Resolution Adopted by the CCAR

Resolution on State Restrictions on Access to Reproductive Health Services

Adopted by the 119th Annual Convention
of the Central Conference of American Rabbis
Cincinnati, Ohio
April, 2008

Background

For decades, the Reform Jewish Movement has supported and defended a woman’s right to control her own reproductive health decisions and has advocated that all people be equipped with the information they need to make healthy choices and the tools to implement those choices. We believe that both American law and Jewish tradition entrust patients with autonomy in making health care decisions, free from government interference, and we assert that in a diverse democracy each person has the liberty to draw upon his or her own faith for guidance, and not be subject to the religious views of others. As the Central Conference of American Rabbis noted in its 1975 resolution on Abortion, with respect to traditional Judaism’s own limited approval of abortion: “as we would not impose the historic position of Jewish teaching upon individuals nor legislate it as normative for society at large, so we would not wish the position of any other group imposed upon the Jewish community or the general population.”

Difference in opinion between religions regarding health care options is inevitable and occurs daily. Since the landmark 1973 case, Roe v. Wade, recognized a woman’s right to terminate a pregnancy, many organizations, religious groups and elected and appointed officials have tried to restrict, if not eliminate, the ability to exercise this right, effectively codifying their own beliefs. More recently, these groups and individuals have focused on state-level initiatives to incrementally chip away at reproductive rights, from curtailing access to abortion services and birth control to imposing an abstinence-only sexuality education curriculum that has not only been proven ineffective, but often misrepresents scientific truths and blatantly asserts a particular moral and religious agenda.

These laws and programs intrude upon a woman’s reproductive rights and infringe upon the our country’s guarantee of religious freedom and personal liberty. State Legislatures are no more suited than Congress to make reproductive health decisions for women.  Government should not, at any level, interfere with personal health choices or intrude upon the confidential decision-making process a woman engages in with her doctor and clergy.

Abortion Services
Over the past decade, individual states have considered and adopted hundreds of pieces of legislation that restrict access to important reproductive health services. As of the beginning of 2008, four states have “trigger” laws that would impose near-total criminal bans on abortion that would go into effect if the Supreme Court overturned Roe v. Wade. Forty-seven states and the District of Columbia currently allow certain entities or individuals associated with the provision of health care to deny a woman specific reproductive health services, information or even referrals. Forty-four states prohibit certain qualified health care professionals from performing abortions, subjecting providers of this service to burdensome restrictions not applied to other medical professionals, and twenty-five of these states restrict the provision of abortion care to hospitals or other specialized facilities. These laws have no medical basis and are solely designed to make it harder for women to  consider or even learn about abortion as an option, creating a de facto ban in those regions.

Forty-three states mandate parental notification or consent before a young woman is allowed to terminate her pregnancy, but only twenty nine of these states’ laws include a medical exception and only 14 include an exception for cases of rape or incest. While all of these states include the option of obtaining a judicial bypass, many judges refuse to grant bypasses to minors; young women without their parents’ help too often do not have access to the qualified legal counsel necessary to put forth a compelling case, making this alternative a non-viable option for those young women. Additionally, because the earlier an abortion is performed, the safer it is, the time required to go through legal process only endangers the patient.

Parental notification and consent laws serve only to force young women already in a terrifying position into further danger and seek to address a problem that does not really exist. The great majority of young women faced with unwanted pregnancy turn to their families for guidance and help, regardless of the law. However, there are too many unfortunate young women who are denied a supportive family and for whom disclosure of a pregnancy may result in abandonment or even physical harm. In some cases, the person whose consent a young woman must secure is the very person who placed her in that situation. These laws only serve to further burden the young women who are least equipped to confront these issues.

Recently, some states have considered laws that would require publication of statistics on judges who grant judicial bypasses to young women seeking abortion care without parental notification or consent.  These laws would compromise the necessary confidentiality of the judicial bypass process, are intended to discourage judges from granting warranted bypasses, and could foster violence against judges who act in accordance with the law.
 
