Regardless of your view on the legal right to have an abortion, the answer should be, "Absolutely not."

Some pro-choice lobbyists and lawmakers disagree. And despite all their "right to choose" rhetoric, pro-choice forces have filed a lawsuit challenging a much-needed amendment signed into law by President Bush last week. The Hyde-Weldon Conscience Protection Amendment says that federal funding cannot be withdrawn from providers who, because of their beliefs, choose not to perform abortions. Before now, federal law protected Catholic doctors from the penalties. The new law protects all doctors, hospitals and insurers.

This nation continues to support the legal right to an abortion, despite technology that shows without any doubt that human life begins at conception. (In fact, the human central nervous system is already forming in a 3-week-old fetus. By fetal-age week four, a baby's heartbeat can be seen on ultrasound. This is before the vast majority of abortions happen and before a lot of women even know they are carrying a child.)

Legal abortions will be with us always, as will doctors and hospitals willing to perform them. Even ardent pro-lifers acknowledge that mass chaos and harm to mothers would result from taking the legal right away. What most pro-lifers want and rightly continue to demand, however, is more reasonable policies concerning abortion. Just as a woman is able to decide for herself if she will abort a child, a doctor or private hospital should have the right to steer clear of having anything to do with the life-ending procedure without penalty.

Rep. Nita Lowey, D-N.Y., told The Chicago Tribune of the Hyde-Weldon amendment, "The conservatives have been emboldened and the moderates have been minimized, and this is a real wake-up call."

It sure is. The wake-up call, however, is that no one should be forced to provide an abortion not that common-sense legislation is finally getting passed. It is sad that the concept of a right to conscience seems foreign to pro-choicers such as Lowey. Judith DeSarno of the National Family Planning and Reproductive Health Association is also at odds with the amendment. She's telling people that it "is meant to deny abortion information and referral to women who receive care that is subsidized by any program funded by" the government.

U.S. Rep. Dave Weldon, R-Fla., counters that the law carrying his name does nothing of the sort. It is meant to "not force people to do abortions or assist in abortions or allow abortions in their hospitals if they don't want to," he told reporters.

Pro-choice extremists contradict themselves. They cannot convincingly say that the public and government have no right to tell a woman she can't have an abortion and at the same time tell a private health care provider that he or she must perform one.

Keep parents clueless

Another area in which some pro-choicers are off the deep end is parental rights. While we hold parents responsible for the destructive actions of their children and won't let them take aspirin in school without parent permission, we continue to limit their ability to help teens make the major medical decision to have an abortion. Washington and other states don't even have parental notification laws.

Angering parents' rights advocates this month is California Attorney General Bill Lockyer's recent legal opinion that says California schools are prohibited from informing parents if a child leaves campus to receive medical services, including an abortion, AIDS treatment or psychological analysis. Heck, many schools, even here in Clark County, have staff members who refer teens to abortion providers during the school day without parent knowledge. The exact opposite ought to be policy in any public school. Parents should be notified whenever a child leaves campus.

Leaders of the pro-choice crowd won't hear of it. Their passion for legalized abortion trumps parents' rights and common sense. That is why they believe health care providers don't have a right to follow their own consciences and that schools supplant parents when an abortion is at stake.

^{Dr. Shahid Athar, M.D.
Clinical Associate Professor
of Medicine & Endocrinology,
Indiana School of Medicine,
Indianapolis, Indiana, U.S.A}...

^{J. Budziszewski, Ph.d
Professor
Departments of
Government & Philosophy,
University of Texas,
Austin, Texas, U.S.A.}

^{Dr. John Fleming,
B.A., Th.L (Hons), Ph.d
President, Campion College
Sydney, Australia}

^{Dr. Henk Jochemsen, Ph.D
Director, Lindeboom Institute,
Center for Medical Ethics
Amsterdam, Netherlands}

^{David Novak,
AB, MHL, Ph.d
Chair of Jewish Studies,
University of Toronto,
Toronto, Ontario, Canada}

^{Lynn D. Wardle, J.D.
Professor of Law,
J. Reuben Clark Law School,
Brigham Young University,
Salt Lake City, Utah, U.S.A.}

PROJECT TEAM
^{Sean Murphy
Administrator}

^{Michael Markwick
Human Rights Specialist}

The Editor,
The Canadian Pharmaceutical Journal
1785 Alta Vista Drive
Ottawa, ON K1G 3Y6

Dear Madam:

Polly Thompson asserts that religious tolerance is "a bedrock value of our democracy, and it goes both ways," but then claims that "the onus is on the health professional to respect the religious beliefs of the patient, not the other way around," a most peculiar form of tolerant reciprocity. The balance of the editorial demonstrates a troubling ignorance of the legal requirements to accommodate conscientious objectors¹ and de facto contempt of the ‘bedrock value’ she purports to respect in theory. (The public trust and access to medication, Canadian Pharmaceutical Journal, October, 2004, Vol. 137, No. 8).

