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Reproductive Freedom News

October 1998
Volume VII
Number 7

Cartoon published with permission of Lalo Lopez Alcaraz www.pocho.com/cuca/roach.html

Table of Contents

Worldwide
The International Criminal Court?

Opinion -
A letter from Janet Benshoof

What Is?
What Are Conscience Clauses

In the States
Anti-Choice Measure Advance in Colorado

On the Docket
Center for Reproductive Rights in the Courts: A Summer of Action

Worldwide
What Is the International Criminal Court?

The International Criminal Court will serve as a permanent tribunal with the power to prosecute genocide, war crimes, crimes against humanity, as well as, eventually, the crime of aggression. The ICC will only be able to move forward on a prosecution when a state with jurisdiction over a defendant is either unwilling or unable to prosecute him or her in its courts. Moreover, either the state of nationality of the accused or the state where the crimes took place must ratify the treaty prior to the Court acting on a case. Provisions were made for an independent prosecutor, reparations for victims of core crimes, and limits on the ability of the U.N. Security Council to withhold cases from the court. The ICC is separate from the International Court of Justice (ICJ), which deals with disputes between nations, not individuals. Based in The Hague, the ICC will most likely begin functioning after the year 2000, following ratification by 60 nations.

Women and the ICC

"After my arrival in the concentration camp, they...raped me...in front of all the rest of the women...who were yelling and defending me, but they were beaten. The [soldiers] said ‘you will give birth to a Serbian child, we're doing that out of revenge.'... [O]ut of the 24 women, 12 of us were raped many times over.... Now I am four-and-a-half-months pregnant."
- Anonymous, Bosnia

Rape, sexual slavery, and forced pregnancy have been used as weapons of war for centuries. Like other war-related brutality, these forms of violence against women are often sanctioned and frequently ordered by the military, police, or other governmental actors. Since rape has historically been seen as part of the "spoils of war," conquering armies have long considered it their right to rape "enemy" women.

In 1948 the international community accepted women's rights as a fundamental precept of human rights in the landmark Universal Declaration of Human Rights. But women have struggled, in the 50 years since, to bring this notion into laws and practices around the world. Indeed, when the United Nations held a conference in Rome this July to finalize a statute leading to the formation of an International Criminal Court (ICC), many were concerned that women's issues not be neglected at a forum intended to codify the most serious violations of international humanitarian law. Women's rights groups from all regions of the world stood side-by-side to ensure that a gender perspective was incorporated into the treaty. And their efforts were rewarded: Wide consensus was reached to define rape as a war crime and a crime against humanity that should be prosecuted by this newly formed international tribunal.

Ensuring accountability for women's rights was not without controversy. Katherine Hall Martinez, the Center for Reproductive Rights representative to the Rome Treaty Conference and an active member of the Women's Caucus for Gender Justice in the ICC, calls the resulting statute a "sobering triumph" for women. "Our experience in Rome was a depressing reminder that there are formidable forces of religious and political fundamentalism throughout the world still intent on blocking any move to muster international law to redress violations of women's rights."

Negotiations heated up when the Vatican and its allies sought to strike the term "forced pregnancy" from the treaty, fearing that the words could be interpreted broadly as a means of challenging anti-abortion laws in many countries. The Vatican had significant lobbying assistance from anti-choice group members, whose principal stated purpose in attending the treaty conference was to oppose the inclusion of the term in the final treaty. In recent years, forced pregnancy, the crime of raping or sexually abusing women so as to make them pregnant and/or confining or coercing pregnant women because of their pregnancy, has been practiced in the Balkans and Rwanda. In an effort to forge a compromise, the Women's Caucus sought a meeting with the delegation of the Holy See, but was rebuffed. Fortunately, the Caucus and other involved groups were successful in persuading delegates to include forced pregnancy though several reactionary Catholic and Islamic governments lined up behind the Vatican to insist on the insertion of a narrow definition.

Despite the widely accepted usage of the terms "gender violence," "gender balance," and "gender persecution" in the U.N. system, the Women's Caucus met systematic opposition to inclusion of those terms wherever they appeared in the draft treaty. Fundamentalist Christian and Arab states sided with a number of nongovernmental organizations to oppose the term. Opposition NGOs expressed their view that gender justice was an "ornamental issue" through which the Caucus sought to exploit victims of war crimes and crimes against humanity to advance their agenda and "reconstruct[ ] world society by targeting religious and cultural traditions." Ultimately, the word "gender" was left intact in most places, but in a concession to the religious factions, "gender" in the ICC Statute will be defined more restrictively than in previous U.N. documents. It will read: "two sexes, male and female, within the context of society."

