HHS Moves to Define Contraception as Abortion

In what it must consider an act of Wilberforcian moral leadership, the Bush administration seems to want to force an increase in the American birth rate and remove freedoms Americans currently enjoy in the name of freedom of choice for health care providers.

They propose to do this with the kind of superficial logic that manipulates thoughts the way someone first learning a foreign language manipulates words in a dictionary. Government officials transferred the reasoning they deciphered from public polling data into legal arguments as if the public has a consistent and logically held medical and ethical position on fertilization and abortion issues. They translated generic polling data into precise legal arguments.

You will have to read the logic for yourself as documented in this source; only the barest outline can be afforded in this post.

Here are key excerpts from this source:

There are two commonly held views on the question of when a pregnancy begins. Some consider a pregnancy to begin at conception (that is, the fertilization of the egg by the sperm), while others consider it to begin with implantation (when the embryo implants in the lining of the uterus).

Up until now, the federal government followed the definition of pregnancy accepted by the American Medical Association and … the American College of Obstetricians and Gynecologists, which is: pregnancy begins at implantation.

So [now] HHS proposes that anyone can enforce his or her own definition of abortion “within the bounds of reason.”

The practical outcome of this logic led to the next step in the following headline:

Redefining abortion

Federal officials considering a rule allowing health care workers to refuse to provide contraceptives

Already “an existing regulation allows health care providers with objections to abortion to abstain from providing it to patients.”

By extending the definition of abortion to cover contraceptives, the new rule being promoted at HHS “would allow health care workers who object to abortion on moral or religious grounds to refuse to counsel women on their birth control options or supply contraceptives.”

Who’s “Good” does this new rule serve?

1. Obviously this rule is not for the good of unwanted babies who will be born, since many providers may opt out. Nor is it for the good of poor people who will be channeled into less than healthy options for dealing with the resulting consequences of unwanted pregnancies or alternative attempts to avoid them. Given the state of the economy, we can be fairly sure that there is no intent to ensure that other providers will be made available in every situation.

2. The rule that exempted health care providers with objections to abortion from providing it to patients was good because it allows them to avoid the direct act of what they perceive as killing. But indirect acts such as providing supplies cannot so simply and so arbitrarily be prescribed because this is a far more complicated issue. Do everyday store clerks have the right to refuse to sell condoms? One can at least imagine a host of legal controversies and more business for the legal profession as a result. One can even imagine a backlash against the original exemption.

3. According to the Houston Chronicle, this federal administrative rule would probably void a great many state laws. This rule is obviously not for the good of democracy, because it does not reflect a democratic decision-making process nor does it come close to reflecting decisions made by that process in the past.

4. Instead, this rule is widely viewed as payback to the Christian and religious right for its support of the Bush administration. Perhaps it is a cynical concession to the belief that the Democrats will win in November and immediately overturn it. But what if they don’t win? After all, John McCain has sided with the religious right on abortion. Real leaders do not play with fire like this. One has to wonder whether tainted hiring practices have also affected this area of the Bush administration.

Fanaticism takes what is good to an extreme. As we pointed out above, exempting conscientious objectors from providing abortions was good. But sneaking in exemptions for indirect contributions, however defined, without extensive debate and democratic decision-making is fanaticism.

Avoiding fanaticism involves a bit of relativistic thinking. A truly Christian approach to social change is not absolutist. Following the Apostle Paul’s example, one does not simply appeal to God’s revelation, but also recognizes the importance of social mores, because the objective of God’s law is love and peace. The goal of such social action is always to gain voluntary agreement.

What is Good about this Rule?

Absolutely nothing as far as I can see, for reasons already cited above.

Then why is it proposed?

The stated reason based on public opinion polls cited and refuted above is also invalid. A professional philosopher could provide a better explanation and the Bush administration would have done well to consult one. Even research specialists would be able to spot some of the errors in this approach since they would recognize the limitations of interpreting social surveys.

