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Both the rights of conscience for health providers and a parent's right to know

about prescription drugs for their minor children are a matter of basic ethics in health care. Mr. Chairman, I learned last year of the need for a comprehensive anti-discrimination protection for health care organizations that choose not to provide abortions. Shockingly, some of our fine private hospitals have recently threatened and even forced, compelled to provide abortions, a procedure to which they are opposed to providing.

Currently, Federal law does provide conscience protection for individuals and providers who choose not to perform or refer for abortions. However, recent court cases have demonstrated that this law needs to be clarified to protect hospitals and health care organizations from abortion-related discrimination.

Ms. Vosburgh, a witness before us today, represents Valley Hospital, located in Palmer, Alaska. Valley Hospital is a private, nonsectarian hospital that decided to have a policy against performing abortions. Valley Hospital had a right to have this policy since it, as I said, is a private hospital. Unfortunately, Valley Hospital was ordered to perform abortions against its will.

Mr. Chairman, this is wrong. Abortion is elective surgery, it is not prenatal care, it is not basic health care, as some of our friends would like us to believe. Private hospitals should be able to decide what types of elective surgery they wish to offer. If they don't want to provide abortions, they shouldn't have to. For every one hospital that does not provide abortion, there are scores of hospitals that do provide them. I wonder what other elective surgeries we will begin forcing our hospitals to provide next.

We are not talking about discrimination here, which would be offering a service to some patients and not others. We are talking about a private hospital board making a decision not to offer one type of elective surgery and making that decision apply to everyone who walks in the door, regardless of race, income, whatever.

Mr. Chairman, I am proud to be a co-sponsor of your legislation, the Abortion Non-Discrimination Act. This legislation strengthens existing law by saying that health care providers may not be required to provide abortions. It is common sense, I think it is a technical change. The authors of the 1996 law admit that they intended for hospitals and health care providers to be included in the definition of health care entity. However, unfortunately, the courts have misconstrued this and thus the need for further clarification.

The second issue before us today is even more disturbing. Mr. Chairman, in the State of Pennsylvania, a minor needs written parental or guardian consent to have his or her ears pierced, to get a driver's learning permit, to get married, to receive aspirin in school, to attend a field trip, to get a tattoo, to participate in athletic activity, to be absent from school, to ride a bus other than his own, the list goes on. We do not allow minors to attend R-rated movies, purchase tobacco products, consume alcohol. However, Federal regulations allow a minor to get contraceptives, including injected drugs, like Depo-Provera, and surgical implants, like Norplant, in health care clinics receiving title X funds without parental consent. In fact, it is against the law for medical staff to inform parents that their child is receiving prescription contraceptives.

Mr. Chairman, it is deplorable that while a 14-year-old girl is required to have parental consent to get an aspirin in school or have her ears pierced, she can receive prescription contraceptive drugs and devices without the consent or knowledge of her parents. I am sure you agree with me that parents have a right to know what the government is doing to their children. Further, under current law, in most States, a minor receiving care in a physician's office must receive parental consent before receiving care. However, if that same minor were to enter a title X clinic, she could receive prescription contraceptives without parental consent or notification. Again, it is mandated under Federal regulations.

The testimony we will hear today from Mr. Heisler will show the danger of this regulation. It is unconscionable that our government regulations prevented a 13-year-old parents-girl's parents from knowing that their daughter had been driven to a clinic by her teacher to receive contraceptives and then raped over a period of 18 months this went on. Another example, in 1998, a 16-year-old in Walton County, Georgia, unbeknownst to her parents, went to receive a pelvic exam, an injection of the contraceptive drug, DepoProvera, in a taxpayer-funded clinic, and as the girl was about to receive the injection she casually mentioned to the nurse that she had a heart murmur. The nurse told the girl she would need a doctor's note, so the clinic would be immune from a malpractice claim, and the family's doctor subsequently notified the mother that the chemical contraception, if it had been administered, there was a great probability that her child would have gone into cardiac arrest and possibly have died because of her heart condition.

These horrific examples could have been prevented if our bill was passed. We don't expect the government to watch over every single teen out there to whom is given birth control. That is a parent's responsibility. However, by keeping them out of the loop, were are, in effect, removing parents from the equation. And so thank you, thank you to all the witnesses for taking time to come and testify I look forward to hearing their testimony.

