Women of America, take note - a letter veeeerry quietly sent by the director of Health and Human Services last week may make it harder for you to get a doctor's care.

    OK, here's the deal. (And thanks to Amanda at Think Progress for piecing this bit of nastiness together and exposing it to the light.)

    Last November, the American College of Obstetricians and Gynecologists outlined the ethical guidelines for doctors. Those who have moral objections to performing a legal abortion for a woman don't have to do it, but they do have to refer her to another doctor or health care provider. [ACOG]

    We'll quote the ACOG: "Physicians and other health care providers have the duty to refer patients in a timely manner to other providers if they do not feel they can in conscience provide the standard reproductive services that patients request. In resource-poor areas, access to safe and legal reproductive services should be maintained."

    The Religious Coalition for Reproductive Choice put out a statement this week in support of what they called ACOG's "principled and sensible policy" which would "leave untouched a physician's right to refuse to provide abortions - a right that has been spelled out in law since 1973 - but would ensure that the patient received the services she needed and wanted." [RCRC]

    It would seem to be a straightforward, ethical guideline, but then the guys at the Bush White House decided to get involved.

    Friday, HHS Secretary Mike Leavitt in effect put an asterisk on the ACOG guideline saying, actually, he doesn't' think doctors should have to refer women to another doctor before they kick them to the curb. [HHS]

    Leavitt: "I am writing to express my strong concern over recent actions that undermine the conscience and other individual rights of health care providers ... It appears that the interaction of the ACOG Bulletin with the ACOG ethics report would force physicians to violate their conscience by referring patients for abortions or taking other objectionable actions, or risk losing their board certification."

    A) What? ACOG never said anything about losing board certification.

    B) Leavitt expresses concern about the well-being of the doctors, which is all well and good, but what about the well-being of women who could be thrown out into the cold, unable to find accessible health care?

    C) And according to OB/GYN Wendy Chavkin of Columbia University, Leavitt's policy may also allow physicians to deny emergency contraception to women who have been raped.

    Discuss.