatomical characteristics of her fetus. The bill would require the Wyoming Department of Health to supply abortion providers with printed materials about abortion to distribute to women seeking the procedure. The printed materials would be required to state that there are organizations willing to help women carry pregnancies to term and that the "state of Wyoming strongly urges you to contact one or more of these agencies before making a final decision about your abortion." State Rep. Bob Brechtel (R), sponsor of the bill, said the bill does not aim to limit access to abortion. Sharon Breitweiser, executive director of NARAL Pro-Choice Wyoming, said the bill "falsely links breast cancer and abortion," adding, "It replaces medical judgment with government intrusion" (Neary, AP/Jackson Hole Star Tribune, 1/11).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Greater Transparency Urged About Use Of Aborted Foetuses In Stem Cell Research
Women in the UK should be provided with detailed information about how aborted foetuses might be used in stem cell research, say leading social scientists.
Writing in the Royal Society of Medicine's Clinical Ethics journal, Naomi Pfeffer* and Julie Kent** said the rules in relation to consent to the use in research of aborted foetuses and embryos were inconsistent.
"Women who agree to the use of their aborted foetuses in stem cell research may only be provided with general information. There is no consistency across hospitals on the type of information provided and women are unable to refuse to allow foetuses to be used in some projects but not others," said the authors.
"As a result, some women are told how the foetus might be used, others are given almost no idea," they added.
Stem cell research using embryos created in an IVF clinic is regulated by the Human Fertilisation and Embryology Authority (HFEA) which requires specific consent to be sought. Women are provided with detailed information about the type of research and/or medical conditions for which their embryos may be used before they give consent. They are also told whether the research is basic research or intended for commercial purposes.
Research using foetal tissue is covered by the Polkinghorne Guidelines which were established in 1989 and still apply. The Polkinghorne Guidelines state that consent from a woman should be general and not specific. These guidelines are in turn interpreted and implemented by Research Ethics Committees, who have no remit to public engagement.
"The Polkinghorne Guidelines were drawn up before the current interest in stem cell had developed. Foetuses are now being used for stem cell research and the guidelines should be re-addressed so that there is consistency with current standards of consent in other types of research," said Dr Kent.
"The HFEA lists all research projects which it has approved in its annual report. However, there is almost no public information about the use of foetuses in stem cell science," she said.
Professor Pfeffer said: "There needs to be greater transparency about how aborted foetuses are used in stem cell research. If the UK is to continue to be seen as facilitating stem cell research through strong regulation, then the Polkinghorne Guidelines need to be urgently clarified."
###
* London Metropolitan University
** University of the West of England, Bristol
EMPIRICAL ETHICS
Consent to the use of aborted fetuses in stem cell research and therapies
Authors:
N Pfeffer
Department of Applied Social Sciences,
London Metropolitan University
http://www.londonmet.ac.uk/
J Kent
School of Sociology,
University of the West of England, Bristol
http://www.uwe.ac.uk
Abstract:
This paper identifies the legal and policy framework relating to the use of aborted fetuses in stem cell research and therapies and contrasts this with the collection of embryos for research. It suggests that more attention should be given to questions about the kind of consent sought by researchers from women and that there should be more transparency about how aborted fetuses are used. It reports on variability in current practices of research ethics committees and researchers and uncertainty about the guidance available to them. It argues that there is a need for wide public discussion about the policy issues relating to fetal tissue use in stem cell research and the need for clarification of the law in this area.
Aborted fetuses are widely used in medical research, both in established fields such as developmental biology and virology, and more recently in pushing back the frontiers of stem cell science. Aborted fetuses are 'produced' by a legal but nonetheless controversial procedure, and their association with pregnancy and reproduction makes their status as human tissue ambiguous. Yet the issues they provoke have received little public scrutiny. This paper addresses two of them: first, what kind of consent should be sought by medical researchers from women undergoing a termination; and second, how transparent should the collection of aborted fetuses be? We draw on some preliminary findings of research into the social, ethical and political conditions under which aborted fetuses are collected and used in stem cell research.1
English law does not recognize a distinction between a fetus in utero and the woman in which it is implanted; put another way, tissue of the fetus in utero and that of a fetus ex utero (up to 24 weeks gestation and that has not been born alive) is the woman's tissue and can be treated like other 'residual tissue' following clinical and diagnostic procedures, of which many millions are carried out each year.2 As such, aborted fetuses fall under the provisions of the Human Tissue Act 2004.3 The separate provisions of the Human Fertilisation and Embryology Act 19904 afford the embryo created in vitro a high level of protection, and the Human Fertilisation and Embryology Authority (HFEA) regulates the creation and use of embryos in treatment and research, including stem cell research. Embryos are regarded in law as exceptional. Together with the EU Tissue and Cells Directive 2004,5 this forms a new legal framework for the collection of all human tissue for research and therapeutic use.
Policy makers, however, acknowledge that the public regard pregnancy-related tissue differently to other residual tissue. The distinctive status of the aborted fetus is recognized in the Polkinghorne Guidelines (1989), which currently govern fetal research. The Polkinghorne Guidelines are named after Reverend Dr John Polkinghorne, chairman of the committee which drew them up. The committee took the view that only tissue from the dead fetus ex utero is ethically available for use; the 'supply' of fetal tissue must be separated from the practice of research and therapy - in other words, the investigator must not be involved in the procedure (the 'separation principle'); the method of terminating the pregnancy must not be influenced by research requirements; and consent for research should be general, not specific (that is, details of the research which might use the material should not be specified to the woman). The committee had been persuaded that women might be influenced in their decision to have an abortion by the possibility of the fetus being used in a particular way; for example, they might conceive a pregnancy deliberately to provide neural tissue for transplantation into a relative with Parkinson's disease.
In the years since the Polkinghorne Guidelines were drawn up, specific and not general consent to the use of human tissue in research has become the norm, yet - controversially - because of the way consent guidelines have been framed with regard to women undergoing termination of pregnancy, they have been treated differently.
The working party convened in 2000 by the Medical Research Council (MRC) to produce guidelines on the collection of human tissue and biological samples for use in research insisted that specific consent is sought for the use of all human biological material in research, but made an exception of aborted fetuses, where general consent must apply.6 Three years later, responses to Human Bodies, Human Choices, the consultation document which informed the Human Tissue Act, revealed some agreement on a move towards specific consent in relation to the collection of aborted fetuses but also some resistance to providing women with a great deal of information about any future research.7
The Human Tissue Authority (HTA), the competent authority with responsibility for both implementing the EU Tissue and Cells Directive and the Human Tissue Act, has issued guidance on the general requirements and good practice regarding the need for consent in relation to the storage and use of human tissue. Section 66 of its Code of Practice on consent states:
'The law does not distinguish between fetal tissue and other tissue from the living - fetal tissue is regarded as the mother's tissue. However, because of the sensitivity attached to this subject, consent should be obtained for the examination of fetal tissue and for its use for all scheduled purposes, regardless of gestational age. It is considered good practice that, wherever practicable, consent should also be obtained for the use in research of non-fetal products of conception. Research Ethics Committee approval is always required for the use of fetal tissue and products of conception in research.'8
However, the Human Tissue Act does not define what constitutes appropriate consent and the HTA has not yet provided any guidance save for a reminder that common law applies.