The underlying rationale for the rule is patent, however. The rule extends the likelihood of denial of abortions by giving high status to the definition of pregnancy as simply fertilization (apart from implantation) and by allowing providers such as pharmacists who contribute indirectly to opt out of providing.

In giving “equal” status to such a narrow ethical stance it allows that view to dominate the broader approach much like having a significant number of non-drinkers in a church tends to mean that alcohol may not be served on church property even though there are also a significant number of drinkers, who may actually be in the majority. The strong must accept the weak, but the weak do not have to accept the strong, because the weak think they are right. A teaching that was intended to express mutual concern becomes a tool for domination of others in express violation of Jesus’ commands to the contrary. Christians who deny Jesus’ paradigm as they contend for the “kingdom” in the civil arena are doing no better than those Jesus condemned for their practice of Corban.

Incidents like these help us begin to understand why Jesus predicted that both the sheep and the goats will be surprised about the verdicts on judgment day!

I’ve already expressed my view on the fertilization issue in a previous post. It boils down to the belief that human beings are called to be more than mere physical matter, including even the aspects of soul that the Bible always associates with the body (which is everything that fertilization represents). We must be “called” in some sense to become human. In a Christian theological sense, we are all are born spiritually dead. To have any spark of life and a chance of making it, individuals have to be wanted. My mother-in-law used to tell my children they used to be “a gleam in your father’s eye.” For communities to survive, older members need to reproduce and draw younger members into them. There are no stand-alone human beings.

Our responsibility is to draw individuals into human relationships and into relationship with God. It is not an isolatable responsibility to protect fertilized eggs. You can’t ethically fulfill the duty of protecting a fertilized egg without also fulfilling the duty to draw that being into the human family. A commitment of our country to a higher birth rate given our history and current economic conditions must be accompanied by a correspondingly huge investment in relevant social services supporting this commitment. It is the very fact that this rule is being introduced in such a backdoor manner that demonstrates that it does not reflect the high moral caliber that its backers would like to claim for it.

I do not believe that the “fertilized” ovum that do not implant are human beings that will some day be resurrected like everyone else. But that is what you as a Christian believe if you believe what the Bush administration is promoting to take precedent over other established laws.

Does that sound “good” to you?

Health Database Was Set Up to Ignore ‘Abortion’

By Robert Pear

NEW YORK TIMES

April 5, 2008

This report lets everyone outside the specialized world of medical librarianship know that the world’s largest database on reproductive health - Popline - with more than 360,000 records and articles on family planning, fertility and sexually transmitted diseases, had stopped allowing researchers to find articles by using the word abortion as a search term.

Why in the world did they do this? 

The New York Times and other news sources have made preliminary investigations (e.g. 1, 2, 3); but perhaps none have presented the results better than the noted British medical journal BMJ.  I have labeled the essential elements of their presentation below to highlight the main points.

WHAT HAPPENED:  The world’s largest database for reproductive health, which is funded by the US Agency for International Development (USAID), last week made it impossible to search its contents for the word “abortion.”

WHY IT HAPPENED:  The explanation given for the ban by the administrator of the website, which is called Popline (population information online) was that because the project was funded by federal money it was thought “best for now.”

BACKGROUND:  Under the US president, George Bush, USAID has been banned from giving funds to any foreign organisation that performs, refers, or counsels on abortion, regardless of whether abortion is legal in their country.

ANALYSIS:  Critics were quick to assume that the decision to ban the word “abortion” as a search term was political.

US federal funded website bans “abortion” as search term, by Bob Roehr;  BMJ  2008;336:792-793 (12 April), doi:10.1136/bmj.39545.500833.DB

Once this ban had created a large public outcry among medical librarians and others, it was quickly reversed by a top administrator of the program.

Most likely nobody will ever be able to prove that political motives led to this policy.  It might simply be that a few influential people who were so inclined had their own way in a small out-of-the-way office that affects the overall operation.  Unless others notice and speak up when these kinds of changes are made, the changes tend to become permanent because after a while people say it’s always been done this way.