"It was an amazing experience," says Hall Martinez. "We were working to change history, namely the world's ongoing failure to take sexual and gender crimes in armed conflict seriously. We've made it much harder - hopefully impossible - for impunity for such crimes to continue."

- Barbara Becker

The Four Core Crimes

Genocide
Actions committed with the intent to destroy a national, ethnic, racial, or religious group such as by killing or preventing births.

War crimes
Grave breaches of the Geneva Conventions, such as torture or inhuman treatment, and other serious violations of the laws and customs applicable in international armed conflict, including rape and other forms of sexual violence.

Crimes against Humanity
Actions committed as part of a widespread or systematic attack directed against any civilian population, including rape and other forms of sexual violence, enslavement, including trafficking of women, and persecution on gender grounds.

Crimes of Aggression
Because the crime of aggression has not yet been defined, the ICC will not have jurisdiction over it unless and until its definition is agreed upon. The crime involves an individual who initiates or carries out an armed attack against another state in violation of the U.N. Charter.

The ICC Statute

The new statute contains several key victories for women: A long overdue codification of rape, sexual slavery, enforced prostitution, forced pregnancy, enforced sterilization, and other grave forms of sexual violence as both war crimes and crimes against humanity. Rape will be charged as a war crime on par with torture.

The definition of crimes against humanity - including persecution against any identifiable group on grounds including gender.

The term "enslavement," defined as the exercise of any power attaching to the right of ownership over a person, including trafficking in women and children.

A requirement that "fair representation" of female and male judges be taken into account in the judicial selection process, as well as fair representation in the selection of prosecutorial staff and those in other departments.

A provision that legal expertise on violence against women or children must be taken into account in the selection of staff. Also, the Prosecutor will be required to appoint advisers with legal expertise on sexual and gender violence.

A provision for a Victim and Witness Unit within the Court's Registry to provide protective measures, security arrangements, counseling, and other appropriate assistance for witnesses, victims, and others at risk. The Unit must include staff with expertise in trauma related to sexual violence.

A provision for reparation and restitution to victims.

"Given massive spending by anti-choice forces, it was remarkable to defeat this effort to eliminate women's right to choose."

Opinion

Reproductive Freedom News rushed to press as I returned from the Capitol, where senators finally sustained the President's veto of the "partial-birth abortion" ban. Given massive spending by anti-choice forces, it was remarkable to defeat this effort to eliminate women's right to choose. Consider that the timing was coordinated with the Christian Coalition's "Road to Victory" and followed vitriolic advertising in target states.

But lawyers at the Center for Reproductive Rights have litigated over a dozen cases on state "partial-birth abortion" laws. Judges in 17 states found unconstitutional defects and stopped the laws.

The voters don't like the concept either. A national poll conducted for the Center for Reproductive Rights showed that by a margin of 44 to 34 percent, voters disapproved of the bill.

We released this data in a campaign, "Deceptive, Unconstitutional, Extreme," conducting briefings in D.C. and running an ad: "Senators: Vote Today to Protect Women's Health." In the end, the pro-choice majority had the victory. But we merely stopped the torrent of oppression. How much sweeter it will feel when we can move forward with a positive agenda for women's reproductive rights.

- Janet Benshoof
President

What is?

Q.What are conscience clauses, and how do they affect a woman's right to choose?

(pullquote) A. Conscience clauses act to exempt health care providers from civil liability for refusing to provide services to which they object.

In the 25 years since Roe v. Wade, state and federal legislatures and regulatory agencies have seen a proliferation of conscience clauses. Conscience clauses act to exempt health care providers from civil liability for refusing to provide services to which they object. The clauses also allow health care organizations to participate in publicly funded programs without providing the entire range of services required by the program.

Conscience clauses exempt huge numbers of health care organizations and providers from liability for refusing to:
1)provide abortion, sterilization, and family planning services (including FDA-approved contraceptive methods and emergency contraception),
2) refer or even discuss these services with patients, and
3) fund these services.