Patients and pharmacists have equal claims to freedom of conscience and expression, but one looks in vain in the editorial for a thoughtful analysis of how to deal fairly with conflicts of conscience in health care. A principled approach to conscientious objection would, among other things, distinguish between life-threatening injuries or conditions, and non-emergent situations. To equate the provision of blood transfusions for accident victims with dispensing contraceptives or post-coital interceptives suggests a disappointing editorial interest in polemics, not principle.

Thompson is mistaken when she claims that some pharmacists raise religious objections to her access to medication. Their concerns are not with her access, but with their own moral culpability should they facilitate harmful conduct or other wrongdoing by someone else.

The fact that a drug is legal does not determine this issue. By way of comparison, mouthwash is a legal product commonly sold in pharmacies. It can also be an intoxicant when consumed as a beverage. A conscientious pharmacist might well refuse to sell mouthwash to an alcoholic known to consume it for that purpose, whether or not the product could be accessed elsewhere.

Similarly, the practice of law is a self-regulated profession, and, like pharmacists, lawyers are expected to serve the interests of their clients. But a client cannot force a lawyer to facilitate what the lawyer considers to be a wrongful act - even if the act is legal.

Ms. Thompson’s fierce determination to adhere to her own moral views is not surprising, but she has failed to demonstrate that her morality is so superior that it should be imposed upon those who disagree with her. Indeed, she did not even attempt such a demonstration before calling for the elimination of "troubling holes" and "wiggle room" that make grudging allowance for freedom of conscience in pharmacy. Her message to those unwilling to go along with her is uncompromising; get out of the profession. Given this totalitarian mindset, Ms. Thompson’s complaint that ‘fundamentalist extremists’ dictate policy in the United States invites the waggish response that in Canada they write editorials for professional journals.

Pharmacy regulatory authorities can, with some imagination and good will, find ways to ensure "timely access to legal medication" without suppressing of freedom of conscience in the profession. The Canadian Pharmaceutical Journal can contribute to this kind of fruitful accommodation. But the profession and the public are not well served by the kind of incoherence, intolerance, polemics and ignorance of human rights jurisprudence displayed in its October editorial.

Sincerely,

(Sean Murphy),
Administrator

Notes
1.  Benson, Iain, "Autonomy", "Justice" and the Legal Requirement to Accommodate the Conscience and Religious Beliefs of Professionals in Health Care.  The Canadian Pharmaceutical Journal declined to publish this essay, which was a response to an article by Frank Archer that had appeared in an earlier number of the Journal. See also Murphy, Sean, In Defence of the New Heretics: A Response to Frank Archer  - also declined by the CPJ.

The House of Representatives recently voted to prohibit government authorities from requiring any health care professional or institution to perform or pay for abortions.

Our Founding Fathers obviously would applaud this protection of individual liberties and conscience. Yet when D.C. officials faced this hot brewing battle a few years ago, they pushed free speech and freedom of religion aside and nearly plunged the capital into a health care crisis.

In July 2000, the D.C. Council thumbed its nose at faith-based hospitals and other conscientious objectors by passing a bill to force D.C. employers to provide health-insurance coverage for contraceptives and abortion-causing drugs -- regardless of providers' ethical or moral objections. The council's unscrupulous decision left conscience-driven hospitals and charities with no other choice than to shut down rather than violate vital religious and ethical principles.

The imperious mandate raised the specter of sick and dying patients lining up at City Hall demanding to know why pro-choice legislators had taken away their doctors' choice and imperiled their own life-saving health care. Only a pragmatic pocket veto by the mayor, under threat of congressional intervention, stopped that measure and averted the potential shutdown of faith-based hospitals and charities.

Dissenting at-large Council member Harold Brazil, who had lobbied to add a "conscience clause" exemption to the mandate, reminded the council at that time, "James Madison once said, 'Conscience is the most sacred of all property.' " [i]

Since the D.C. debacle, abortion activists have hotly pursued their conscience-crushing campaign to make others provide and pay for their abortions and birth control.

