NEWS
 No pregnancy drug in U.S. Department of Justice first-ever medical guidelines for treating sexual assault victims, 2 January 2005

The U.S. Department of Justice has issued its first-ever medical guidelines for treating sexual assault victims - without any mention of emergency contraception, the standard precaution against pregnancy after rape.

The omission of the so-called morning-after pill has frustrated and angered victims' advocates and medical professionals who have long worked to improve victims' care.

Gail Burns-Smith, one of several dozen experts who vetted the protocol during its three-year development by Justice's Office on Violence Against Women, said emergency contraception was included in an early draft, and she does not know of anyone who opposed it.

"But in the climate in which we are currently operating, politically it's a hot potato,'' said Burns-Smith, retired director of Connecticut Sexual Assault Crisis Services.

For two weeks, Justice officials were unavailable to talk about the new 141-page protocol, published in September. But in an e-mail, department spokesman Eric Holland reiterrated points made in the document.

"The goals of the protocol are to ensure that all victims, regardless of differences in background or location of service, receive the same high quality medical and forensic exam, while being treated with respect and compassion, and to improve prosecution of sexual assault cases through the appropriate collection of evidence,'' he wrote. "The protocol is not intended to supercede the many state, local, and tribal protocols that are currently in practice.''

Lynn Schollet, a lawyer with the Illinois Coalition Against Sexual Assault, said without emergency contraception, the trauma of rape could be compounded by an unplanned pregnancy.

"It is very unfortunate to set forth a model national standard that is not giving women the best care available,'' Schollet said.

The controversy has erupted just weeks before the Food and Drug Administration is scheduled to reconsider whether to make it easier to get emergency contraception. A year ago, the FDA rejected non-prescription sales of Plan B, an emergency contraceptive. The ruling delighted conservative groups who had lobbied the Bush administration, but went against the FDA's own staff, advisory panels and major medical societies.

The manufacturer's latest application would make Plan B available without a doctor's orders only to women 16 and over.

The Pennsylvania chapter of the American Civil Liberties Union is now collecting signatures on a petition urging the Justice Department to fix the "glaring omission in an otherwise thorough document.''

In the half-page on pregnancy "risk evaluation and care,'' the protocol says to take victims' pregnancy fears "seriously,'' give a pregnancy test, and "discuss treatment options, including reproductive health services.''

Advocates point out that emergency contraception, which is nothing more than high-dose birth control pills, reduces the chance of pregnancy 75 to 90 percent - but only if taken within 72 hours of unprotected sex.

"This narrow window of effectiveness makes timely access to emergency contraception critical,'' declares the petition.

The development of national guidelines was required under the 2000 renewal of the decade-old federal Violence Against Women Act to develop uniform, quality care for sexual assault victims.

The risk of pregnancy after rape is small - less than 5 percent - but the vulnerable group is large. Of 333,000 sexual assaults and rapes reported in 1998, about 25,000 resulted in pregnancies - of which 22,000 could have been prevented, estimated Princeton University population researcher James Trussell.

..."I think it's very smart not to put that in the guidelines,'' said Dr. George Isajiw, a board member of Physicians for Life, a Philadelphia anti-abortion group.

...Anne Liske, executive director of the New York State Coalition Against Sexual Assault said the decision should be left to the woman. "The victim needs to be in charge of decisions about her care.''

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