A change as radical as this will not be accepted if it is noticed and enough people say something because George Orwell has already alerted us to the dangers of governments attempting to determine truth. But people who want changes such as this try to sneak them in because they hope no one will notice in time to make a difference.  

This case is an example of how government can abuse power.  It may seem like a small issue; but worlds of information are uncovered by a single word, or hidden by the absence of a word; and therefore what we discover and learn can be affected by one word.  As a government agency, USAID made a decision to restrict information access by not allowing researchers to use a very commonly accepted search term.  In an online environment, there was no practical reason for making such a restriction since it did not offer any financial savings or improvement to the system.

This case is also an example of how the public must respond in order to get government to change. Medical librarians and others responded en masse individually and through their professional organizations to this issue. It is sometimes said that there are three branches of government to serve as checks and balances on each other’s powers; and we therefore view governmental power as divided between those three branches. 

That’s fine when we consider that all three branches get their power from the people. But since the delegation of power from the people primarily occurs when they vote, more often than not, it is more helpful to think of government as four powers that should be balanced: executive, legislative, judiciary, and the people. 

We the people need to be supporting or in some cases pushing back against our government when it is making mistakes, in order to keep it in line with what we believe are constitutional principles.  We are still the power on which our republic rests even when we are not in the ballot box.  We should take care how we exercise that power at all times.

Mukasey Torture Testimony Weak

News Analysis

By Daniel Schorr

October 21, 2007

Michael Mukasey waffled on how he defined torture before Congress last week. 

He seemed to have three main goals:

1. Preserve the right of the President to do what he thinks is best as far as interrogation techniques are concerned (and we already know what that means since the administration’s practice already contradicts the President’s public statements against torture);
2. Defend the U.S. Constitution, which he clearly believes prohibits torture, which he defined as that which shocks the conscience of the public;
3. Demonstrate his intention to serve as a fully independent attorney general, which would be in keeping with his reputation and was the overall effect of his performance in last week’s hearings according to most critics.

The semantic argument about torture turns entirely, of course, on what shocks the public conscience, which has a lot to do with how frightened we are.  This plays into how presidential election politics are being framed.  We can already see how Republicans are suggesting “radical Islamic terrorists” are the greatest enemy we face, as if we are challenged in a one-front war.  Never mind that the disruptions already caused by global warming are expected to escalate even further as the years go by if we don’t mobilize global cooperation. 

The torture problem is much deeper than semantics, however; and even though it seems that Congress must move on and approve a decent man such as Mukasey, we also have to groan as we see the trust placed in the American president get further eroded.  When you see a person who is a strong supporter of presidential powers being asked to serve a president who has overstepped those powers in the opinion of a very large number of people, then we can expect only greater conflict between the branches of government rather than cooperation. 

Eventually we will have to face the fact that, “If a house is divided against itself, that house cannot stand”(Mark 3:25).   Separation of powers to balance competing interests can be a good thing; but distrust and dissention on fundamental human values is a totally different matter.  Our nation is founded on a common vision of human rights, and it cannot continue to exist if it leaves that foundation. 

Fortunately the ballot box allows us to reaffirm our foundations.  But we have to decide whether we are motivated primarily by our fears or by our beliefs.  Either one or the other must take the priority.  That seems to be the way we are designed to function. 

President Bush Vetoes Children’s Health Insurance Legislation

Here’s how you play:  If you have a job that doesn’t have insurance for your children, quit and get on welfare so you can get health insurance.  But you can only stay on welfare for 5 years. Then you’re off.  Decent people work for a living, you know.  And don’t go aborting any babies, either.

It’s pretty easy to see the malicious game plan in the words of Rep. Eric Cantor, as all he could do in defending the president’s veto of the SCHIP program was to repetitiously reiterate that we should “deal with poor kids first” - meaning of course that only they should be covered.  He showed no sympathy for parents who work and are therefore above the poverty line but cannot afford private health insurance.