Of course, they can't easily explain why employers' health-insurance plans, designed to help employees defray the cost of treating illness and disease, should suddenly be made to pay for preventing or ending a healthy pregnancy. Nor can they justify why providing relatively easily obtained contraceptive and abortifacient drugs requires violating the conscience rights of those who remain morally opposed to such practices.

Pushing reproductive rights toward reproductive mandates seems certain to backfire in the court of public opinion. The irony of trampling individual liberties and conscience rights while marching under the banner of "choice" will not be lost on the American public.

[i] Brazil, Harold, Letter to the Editor, Washington Post, August 5, 2000; Page A18

Three years later the Assistant Registrar of the College indicated that complaints about physician ‘moralizing’ were largely hearsay "from groups who provide birth control and family planning counselling to women" - not a bad definition of Planned Parenthood.³ First-hand accounts from individual patients were a "distinct minority" of the total.⁴

Planned Parenthood Alberta is now recycling the accusation that physicians who object to abortion may "scare" patients with "misinformation" or "impose their moral beliefs."⁵ One of the problems with this kind of generalized smear is that it may be unfairly applied to conscientious objectors to abortion who follow the guidelines of the Canadian Medical Association (CMA) and the College of Physicians and Surgeons of Alberta (CPSA).

The CMA advises physicians to "inform a patient when their personal morality would influence the recommendation or practice of any medical procedure that the patient needs or wants," and to advise patients of their objections to abortion so that they can consult another physician.⁶ The CPSA does not require physicians to advise every pregnant woman that she can have an abortion or put her child up for adoption,⁷ but does expect them to provide information to patients seeking abortion so that they can "make informed decisions on all available options for their pregnancies, including termination."⁸

In following these guidelines an objecting physician must, at all times, be respectful of the patient’s dignity, and must not be threatening, overbearing or abuse his authority by preaching or moralizing in order to influence his patient’s decision. On the other hand, objecting physicians can hardly be expected to present morally controversial procedures as morally uncontroversial, or in such a way as to indicate that they approve of them or are indifferent to them (i.e., to adopt a ‘neutral’ position). Moreover, the information they reasonably believe necessary to permit the patient to make a truly "informed decision" may be more comprehensive or in other respects different from what Planned Parenthood is accustomed to provide its clients.

A third party who was not present during this kind of exchange, especially an interest group like Planned Parenthood, might well stigmatize the discussion as ‘moralizing’ and providing ‘misinformation’. Partisan polemics of this sort do not provide a basis for sound policy making.

Planned Parenthood Alberta suggests that patients who are unsure of their doctor’s position on abortion should contact the organization because it is compiling a list of what it calls "anti-choice doctors". Asking the doctor directly seems a simpler and more reliable way for patients to resolve such doubts. If it is desirable to help patients find physicians who share their outlook on moral issues, it would be preferable for doctors to identify themselves, perhaps through the College of Physicians and Surgeons or professional associations.

In the meantime, if Planned Parenthood persists in its plan to identify "anti-choice doctors", it should include in its list the names of physicians who believe that their colleagues should not be forced to provide or facilitate morally controversial procedures.

1. "Ethical Responsibilities in Dealing with Women Requesting Abortion Services". College of Physicians and Surgeons of Alberta, The Messenger, Sept. 1999, Issue No. 73, p. 8.  Accessed 28 August, 2004 [Back]

2. Canadian Physicians for Life, Alberta College of Physicians and Surgeons challenged to think about conscience rights. October 11, 1999. [Back]

3. Freedom of Conscience and the Needs of the Patient. Presentation to the Obstetrics and Gynecology Conference "New Developments-New Boundaries", Banff, Alberta, 9 -12 November, 2001. Trevor W. Theman, MD FRCSC, Assistant Registrar, College of Physicians and Surgeons of Alberta.  [Back]

4. Letter to the Protection of Conscience Project Administrator from the Assistant Registrar, College of Physicians and Surgeons of Alberta, 27 March, 2002.  [Back]

5. Planned Parenthood Alberta, Be Aware of Anti-Choice Doctors and Radiologists. Accessed 28 August, 2004.  [Back]

6. CMA policy on induced abortion, 15 December, 1988.  Accessed 30 August, 2004.  [Back]

7. Letter to the Protection of Conscience Project Administrator from the Assistant Registrar of the College of Physicians and Surgeons of Alberta, 27 March, 2002.  [Back]