We found a wide variability in the kinds of information being given to women being asked to agree to the use of aborted fetuses in stem cell research. Some information sheets describe at length the project for which aborted fetuses are sought; some provide a brief account of several different projects in which the fetus might be used; some set out briefly a very broad field. None offer women a choice to agree to the fetus being used in some projects but not others. Yet some projects are funded by the MRC, whose model consent form for research involving new samples of human biological material allows people to agree to or refuse the use of their tissue in possible future research projects, genetic tests of known clinical and/or predictive value, and other genetic research.
This variability suggests uncertainty on the part of members of Research Ethics Committees about whether or not general or specific consent is required or desirable. No- one has taken responsibility for clarifying the situation. Yet, following a complaint by Professor Austin Smith (a leading stem cell scientist) to members of the House of Commons' Science and Technology Committee about the failure of the HFEA to provide guidelines for drawing up consent forms for embryo donors,9 the MRC agreed to sponsor a review of the paperwork by a nationwide network of stem cell co-ordinators working in IVF clinics associated with stem cell laboratories, a review expected to result in a standardized approach organized around the specific consent requirements of the Human Fertilisation and Embryology Act.10 While it may be considered unnecessary or inappropriate to prescribe a uniform approach in relation to information about the use of aborted fetuses in research, there is clearly a need for agreement in this area.
The Polkinghorne Guidelines were drawn up by a committee of four people convened to consider concerns about the use of neural tissue of aborted fetuses in experimental transplants into the brains of people with Parkinson's disease.11 Whether or not the Guidelines meet the requirements of stem cell scientists is unclear. Nor is it possible to tell whether some operate within them while others do not, and whether those deviating from them do so with or outwith the agreement of the Research Ethics Committee which reviewed their proposal: the Polkinghorne committee did not see the need for a system of public oversight. Yet in the year following publication of its Guidelines, the Human Fertilisation and Embryology Act created the HFEA, which is charged with (amongst other things) oversight and inspection of how embryos created in vitro are sought and used in research.
The government has responded to requests for the amendment of the Human Fertilisation and Embryology Act to accommodate the requirements of stem cell scientists.12 The Human Fertilisation and Embryology (Research Purposes) Regulations 2001 extended the list of purposes for which human embryo research could be licensed by the HFEA to include research aimed at understanding the development of embryos, or understanding or treating serious disease; that is, it effectively provides a regulated space in which human embryos might legitimately be used in stem cell research.13 The Department of Health is responsible for keeping the Polkinghorne Guidelines up to date. Its first and only official amendment was issued in 1995 in an NHS circular which encouraged investigators to source frozen fetal material from the MRC Fetal Tissue Bank at Hammersmith Hospital (now closed), which then stood as an intermediary body between source (a woman) and user (a researcher).14 However, the Department also recognized that some research needs 'fresh' material and allowed investigators to establish what it called 'local arrangements' - that is, to find a compliant local hospital or clinic.
The Department of Health's modification of the Polkinghorne Guidelines took place without public debate. Yet nowadays, in situations such as abortion where moral pluralism is found, the importance of transparency in policy making is emphasized. The HFEA boasts of its capacity to maintain public confidence in a controversial field and takes the lead in encouraging awareness and debate about research and treatment involving human embryos. As Suzi Leather, HFEA's current chair, told the House of Commons Science and Technology Committee, they do this by 'communicating what we are doing, communicating what the possibilities of science are, what the benefits and disbenefits are.'15 In contrast, Research Ethics Committees, who are responsible for interpreting and implementing the Polkinghorne Guidelines, have no remit in relation to public engagement. Indeed, whereas the HFEA meets in public, they deliberate behind closed doors.16 There is currently no publicly available information about the projects using fetal tissue in research, whereas the HFEA, in its annual report, lists all the research projects which it has approved.
In our view what is needed is a wide public discussion about the issues surrounding the use of fetal material for stem cell and other research.17 A system of governance which provides clear oversight and transparency will also provide protection for researchers using fetal material. Moreover, if the UK environment is to continue to be seen as facilitating stem cell research because of its strong approach to regulation, the current contradictions between the guidance set out in the Polkinghorne Guidelines and the law need clarification.
References
1 The research falls under a programme of research looking at social, ethical and political aspects of stem cell science sponsored by the Economic and Social Research Council. RES -340-25-0002
2 Human Tissue Authority. Code of Practice 5: Removal, Storage and Disposal of Human Organs and Tissue. Available at http://www.hta. gov.uk/_db/_documents/2006-07-04_Approved_by_ Parliament_-_Code_of_Practice_5_-_Removal.pdf (accessed July 2006)
3 Human Tissue Act 2004. London, TSO
4 Human Fertilisation and Embryology Act 1990 (c 37). London: HMSO
5 Directive 2004/23/EC of the European Parliament and of the Council of 31 March 2004 on Setting Standards of Quality and Safety for the Donation, Procurement, Testing, Processing, Preservation, Storage and Distribution of Human Tissues and Cells. Official Journal L102 48-58
6 Medical Research Council. Human Tissue and Biological Samples for use in Research: Operational and Ethical Guidelines. London: MRC, 2001
7 Department of Health. Human Bodies, Human Choices: Summary of Responses to the Consultation Document. London: DoH, 2003
8 Human Tissue Authority. Code of Practice 1: Consent. Available at http://www.hta.gov.uk/_db/_documents/2006-07-04_Approved_ by_Parliament_-_Code_of_Practice_1_-_Consent.pdf (accessed July 2006)
9 Memorandum submitted by Professor Austin Smith, Centre for Genome Research, University of Edinburgh, to The Science and Technology Committee. Developments in Human Genetics and Embryology, Appendix 4. London: HMSO, 2002. Available at http://www.publications.parliament.uk/pa/cm200102/cmselect/cmscte ch/791/791ap06.htm (accessed 14 July 2006)
10 Franklin S. Embryonic Economies: The double reproductive value of stem cells. Biosocieties 2006;1:71-90
11 Review of the Guidance on the Research Use of Fetuses and Fetal Material. Cm762. London: HMSO, 1989
12 Human Fertilisation and Embryology (Research Purposes) Regulations 2001. London: TSO, 2001
13 Human Fertilisation and Embryology (Research Purposes) Regulations 2001. Statutory Instrument 2001 no.188. Available at www.opsi. gov.uk/si/si2001/20010188.htm (accessed 21/11/2005)
14 Department of Health. Guidance on the Use of Fetal Tissue for Research, Diagnosis and Therapy. London: DoH, 1995
15 Leather S. Minutes of evidence. In: The Science and Technology Committee. Developments in Human Genetics and Embryology. London: HMSO, 2002. Available at http://www.publications.parliament.uk/pa/cm200102/cmselect/cmsctech/791/2042403.htm (accessed 14/07/2006)
16 Ashcroft R, Pfeffer N. Ethics behind closed doors: do research ethics committees need secrecy? BMJ 2001;322:1294-6
17 Kent J, Pfeffer N. Regulating the collection and use of fetal stem cells. BMJ 2006;332:866-7
Clinical Ethics 2006 Volume 1 Number 4
'Consent to the use of aborted foetuses in stem cell research and analysis' by N Pfeffer and J Kent is published in the current issue of Clinical Ethics (2006; 1: 216-218).
