Thursday, 10 April 2003
Guest Opinion
House will serve rape victims by passing bill intact
Bridget
Riceci and Nancy J. Hiatt
SPECIAL TO THE ARIZONA DAILY STAR
Imagine suffering the intense trauma of being sexually assaulted. Then imagine discovering that as a result of the rape, you are pregnant.
Now, imagine finding out that if you had been given the right information and treatment when you first sought medical care, you could have taken emergency contraception and prevented the pregnancy.
That's a situation that rape victims in many parts of Arizona potentially face, a situation that the Compassionate Care for Sexual Assault Survivors Bill (SB 1087/HB 2374), which is currently being considered in the Legislature, seeks to rectify.
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As leaders of the two largest sexual assault centers in Arizona, we see thousands of women every year who have been raped. Women who come to our centers are routinely offered emergency contraception to prevent an unwanted pregnancy. But in parts of the state that are not served by such centers as ours, the treatment of a rape victim may depend on where she lives or on who happens to be on duty when she presents for medical care or whether or not she chooses to report the crime to law enforcement. The assault survivors bill would eliminate this inhumane lottery for sexual assault victims by requiring that all health care professionals in Arizona comply with American Medical Association guidelines by offering emergency contraception to women who have been raped. The need for improved access to emergency contraception for rape victims is well-established. A 2002 study published in the Annals of Emergency Medicine found that fewer than half of sexual assault survivors at risk of pregnancy who were treated in hospital emergency departments received emergency contraception. Emergency contraception can reduce the risk of pregnancy by as much as 89 percent, but its effectiveness decreases with any delay in the initiation of treatment - currently up to a maximum of 72 hours - following unprotected intercourse. A sexual assault victim may have already delayed seeking medical treatment; even if she is aware of the existence of emergency contraception - many women are not - forcing her to seek out and obtain emergency contraception on her own will create further delay and increase the likelihood of an unwanted pregnancy. This issue should not be clouded by controversies relating to abortion. Emergency contraception is entirely different from the abortion pill, mifepristone or RU-486. Emergency contraceptive pills contain a high dose of the hormones found in regular birth control pills and work in exactly the same way. Emergency contraception will not interrupt or disrupt an established pregnancy, nor will it affect a developing pre-embryo or embryo. Religious concerns over contraception should not be a barrier to passing this legislation. The Ethical and Religious Directives for Catholic Health Care, which govern how Catholic hospitals in the United States operate, clearly state that "a female who has been raped should be able to defend herself against a potential conception from the sexual assault." And a clause in the bill would allow medical professionals with a religious objection to contraception immediately to refer the victim to another health care provider for treatment. Although the bill has been passed by the full Senate and by two committees in the House, Rep. Karen Johnson, R-Mesa, is currently refusing to hear the bill in the House Rules Committee, claiming that the passage of an amendment proposed by Rep. Steven B. Yarbrough, R-Chandler, is necessary to "avoid legal issues" raised by the bill's provisions. In fact, the Yarbrough amendment is bad law and would leave the bill open to a range of legal challenges. Its conscience clause provision would allow a health care provider to refuse appropriate care to a rape victim when no alternative source of care is realistically available, potentially causing her to become unnecessarily pregnant. This is a gross violation of medical ethics and directly contravenes the American Medical Association's guidelines on the treatment of sexual assault victims. The amendment's provision for parental consent would be the first such provision for access to contraception in the entire country and would make it more difficult for a rape victim to obtain emergency contraception than it is for any other woman in Arizona, while its requirement for health care professionals to give legal advice would certainly be challenged by the medical profession. This week, is National Crime Victims' Rights Week. We hope members of the state House of Representatives will take the opportunity to establish this Legislature as one that respects crime victims' rights by uniting in the interests of rape victims and passing the Compassionate Care for Sexual Assault Survivors Bill in the same form as it passed the full Senate two weeks ago. No woman in our state should be denied the information and contraceptive treatment she needs to prevent an unwanted pregnancy resulting from rape. * Bridget Riceci, MSW, is president and CEO of the Southern Arizona Center Against Sexual Assault. Nancy J. Hiatt, MSW, is the executive director of Victim/Witness Services for Coconino County and the Northern Arizona Center Against Sexual Assault. |
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