Conscience clauses vary considerably in their scope, in definitions of services that can be refused, and in who is permitted to exercise the right to deny services based on a moral or religious conscience. The impact of conscience clauses has evolved since their inception to affect a wide range of reproductive health services, raising new questions and introducing additional complications for many women.

In Roe's Wake

Conscience clauses gained popularity soon after Roe v. Wade, the Supreme Court's 1973 ruling that legalized abortion. In 1973, Congress passed the Church Amendment, which allowed individuals and medical facilities to refuse to provide abortion and sterilization services based on moral and/or religious convictions. By late 1978, most states had passed similar laws.

In today's era of huge medical conglomerates, even more health care professionals are protected from liability for refusing to provide services. Catholic hospitals routinely use conscience clauses when they merge with secular hospitals and managed care organizations.

Medicaid requires that state plans cover family planning and abortions in cases of rape, incest, or threat to the woman's health. But a conscience clause exists that allows Medicaid managed care plans to refuse to provide coverage or counseling or referral services for moral or religious objections. The measure allows plans to prohibit physicians from discussing such services with their patients.

In recent years, numerous Catholic health organizations have taken over Medicaid managed care plans. They are allowed to opt for the conscience clause and cannot be excluded as Medicaid providers because they deny certain services under it. The Medicaid program mandates that if the managed care organization does not provide, reimburse for, provide coverage of, or refer for abortion or family planning due to moral or religious objections, individuals can be treated by any other provider that accepts

Medicaid.

Although such plans are required to inform the enrollee of the benefits that are not available through their managed care organization, language in plan handbooks is often vague and evasive. Enrollees may have difficulty discerning their options with respect to family planning and abortion services.

Contraceptive Coverage

Some states are currently considering legislation requiring insurance coverage for contraceptives. Here, too, conscience clauses arise. The California contraceptive coverage bill (AB1112 as amended, California, 1998), which was vetoed in September by Governor Pete Wilson, would have required coverage of FDA-approved contraceptive drugs and devices in employee benefit packages and required referral for services not provided under an enrollee's plan.

The bill provided a conscience clause, but additional requirements attempted to minimize the negative effects of the conscience clause by providing alternative means for enrollees to obtain contraception. AB 1112 defined religious entities narrowly, based on the state's definition for tax-exemption purposes. It required plans to inform enrollees about which services were not covered or provided, and it allowed women at certain income levels whose contraceptives were not covered through their company to obtain them through a state program.

Clauses for Pharmacists

Several states have also considered clauses that allow pharmacists to refuse to dispense any medication to which they have a moral or religious objection.

In South Dakota, for example, pharmacists are not required to dispense medication if there is reason to believe a medication will "cause abortion" or "destroy an unborn child." This could impact on the dispensation of emergency contraceptive pills, which anti-choice organizations characterize as abortifacients, claiming that they inhibit implantation of a fertilized embryo.

Pharmacist conscience clauses may limit women's access to this extremely time-sensitive contraceptive method by requiring extra steps in order to obtain it. To counter these potentially damaging effects, reproductive rights activists have attempted to modify the clauses, suggesting rules that require pharmacists to post a sign indicating which medications they do not dispense or to phone doctors and inform them of their refusal to fill certain prescriptions.

Providing an Alternative

Activists have eased the impact of conscience clauses by supporting legislation that requires rigorous enforcement of disclosure about alternative providers, mandatory referrals for reproductive health services that the provider refuses, and explicit communication between plans and enrollees. Because conscience clauses can have an enormous effect on reproductive services, it is clear that advocates must closely scrutinize patterns of practice, new mergers, and legislative and regulatory health care proposals. - Melissa Querido

In the States

Anti-Choice Measures Advance in Colorado

When Colorado residents vote in November, they'll be confronted by two anti-abortion initiatives: a ban on "partial-birth abortions" and a parental-consent measure requiring that parents are notified at least 48 hours before a minor can obtain an abortion.

The Colorado Pro-Life Alliance says it gathered more than 75,000 signatures for each referenda, far more than needed to place the measures on the November ballot. Colorado's initiatives are the first nationwide on the topic of "partial-birth abortion," but if petition drives are successful voters in Maine and Washington may also face bans.