Naomi Pfeffer is Professor of Social and Historical Studies of Health at London Metropolitan University. Her research investigates controversial developments in medicine during the second half of the twentieth century, specifically reproductive technologies, human tissue collections and the development and conduct of medical research ethics. Her latest book, Insider Trading: Collecting Human Tissue for Medicine in the USA and UK (Yale University Press), will be published in 2008. Naomi has been involved in CERES (Consumers for Ethics in Research) since it was established in 1989 and is currently its Chair. She also serves on the Human Remains Advisory Service established by the Department of Culture, Media and Sport.
Julie Kent is Reader in Sociology of Health Technology at the University of the West of England, Bristol. She has research interests around the regulation and governance of health technologies, the emergence of new tissue and cell based technologies and the implications for conceptions of the body, self and identity. She is currently writing a book on regenerative medicine. She is a member of the Medicines and Healthcare products Regulatory Authority, Committee on Safety of Devices.
Clinical Ethics is published quarterly by the Royal Society of Medicine. Its Editors are Bobbie Farsides and Sue Eckstein. http://www.clinicalethics.co.uk
Writing in the Royal Society of Medicine's Clinical Ethics journal, Naomi Pfeffer* and Julie Kent** said the rules in relation to consent to the use in research of aborted foetuses and embryos were inconsistent.
"Women who agree to the use of their aborted foetuses in stem cell research may only be provided with general information. There is no consistency across hospitals on the type of information provided and women are unable to refuse to allow foetuses to be used in some projects but not others," said the authors.
"As a result, some women are told how the foetus might be used, others are given almost no idea," they added.
Stem cell research using embryos created in an IVF clinic is regulated by the Human Fertilisation and Embryology Authority (HFEA) which requires specific consent to be sought. Women are provided with detailed information about the type of research and/or medical conditions for which their embryos may be used before they give consent. They are also told whether the research is basic research or intended for commercial purposes.
Research using foetal tissue is covered by the Polkinghorne Guidelines which were established in 1989 and still apply. The Polkinghorne Guidelines state that consent from a woman should be general and not specific. These guidelines are in turn interpreted and implemented by Research Ethics Committees, who have no remit to public engagement.
"The Polkinghorne Guidelines were drawn up before the current interest in stem cell had developed. Foetuses are now being used for stem cell research and the guidelines should be re-addressed so that there is consistency with current standards of consent in other types of research," said Dr Kent.
"The HFEA lists all research projects which it has approved in its annual report. However, there is almost no public information about the use of foetuses in stem cell science," she said.
Professor Pfeffer said: "There needs to be greater transparency about how aborted foetuses are used in stem cell research. If the UK is to continue to be seen as facilitating stem cell research through strong regulation, then the Polkinghorne Guidelines need to be urgently clarified."
###
* London Metropolitan University
** University of the West of England, Bristol
EMPIRICAL ETHICS
Consent to the use of aborted fetuses in stem cell research and therapies
Authors:
N Pfeffer
Department of Applied Social Sciences,
London Metropolitan University
http://www.londonmet.ac.uk/
J Kent
School of Sociology,
University of the West of England, Bristol
http://www.uwe.ac.uk
Abstract:
This paper identifies the legal and policy framework relating to the use of aborted fetuses in stem cell research and therapies and contrasts this with the collection of embryos for research. It suggests that more attention should be given to questions about the kind of consent sought by researchers from women and that there should be more transparency about how aborted fetuses are used. It reports on variability in current practices of research ethics committees and researchers and uncertainty about the guidance available to them. It argues that there is a need for wide public discussion about the policy issues relating to fetal tissue use in stem cell research and the need for clarification of the law in this area.
Aborted fetuses are widely used in medical research, both in established fields such as developmental biology and virology, and more recently in pushing back the frontiers of stem cell science. Aborted fetuses are 'produced' by a legal but nonetheless controversial procedure, and their association with pregnancy and reproduction makes their status as human tissue ambiguous. Yet the issues they provoke have received little public scrutiny. This paper addresses two of them: first, what kind of consent should be sought by medical researchers from women undergoing a termination; and second, how transparent should the collection of aborted fetuses be? We draw on some preliminary findings of research into the social, ethical and political conditions under which aborted fetuses are collected and used in stem cell research.1
English law does not recognize a distinction between a fetus in utero and the woman in which it is implanted; put another way, tissue of the fetus in utero and that of a fetus ex utero (up to 24 weeks gestation and that has not been born alive) is the woman's tissue and can be treated like other 'residual tissue' following clinical and diagnostic procedures, of which many millions are carried out each year.2 As such, aborted fetuses fall under the provisions of the Human Tissue Act 2004.3 The separate provisions of the Human Fertilisation and Embryology Act 19904 afford the embryo created in vitro a high level of protection, and the Human Fertilisation and Embryology Authority (HFEA) regulates the creation and use of embryos in treatment and research, including stem cell research. Embryos are regarded in law as exceptional. Together with the EU Tissue and Cells Directive 2004,5 this forms a new legal framework for the collection of all human tissue for research and therapeutic use.
Policy makers, however, acknowledge that the public regard pregnancy-related tissue differently to other residual tissue. The distinctive status of the aborted fetus is recognized in the Polkinghorne Guidelines (1989), which currently govern fetal research. The Polkinghorne Guidelines are named after Reverend Dr John Polkinghorne, chairman of the committee which drew them up. The committee took the view that only tissue from the dead fetus ex utero is ethically available for use; the 'supply' of fetal tissue must be separated from the practice of research and therapy - in other words, the investigator must not be involved in the procedure (the 'separation principle'); the method of terminating the pregnancy must not be influenced by research requirements; and consent for research should be general, not specific (that is, details of the research which might use the material should not be specified to the woman). The committee had been persuaded that women might be influenced in their decision to have an abortion by the possibility of the fetus being used in a particular way; for example, they might conceive a pregnancy deliberately to provide neural tissue for transplantation into a relative with Parkinson's disease.