Women with low incomes also have been disproportionately affected by restrictions. Seventeen states prohibit insurance plans for public and/or private employees from covering abortion services. Nineteen states prohibit some or all state employees or organizations that receive state funds from providing counseling or referrals for women for abortion services. Because of the Hyde Amendment, passed in 1976, no federal funding is available for abortion counseling or services either, forcing women in these states, particularly including those who rely on Medicaid, Medicare, the State Children's Health Insurance Program, Indian Health Service clients, and clients of the District of Columbia's public health care programs for health care to risk their health by delaying the procedure as they seek private funds, or leaving them entirely unable to afford abortion services. Unwanted pregnancy creates an additional burden for poor women, who may not have the resources to afford pre-natal medical care, or be able to take time off from work to visit their doctor, stay on bed-rest if prescribed or recuperate from their delivery.

Thirty-one states further meddle with women’s reproductive health by subjecting women seeking abortions to biased counseling requirements and/ or mandatory delays. Some require doctors or nurses to inform all women seeking an abortion of the pain their fetus could endure during the procedure, despite the lack of any compelling scientific evidence proving this is true before the seventh month, while other states require women to wait twenty-four hours after mandated counseling to undergo the procedure. These laws force women to take an additional day off from work for the paternalistic purpose of insisting that women further agonize over their choice, as if they had not yet already sufficiently considered their decision.

Only ten percent of counties in the United States have abortion service providers, many of whom only work part time at each of several clinics. The laws discussed above impede safe reproductive health services and chip away personal rights, creating a de facto, if not legal, abortion ban in many regions of the country. However, research shows that banning abortion does not reduce the number of procedures performed; it only reduces the number of safe procedures. Allowing states to restrict access to reproductive health services condemns desperate women to seek illegal, unsafe abortions that all too often end in the woman’s injury or death.

Family Planning
The United States has one of the highest rates of unintended pregnancy among Western nations. Each year, half of the more than 6 million pregnancies in this country are unintended, and nearly half of those end in abortion. Access to family planning services significantly reduces the number of unintended pregnancies. While many states have, thankfully, expanded access to these services, including birth control, others have restricted access.

Recently, a new trend has emerged, with pharmacists refusing to dispense Emergency Contraception (EC) or prescription birth control because of their own religious beliefs. Emergency Contraception is essentially a high dose of birth control medication taken within seventy-two hours of unprotected sex to prevent pregnancy. Though some confuse Emergency Contraception with medication that induces abortion, in fact, EC does not interrupt an existing pregnancy, but rather prevents pregnancy from occurring. In August 2006, the Food and Drug Administration approved the sale of Plan B (the brand-name of the only approved Emergency Contraception medication) without a prescription for people over 18 and with a prescription for those under 18. Plan B is kept behind the pharmacy counter and, even for those who do not need a prescription, can only be purchased from a licensed pharmacist. This allows pharmacists the power to refuse to supply patients with Emergency Contraception, just as they can refuse to dispense a birth control prescription.

When a health care provider objects on religious grounds to filling a valid prescription, a conflict arises between the rights of the provider and the rights of the patient. Under Title VII of the Civil Rights Act, employers with 15 or more employees must accommodate the religious beliefs of their employees, provided such accommodations do not impose more than a minimal burden on the employer. But the provider’s religious liberty, with which the CCAR is also particularly concerned, must be balanced by the patient’s right to make his or her own health care decisions. There are thirteen states that currently permit health care providers to refuse to provide contraceptive services and four states have existing laws or regulations that explicitly permit pharmacists to refuse to dispense contraception. None of these statutes protect the patient by requiring that the prescription be filled on the premises without undue delay by another pharmacist without a religious objection. It is our belief, as well as that of the American Civil Liberties Union and the Religious Coalition for Reproductive Choice that pharmacies can accommodate both concerns without placing undue burdens on the patient, such as an unreasonable delay or forcing the patient to travel to other pharmacy locations.

In addition, some states have enacted laws that prohibit Medicaid family planning funds to be allocated to entities that also provide abortions, even if they do so with private funds.  At the same time, these and similar laws set aside significant percentages of federal family planning funds, which pass through the States, for Federally Qualified Health Centers, which may be outstanding health care providers but are not necessarily the best qualified to provide family planning services.  Moreover, these laws cynically misdirect a percentage of federal family planning funds to “Crisis Pregnancy Centers,” which provide no birth control services whatsoever.

