New Rules Curbing Abortion Counseling Assailed

Organizations of doctors and nurses Monday denounced the Bush Administration’s latest version of regulations that restrict abortion counseling and referrals at family planning clinics that get federal funds.

They charged that allowing only doctors to discuss abortion with pregnant women would destroy the clinics’ effectiveness, since nurses and nurse practitioners provide the vast bulk of care in these facilities.

Furthermore, it is unclear how far doctors may go in talking about abortion. While the regulations appear to permit doctors to discuss all medical options with patients, they are prohibited from making referrals to abortion clinics.

Rep. Henry A. Waxman (D-Los Angeles), chairman of the House Energy and Commerce subcommittee on health and the environment, presided at the hearing. He accused the Administration of “doublespeak worthy of Big Brother” and vowed to fight the new rule.

Administration officials, however, defended the revised guidelines as essential to preventing federally supported clinics from “steering” pregnant women to abortion services without interfering with doctor-patient relationships.

Dr. Richard H. Schwarz, speaking for the American College of Obstetricians and Gynecologists, opposed the new rules as ambiguous and confusing.

“Under any interpretation of the guidelines, doctors are still ‘gagged’ in that they are unable to make referrals, a normal part of medical practice,” Schwarz said. “If we were not talking about abortion here, I venture to say the public would be all over a doctor who told a patient to look in the yellow pages for the medical services he or she needed.”

Schwarz said a doctor could not be sure he or she could answer patients’ questions such as: “Where can I get an abortion?” or even: “Is it legal in this state to have an abortion?”

Lucille Joel, president of the American Nurses Assn., charged that the latest Administration guidelines would affect the vast majority of nurses who work in and often manage the family planning clinics that receive federal funds.

“Forcing nurses by regulations to provide only partial information places nurses in an unethical and possibly illegal situation,” she said, referring to state laws that require nurses to counsel patients.