In the years since the Polkinghorne Guidelines were drawn up, specific and not general consent to the use of human tissue in research has become the norm, yet - controversially - because of the way consent guidelines have been framed with regard to women undergoing termination of pregnancy, they have been treated differently.
The working party convened in 2000 by the Medical Research Council (MRC) to produce guidelines on the collection of human tissue and biological samples for use in research insisted that specific consent is sought for the use of all human biological material in research, but made an exception of aborted fetuses, where general consent must apply.6 Three years later, responses to Human Bodies, Human Choices, the consultation document which informed the Human Tissue Act, revealed some agreement on a move towards specific consent in relation to the collection of aborted fetuses but also some resistance to providing women with a great deal of information about any future research.7
The Human Tissue Authority (HTA), the competent authority with responsibility for both implementing the EU Tissue and Cells Directive and the Human Tissue Act, has issued guidance on the general requirements and good practice regarding the need for consent in relation to the storage and use of human tissue. Section 66 of its Code of Practice on consent states:
'The law does not distinguish between fetal tissue and other tissue from the living - fetal tissue is regarded as the mother's tissue. However, because of the sensitivity attached to this subject, consent should be obtained for the examination of fetal tissue and for its use for all scheduled purposes, regardless of gestational age. It is considered good practice that, wherever practicable, consent should also be obtained for the use in research of non-fetal products of conception. Research Ethics Committee approval is always required for the use of fetal tissue and products of conception in research.'8
However, the Human Tissue Act does not define what constitutes appropriate consent and the HTA has not yet provided any guidance save for a reminder that common law applies.
We found a wide variability in the kinds of information being given to women being asked to agree to the use of aborted fetuses in stem cell research. Some information sheets describe at length the project for which aborted fetuses are sought; some provide a brief account of several different projects in which the fetus might be used; some set out briefly a very broad field. None offer women a choice to agree to the fetus being used in some projects but not others. Yet some projects are funded by the MRC, whose model consent form for research involving new samples of human biological material allows people to agree to or refuse the use of their tissue in possible future research projects, genetic tests of known clinical and/or predictive value, and other genetic research.
This variability suggests uncertainty on the part of members of Research Ethics Committees about whether or not general or specific consent is required or desirable. No- one has taken responsibility for clarifying the situation. Yet, following a complaint by Professor Austin Smith (a leading stem cell scientist) to members of the House of Commons' Science and Technology Committee about the failure of the HFEA to provide guidelines for drawing up consent forms for embryo donors,9 the MRC agreed to sponsor a review of the paperwork by a nationwide network of stem cell co-ordinators working in IVF clinics associated with stem cell laboratories, a review expected to result in a standardized approach organized around the specific consent requirements of the Human Fertilisation and Embryology Act.10 While it may be considered unnecessary or inappropriate to prescribe a uniform approach in relation to information about the use of aborted fetuses in research, there is clearly a need for agreement in this area.
The Polkinghorne Guidelines were drawn up by a committee of four people convened to consider concerns about the use of neural tissue of aborted fetuses in experimental transplants into the brains of people with Parkinson's disease.11 Whether or not the Guidelines meet the requirements of stem cell scientists is unclear. Nor is it possible to tell whether some operate within them while others do not, and whether those deviating from them do so with or outwith the agreement of the Research Ethics Committee which reviewed their proposal: the Polkinghorne committee did not see the need for a system of public oversight. Yet in the year following publication of its Guidelines, the Human Fertilisation and Embryology Act created the HFEA, which is charged with (amongst other things) oversight and inspection of how embryos created in vitro are sought and used in research.
The government has responded to requests for the amendment of the Human Fertilisation and Embryology Act to accommodate the requirements of stem cell scientists.12 The Human Fertilisation and Embryology (Research Purposes) Regulations 2001 extended the list of purposes for which human embryo research could be licensed by the HFEA to include research aimed at understanding the development of embryos, or understanding or treating serious disease; that is, it effectively provides a regulated space in which human embryos might legitimately be used in stem cell research.13 The Department of Health is responsible for keeping the Polkinghorne Guidelines up to date. Its first and only official amendment was issued in 1995 in an NHS circular which encouraged investigators to source frozen fetal material from the MRC Fetal Tissue Bank at Hammersmith Hospital (now closed), which then stood as an intermediary body between source (a woman) and user (a researcher).14 However, the Department also recognized that some research needs 'fresh' material and allowed investigators to establish what it called 'local arrangements' - that is, to find a compliant local hospital or clinic.
The Department of Health's modification of the Polkinghorne Guidelines took place without public debate. Yet nowadays, in situations such as abortion where moral pluralism is found, the importance of transparency in policy making is emphasized. The HFEA boasts of its capacity to maintain public confidence in a controversial field and takes the lead in encouraging awareness and debate about research and treatment involving human embryos. As Suzi Leather, HFEA's current chair, told the House of Commons Science and Technology Committee, they do this by 'communicating what we are doing, communicating what the possibilities of science are, what the benefits and disbenefits are.'15 In contrast, Research Ethics Committees, who are responsible for interpreting and implementing the Polkinghorne Guidelines, have no remit in relation to public engagement. Indeed, whereas the HFEA meets in public, they deliberate behind closed doors.16 There is currently no publicly available information about the projects using fetal tissue in research, whereas the HFEA, in its annual report, lists all the research projects which it has approved.
In our view what is needed is a wide public discussion about the issues surrounding the use of fetal material for stem cell and other research.17 A system of governance which provides clear oversight and transparency will also provide protection for researchers using fetal material. Moreover, if the UK environment is to continue to be seen as facilitating stem cell research because of its strong approach to regulation, the current contradictions between the guidance set out in the Polkinghorne Guidelines and the law need clarification.