Mr. BILIRAKIS. The Chair thanks the gentleman. Mr. Deutsch, for an opening statement.

Mr. DEUTSCH. Thank you, Mr. Chairman. Just listening to opening statements, it is almost as if it is a tale of two cities or a tale of two countries. My good friend and colleague talked about an America which I wish it existed. I wish everyone in America could go to private physicians or go to clinics that are not affected by H.R. 4691, but that is not the case. This type of legislation, in fact, the facts are that it does discriminate. It does discriminate disproportionately of low-income women, people who don't have a choice, people in rural areas. And that would be the effect. I can turn the questions on its head that these are title X funded clinics that they don't have to participate. If they feel so objectionable of the requirements that go along with the funding, then they can choose not to participate; that is their choice.

It is also—I mean, obviously, we have two separate parts of the hearing. It is also interesting, and the chairman well knows this coming from Florida, as I do, that the Florida Supreme Court has actually found a Florida constitutional right of non-notification. And it is interesting. I mean this is not a radical court by any

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stretch of the imagination. And it is also—again, I don't know what other States provide State constitutional protection that has been interpreted to provide this. But it is the follow-up of really this whole issue of a tale of two countries.

I don't ever like to personalize statements as a member, but I have a daughter that I hope she never gets pregnant outside of marriage, but if she did, I would hope she would have the relationship with her mom and me to talk to us. But there are many children in America, unfortunately, and we are talking the tens of thousands, who unfortunately don't have those relationships with their parents and situations of abuse, potentially incest, potentially all sorts of other issues that exist. And there is a reason for the distinction that my colleague mentioned between going on a bus without permission and being able to receive contraception or for that matter abortion. There is a very real reason, and the experience of a 16-year-old girl who might be far more experienced than maybe anyone in this room in this area defies the conditions that still exist in America, in many places, under many times and many circumstances.

So I welcome this hearing, I welcome the testimony from different people, and I urge my colleagues who have not seen both sides of America to visit

both sides of America. Thank you. Mr. BILIRAKIS. I thank the gentleman. Mr. Wynn, for an opening statement.

Mr. WYNN. Thank you, Mr. Chairman. I appreciate your calling this hearing on a very, very important issue facing us today. I have very mixed feelings, but I think in listening to the testimony I will be focusing on, and I hope as a committee we focus on the welfare of the child from the standpoint of the child's health. In an era of AIDS and as well as rampant teen pregnancy, it seems to me that young people do have the need to have unfettered access to information about contraception as well as contraceptive devices. Having said that, I also acknowledge that there is a parental role, I just think that that parental role should not come into play once you reach the point of making these crucial decisions.

I also would be interested, however, in hearing from people comment on the question of their interaction of contraceptives with other drugs that the child may be taking and how we can again look at the child's best-protect the child's welfare in those situations where there may be an adverse reaction if full information is not disclosed to the person making the contraceptive information or devices available.

So there are a lot of complex issues before the committee. I also look forward to hearing from the witnesses, but I do believe we have to take the child's physical health, keep that in the forefront of this discussion. Again, I thank you for calling this hearing and look forward to the testimony. Thank you.

Mr. BILIRAKIS. And the Chair thanks the gentleman. And we will go on to the panel now, but before we do I would like to say that Congressman Akin is here at his own time because he has an interest in this subject, and he is more than welcome to be sitting in during our deliberations.

The first panel consists of Ms. Karen Vosburgh, from Palmer Alaska, a very beautiful community, I have been to it; Ms. Catherine Weiss, director of ACLU Reproductive Freedom Project out of New York City; and Professor Lynn Wardle, J. Reuben Clark Law School, Brigham Young University, Provo, Utah.

Welcome. Your submitted testimony is a part of the record, and we would hope you would complement it. We will set the clock at 5 minutes and hopefully we will all do our best to adhere to that time limit. Ms. Vosburgh, please start off. Please, the mike, yes. STATEMENTS OF KAREN VOSBURGH; CATHERINE WEISS, DI


Ms. VOSBURGH. Good afternoon, Mr. Chairman, and thank you for bringing this up to the forefront. I do thank you for that. And also other members of the committee. Thank you for providing me this opportunity to testify and to express my support for protecting health care providers from forced involvement in abortion.