He gave no definition of poor kid.  But we know that means even poorer than the ones the vetoed bill would cover, which were children of working families who could not afford enough insurance to cover their health care needs.  He gave no reason for aiming so low, but he obviously thinks families need to step down a notch if they really need health insurance.

This discussion with Rep. Rahm Emanuel on the News Hour with Jim Lehrer is worth a listen for those not familiar with the debate, or you can read the transcript.  In contrast to the above emphasis, Rep. Cantor’s main point was… “41 days of the war in Iraq, 10 million kids get health care for a year.”  In other words, the annual cost of this program is only a fraction of the cost of the Iraq war.  Yet it is an investment in our country’s future.

It is difficult to reconcile how the president can veto a bill such as this given his stated promises.

In contrast, the president is now requesting $190 billion for the wars in Iraq and Afghanistan. 

Seems to me if the Democratic Congress is serious, then their new game plan should now be No SCHIP, No$190B  

“I was against the war, but now I’m against a precipitous withdrawal of American forces.”

Joost Hiltermann

NPR Morning Edition, July 11, 2007

In the NPR interview at the cited link, Joost Hiltermann suggests that the most important benchmarks for progress in Iraq should involve the success of the Iraqi government in delivering essential services to Iraqis in order to gain their support.  Without popular support there will be no government.

Hiltermann is suggesting that our primary goal in Iraq should be the success of the Iraqi government, and that benchmarks of that success should be those markers that indicate such success. 

In previous years President Bush has generally been content to insist that our primary goals are to defeat terrorism and to promote democracy.  But as the war has gone on without apparent success, he has been called into account.

The following are the 18 benchmarks agreed to by the President and Congress for measuring progress in Iraq, as defined in the Iraq Supplemental Appropriations bill and reported on NPR, except that I have grouped them under arbitrary and somewhat debatable topical headings to enhance this discussion, and have highlighted parts for emphasis:

POLITICAL & LEGAL ISSUES

1. Forming a Constitutional Review Committee and then completing the constitutional review.

2. Enacting and implementing legislation on de-Baathification.

4. Enacting and implementing legislation on procedures to form semi-autonomous regions.

5. Enacting and implementing legislation establishing an Independent High Electoral Commission, provincial elections law, provincial council authorities, and a date for provincial elections.

6. Enacting and implementing legislation addressing amnesty.

16. Ensuring that the rights of minority political parties in the Iraqi legislature are protected.

ECONOMIC MATTERS

3. Enacting and implementing legislation to ensure the equitable distribution of hydrocarbon resources of the people of Iraq without regard to the sect or ethnicity of recipients, and enacting and implementing legislation to ensure that the energy resources of Iraq benefit Sunni Arabs, Shia Arabs, Kurds, and other Iraqi citizens in an equitable manner.

17. Allocating and spending $10 billion in Iraqi revenues for reconstruction projects, including delivery of essential services, on an equitable basis.

SECURITY MATTERS

7. Enacting and implementing legislation establishing a strong militia disarmament program to ensure that such security forces are accountable only to the central government and loyal to the Constitution of Iraq.

8. Establishing supporting political, media, economic, and services committees in support of the Baghdad Security Plan.

9. Providing three trained and ready Iraqi brigades to support Baghdad operations.

10. Providing Iraqi commanders with all authorities to execute this plan and to make tactical and operational decisions, in consultation with U.S commanders, without political intervention, to include the authority to pursue all extremists, including Sunni insurgents and Shiite militias.

11. Ensuring that the Iraqi Security Forces are providing even handed enforcement of the law.

12. Ensuring that, according to President Bush, Prime Minister Maliki said “the Baghdad security plan will not provide a safe haven for any outlaws, regardless of [their] sectarian or political affiliation”.

13. Reducing the level of sectarian violence in Iraq and eliminating militia control of local security.

14. Establishing all of the planned joint security stations in neighborhoods across Baghdad.

15. Increasing the number of Iraqi security forces units capable of operating independently.

18. Ensuring that Iraq’s political authorities are not undermining or making false accusations against members of the Iraqi Security Forces.

