News Commentary 2007
Milwaukee Journal Sentinel
18 December, 2007
Reproduced with permission
John Rinke, a doctor opposed to abortion, finds he must make an unpopular
argument if he wants to keep his job. This is unfortunate.
The argument is about a proposed state law saying that all hospitals must
immediately give any rape victim who asks for it emergency contraception -
in practice, the drug called Plan B. The law makes no exceptions for those
hospital employees who think this is wrong.
Rinke is one of them because one way the drug works is to cause an
abortion. His view is not popular. The bill passed 56-41 in the Assembly and
27-6 in the Senate. It will likely pass a second vote in January and be
signed into law.
A woman who is raped undeniably is a victim. Surely, the popular
reasoning goes, keeping her from having to suffer consequences such as
pregnancy trumps any doctor's qualms. Surely, we can make hospitals tell her
emergency contraception exists.
But no one hides the existence of Plan B. The manufacturer and Planned
Parenthood have made the drug a crusade. Not telling a patient that such a
drug exists violates law and ethics, says Rinke, medical director of the
emergency room at Community Memorial Hospital in Menomonee Falls. He has
never heard of a doctor hiding the existence of the drug. That this is all
about informing patients is a canard.
Emergency contraception is widely available. Anyone over 18 can buy it
without prescription. At least 10 clinics in Milwaukee will give it to you.
It's available overnight online. There's a statewide toll-free hotline to
get it well within the 72-hour window in which it works.
More to the point, police take rape victims to hospitals that handle
them. Not all hospitals can, says Rinke, a fact lost in the advocacy.
Hospitals with rape centers have staff trained, for instance, in the
particular protocol for collecting evidence.
Rinke, in a 27-year career in busy emergency rooms, has seen 10 sexual
assault victims total, because he doesn't work at such hospitals. If he did,
he'd have to give Plan B. His hospital made a decision not to call itself a
rape center because, even though it has no religious affiliation, its staff
wants to avoid those moral straits. The proposed law forecloses that option.
It would make the hospital give a drug that may cause an abortion. The
bill's advocates say, correctly, that Plan B doesn't halt an established
pregnancy, one where the fertilized egg has implanted itself in the uterine
But that happens a week or more, says Cynthia Jones-Nosacek, after the
egg is fertilized - after a child is conceived. Plan B sometimes works by
preventing that conception. But as the drug's own maker notes, it sometimes
works by preventing the fertilized egg - the conceived child - from
implanting. That would be an abortion by the lights of Jones-Nosacek, a
doctor who handles obstetrics at Columbia-St. Mary's, and others.
This will have an effect. If hospitals must always staff the ER with a
doctor willing to give Plan B, "they're not going to hire people who believe
life begins at conception," Rinke says.
The law alters medicine, too. It makes abortion - in the one circumstance
where a majority of people would permit it - a mandatory part of being a
doctor or nurse.
Our tendency is to say that these are ethical niceties that can't trump a
need for compassion. Wouldn't you want, the law's backers will ask, your
daughter to be able to defend herself against the consequence of a rape?
But the consequence is a human. Rape is terrible, says Rinke, but it's
not the baby's fault. The baby shouldn't be capitally punished. Our desire
to ease the suffering of a raped woman has led a majority of the Legislature
to overlook the baby, as if its humanity were contingent on how it was
Yet, as Jones-Nosacek puts it, "When you say some human (lives) are worth
living and some aren't, who ultimately makes that decision? It's not the
person whose life we're going to take. It's usually someone much more
This is an outlook society should favor in doctors, a keen realization of
patients' humanity. Instead of encouraging it or even letting it exist while
Planned Parenthood passes out Plan B freely, we're going to mandate that all
doctors shut such views in a mental closet and either act against their
consciences or get out of the profession.
Patrick McIlheran is a Journal Sentinel editorial columnist. His
e-mail address is
Note: The Protection of Conscience Project
refers to the morning-after pill as a potential embryocide, while Mr.
McIlheran's article reflects the fact that most of those who object to
dispensing it describe it as an abortifacient. Regardless of the
terminology, the concern usually voiced by objectors is that the drug may
cause the death of an early embryo, which they consider morally equivalent
to abortion. [Administrator]
National Review On-Line,
17 October, 2007
Reproduced with permission
Jennifer A. Marshall
If rising costs, declining quality, administrative hassles, and coverage
gaps aren't reasons enough to reform American health care, here's one more:
Consider this: 46 percent of American workers participate in
employer-sponsored health-care plans that subsidize abortion. That means
many Americans praying on Sunday for the protection of unborn children are
paying on Monday with their insurance dollars for others to abort them.
