Abortion raises the springtime temperature in the nation’s capital

Abortion was the hottest issue in Washing- ton this spring, competing with the deep Ad- ministration cuts in health program funding. Attention has shifted from a proposed consti- tutional amendment to legislation such as human life bills (S 158 and HR goo), which propose to define when life begins.

Abortion opponents have chosen to pursue the bills because they require only a majority vote in both houses and a presidential signa- ture, rather than the two-thirds required to pass a constitutional amendment. Changes in the Constitution must also be ratified by two-thirds of the state legislatures.

The bill route is simpler, but the questions it raises are not. The purpose is to override the 1973 Supreme Court decision (Roe v Wade), which made an abortion in the early stages of pregnancy a matter of individual choice pro- tected by a right to privacy. The decision did not find precedents for declaring a fetus to have constitutional rights.

Whether human life begins at conception does not address the issue of whether a fetus is a person deserving of protection under the 14th Amendment, the bill’s opponents say. A complex tangle of medical, legal, economic, social, and ethical problems would arise.

In opposing the legislation, the American College of Obstetricians and Gynecologists (ACOG) said, “Such legislation poses unsolv- able problems in the health care of women.” In its official statement, the College said physi- cians would be faced with medical questions

about the impact on contraceptive practices, use of drugs in pregnancy, maternal use of exogenous substances, fetuses that are in- compatible with life or have incapacitating conditions, spontaneous and septic abortions, adolescent pregnancy, blighted ovum, eco- topic pregnancy, hydatidiform mole, abdomi- nal pregnancy, amniocentesis, and managing maternal disease in the second and third tri- mesters. Other issues the group mentioned were hazards of the work environment that might affect pregnant women, involuntary ser- vitude of the maternal host, informed consent of the fetus, and illegal traffic in drugs and devices.

“The management of personal health care is primarily the responsibility of the individual and his or her physician,” the statement continued. “The choices which affect the life and health of the individual are specifically the continuing responsibility of the individual. The choice to use appropriate medical and surgical treat- ments is essential for physicians to provide health care.”

The College took its stand at its annual meet- ing April 27 to 30 in Las Vegas. President George M Ryan, MD, was representing the group at hearings on the bill in Washington, DC. The Nurses Association of ACOG has endorsed the statement.

Sen John East (R-NC) held hearings on S 158 in April and May before his subcommittee on separation of powers of the Senate Judiciary Committee. Addressed were medi- cal, legal, and constitutional issues. Main bill sponsors were Sen Jesse Helms (R-NC) and Sen Henry J Hyde (R-Ill). Hyde also sponsored amendments to deny federal funding for abor- tions.

Senator East believes that the Supreme

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Court left the door open in the 1973 decision for Congress to define when life begins, but legal experts question whether the legislative branch has the authority to overrule the high court. He was criticized in April when seven out of eight witnesses whom he invited to testify were antiabortion.

Nursing had not received a reprieve from Reagan’s budget cutting as of mid-May, al- though nurses were pointing out that it is the only health profession suffering from critical nationwide shortages.

Hard bargaining was expected between the House and Senate over different levelsof fund- ing in the new Nurse Training Act bills. Com- mittees in both houses completed hearings on their bills in April, and the Senate had reported out its bill. The House bill (HR 2004) proposed $1 12.3 million, and the Senate bill (S 799) was offering $30 million.

The American Nurses’ Association (ANA) Washington office expected the higher figure to “come down considerably” to fit within the President’s budget. He had recommended only $15 million for nursing.

Sen Edward Kennedy (D-Mass) was able to pull political strings to add an extra $21 million for nursing, although Committee Chairman Orrin Hatch (R-Utah) reminded him it would have to come from other areas of the health professions bill.

Meanwhile, House and Senate committees were also deciding what to do about President Reagan’s requests that Congress rescind funds already appropriated for 1981. He had wanted to take back $63.2 million of the $1 06.2 million provided for nursing education this year. A House subcommittee went along with only $35 million of these proposed cuts, and other action was pending in early May. A Pres- ident’s rescission requests require the ap- proval of Congress within 45 days, or the money is available for spending.

President Reagan’s proposed rescissions in the fiscal year 1981 budget for nursing and his proposed budget for 1 982 have been called “devastating to nursing students” by Valisa Saunders, president of the National Student Nurses’ Association (NSNA).

Rescissions for 1981 would eliminate scho- larships and traineeships entirely. In 1982, if

the budget stands as proposed, there would be no money for student loans, scholarships, or traineeships. In testimony before the US House of Representatives, NSNA spokesman Mary Copeland said, “Now more than ever, nursing education stands in need of federal support for its continuation and improvement.”

She stated that approximately 1,145 nursing programs with an estimated 16,700 students participated in the nursing student loan pro- gram in the 1980-1 981 academic year. Fifty- seven percent of the NSNA members sur- veyed in 1980 received some type of federal financial aid. NSNA is particularly concerned about the discontinuation of nursing student loans and scholarships, as these are the main mechanisms many students use to finance their education.

The Florida Medical Association is sponsor- ing a bill to clamp down on physicians who employ nurse practitioners, reports Virginia Haggerty, RN, executive director of the Florida Nurses’ Association. Any physician who wants to employ a nurse practitioner would have to have prior approval by the Florida Board of Medical Examiners. He would have to submit proposed protocols for review and approval, and he would not be permitted to supervise more than two of these nurses. Not complying with the law, if passed, would be grounds for professional discipline.

Haggerty sees this as an attempt to control nursing through physicians who hire nurse practitioners. Medicine wants “to control how nurse practitioners work, where they work, with whom they work, and how many can work.

“In effect, the medical assocation wants to strip the nurse practitioners of their nursing licenses,” she said.

Nurses are fighting the bill hard, but medicine is working hard to pass it. As of mid-May the bill had not progressed beyond the committee stage.

Patricia Patterson Associate editor

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