I serve as a director of the Association Board of Valley Hospital, which is a nonprofit, nonsectarian community-based hospital. This hospital lies in an amazingly beautiful valley, as you said, Mr. Chairman. It is surrounded on three sides by these incredible mountains and beautiful rivers. I mean it is just a very pristine area. It is Palmer, Alaska, and it is located about 50 miles east of Anchorage. There is also another town, Wasilla, that is 10 miles from Palmer. And these two towns and the outlying areas make up a place we call the Valley. There is about 50,000 people there.

It is a place of faith. There are 70 churches in this valley, and we are a very God-based community, and we believe that abortion—we know that abortion is killing a human being.

Valley Hospital is truly a community hospital in that it is governed by the members of the community. Membership in the hospital is open to all residents of our community without regard to citizenship, race, sex or religious preference. The members elect the association board on which I serve. The association board is responsible for raising funds, acquiring land, property and equipment for the hospital and for selecting the members of the hospital's operating board. This board sets the policy of the hospital. And because the members of the operating board are ultimately selected from our community, the board truly represents the community. Among the operating board's current members, for example, are a pastor, a realtor, an attorney, a teacher and a physician.

The community both serves and is served by the hospital. The mission of the hospital is to enhance the health of those we serve, guided by the values of honoring the dignity of all people, representing the interests of the community and providing the highest level of care within the bounds of ethics. Our small town has an OB/

GYN who performs elective abortions. She uses Valley Hospital for her later-term, second trimester elective abortions. For the most part, our community wants abortion to stop at Valley Hospital. So, in the early 1990's, the members elected people to the association board who believe in respect for human life and who hold the philosophy that hospitals are for healing and not for killing. The association board selected the operating board, which passed a resolution reflecting this policy. The resolution ended abortion at Valley Hospital except in the cases of rape, incest and danger to the life of the mother, which is exactly the same policy that the Federal Government has had in Medicaid and its other health programs for many years. In fact, every year, our operating board continues to update this policy. This is the latest one, and it states that, “A policy has been adopted that elective abortions shall not be performed at Valley Hospital. The exceptions to this policy include documentation by one or more physicians that the fetus has a condition that is incompatible with life, a life-threatening condition exists for the patient or the pregnancy is a result of rape or incest.”

When the abortionist was told she could no longer perform abortions at Valley Hospital, she was overheard complaining that abortions were a good portion of her income. She sued. The trial judge, Judge Dana Fabe, ruled in her favor, stating that because Valley Hospital received some Federal and State money from Medicaid and Medicare, that it was a quasi-public entity and therefore has to provide abortions. The judge's reasoning was strange, to say the least. How can our receipt of Federal funds be used to forbid us to have the same abortion policy that the Federal Government requires in all its own health facilities?

I believe, however, that this particular Judge Fabe's opinion was colored by her personal views on abortion. In 1993, she made the statement in a newspaper there that, “If a high school student in this State has a fundamental right to choose his or her hairstyle, an Alaskan woman must certainly have a fundamental right to choose whether or not to terminate a pregnancy.” That is her reasoning

Of course, Valley Hospital challenged this decision, and it went before the Alaska Supreme Court. The five-member court is one of a handful of State supreme courts to rule that State funds must be used for elective abortions despite the contrary decision of the State legislature. One member, Justice Bryner-I was there when he said this, and I just about fell on the floor-he said during oral arguments for the State funding issue, he declared that pregnancy is a disease. It was no surprise that this court upheld Judge Fabe's original decision. The Alaska Supreme Court held that Valley Hospital was quasi-public because of its receipt of public monies.

In addition, the court struck down a State law protecting hospitals that refuse to participate in abortions, denying the right of our board to exercise its rights of moral conscience. The court even suggested that it would not respect the religious beliefs of those who decline involvement in abortion, saying, "recognizing such a policy as compelling could violate the Establishment Clause of the First Amendment.” And you will find that in Valley Hospital Association v. Mat-Su Coalition for Choice.

In response, the legislature sought to reverse the decision by constitutional amendment, which requires a two-thirds vote of our legislators. Sadly, the amendment failed to garner the two-thirds majority by just one vote, and I am sure many of you understand that here.

Mr. BILIRAKIS. Please summarize, Ms. Vosburgh.

Ms. VOSBURGH. Will do. This court decision potentially places all hospitals in our State in a Catch-22 situation. If you are a non-reli

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