Tuesday, March 17, 2009

More on the Arizona Abortion Bill: Tiny Conversations with Steve Farley

Steve Farley (D-28th) is the representative for my Arizona state congressional district. I e-mailed him after the Frank Antenori kerfuffle for his side of the Arizona Health & Human Services Committee hearing on HB 2564, which was introduced to further place restrictions and impediments in the paths of women seeking not only abortion but also emergency and other contraception in the state. He was kind enough to respond the same day and provided a little more information than I'd had before.

Steve doesn't sit on the HHS committee, so he wasn't present at the hearing the Democrats and their healthcare-providing allies decided to walk out of last month, nor did he discuss the strategy with them prior to the meeting. He suspects the intention was to prevent giving the Republicans a bigger platform than they were already going to have for what by many accounts was a predetermined outcome. He also provided a link to the debate over the bill and the amendment he offered when it came to a floor vote so that, as he said, I would be able to form my own opinion of it rather than simply getting his, and would be able to quote participants directly. The Farley amendment would have exempted women who are the victims of sexual assault (of both the incestual and non-incestual varieties) from the waiting period and doctor's script-reading requirement, and would have eliminated the pharmacist conscience clause for emergency and conventional contraception.

Dr. Matt Heinz's (D-27th) testimony in favor of the Farley amendment focused on the language in the bill defining pregnancy as beginning with conception, as well as on the conscience clause. It served up a simply stated bit of scientific information for people who believe that pregnancy starts at conception. Unfortunately, it's not clear that anyone who believes otherwise and had already decided to vote for the bill was listening.

As a medical professional myself, I'm very concerned, first of all that we're discussing this at all. But as the bill is written at this time it appears to actually redefine some accepted medical terminology, which is something I believe we should try to avoid as the Legislature. What I’m referring to in particular, which I’ll begin with, is a viable, clinically diagnosable pregnancy. Now, I understand that the bill defines this as the union of a sperm and ovum. However, fertilization, as I hope everyone knows, occurs at the ends of the fallopian tubes, which are attached to the uterus—forgive me for not bringing my uterus model—and that’s not where a pregnancy occurs or even could be defined necessarily as a viable intrauterine pregnancy. That [pregnancy] is where the ovum, the conceptus, that has been fertilized travels through the fallopian tubes, which takes seven to twelve days, and then there’s implantation in the endometrium, in the wall and lining of the uterus, and blood vessels supply the developing embryo in that situation, and that—that is what a pregnancy is, a clinically diagnosable, viable pregnancy. So I’m a little bit unclear as to what we’re trying to do with that language.

Next, I’m very concerned about how, um, about how this bill is going to affect the provision of healthcare, especially to women… Pharmacists being allowed to refuse any sort of medication ordered by a licensed physician is very disturbing to me, especially in regards to emergency contraception, where there’s not exactly a lot of time available for the patient to go to another place. There’s also no requirement that I see in the bill that says that the pharmacist who is refusing for moral reasons or for a conscience has to refer the women to somewhere where they can obtain this urgently needed medical attention or device or prescription. So I don’t like that at all.

And I do believe this is beyond the pharmacist’s scope of practice because then, again in this bill, the way things are defined even with the Barto amendment, it is unclear to me if this could also possibly prohibit certain other types of hormonal therapy which may not be used for birth control at all, to control excessive uterine or vaginal bleeding. A pharmacist should not be authorized to refuse these medications when prescribed by an appropriate licensed physician.

Nancy Barto--one of the original sponsors of the bill--came up with a rebuttal on the conscience issue that is a work of art, if by "art" we mean "flinging every can of paint I can find at the canvas in hopes something will stick."

The fact of the matter is that emergency contraception is not hard to get these days. In fact, it’s available over the counter. And it’s available online, there are websites to deliver it. You can get it through the mail. And so this does not deal with emergency contraception availability. This merely protects the right of conscience. If you have an opportunity to go, to receive emergency contraception, shouldn’t an ab- a pharmacist have an opportunity to keep his job and protect his faith, live by his faith and belief? Both rights are important. This bill makes sure those rights are protected.