Care for Victims of Rape and Incest
At some hospitals, information about Emergency Contraception is not provided to victims of sexual assault.  While such a policy may be in line with the protected religious expression of the hospital, it is highly problematic, for the traumatized victim, who may not know such options exist and may face the added trauma of a pregnancy resulting from a sexual assault. In some jurisdictions, government funds for treating sexual assault victims are allocated to hospitals that do not provide Emergency Contraception or any information about it.

Sexual and Reproductive Education
Comprehensive, medically accurate sexuality education in schools has repeatedly been shown to significantly reduce unintended pregnancy and sexually transmitted infection rates among students. In contrast, the government’s own reviews of the federally funded abstinence-only-until-marriage programs have shown that such programs do not significantly delay sexual debut or reduce rates of unintended pregnancy or sexually transmitted diseases when compared to students receiving no sexuality education. The CCAR stated in 2001 that modern Judaism “views sexuality, and its ultimate goal of a healthy and committed relationship, a matter of religious concern” and resolved to urge the inclusion of comprehensive sex education in public schools from grade school through high school.

The content of educational curricula is determined at the state and local levels and it is up to each state to decide whether or not to accept federal funds that are restricted for abstinence-only sex education programs. It is our belief that allocating money to these programs not only diverts funds from the more effective comprehensive programs, but also provides government endorsement of ineffective and misleading curricula laden with false gender stereotypes and unhelpful moralizing.

THEREFORE, the Central Conference of American Rabbis resolves to:

  1. Affirm the legal right of a family or a woman to determine on the basis of their or her own religious and moral values whether or not to terminate a particular pregnancy, free from government interference; the right of all women to access the birth control; and the right of all people to receive comprehensive and medically accurate sexuality education;
  2. Urge the broad liberalization of abortion laws in the various states;
  3. Oppose laws that require a minor to obtain parental consent or notification before she is legally able to terminate her pregnancy that do not include:
    1. An exception for pregnancies that endanger the life or health of the pregnant woman and pregnancies resulting from sexual crimes including rape, statutory rape, and incest; and
    2. A judicial bypass alternative, taking into account the difficulty minors may experience in their attempt to navigate the court system without the help, consent or knowledge of their parents.
  4. Oppose any law or process that seeks to publicize the records of or target judges who have granted bypasses to minors, in an attempt to direct public pressure toward such judges;
  5. Oppose conditions placed on the allocation of federal or state funds for family planning that restrict the provision of counseling or abortion services;
  6. Oppose measures that require women seeking abortions to be counseled with misleading, incorrect, or unscientific information regarding the abortion procedure;
  7. Oppose laws that mandate a waiting period before a woman may undergo an abortion procedure;
  8. Support pharmacy policies that recognize both the religious liberty of providers and a woman’s right to obtain contraceptives in a timely manner by guaranteeing that:
    1. Patients at a pharmacy receive contraceptives without delay caused by a staff member who has a religious objection to dispensing them;
    2. When an employee of a pharmacy objects to providing contraceptives on religious grounds, the pharmacy accommodates that employee in a manner that provides the patient timely access to contraceptives without requiring the patient to go to another pharmacy or return to that same pharmacy at another time; and
    3. Pharmacy staff members provide all medications absent advance notice to their employers of their religious objection to dispensing a particular type of medication, thereby giving the employer the opportunity to make appropriate arrangements;  
  9. Encourage hospitals and other emergency care facilities that cannot, because of religious principle, provide Emergency Contraception to direct victims of sexual assault to other facilities, wherever available; Facilities that provide care for sexual assault victims utilizing governmental funds should be required to provide information about emergency contraception to all female patients who are not clearly pre-pubescent.
  10. Recognize that it is up to individual parents to imbue their children with their specific moral and religious values and that no government funds should go to any program that promotes a particular religious view;
  11. Encourage states to refuse federal funding directed specifically for abstinence-only-until-marriage sexuality education programs; and
  12. Urge states to implement comprehensive, medically accurate sexuality education curricula that inform all students about their bodies, how to make healthy decisions and negotiate with their partners, thus equipping them with the information they need to make intelligent decisions for themselves, to avoid unwanted pregnancy and sexually transmitted diseases and to better ensure good health throughout their lives.