References
1 The research falls under a programme of research looking at social, ethical and political aspects of stem cell science sponsored by the Economic and Social Research Council. RES -340-25-0002
2 Human Tissue Authority. Code of Practice 5: Removal, Storage and Disposal of Human Organs and Tissue. Available at http://www.hta. gov.uk/_db/_documents/2006-07-04_Approved_by_ Parliament_-_Code_of_Practice_5_-_Removal.pdf (accessed July 2006)
3 Human Tissue Act 2004. London, TSO
4 Human Fertilisation and Embryology Act 1990 (c 37). London: HMSO
5 Directive 2004/23/EC of the European Parliament and of the Council of 31 March 2004 on Setting Standards of Quality and Safety for the Donation, Procurement, Testing, Processing, Preservation, Storage and Distribution of Human Tissues and Cells. Official Journal L102 48-58
6 Medical Research Council. Human Tissue and Biological Samples for use in Research: Operational and Ethical Guidelines. London: MRC, 2001
7 Department of Health. Human Bodies, Human Choices: Summary of Responses to the Consultation Document. London: DoH, 2003
8 Human Tissue Authority. Code of Practice 1: Consent. Available at http://www.hta.gov.uk/_db/_documents/2006-07-04_Approved_ by_Parliament_-_Code_of_Practice_1_-_Consent.pdf (accessed July 2006)
9 Memorandum submitted by Professor Austin Smith, Centre for Genome Research, University of Edinburgh, to The Science and Technology Committee. Developments in Human Genetics and Embryology, Appendix 4. London: HMSO, 2002. Available at http://www.publications.parliament.uk/pa/cm200102/cmselect/cmscte ch/791/791ap06.htm (accessed 14 July 2006)
10 Franklin S. Embryonic Economies: The double reproductive value of stem cells. Biosocieties 2006;1:71-90
11 Review of the Guidance on the Research Use of Fetuses and Fetal Material. Cm762. London: HMSO, 1989
12 Human Fertilisation and Embryology (Research Purposes) Regulations 2001. London: TSO, 2001
13 Human Fertilisation and Embryology (Research Purposes) Regulations 2001. Statutory Instrument 2001 no.188. Available at www.opsi. gov.uk/si/si2001/20010188.htm (accessed 21/11/2005)
14 Department of Health. Guidance on the Use of Fetal Tissue for Research, Diagnosis and Therapy. London: DoH, 1995
15 Leather S. Minutes of evidence. In: The Science and Technology Committee. Developments in Human Genetics and Embryology. London: HMSO, 2002. Available at http://www.publications.parliament.uk/pa/cm200102/cmselect/cmsctech/791/2042403.htm (accessed 14/07/2006)
16 Ashcroft R, Pfeffer N. Ethics behind closed doors: do research ethics committees need secrecy? BMJ 2001;322:1294-6
17 Kent J, Pfeffer N. Regulating the collection and use of fetal stem cells. BMJ 2006;332:866-7
Clinical Ethics 2006 Volume 1 Number 4
'Consent to the use of aborted foetuses in stem cell research and analysis' by N Pfeffer and J Kent is published in the current issue of Clinical Ethics (2006; 1: 216-218).
Naomi Pfeffer is Professor of Social and Historical Studies of Health at London Metropolitan University. Her research investigates controversial developments in medicine during the second half of the twentieth century, specifically reproductive technologies, human tissue collections and the development and conduct of medical research ethics. Her latest book, Insider Trading: Collecting Human Tissue for Medicine in the USA and UK (Yale University Press), will be published in 2008. Naomi has been involved in CERES (Consumers for Ethics in Research) since it was established in 1989 and is currently its Chair. She also serves on the Human Remains Advisory Service established by the Department of Culture, Media and Sport.
Julie Kent is Reader in Sociology of Health Technology at the University of the West of England, Bristol. She has research interests around the regulation and governance of health technologies, the emergence of new tissue and cell based technologies and the implications for conceptions of the body, self and identity. She is currently writing a book on regenerative medicine. She is a member of the Medicines and Healthcare products Regulatory Authority, Committee on Safety of Devices.
Clinical Ethics is published quarterly by the Royal Society of Medicine. Its Editors are Bobbie Farsides and Sue Eckstein. http://www.clinicalethics.co.uk
Advocate Protesting China's One-Child Policy Sentenced To Two-and-a-Half-Year Prison Sentence For Breaking Lamps, Group Says
Human rights advocate Mao Hengfeng, who has protested for the past 19 years against China's one-child-per-family policy, recently was sentenced to an additional two-and-a-half years in prison for breaking two lamps while in a detention house in Shanghai, the advocacy group Human Rights in China said on Wednesday, the Agence France-Presse reports (Agence France-Presse, 1/16). Mao in 1988 was fired from her job at a Shanghai soap factory after becoming pregnant with a second child. She carried her pregnancy to term despite pressure from the government to have an abortion. After Mao became pregnant again, she sued the soap factory for firing her, and the presiding judge told her he would rule in her favor if she aborted her third pregnancy. She then aborted her pregnancy at seven months gestation, but the court ruled against her, saying that the factory had a right to dismiss her because she violated China's family planning policy. Mao in April 2004 was sentenced to 18 months in a prison labor camp for refusing to stop protesting the government's family planning policy. According to Human Rights in China, Chinese authorities in January 2005 added three months to the sentence, and Mao allegedly has been tortured while in custody because of her protests. China's State Council in a January 2005 statement said Mao's incarceration "had nothing to do with the family planning policy" and her firing from the soap factory was because she missed 16 days of work, not because she was pregnant for a second time (Kaiser Daily Women's Health Policy Report, 1/11/05). According to a Human Rights in China release, Mao was being held in a detention house in Shanghai with six other men and women and broke two lamps while protesting the conditions. Shanghai court sentenced Mao to prison for "intentionally destroying property" according to the release. The group "condemn[ed]" the sentence for being "disproportionate to the crime" of which Mao was convicted, adding, "The handling of this case by the public security and judicial authorities raises strong concerns of retaliation against individuals invoking their constitutionally protected right to petition the authorities" (Agence France-Presse, 1/16).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Colorado, Kansas, West Virginia Introduce Legislation On HPV Vaccines, Abortion
The following highlights recent news on state actions regarding human papillomavirus vaccines and abortion.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
HPV Vaccines
- Colorado: State House Minority Leader Mike May (R) and state Sen. Suzanne Williams (D) recently introduced a bill that would require girls ages 12 and older to show proof they have received Merck's HPV vaccine Gardasil or show that their parents have declined the vaccine, the Denver Post reports. The bill also would require health care providers to give parents information about Gardasil, HPV and HPV's link to cervical cancer (Auge, Denver Post, 1/16). According to Merck, Gardasil -- which is given in three injections over six months and costs $360 -- in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. CDC's Advisory Committee on Immunization Practices in July 2006 voted unanimously to recommend that girls ages 11 and 12 receive the vaccine. CDC has added Gardasil to its Vaccines for Children Program, which provides no-cost immunizations to children ages nine to 18 covered by Medicaid, Alaska Native and American Indian children, and some uninsured and underinsured children (Kaiser Daily Women's Health Policy Report, 11/2/06). According to the Post, the Child Health Plan Plus also will pay for the vaccine in Colorado. About 57,000 children in the state are in families who lack health insurance and who have incomes too high to qualify for Medicaid or Child Health Plan Plus, according to the Colorado Children's Campaign. Some groups who oppose government vaccine requirements, as well as some social conservatives who say giving Gardasil to young girls could encourage sexual promiscuity, have voiced opposition to the measure. May said the bill would not mandate vaccination. "Other than that it's parental choice," he said. The legislation would take effect in 2008 if passed (Denver Post, 1/16).
