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A Voice for Private Physicians Since 1943

Is freedom of conscience at risk?

The Bush Administration has proposed a rule that would deny federal funding to medical facilities that discriminate against employees who choose not to provide services they deem to be morally wrong—such as performing abortions or making abortion referrals.

Unlike rules that ban discrimination on the basis of race, ethnicity, gender, or sexual preferences, this one is called an attack on “choice.” Sen. Patty Murray (D-WA) and Sen. Hillary Clinton (D-NY) objected to the proposed rule.

It is feared that the wording could be expanded to include oral contraceptives or the “morning after” pill (Seattle Times 8/25/08).

U.S. Health and Human Services Secretary Mike Leavitt says the regulation is about abortion, not contraception. But the meaning may depend on what an abortion is. And that depends partly on when pregnancy begins. In 1965, the American College of Obstetrics and Gynecology (ACOG) decreed that pregnancy begins after implantation, thus avoiding the charge that its members were encouraging, if not performing, early-term abortions in prescribing non-barrier contraceptives (PRI Weekly Briefing 8/12/08).

Karen Brauer, president of Pharmacists for Life, expects that members of her group would like to see states lose federal funding if they pass laws forcing pharmacists to fill prescriptions for what they consider to be abortofacients. And Catholic hospitals would like to be freed from requirements that they offer emergency contraception to victims of sexual assault.

Planned Parenthood Action Fund and MoveOn.org Political Action delivered 325,000 signatures of protest to Leavitt, but he signified that he planned to go forward with the rule, citing the need to protect medical professionals.

Their right to decline certain actions, including certain types of speech, is a “fundamental freedom: that “every American values,” Leavitt said (Stephanie Simon, Wall St J 8/22/08).

Leavitt believes that that freedom is threatened. On Aug 8, he wrote in the HHS blog: “Several months ago I became aware that certain medical specialty groups were adopting rules which potentially violate a physician’s right to choose whether he or she performs abortion. I wrote to the organizations in question, protesting their actions. Frankly, I found their responses to be dodgy and unsatisfying. I sent another letter, more of the same.”

This weblog notes that the proposed rule is open for comment for 30 days, and provides a link.

ACOG has been heavily criticized for its November 2007 Ethics Committee Opinion entitled “The Limits of Conscientious Refusal in Reproductive Medicine.” In addition to stating that physicians had the duty to refer patients for procedures they themselves were not willing to perform, it wrote: “Physicians with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place.”

A newly publicized twist on the question of what an abortion is concerns what ACOG terms a “labor-inducing abortion.” Although ACOG does not mention live birth as a complication in its patient education materials, this is the issue addressed by the Born-Alive Infant Protection Act passed by the U.S. Congress in 2002.

Jill Stanek, R.N., gave testimony that infants who survived this procedure were placed in the soiled utility room to die; some lived for as long as 8 hours. She recounted having cradled one infant for 45 minutes as it struggled to breathe, and finally died.

What would have happened to a nurse or physician who had resuscitated such an infant, before this Act was passed?

While most people consider it infanticide to dispose of a baby who survives an abortion attempt, then-Illinois state senator Barack Obama considered the Born-Alive Infant Protection Act to be a ploy to undercut Roe v. Wade—one of many reasons he gave for blocking the identical bill in the Illinois Senate.

Other threats to freedom of conscience:

The California Supreme Court ruled, in Benitez v. North Coast Women’s Care Medical Group, that doctors have an obligation to provide medical care regardless of their religious views. The case concerned a lesbian woman who was refused artificial insemination on the basis that the physicians had determined to provide in vitro fertilization only to married patients (LifeNews.com 8/19/08).

The British parliament is debating a bill that would imprison staff at pregnancy centers for up to 2 years for counseling against abortion—if, in the opinion of the British government, the counseling was misleading or inaccurate. No similar penalties have been suggested for misleading pro-abortion counseling (LifeNews.com 8/27/08).

The Yale Human Rights and Development Law Journal has published an article by Carter Dillard, entitled “Rethinking the Procreative Right,” arguing that because it is not specifically enumerated in the Bill of Rights, the right to procreate is limited to one child. The only absolute reproductive right, he argues, is the right not to procreate at all. The right to bear children must be “balanced” against other rights—of other people, of future generations, of nature, of the wilderness, and of nonhuman species (LifeNews.com 7/23/08).

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