Battle of Ideas: Hospitals Should Be Mandated to Distribute Emergency Contraception to Rape Victims-Bill Alive in 2003, 2004 Mandates Hospitals Be Shut Down if Not in Compliance

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”’HB 189 HD2 passed the state Legislature but was vetoed by Gov. Linda Lingle. The purpose of the bill was to require hospitals to provide emergency contraception to sexual assault victims. The issue centered around whether or not a religious hospital, such as St. Francis, a Catholic hospital, would be exempted or forced to provide the contraception against its clearly stated religious philosophy. The original bill had been amended to allow such hospitals to be exempt considering there were other alternative hospitals available in near proximity. The final version of the bill, however, took out the exemption and further provided as part of the penalty provision closure of the facility by the state if it did not provide emergency contraception. A legal challenge to the bill was threatened by the hospital and other religious groups. The debate in the House and the Senate was passionate and extensive. No one was really in opposition to the concept of providing assistance including emergency contraception to rape victims, including the governor. Rather the debate centered around forcing all hospitals to comply and the severity of the penalty provision. Speaking in favor of the bill in its final form on the floor of the House is Rep. Marilyn Lee, D-Mililani. She debates Rep. Mark Moses, R-Kapolei, to further the battle of ideas. See his statement at”’ “Battle of Ideas: Don’t Shut Down Religious Hospitals That Won’t Administer Emergency Contraception to Rape Victims”

“Marilyn Lee Image”


Rep. Marilyn Lee rose to speak in support of the measure, stating:

Mr. Speaker, I rise in support of the measure because women who have been sexually assaulted have a particularly compelling need for quick and easy access to emergency contraception. Widespread access and availability of EC for all women as a means of reducing unintended pregnancy is endorsed by many groups, including the American Medical Association, and the American College of Obstetricians and Gynecologists. The price of EC varies but generally in the range of $20-$25.

According to universally accepted medical definitions that have been endorsed by the American College of Obstetricians and Gynecologist and the United States Department of Health and Human Services, pregnancy begins when a pre-embryo completes implantation into the lining of the uterus. Other definitions are theological. EC will not induce an abortion in a woman who is already pregnant, nor would it affect the developing pre-embryo or embryo. Documentation can be provided for anyone who doubts these claims.

The purpose of HB 189 is to authorize hospitals to provide emergency contraception to sexual assault survivors. No one hospital is singled out in this bill, no emergency room, regardless of its religious affiliation should be allowed to place rape survivors at risk of pregnancy because of its adherence to religious tenants that its patients, staff and its community do not share.

Emergency contraception works with declining effectiveness for approximately 72 hours after unprotected sex. Therefore, a refusal to offer the drug on-site to a rape survivor risks harmful delay and will prevent some women from getting the drug on time. Women who have survived a sex assault should not be expected to find another doctor, obtain a prescription, find a pharmacy to fill it, all within 72 hours of the rape. This is a context in which no refusal is acceptable and even mandatory referral to another provider is not enough.

Mr. Speaker, it is unconscionable that health-care systems and practitioners would unnecessarily place women who have been sexually abused at risk of the additional trauma of an unwanted pregnancy. EC has been shown to be safe and effective and it is unethical, unethical to withhold it for any reason from a woman who has been raped. Guidelines must be established and enforced so that hospitals uniformly counsel sex assault survivors and offer them EC.

I just want to thank the Representative from Waipahu for recounting his experience with a friend who was raped. Rape is not pretty. It is dirty, and it’s messy, and it’s bloody. I want you all to realize that … . It is not something that you just forget about tomorrow. The bottom line is that no one has the right to refuse access to care that is appropriate for rape victims and meets the accepted standard of care. In fact, how dare anyone even suggest it?

”’Marilyn Lee is the Democrat Representative for the Mililani area on the island of Oahu.”’