- West Virginia: State Delegate Bonnie Brown (D) on Wednesday announced that she is sponsoring a bill that would require all girls entering the sixth grade to receive Gardasil, the AP/BusinessWeek reports. West Virginia has the second-highest cervical cancer mortality rate in the U.S. Brown said details of how the vaccine -- which costs $360 for the full course -- will be funded are not in the legislation. She said the state Public Employees Insurance Agency and Medicaid will cover for the vaccinations for some people, and some private insurers are assessing the cost to cover Gardasil. There are 10,235 girls entering the sixth the grade this year in West Virginia, Department of Education spokesperson Liza Cordeiro said (Breen, AP/BusinessWeek, 1/16).
Abortion Regulations
- Kansas: The state Senate Judiciary Committee on Tuesday said it would sponsor a bill aimed at increasing the penalties for homicides of pregnant women, and the state House Judiciary Committee on Thursday is scheduled to hold a hearing on legislation (HB 2006, SB 2) that would define a "person" in Kansas criminal code as an "unborn child" from the time of conception, the AP/Wichita Eagle reports. Similar bills to the House measure in 2002 and 2005 passed in the state House but were not voted on in the state Senate. The House proposal is backed by abortion-rights opponents, while abortion-rights supporters have suggested that the state instead make it a crime to harm a fetus or increase the penalties for crimes against pregnant women and girls. Ashley Anstaett -- spokesperson for Kansas Attorney General Paul Morrison (D), who supports abortion rights -- said increased penalties for crimes against pregnant women are the "best way to deal with these kind of situations" (Hanna, AP/Wichita Eagle, 1/16).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
February 27, 2007
Keroack Appointment 'Roadblock' Toward 'Middle Ground' Of Reducing Abortions, Maintaining Abortion Rights, Opinion Piece Says
Democrats in Congress plan to consider several bills that would "at the very least expand family planning programs to more women, especially poor women," but President Bush's recent appointment of Eric Keroack to deputy assistant secretary of HHS' Office of Population Affairs is a "roadblock to this common ground," Boston Globe columnist Ellen Goodman writes in an opinion piece (Goodman, Boston Globe, 1/19). Keroack before the appointment was medical director for A Woman's Concern, a pregnancy-counseling organization. Many family planning advocates were angered by the appointment -- which does not require Senate confirmation -- noting that A Women's Concern opposes contraception and supports sexual abstinence until marriage. Keroack will advise HHS Secretary Mike Leavitt on issues including reproductive health and adolescent pregnancy, and he will administer $283 million in annual family planning grants that HHS says are "designed to provide access to contraceptive supplies and information to all who want and need them with priority given to low-income persons" (Kaiser Daily Women's Health Policy Report, 12/22/06). According to Goodman, Keroack's appointment "has produced a furor that has yet to diminish" or "succeed." Abortion-rights groups have spent at least 12 years "with their ear to the middle ground, listening to the people who want to keep abortion legal but less numerous," Goodman writes, adding that "most Americans have wearily come to agree on the best way to reduce abortions." A policy of "prevention first" cannot take place after Bush "handed the deed for common ground" to Keroack, she concludes (Boston Globe, 1/19).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Some Congressional Democrats Promote Family Planning, Assistance For Women Proceeding With Unintended Pregnancies, Avoid Abortion Issue Directly
The Washington Post on Sunday examined how Democratic congressional leaders are attempting to "tiptoe around the abortion issue" by calling for the approval of legislation that would assist women who carry unintended pregnancies to term and encourage contraception use. According to the Post, House Speaker Nancy Pelosi (D-Calif.) has "helped smooth the path" for a measure sponsored by Rep. Tim Ryan (D-Ohio), who opposes abortion rights, and Rep. Rosa DeLauro (D-Conn.), who supports abortion rights, that would expand access to contraception, extend adoption tax credits, boost health care access for low-income women and children, and fund sex education programs. Senate Majority Leader Harry Reid (D-Nev.), who opposes abortion rights, has introduced a measure (S 21) that would increase access to emergency contraception, and increase family planning services funding and ensure contraception equity in health insurance plans. The bills are an "attempt to broaden the discussion beyond the traditional framework of whether abortion should be legal," and the moderate Democratic policy group Third Way has been giving counsel to lawmakers about "prevention rhetoric," the Post reports. Some Democrats hope measures aimed at preventing unintended pregnancies will "become a bridge within the party and even across the aisle to some Republicans," but there are "still minefields" in regard to the issue, the Post reports. Democrats for Life, which opposes abortion rights, does not support Ryan and DeLauro's measure. Instead, the group is calling for approval of a bill supported by some Republicans that would expand health benefits and welfare services for pregnant women and would improve health insurance for prenatal care. The measure does not include provisions on contraception (Murray, Washington Post, 1/21).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
U.S. Supreme Court To Expedite Review Of Ruling Over Wisconsin Antiabortion Group's Appeal Of Campaign Finance Law
The U.S. Supreme Court on Friday announced that it will expedite a review of a U.S. Circuit Court of Appeals' three-judge panel ruling in favor of a Wisconsin antiabortion group's constitutional challenge to the McCain-Feingold federal campaign finance law, the New York Times reports (Greenhouse, New York Times, 1/20). Wisconsin Right to Life in its lawsuit challenging McCain-Feingold was seeking permission to run television and radio advertisements within 30 days of a 2004 primary that mentioned Sen. Russell Feingold's (D-Wis.) name and focused on his opposition to several of President Bush's judicial nominees. The group claims that the campaign finance law's prohibition of such ads is unconstitutional. A three-judge panel of the U.S. District Court for the District of Columbia in August 2004 unanimously rejected WRTL's challenge to campaign finance law provisions that prohibit the use of interest groups' "issue ads" during the weeks preceding an election. A three-judge panel in September 2004 upheld the district court's ruling, saying the Supreme Court in 2003 effectively barred constitutional challenges to the provisions of the law that the high court upheld. WRTL appealed the ruling to the Supreme Court. The Supreme Court in January 2006 said that when it upheld in unanimous, unsigned opinion the law's provision concerning "electioneering communications" against a "facial challenge in the 2003 decision," it did "not purport to resolve future as-applied challenges." The justices ordered the district court "to consider the merits of WRTL's" challenge of the provision. The three-judge panel of the U.S. Circuit Court of Appeals for the District of Columbia in December 2006 overturned key segments of the campaign finance law that restrict issue ads funded by unions or corporations, such as WRTL, during the weeks before federal elections (Kaiser Daily Women's Health Policy Report, 12/22/06).
