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
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.
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.
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: