What century is this? That's the first of many disturbing questions prompted by a new federal health proposal clearly targeting women's access to birth control and abortion. The Pill was approved in the United States in 1960. Abortion, legalized by the U.S. Supreme Court in 1973. Yet the nation's leading medical organizations -- from the American Medical Association to the American Nurses Association -- are now fighting to ensure that women continue to get these important medical services and information about them.

This Trojan horse of a proposal comes from the U.S. Department of Health and Human Services, which sets federal health policy and controls billions in funding for everything from low-income clinics to big teaching hospitals. The new policy is ostensibly designed to protect medical staff from discrimination if they refuse to participate in abortion or sterilization procedures. But for decades, there have been strong national laws in place to safeguard medical staff. As justification for the new policy, officials do not cite even one case of discrimination that existing laws have failed to prevent.

The real intent of the proposed policy rapidly becomes clear to anyone who reads a draft leaked recently to the news media. It appears that federal officials invited in the most extreme elements of the prolife coalition and said, "Bring your wish list." The result is a hamhanded, 40-page document that limits women's health care by vastly expanding the opportunities for medical staff to refuse to provide care or information because of their abortion views.

Under the rule, that right of refusal could now include objections to common forms of birth control. The proposal radically redefines abortion to include contraception that may interfere with the implantation of a fertilized egg. Among those methods: IUDs and Plan B, which contains a birth control pill hormone and is often given to rape victims. The rule also expands the definition of federally funded facilities and enlarges the universe of medical staff who can object.

The bottom line: Staff from physicians to surgical instrument cleaners to health insurance employees could refuse to provide or discuss these services. At no time would anyone have to disclose to the patient that an incomplete array of care options was being offered.

Groups such as Planned Parenthood also worry that the new rule could override state laws that require pharmacies to fill birth control prescriptions or health insurers to cover contraception equitably. At the same time, it should be noted, the U.S. Conference of Catholic Bishops has expressed strong support for the proposal.

But politics do not make for good health care or health care policy. The proposed rule puts the personal views of medical staff above the needs of even the most vulnerable patients. That's wrong. President Bush could enact this new rule before he leaves office. Instead, he should heed the advice of the nation's doctors and nurses and stop this backwards, misguided proposal from becoming a reality.