Expedited Review, Reaction
The Supreme Court on Friday announced it would hear a free-speech challenge to the law in April, the Los Angeles Times reports (Savage, Los Angeles Times, 1/20). The "basic argument" at issue is how the Circuit Court in December 2006 analyzed the ads and found that they were "genuine" issue ads and not "thinly veiled" campaign commercials, the Times reports (New York Times, 1/20). The panel's ruling said that WRTL ads were not campaign ads but general issue ads and that the government did not demonstrate a compelling enough argument to impose restrictions on groups' free-speech rights. The decision also said that the portion of the McCain-Feingold law banning issue ads paid for by corporate or union money is unconstitutional because it imposes campaign finance restrictions on groups that are using ads to advance legislative policy (Kaiser Daily Women's Health Policy Report, 12/22/06). If the Supreme Court adopts the reasoning of the lower court, it would "really blow a hole" in the provision of the McCain-Feingold act banning issue ads, Richard Hasen, an election law expert at Loyola Law School, said. According to Hansen, the "purpose of the provision was to close a loophole that was allowing large amounts of corporate and union money to be spent on ads intended to influence federal elections." He added that the court could reopen "that loophole for a large number of ads" (Sherman, AP/CBS News, 1/19). Supporters of the law, including Sen. John McCain (R-Ariz.), have said that if the lower court's ruling is upheld, large corporate interests could broadcast ads that fault candidates for their positions on prevalent issues, the Times reports. James Bopp, an attorney who represents WRTL, on Friday said the provisions allow lawmakers to protect themselves from criticism, adding, "Politicians should not be able to use campaign finance laws, like McCain-Feingold, to prohibit citizen groups from engaging in grass-roots lobbying." The case likely will be decided in late June, according to the Times (Los Angeles Times, 1/20).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Abortion-Rights Opponents Rally In Washington, D.C.; Republican Presidential Candidates, Bush Address Protesters
Tens of thousands of abortion-rights opponents on Monday rallied in Washington, D.C., as part of the annual March for Life and called for the U.S. Supreme Court to reverse its 1973 Roe v. Wade ruling, which effectively barred state abortion bans, the Washington Post reports. The demonstration marked the 34th anniversary of Roe. According to the Post, youth comprised the majority of the protesters, who came from across the country, wearing matching clothes or carrying posters with slogans, such as "Face It Abortion Kills" (Chandler/Boorstein, Washington Post, 1/23). President Bush via a telephone message from Camp David said, "We believe every human life has value, and we pray for the day when every child is welcome in life and protected into law" (Abruzzese, New York Times, 1/23). He also said, "Our challenge is to make sure that science serves the cause of humanity instead of the other way around. I have made clear to the Congress, we must pursue medical advances in the name of life, not at the expense of it." Bush added, "We've all got to remember that a true culture of life cannot be built by changing laws alone. We've all got to work hard to change hearts" (AP/Forbes, 1/23). In addition, Bush highlighted the progress his administration has made in strengthening the antiabortion movement, including supporting state parental notification laws, funding crisis pregnancy centers and signing into law the Partial-Birth Abortion Act of 2003 (S 3), which bans so-called "partial birth abortion" (Washington Post, 1/23). The U.S. Supreme Court in November 2007 heard arguments in a Department of Justice appeal to uphold the law, and the court is expected to rule on the case by July 2007 (Kaiser Daily Women's Health Policy Report, 11/9/06). According to the Post, the demonstration on the National Mall paralleled events at state capitals around the country and ended a weekend of events in the district, including a series of workshops and seminars, a youth rally and church service, and a conference at which antiabortion bloggers discussed potential 2008 presidential candidates (Washington Post, 1/23).
Republican Presidential Candidates Address Protesters
Sen. Sam Brownback (R-Kan.) and Rep. Duncan Hunter (R-Calif.), who are running for the 2008 Republican presidential nomination, addressed the abortion-rights opponents at the demonstration. "This is where the heart of my base, and where the heart of the base of the Republican Party lies," Brownback said. According to the McClatchy/Kansas City Star, dozens of "Brownback for President" posters were at the protest (Stearns, McClatchy/Kansas City Star, 1/22). "We recognize a tragedy of life in Roe v. Wade, but that tragedy will not always stand," Brownback said. Hunter said, "If we have a judicial applicant, a judicial nominee who can look at a sonogram of an unborn child and not see the value of human life ... if I should become president of the United States, he will not receive a judicial appointment" (Hananel, AP/San Jose Mercury News, 1/23).
NPR's "Talk of the Nation" on Monday included a discussion on the abortion-rights debate and how advocates from both sides of the issue recently addressed each other in Massachusetts. The program includes comments from Frances Hogan, president of Women Affirming Life, and Nicki Nichols-Gamble, chair of the Center for Reproductive Rights (Conan, "Talk of the Nation," NPR, 1/22). Audio of the segment is available online in RealPlayer.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
February 26, 2007
New York Times Magazine Examines Antiabortion Strategy Seeking To Persuade Voters That Abortion Is Harmful To Women's Health
The New York Times Magazine on Sunday examined an evolving antiabortion strategy that aims to "dismantle th[e] framework" of "pitt[ing] the rights" of fetuses against women and replace it with the argument the procedure is at the "root of women's psychological ills." According to the Times Magazine, the strategy says that undergoing abortion can increase the risk of depression, drug abuse and other psychological problems. Antiabortion advocates aim to use the strategy to persuade the 40% to 50% of U.S. voters who are "uncomfortable with abortion but unwilling to ban it" that banning abortion would be more beneficial to women, the Times Magazine reports. According to the Times Magazine, the strategy "challenges the connection" between access to abortion and women's rights by arguing that "if women are suffering because of their abortions, then how could making the procedure readily available leave women better off?" In addition, the strategy "replaces mute pictures of dead fetuses with the voices of women who narrate their stories in raw detail and who claim they can move legislators to tears," and it "trades condemnation for pity and forgiveness," the Times Magazine reports. The majority of scientific research "strongly" shows that abortion does not increase a woman's risk of any psychological condition, including depression and drug abuse, any more than having an unintended pregnancy or delivering an infant, according to the Times Magazine. An American Psychological Association panel in a 1990 issue of the journal Science concluded the "weight of evidence" indicates that an abortion during the first-trimester after an unintended pregnancy "does not pose a psychological hazard for most women." APA has convened a new task force to examine the more recent scientific studies about the effects of abortion, and it is expected to issue findings next year (Bazelon, New York Times Magazine, 1/21).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Illinois AG Requests Federal Court Allow Enforcement Abortion Law's Parental Notification Rules
Illinois Attorney General Lisa Madigan (D) on Friday filed a motion requesting that a federal court in Chicago lift an injunction on a 1995 state law requiring parental notification for minors seeking abortions, the Chicago Tribune reports (Higgins/Peres, Chicago Tribune, 1/20). The law, which has never been enforced, requires physicians to notify an adult family member 48 hours before performing an abortion on an unmarried minor or an "incompetent person." Physicians can bypass the requirement if they certify there is a medical emergency, and a minor seeking an abortion could request a judicial bypass or be exempt by declaring in writing that she is a survivor of neglect or abuse from an adult family member. The state Supreme Court in September 2006 issued rules for the law that say a judge hearing a bypass request should attempt to issue a decision at the end of the hearing and rule within 48 hours if a decision could not be made immediately. If a judge denies a waiver, the decision can be appealed; an appellate court would have to rule within two days and the state Supreme Court would have to rule within five days. No oral argument would be permitted during appeals. The rules do not say anything about the circumstances in which a judge should grant a waiver (Kaiser Daily Women's Health Policy Report, 9/21/06).