Colorado's "partial-birth abortion" ban provides for civil and criminal penalties (including a one-to-three-year prison term) against doctors who perform the procedure. "This is a violation of the fundamental right of a woman to get an abortion," the Center for Reproductive Rights' Janet Crepps told the Rocky Mountain News. "These laws fly in the face of Roe v. Wade," said Sylvia Clark in a press release. Clark, President of Planned Parenthood of the Rocky Mountains, continued, "As a nurse and nurse midwife, I find these measures intrusive, unnecessary, and unsupportable."

On the Docket

Center for Reproductive Rights in the Courts: A Summer of Action

"Partial-birth Abortion"

Wisconsin
Current Status: On August 10, the U.S.Court of Appeals for the 7th Circuit heard arguments in Planned Parenthood of Wisconsin v. Doyle (98-C-305). The 7th Circuit is the first federal appeals court in the nation to fully consider the constitutional merits of a so-called "partial-birth abortion" ban. Wisconsin's "partial-birth abortion" law is the harshest in the nation, carrying the threat of life imprisonment for doctors.

Background: On April 30, the Center for Reproductive Law & Policy, together with the Planned Parenthood Federation of America (PPFA), filed a legal challenge to block enforcement of Wisconsin's ban. On May 13, Federal District Judge John C. Shabaz became the first judge to deny a preliminary injunction against a "partial-birth abortion" law that would apply to pre-viability abortions. Fearing the broadly-worded abortion ban had rendered all abortions illegal, some Wisconsin physicians stopped providing abortions. At the same time, attorneys filed an appeal with the 7th Circuit, which reversed Judge Shabaz and temporarily enjoined the law on June 25 and stopped further proceedings in the district court pending appeal.

Virginia
Current Status: On August 18 and 19, the Center for Reproductive Rights went to trial before U.S. District Court Judge Robert E. Payne in the challenge to Virginia's "partial-birth abortion" law, Richmond Medical Center v. Gilmore (98-1930), a case filed with PPFA. A decision is expected after additional arguments. Virginia is the only state in which an appeals court has reversed a lower court's decision to block a "partial-birth abortion" law.

Background: On June 25, Judge Payne blocked enforcement of the law, stating that "‘partial birth abortion' is a term coined by legislators, anti-abortion activists, and the media" and "has no accepted medical meaning." Refusing to accept this determination, the Commonwealth of Virginia filed an emergency appeal, and sought immediate relief from one of the most conservative members of the U.S. Court of Appeals for the 4th Circuit, Judge Michael Luttig. On June 30, Judge Luttig stayed the district court's injunction, letting the law take effect. A three-judge panel, which included Judge Luttig, denied a motion to reinstate the injunction on July 29, and parallel to the trial court proceedings, further briefing on the issue of the preliminary injunction continues.

In addition, on August 11, the Center for Reproductive Rights filed papers, challenging procedures of the 4th Circuit that allow one party to choose a judge who then becomes part of the appellate panel. The court rejected that argument in mid-September.

Other cases: Because "partial-birth abortion" laws took effect in many states on July 1, the Center for Reproductive Rights was in courts across the country, seeking to block enforcement. The Center for Reproductive Rights prevailed in securing temporary injunctions in federal courts in WV (West Virginia Brancazio v. Underwood, Civ.2:98-0495 S.D. W.Va.) on June 11; in Iowa (Niebyl v. Miller, CIV-4-98-CV-90149, S.D.Iowa) on June 26; and Florida (A Choice for Women v. Butterworth, 98-0774-CIV-GRAHAM, S.D.Fla.) on June 30. On July 2, a federal district court issued a permanent injunction in the challenge to Nebraska's law (Carhart v.Stenberg, 4:97CV3205, Neb.), and in August ordered the state to pay $46,855 to cover the plaintiff's legal expenses.

Restrictions on Young Women

On August 21, the U.S. Court of Appeals for the 4th Circuit issued a decision upholding Virginia's parental involvement law (Planned Parenthood of the Blue Ridge v. Camblos, No.97-1853), marking a significant departure from the rulings of other federal circuit courts. Distinguishing between "parental notification" and "parental consent," the opinion declined to find flaws in the state's judicial bypass.

The U.S. Supreme Court has consistently held that when a young woman is found to be mature, she is "entitled" to an abortion, but the Virginia law states that judges "may" determine whether or not to permit the pregnancy termination to proceed. A decision about a further appeal is pending.

- Margie Kelly | |