Religious beliefs trumped science in the Supreme Court’s Hobby Lobby ruling
Jul 3, 2014 |By Annie Sneed
This week’s Supreme Court ruling that the Affordable Care Act violated the craft store chain Hobby Lobby’s religious freedom by requiring it to provide employees with insurance coverage for certain contraceptives was based on a complete misunderstanding of how these forms of birth control work. The owners of Hobby Lobby believe the contraceptives—Plan B, Ella and intrauterine devices (IUD)—cause abortions, which they object to as Christians. It is scientifically accepted that pregnancy starts when a fertilized egg implants in the uterus. These contraceptives, however, act before implantation so they cannot be said to terminate pregnancy.
Yet some religious practitioners, including the owners of Hobby Lobby, hold that life begins at conception—when the sperm fertilizes the egg. They believe that these particular contraceptives interfere with the fertilized egg, which they view as destruction of life. Scientific studies indicate this isn’t the case either. Rather, these contraceptives appear to work before fertilization. For instance, Plan B affects ovulation, thereby ensuring that the egg never meets a sperm. This hormonal contraceptive operates similarly to other birth control pills. “We have a very high level of certainty that Plan B only works before ovulation,” says Kelly Cleland, a population researcher at Princeton University.
Medical experts understand less clearly how the other methods of contraception act, because all of them have multiple effects on the egg, sperm and uterus. They can impede sperm mobility, change cervical mucus and modify uterine lining as well as slow the movement of an egg or prevent its release. Although researchers allow that IUDs could potentially interfere with implantation of a fertilized egg, studies indicate that the devices mainly impede pregnancy prefertilization. “With the IUD, the primary mechanism impacts ovulation and sperm behavior,” says Jeanne Conry, past president of the American Congress of Obstetricians and Gynecologists (ACOG).
But again, as Cleland and Conry emphasize, preventing implantation of a fertilized egg isn’t abortion. Another form of emergency contraception—Ella—only recently became available, so researchers have yet to study its modes of action as extensively as those of other methods. But Ella “is just a variation on the theme for the IUD,” Conry explains.
It’s unclear why the known medical science behind these contraceptives did not seem to bear on the Supreme Court’s decision. In the case of Plan B, it’s evident that the contraceptive does not violate Hobby Lobby’s religious beliefs about abortion. Research also suggests that the other contraceptives don’t conflict with such religious beliefs either. This means that, at least in part, Hobby Lobby based its argument on scientific ignorance. Medical organizations such as the ACOG conveyed the science during the trial, but to no avail—at least for the justices rendering the majority opinion. “We made these points every step of the way,” Conry says, “but the Supreme Court decided on religion, not science.”
pThe American College of Obstetricians and Gynecologists, a national organization representing thousands of women’s health experts, has publicly come out against the state-level abortion restrictions that impact the way doctors are allowed to treat their patients. The group’s Executive Board has issued an official statement opposing all laws that “unduly interfere with patient-physician relationships” and […]/p
By Tara Culp-Ressler on Jun 10, 2013 at 2:45 pm
The American College of Obstetricians and Gynecologists, a national organization representing thousands of women’s health experts, has publicly come out against the state-level abortion restrictions that impact the way doctors are allowed to treat their patients. The group’s Executive Board has issued an official statement opposing all laws that “unduly interfere with patient-physician relationships” and compromise patients’ health care for political gain.
“Given the relentless legislative assault on the patient-physician relationship that we’ve seen in the past few years — and unfortunately continue to see — we were compelled to issue a formal Statement of Policy,” the group’s president, Dr. Jeanne A. Conry, explained in a press release. “A disproportionate number of these types of laws are aimed at women’s reproductive rights and the physicians that provide women’s health care services.”
In its formal statement, the doctors’ group criticized specific pieces of anti-abortion legislation that comes between women and their doctors — including forced ultrasound laws that require women seeking abortions to look at an image of their fetus before continuing with the medical procedure, “disclosure” laws that require doctors to tell women about the scientifically disputed link between abortion and breast cancer, and laws that require doctors to use an outdated procedure for administering the abortion pill.
The OB-GYNs point out that these type of laws allow legislators, instead of doctors, to set medical protocol. When doctors aren’t allowed to follow the current accepted medical practice because of a politically-motivated law, they aren’t able to provide their patients with the best quality of care. That dynamic has contributed to a serious shortage of women’s health doctors in states with harsh abortion restrictions, since medical professionals would rather avoid situations in which they may have to choose between providing their patients with the best health care and following a complicated state law.
“We are speaking out not just on behalf of OB-GYNs, but for all physicians and patients,” Dr. Conry noted. “Many of these laws are dangerous to patients’ health and safety. As physicians, we are obligated to offer the best evidence-based care to our patients. Government should stay out of imposing its political agenda on medical practice.”