Madigan's Request, Reaction
Madigan in her motion wrote that she agrees the constitutional defect in the law was fixed by the rules issued by the state Supreme Court. She also wrote that the state's circuit courts need time to prepare before the law takes effect (Chicago Tribune, 1/20). The American Civil Liberties Union of Illinois promised to oppose Madigan's motion in court, the Chicago Sun-Times reports. The statute "makes it very difficult for young women to access reproductive health services," Lorie Chaiten, director of the ACLU of Illinois Reproductive Rights Project, said, adding, "This is the kind of law that every major medical organization, including the American Academy of Pediatrics, opposes" (Fornek, Chicago Sun-Times, 1/20). Madigan's chief of staff, Ann Spillane, declined to comment Friday on whether Madigan agreed with the law as a matter of public policy. "The attorney general's personal views are not relevant at this juncture given her legal obligation to defend the laws of the state," Spillane said. Madigan requested the federal court to appoint Chicago attorney Zaldwaynaka Scott, a former executive state inspector general, as a special master to assist the state courts and to report on the courts' progress to the federal judge assigned to the case (Chicago Tribune, 1/20).
Bill Would Replace, Repeal Parental Notification Law
Pam Sutherland, president of the Illinois Planned Parenthood Council, said the organization will focus on a bill (HB 5840) -- introduced by state Rep. John Fritchey (D) -- that would repeal and replace the parental notification law, the St. Louis Post-Dispatch reports (Jadhav, St. Louis Post-Dispatch, 1/20). The bill -- which has bipartisan support -- would expand the law to allow a girl seeking an abortion to notify an uncle, an aunt or an adult sibling. In addition, the bill would allow girls to avoid notifying their parents if they receive counseling -- including information about prenatal care, the implications of carrying a pregnancy to term and adoption -- from a clergy member, medical professional or an adult family member (Kaiser Daily Women's Health Policy Report, 10/5/06).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Legislation Introduced Related To HPV Vaccine, Abortion, Drug Use During Pregnancy In Idaho, Indiana, Nevada, Mississippi, Virginia
The following highlights recent news on state actions regarding legislation on human papillomavirus vaccines, abortion and drug use during pregnancy.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
HPV Vaccines
- Indiana: Thirteen female state senators -- seven Democrats and six Republicans -- recently introduced a bill (SB 327) that would say girls entering the sixth grade should receive a human papillomavirus vaccine, the Indianapolis Star reports (Hupp, Indianapolis Star, 1/18). The legislation states that students "may not be prevented from enrolling in, attending or graduating from school for the sole reason that the student has not been immunized" against HPV vaccine. The measure would require every school beginning in the 2008-2009 school year to report how many girls have been vaccinated (SB 327 text, 1/23). Merck's HPV vaccine Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. CDC's Advisory Committee on Immunization Practices in July 2006 voted unanimously to recommend that girls ages 11 and 12 receive the vaccine (Kaiser Daily Women's Health Policy Report, 1/12). Opponents of the measure have said the vaccine might encourage promiscuity and have criticized the estimated $2.7 million cost for the vaccine during the 2008-2009 school year (Indianapolis Star, 1/18).
- Nevada: State lawmakers recently introduced more than 70 bills relating to health care in the 2007 legislative session, including a bill that would require health insurance plans to cover Merck's human papillomavirus vaccine Gardasil, the AP/Las Vegas Sun reports. Currently, health plans operating in the state are required to cover birth control pills and mammograms, the Sun reports. The bill that would require insurers to cover the vaccine is sponsored by state Senate Minority Leader Dina Titus (D), (Fehd, AP/Las Vegas Sun, 1/20).
Abortion Regulations
- Mississippi: State lawmakers recently introduced several abortion-related measures, including a bill (H 670) that would ban all abortions in the state except to save the life of the pregnant woman. Under the legislation, sponsored by state Reps. Deryk Parker (D) and Mike Lott (R), performing an abortion would be a misdemeanor offense punishable by a $5,000 fine and up to one year in prison. Another measure (H 1241) would ban all abortions in the state if Roe v. Wade -- the 1973 Supreme Court decision that effectively barred state abortion bans -- is overturned. Legislation (SC 531) recently introduced by state Sen. Joey Fillingane (R) would place on the November ballot a state constitutional amendment that says "nothing in the Constitution shall be construed as granting to any person the right to choose to have an abortion." If state senators do not pass an abortion ban, State Senate Public Health Committee Chair Alan Nunnelee (R) said he aims to gain approval for a bill (S 2801) that would require abortion providers to give women seeking abortion a chance to hear the fetus' heartbeat and view a sonogram of the fetus before undergoing the procedure (Mohr, AP/Biloxi Sun Herald, 1/21).
- Virginia: State lawmakers and advocates who support abortion rights on Thursday called for the approval of a bill (HB 2221) that would define birth control as an FDA-approved contraceptive method, not a form of abortion, the AP/Newport News Daily Press reports. The legislation, sponsored by state Delegate Kristen Amundson (D) states that birth control "shall not be considered abortion." According to the AP/Daily Press, emergency contraception, which can prevent pregnancy if taken up to 72 hours after intercourse, is included in the list of FDA-approved contraceptives. According to the AP/Daily Press, legislation introduced in previous sessions that would have defined contraception was not approved because of wording disputes. In related news, the state House Health, Welfare and Institutions Committee on Thursday voted 9-6 to approve a measure (HB 1883) that would require clinics that perform abortions to be licensed by the state and abide by requirements for ambulatory surgery centers (O'Dell, AP/Newport News Daily Press, 1/18).
Drug Use During Pregnancy
- Idaho: State Sen. Denton Darrington (R) plans to reintroduce a bill that would make methamphetamine or other drug use by a pregnant woman a felony punishable by up to five years in jail and a $50,000 fine, the AP/Twin Falls Times-News reports (AP/Twin Falls Times-News, 1/20). The measure would also allow women to take part in the state's drug-court system, which attempts to help drug users who commit crimes to stop using drugs (AP/Twin Falls Times-News, 1/20). Darrington introduced a similar measure (SB 1337) last year that would have allowed authorities to take custody of an infant if the woman tested positive for drugs at birth (Kaiser Daily Women's Health Policy Report, 3/20/06). Some pediatricians opposed last year's measure because of fear that it will lead to less prenatal care and more abortions, according to the AP/Times-News. In an attempt to relieve those concerns, Darrington said he plans to meet with state Rep. Jim Clark (R), chair of the state House Judiciary, Rules and Administration Committee. "I haven't decided what I'm going to do. I don't know how much I can change it," Darrington said (AP/Twin Falls Times-News, 1/20).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.