(Nov 2009) Denial of Abortion Care Information, Referrals, and Services Undermines Quality Care for U.S. Women
Tracy A. Weitz and Susan Berke Fogel
9 November 2009
Women’s Health Issues 20 (2010) 7–11
On September 9, 2009, President Barack Obama spoke before a joint session of Congress on the imminent need for health care reform. In his speech, he addressed the contested social issue of abortion in two ways: by reaffirming the ongoing exclusion of abortion from federal health care financing and supporting health care providers’ right to opt out of providing health care they find objectionable. “I want to clear up—under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place” (Obama, 2009). His acceptance of the right to deny health care for ideological reasons directly contradicts the expectation most Americans share—that the care they receive will be consistent with the highest standards of scientific evidence, based on individual patient need, and with the goal of maximizing health and wellness.
This commentary provides a brief investigation into this contradiction by providing a new way of thinking about health care denials using the same yardsticks employed to assess health care quality more generally: the adherence to evidence-based standards of care, a commitment to patient centeredness, and focus on prevention of poor health outcomes (Institute of Medicine Committee on Quality of Health Care in America, 2001). The contents of this commentary are drawn from a report to be released by the National Health Law Program, Health Care Refusals: Undermining Quality Care for Women (Fogel & Weitz, 2009). Although the full report addresses broader needs for care related to pregnancy prevention, pregnancy termination, fertility achievement, and healthy sexuality, this commentary is limited to a few standards of care that necessitate abortion as a health care option for women.