This isn’t the first time that the College has weighed in on an area of women’s health that has become overly politicized by elected officials. Last fall, the group came out in support of improving women’s access to birth control by allowing them to buy it over the counter. It has repeatedly encouraged doctors to help reduce unintended pregnancies by providing teens with long-lasting contraception like IUDs. And, as the Obama Administration has continued to advocate imposing age restrictions on over-the-counter emergency contraception, OB-GYNs have reiterated that they don’t support preventing young teens from buying Plan B without a prescription.
NOW Applauds Obama Administration’s Movement toward Allowing Access to Over-the-Counter Emergency Contraceptive Without Age Restrictions
June 11, 2013
The National Organization for Women is encouraged by the Obama administration’s promise to federal district court Judge Edward R. Korman that it will withdraw its appeal of his ruling, in which the FDA was ordered to make all forms of emergency contraception available over the counter without age restrictions. With access to this safe and effective product, women of all ages will be able to take immediate action to prevent pregnancy after unprotected sex.
Study after study has demonstrated that emergency contraception is an effective and safe way of preventing unwanted pregnancies. After a decade of wrangling over access to this medication, it is time for common sense and science-based medicine to win the day. NOW calls on the Obama administration to comply with Judge Korman’s order without delay and without qualification.
Buoyed by this victory, NOW activists across the country will continue to work to advance reproductive justice and defeat the radical right forces that play politics with women’s lives.
UPDATE: Judge Korman refused to put on hold his order to make emergency contraception available over the counter to all ages. He has extended the implementation of his order until Monday at noon in order to allow time for the Obama administration to appeal to the 2nd U.S. Circuit Court of Appeals in Manhattan. In the decision, Korman said the government’s choices in this issue have been “largely an insult to the intelligence of women.”
After District Court Judge Edward Korman’s order last month that the Food and Drug Administration must provide emergency contraception over the counter to all ages was appealed last week by the Department of Justice, he got a chance to respond Tuesday morning.
In the two-hour hearing, the Obama administration defended its stance while Korman argued the administration’s policy is based on politics rather than on scientific evidence. Korman said,
It turns out that the same policies that President Bush followed were followed by President Obama.
The FDA announced last week that it would be loosening restrictions on Plan B One-Step—now allowing Plan B One-Step to be sold over the counter and to those ages 15 and older, rather than the previous regulation of 17 and older—and that its decision was independent of Korman’s order. However, on Tuesday, Korman accused the Department of Justice of using the FDA’s new regulations to “sugarcoat” its appeal of Korman’s order.
The FDA decided in 2011 that EC would be available over the counter to all ages, but in December of that year Kathleen Sebelius, the secretary of Health and Human Services, blocked the decision, saying there was not enough information to prove EC was safe for all ages. When Korman overruled Sebelius’ decision last month, he called her decision “politically motivated, scientifically unjustified and contrary to agency precedent.”
In response to the Department of Justice’s appeal of his order, Korman says:
The irony is that I would be allowing what the FDA wanted. This has got to be one of the most unusual administrative law cases I have ever seen … I would have thought that on the day I handed down my decision, they would be drinking champagne at the FDA.
A large part of Korman’s overall argument, and one he presented Tuesday morning, was that restricting EC by requiring a form of photo ID excludes a large part of the population—specifically, minorities and immigrants. Of the U.S. population that is of voting age, 11 percent don’t have a government-issued photo ID. That impact proves to be greater on minorities—9 percent of whites don’t have photo IDs while 16 percent of Latino Americans and 25 percent of African Americans don’t have them. Korman argues,
You’re disadvantaging young people, African-Americans, the poor—that’s the policy of the Obama administration?
Nancy Northup, president and CEO of the Center for Reproductive Rights, also believes the lessened restrictions are not sufficient. She said:
Lowering the age restriction … may reduce delays for some young women—but it does nothing to address the significant barriers that far too many women of all ages will still find if they arrive at the drugstore without identification or after the pharmacy gates have been closed for the night or weekend.
These are daunting and sometimes insurmountable hoops women are forced to jump through in time-sensitive circumstances …
Frank Amanat, a representative to the Obama administration, said making EC an over-the-counter drug was unprecedented and that public interest was best served when “the government acts deliberately and incrementally.” To which Korman sarcastically replied:
Tell me about the public interest. Is there a public interest in unplanned pregnancies? Some of which end in abortions?
Korman is due to rule on the administration’s request for a stay before the end of this week. Based on his previous stance and his impassioned reaction Tuesday morning, most likely Korman will deny it [Note: Korman did deny it] and defer the enforcement of the stay to the Court of Appeals for the Second Circuit (where it could then be deferred to the U.S. Supreme Court for a final decision).