Jesus. One more time! If you have the opportunity to go request a legal and necessary medication from the only middleman licensed and authorized to dispense it to you within the timeframe required for the medication to be effective, shouldn't that middleman have the opportunity to refuse to perform his job, at no risk to his continued employment? I'm not sure which is more disturbing to me--that Rep. Barto considers both of those "opportunities" to be "rights"--guess which of the two does not really fit into the "rights" category--or that she can say with a straight face that the bill protects the rights of women to obtain something that is legal.

Because despite her statement that both rights are important, it's only the rights of certain pharmacists that are really being protected here. And while emergency contraception is indeed "available over the counter," which simply means "without a prescription," if it were really as easy to lay hands on EC as on peanut M&Ms, then pharmacists wouldn't be its gatekeepers and their consciences would not be at issue either way. The simple fact that Barto's fighting to give some pharmacists the ability to bar all women from obtaining the medication is the proof that the only way to buy the stuff in a store is through a transaction with a pharmacist. You can't get it from the lady at the cosmetics counter or the guy in the liquor department. Yes, you can have EC delivered through the mail if you order it online, but good luck having it show up on your doorstep within your 72-hour window of opportunity (and remember that the further your timer ticks away from hour one toward hour 72, the chances of it working drop off precipitously, because if you ovulate before you can take the pill, you're screwed again). No computer or internet access? Too bad, so sad--but you can always comfort yourself with the knowledge that you've at least kept your pharmacist's delicate sensibilities from being injured.

As an interesting side note, Steve pointed out in his e-mail that the House Republicans had promised smart-as-a-whip Assistant Minority Leader Kyrsten Sinema (D-15th) that they wouldn't bring the bill to a floor vote until she was back from an overseas trip. And as soon as she was gone they hustled it to the floor because, Steve says, "they did not want her brilliant strategic mind to get in the way of their show." This is the same group that illegally shut off a Democrat's microphone to stop a filibuster that was intended to kill the no-gay-marriage constitutional amendment before it could come to a vote. They later admitted they broke the rules on that one, but hey, it was officially too late to do anything about it. It isn't too late to hammer your state senator now with arguments against this piece of crap bill.

1 comment:

Anonymous said...

Thanks for the link to the hearing, I hadn't found that (although I had been on the legislative website looking for it). And yes, I watched the entire thing- just like you.:>)
I have been following this bill since it was first proposed this year (apparently it is something of a retread- Janet N.vetoed the thing last year I believe)

There are so many things wrong with the bill- I would get carpal tunnel going through all of them.
But the so-called conscience clause is a joke. Let's see, those young women out on the reservation, getting on thier computer and waiting for the pony express to deliver their medicine. Right.And that would be in less than 48 hours since unprotected sex? Who is Barto trying to fool (apparently a lot of Republicans- who I think should personally pay for all the unintended children.)
I loved what Rachel Maddow said ( and I'm not even a fan!!)speaking about the federal rule that Bush tried to sneak through as a midnight regulation. She called it the Amish Bus Driver Rule.
If you’re Amish, and have religious or moral convictions against internal combustion engines, then you have disqualified yourself from employment as a bus driver. The same rule ought to apply to medical professionals.
Once you agree, as a licensed medical professional (that is, as the holder of a privileged and restricted position regulated by the state), to provide approved medical services, then you are naturally obligated to provide any legitimate medical services that lie within the purview of your job. Specifically, if necessary in order to conduct the job you have agreed to do, you are obligated to check your personal - and most especially, your religious - convictions at the door. If you are unwilling to carry out this obligation, then, like the Amish bus driver, you should simply be disqualified from that privileged position. This logic is eminently simple.