A Plan B mistake

THE LEGISLATURE took a major step to reduce the number of unintended pregnancies and abortions in Massachusetts by passing a law allowing pharmacies to dispense morning-after pills without prescriptions. The bill, enacted over Governor Romney's veto, also required all hospital emergency rooms to have this emergency contraception available for rape victims.

The legislators failed, however, to include wording in the bill explicitly repealing a clause in an older statute that gives hospitals the right, for reasons of conscience, not to offer birth control services. This has led the state Department of Public Health to come up with an advisory directive that Catholic and other private hospitals that object to Plan B, as the medication is called, can still refuse to provide it.

While Attorney General Thomas F. Reilly has said the intent of the new law to mandate Plan B in all emergency rooms is clear, the action of the DPH means that, for the time being, rape victims going to a handful of the state's 71 hospitals with emergency rooms will not have access to it. This is unacceptable. A woman who has been raped should not have to do a telephone survey to find which, if any, hospital in her region can provide the care she needs.

The issue will not be resolved definitively until legal action gives priority to one law or the other, or until the Legislature does what it should have initially: nullify the conscience exemption in the older statute as it applies to emergency contraception for rape victims.

Plan B, essentially a heavy dose of conventional birth control pills, has been effective as a prescription drug at blocking conception if taken within 72 hours and is very effective if taken within 24 hours. Because prescriptions can be hard to secure in a hurry, advocates of reproductive rights have tried to make it available over the counter and at all hospital emergency rooms for rape victims. Social and religious conservatives have fought these efforts at the state and federal level, in part because they fear it would encourage promiscuity, a concern unsupported by studies. The Food and Drug Administration has balked at making Plan B available over the counter despite recommendations that it do so from its staff and outside scientific advisers.

The Romney administration has gone in different directions on this issue. During the 2002 campaign, Romney said he supported broader access to emergency contraception, but then he vetoed the bill. Yesterday, Lieutenant Governor Kerry Healey took issue with the DPH advice, saying all hospitals should provide Plan B. Women throughout the state would be closer to getting the care they need at all hospitals if the Legislature or a court made clear once and for all that there are no exceptions to the Plan B requirement.