The most basic question about these benchmarks is what is their guiding principle?  Are they primarily a yardstick to justify our exit, or are they a means of ensuring that Iraqis have achieved a level of independence? 

Most of the benchmarks simply measure what the Iraqi government will do from a leadership perspective, not what it will accomplish from the Iraqi peoples’ perspective.  They are activities to be performed, not results to be achieved.  #17 requires that they will spend $10 billion on reconstruction projects and essential services. But will they make the greatest possible impact on peoples’ lives, or are they pork barrel projects?  There are no measurable objectives for improving the lives of Iraqi citizens.  It is simply assumed that if money is spent and a successful security plan is put into place, then everything else will fall into its proper place as well.  That’s a faulty assumption.  It makes you think of the faulty assumptions that began with the invasion of Iraq in the first place, that if we just got rid of Saddam, then the Iraqis would welcome us and soon take over governing their own country.

President Bush has reported that some progress has been made on these benchmarks; but most commentators recognize that it is quite limited.

The following excerpts from the President’s full report highlight the limited extent of the achievement of benchmark #17, the only one that directly addresses reconstruction and essential services.

True success lies not only in the percentage of the capital budget actually spent in 2007, but in the effects of spending, as the Iraqi Government seeks to establish its credibility with citizens though improved delivery of public services and tangible economic development. Moreover, adherence to and improved familiarity with the decentralized and accountable fiduciary structures introduced since the fall of Saddam will give Iraqi citizens added confidence in and a reason to support their local, regional, and national governments. The effects of this new emphasis and these new procedures are already being felt, albeit unevenly, across the country. Some ministries have developed and are implementing aggressive spending plans (such as the Ministry of Education), and several provinces (Anbar, in particular) are demonstrating their empowerment through their new spending programs. Should these successes spread across Iraq, this would mark the beginning of a new relationship between citizens and their government.

These changes have nearly tripled the ministries’ rates of allocation when compared to last year at this time, though efforts must continue accelerating to make sufficient progress on this benchmark. Ministerial spending is moving ahead. The Ministry of  Finance has moved more than 21 percent of the overall ministerial capital budget to the individual ministries’ capital investment accounts, which enables them to award contracts and request additional releases based on contract schedules. With respect to provinces, a majority of the 2006 budget funding was released late in December. Provinces continue to apply those funds to improving services and advancing local reconstruction priorities, while at the same time processing their 2007 budgets. Most provinces are making significant progress in capital spending, but those with security challenges are lagging. Importantly, provincial budget allocations were calculated based on population statistics, which supports the constitution’s concerns with equality. [emphasis added]

Joost Hiltermann is the Middle East Project Director of the International Crisis Group.  In the interview that began this post, he suggests that little meaningful progress has been made on most of the U.S. benchmarks, and he highlights what he sees as more important emphases that seem to be missing from these benchmarks.  The interview focuses on what everyday Iraqi citizens would consider progress, that which makes a difference in the daily life of people.

What about electricity production?  Oil production?  Law enforcement?  Jobs?

We might well ask ourselves: should not achievement of prewar levels in each of these areas be benchmarks of adequate progress?  

Hiltermann says…

For Iraqi people these are critical and they were critical from day one… these issues have only been aggravated in the past three years, four years.  And so, if a government wants to show that it is capable of governing Iraq it would start providing these essential services to people and they might actually get some support.

If there is to be a successful government in Iraq, then it must gain the support of its people. To do that it must provide for the essential services of its citizens.  It does not make sense to ignore these matters.

Hiltermann adds…

I was against the war, but now I’m against a precipitous withdrawal of American forces.  This may sound contradictory; but I think it is utterly consistent with the fact that the arrival of American forces created a huge security vacuum, and you have to fill it lest the country and the region descend into chaos.

The stated U.S. benchmarks seem to assume that if security can be attained then peace will be attained; but that is a false assumption because the “security vacuum” is not resolved simply by defeating some “enemy” - it is filled by providing essential services that meet peoples’ needs so they will stand together against threats to those services.

