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On Wednesday, January 27, the Senate Healthcare Committee in Olympia heard six citizens opposed to Senate Bill 6452 and six in favor. Three of the opposition’s speakers were women who described bad abortion experiences. One particular woman testified against the bill by describing a traumatizing abortion she had had. The Committee chair gently interrupted her choked-up testimony to ask the question, “But what do you have to say about the bill?” The woman, though she pulled herself together, was clearly confused. She thought she was talking about the bill.
The Basics
SB 6452 (also introduced concurrently in the House as HB 2837) was introduced by Senator Rodney Tom of the 48th District. Its purpose is to regulate “limited service pregnancy centers (LSPCs),” also known as “pregnancy resource centers,” “crisis pregnancy centers” or “alternative pregnancy centers.” These organizations are usually listed in phone books under the heading “abortion alternatives.” The bill defines them as “an organization that advertises, offers, or provides pregnancy tests or ultrasounds, and information about abortion and adoption, whether for a fee or as a free service, but does not offer any of the following: Prenatal medical care, comprehensive birth control services, abortion or referrals for abortion.” The bill does not include Planned Parenthood or other family planning healthcare providers because these organizations are already heavily regulated by various laws as medical service providers, while LSPCs are currently classified as non-profits and have no medical oversight by law whatsoever.
The bill has several goals:
1. To require LSPCs to disclose immediately to patients that they do not provide abortion services, referrals for abortion, comprehensive birth control services, or medical care for pregnant women. That is, the LSPC can at no time lead clients to believe that they are in a medical clinic equivalent to a family planning clinic.
2. LSPCs must follow the same privacy laws protecting client information as all other medical providers. This includes giving clients all medical records in writing, including pregnancy test results. LSPCs generally refrain from doing this as a strategy to prevent low-income women from using the records to apply for state funding for abortions.
3. LSPCs must only give out medically accurate information. At this time, LSPCs often mislead or lie to clients about medical facts such as the way pregnancy tests function, the failure rates of condoms, the risks of sex and sexually transmitted infections, and even the psychological effects of abortion (which is, admittedly, controversial).
The bill recently died in committee due to a lack of support. No formal vote was taken, so there is no record of which senators supported the bill. However, it is currently under revision and will probably be introduced next legislative session.
The Survey
Planned Parenthood of the Greater Northwest (formerly Planned Parenthood of Western Washington), Legal Voice (formerly the Northwest Women’s Law Center), the National Organization for Women and other women’s rights organizations became concerned about the conduct of LSPCs in Washington after hearing stories of inappropriate behavior from women who had used LSPC services around the state. They were crucial in gathering more information about the common practices of LSPCs and bringing it to the attention of representatives in Olympia as an important healthcare issue. I was one volunteer who helped gather crucial information by using the services of two LSPCs, Care Net Tacoma and Care Net Gig Harbor.
The legal basis for doing this originates in part from the Fair Housing Act and its enforcement. There is no way to prove discrimination unless one has proof that identical applications were approved or rejected depending on the race of the applicant, and so it is a legitimate legal strategy for certain people to pose as applicants for a service and to see what happens. Lest you think that this is something only pro-choice organizations do, Lila Rose is a notorious pro-life activist who surveys Planned Parenthood clinics across the country, secretly and often illegally taping her phone calls or visits in an attempt to reveal misconduct. In some cases she has been successful. Or look at this survey by STOPP: “The data used in this survey come from a variety of sources, including, but not limited to, printed Planned Parenthood material, Planned Parenthood internet postings, and reports from individuals around the country [emphasis mine].” It is clear that a strategy that is appropriate for one side should be appropriate for the other.
Furthermore, myself and volunteers were given legal briefings about our rights and how to protect the rights of the organizations we surveyed. We were told several times, for instance, that taping people without their knowledge or consent is illegal in the state of Washington. As a result SB 6452 and HB 2837 are responses to the documented bad behavior of LSPCs rather than being based on unsubstantiated rumors.
The Opposition and Freedom of Speech
The primary and most robust argument against SB 6452 comes from the First Amendment right to free speech. In regulating what can and cannot be said – that is, in requiring LSPCs to disseminate only medical facts – isn’t this bill treading on the rights of people to say what they believe? Moreover, since they are not medical clinics, why should they be held to the same standard as healthcare providers? Isn’t this inappropriate state intrusion into the affairs of community organizations?
The main sticking point behind the freedom of speech objection comes from the provision to regulate the medical facts LSPCs give. Moral speech, religious speech, and personal opinions by staff will still be legal under this bill – when they are specified as such. But LSPCs push their religious/moral agendas by twisting medical facts. However, they don’t see it that way, as evidenced most strongly by this statement from LifeNews: “One woman who testified [in favor of SB 6452], Glynnis Kirchmeier, claimed a pregnancy center she visited withheld pregnancy test results and that it informed her of the problems with condoms [emphasis mine].”
Here, for the record, is what I was told about condoms: At Tacoma Care Net, I was told that “the AIDS virus goes through condoms like rice through a tennis racquet.” (This is incorrect, a rumor probably dating back to this 1992 controversy when the AIDS virus was still poorly understood. In any case, if condoms did not prevent AIDS then pretty much everyone would be infected already.) At Gig Harbor Care Net, I was told not only that condoms fail 50% of the time, but that the CDC says that condoms fail 50% of the time. “That’s not true in my experience,” I said. “Well, you must be really lucky then,” was the reply. (It is statistically unlikely that I would be so lucky. Think of Rosencrantz and Guildenstern Are Dead.) Though reports of condom failure rates differ between studies, they are highly effective at preventing disease transmission and pregnancy when used consistently and correctly.
And yet Care Net claims to offer “clear and medically accurate information.” It is clear that they think “medically accurate” is a matter of personal, not medical, opinion.
Here is what the CDC says about condoms, effectiveness, and the AIDS virus:
“Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of HIV.
“Theoretical basis for protection. Latex condoms cover the penis and provide an effective barrier to exposure to secretions such as urethral and vaginal secretions, blocking the pathway of sexual transmission of HIV infection.
“Epidemiologic studies that are conducted in real-life settings, where one partner is infected with HIV and the other partner is not, demonstrate that the consistent use of latex condoms provides a high degree of protection.”
LSPCs and the pro-lifers who run them think that medical fact is not objective, but merely opinion. However, most of us believe that laboratory studies, carefully designed to control for outside variables, with clear methodologies and replicable results, published in peer-reviewed journals, have a level of objectivity that greater than the objectivity of personal opinion. Most of us know that epidemiologic studies, carefully designed to control for outside variables, guided by ethics committees, with clear methodologies and replicable results, published in peer-reviewed journals, qualify also as “fact” rather than “opinion.”
Medical fact can be objectively obtained by anyone following the same experimental standards, and as such it is not opinion. As such it is fundamentally different than the speech that the First Amendment was designed to protect. Therefore to require LSPCs to give out accepted medical fact (as they claim to do) only does not violate their rights to express their opinions. They can still make moral, religious, or philosophic statements about sex, abortion, and so forth. They can even give their own personal opinions about medical facts (e.g., “Well, the CDC says that condoms work, but I don’t believe that.”) And after all, they may refrain from mentioning particular medical facts – they just can’t misrepresent the ones they do give. Other healthcare providers are held to this same standard – why shouldn’t LSPCs?
I should also note that, under the Washington State Healthy Youth Act, it would be illegal for an LSPC to teach its “medically accurate information” to students in schools, because they are not, in fact, true.