But religious and ethnic hostilities will continue since local group solidarity will be seen as the best source of security and will prevent a democratic government from developing if nothing more successful in meeting their needs is forthcoming.  As an NPR interview with a warrant officer recently returning from Iraq so vividly illustrates, the military so often are serving as a buffer between these groups and are helping to keep the peace that the Iraqis are not able to maintain for themselves.  Those in the military know they are needed; but their role is at the ground level because that is where they were placed.

Leaders have set up these situations and are accountable for the overall plans and strategies.  American leaders never have made Iraqi welfare their top priority.  Instead, they have made assumptions that have generally gone against the welfare of Iraqis.  From invading without enough support of the world community; to not sending in enough troops to secure Iraq’s resources; to summarily dismissing Iraq’s most well organized and well trained military leaders without capitalizing on what they could get out of them; and so on through the years.   

Now it looks like America’s leaders are preparing for a major drawdown without much more than legal paperwork to show for all this effort.  Goals have become pipedreams and benchmarks seem mainly intended to help us mark time. The only thing we can be sure of is that the Middle East will be changing more rapidly in the future than it did in the past.

Pre-war reports warned of pitfalls

Intelligence agencies told President Bush that attack could spur sectarian strife, al-Qaida risks

Saturday, May 26, 2007

By Jonathan S. Landay, McClatchy Newspapers

The Senate Intelligence Committee has just released declassified prewar intelligence reports which cautioned the Bush administration about the risks and consequences of an attack on Iraq.

These likely consequences included the following:

1. ousting Saddam Hussein would create a “significant risk” of sectarian strife
2. it would encourage al-Qaida attacks
3. it  would open the way for Iranian interference
4. establishing democracy in Iraq would be “long, difficult and probably turbulent”

Naturally these predictions raise questions about the administration’s decision-making ability.  President Bush defended his administration in the following way, as reported in this article –

President Bush said at a news conference Thursday that his administration was “warned about a lot of things, some of which happened, some of which didn’t happen.” But, he added, “The world’s better off without Saddam Hussein in power. I know the Iraqis are better off without Saddam Hussein in power. I think America is safer without Saddam Hussein in power. As to al-Qaida in Iraq, al-Qaida’s going to fight us wherever we are.”  [emphasis added]

Framing the problem this way, as if it was simply a matter of sorting out a complicated problem and unfortunately coming up with a few miscues but still arriving at a justifiable solution, fails to seriously face up to the social dynamic that more and more people are recognizing in the Bush administration, that personal beliefs must be sacrificed out of loyalty to the administration, and that the administration does not fully consider all points of view.  Since the administration has strong biases, the range of input acceptable for serious consideration in decision making is narrowed considerably.  John Dean identified this pattern quite early, though coming at the same broad issue from a different perspective.

As Michiko Kakutani put it  in his review of Bob Woodward’s book, STATE OF DENIAL –

As depicted by Mr. Woodward, this is an administration in which virtually no one will speak truth to power, an administration in which the traditional policy-making process involving methodical analysis and debate is routinely subverted. He notes that experts - who recommended higher troop levels in Iraq, warned about the consequences of disbanding the Iraqi Army or worried about the lack of postwar planning - were continually ignored by the White House and Pentagon leadership, or themselves failed, out of cowardice or blind loyalty, to press insistently their case for an altered course in the war. [emphasis added]

Several books  have been published by former White House insiders who support this impression.  George Tenet’s recent book, AT THE CENTER OF THE STORM: MY YEARS AT THE CIA, seems to do nothing to dispel this conclusion, as witnessed in an expert analysis by Bob Woodward.  Although Tenet believed Iraq had weapons of mass destruction, he also believed that attacking Iraq was a bad idea, but failed to communicate this to the president.  In other words, Tenet takes over 500 pages to describe how he was a “yes man” to the president, giving him only the part of the picture that he wanted to hear.