Freedom of conscience for physicians and pharmacists is a familiar concept.
Now it's time for patients to have a conscience option when it comes to
choosing health coverage. Freedom of conscience - for both provider and
patient - should be the rule in health care, one of the most sensitive areas
of human life.
Reforming health care is about more than reducing costs and expanding
individual coverage, important as those are. Health care reform should
empower Americans to choose plans that are affordable, high-quality and
consistent with their ethical and religious convictions.
Part of the problem is that Americans don't have direct control over issues
of either cost or conscience. Third-party decision-makers do. They are at
the fulcrum of the current health-care system, setting the rules for
coverage. The kinds of benefits financed through health insurance are
determined largely by employers, insurance executives, managed-care network,
officials or government officials. Patients' personal choice is very
As biomedical advances push us into increasingly murky ethical depths about
everything from prenatal to end-of-life decisions, the moral map should not
be left to the third-party decision-makers. Even worse is the prospect of
handing the moral compass to anonymous bureaucrats in a single-payer
government system. There's more to be feared about a national health system
than poor quality care and rationing.
With moral dilemmas looming large in areas like genetic engineering, human
embryo research and end-of-life treatment, patient empowerment is more vital
than ever. Public consensus in law should be achieved where possible - on
issues such as human cloning and the creation of animal-human hybrids. But
the variety of ethical issues involved in personal care will be difficult to
resolve in legislatures, and undesirable to leave to court decisions.
Instead, they should be put to the test of individual conscience. If
individuals and families had control of their health care dollars, they
could "vote with their feet" when choosing which health plans and medical
procedures to subsidize with their insurance premiums.
Once empowered with the freedom to choose their health coverage, families
need safe havens to which they can turn. They need new arrangements that
aren't feasible under the present system. For example, plenty of Americans
have moral qualms about paying for abortion, and plenty of American doctors
have moral qualms about providing them (and therefore decline to do so). But
the current system doesn't allow providers and patients to get together and
organize health insurance plans around shared values.
In an alternative model, membership associations such as professional and
faith-based organizations could sponsor or endorse a health-insurance plan
in which participating doctors and patients agree on clearly established
ethical parameters for care. Trusted intermediaries like the Knights of
Columbus, Southern Baptists, or the Salvation Army, for example, could help
individuals and families navigate the moral and fiscal complexities of
health care coverage by negotiating with an insurance company to offer a
group plan that meets their standards.
Such a faith-based health plan is available to one of the few
groups in America with a wide choice of plans: federal employees. The
Federal Employees Health Benefits Program (FEHBP), the largest group
insurance system in America, is a national consumer-driven market for
federal employees, retirees, and their families. They can choose a plan from
a large pool of health care options (278 plans participated in FEHBP in
2006). One of these federal employee plans is the Order of Saint Francis
Healthcare System, run by an order of Catholic nuns in Illinois, who are
very clear about their governing values for the care of human life, from
conception to natural death. Regrettably, only federal employees in the
region can select this option, but this is precisely the kind of plan that
could proliferate if there were true choice in health-insurance design.
Unlike these federal employees, most Americans don't have access to
health-insurance plans that are governed by religious values. This lack is
emblematic of a general limitation on personal freedom, a central defect of
the American health-care system.
To expand families' freedom to choose cost-effective health-insurance plans
consistent with their ethical and religious convictions, policymakers should
change tax and insurance rules in these ways:
- Allow Americans to choose their own health plans. In addition to
conventional employer-sponsored health plans, Americans should be
allowed to choose plans sponsored or endorsed by professional
associations or faith-based and religious groups.
- Eliminate discrimination in the tax code. To make this choice a
reality, federal and state tax codes should treat all types of plans
equally and stop giving preference to employer-based health plans.
- Reduce mandates. State mandates drive up costs and raise conscience
concerns. Thirteen states, for example, require health plans to cover in
vitro fertilization (IVF). Thirty states mandate coverage of
contraception. State-level reform offers the occasion to expose mandates
to popular debate.
- Open up health-insurance markets. State mandates define and limit
the kind of health insurance available to individuals and families - and
often prevent them from getting the specific kind of coverage they want
at an affordable price. To address this, some states are considering
reforms that would create a statewide health insurance "exchange," or
marketplace for health-care plans. Consumers would have multiple choices
in such a marketplace, and employers could contribute a specified amount
(a "defined contribution") to the health plans designated by their
employees. Plans - including those organized around shared moral values
- would compete with each other directly for consumers' dollars.
Individuals and families can no longer afford - financially or ethically -
to be passive recipients of third-party decisions. They should be free to
control their health-care dollars. Americans need the freedom to choose
health care they can trust.
- Jennifer A. Marshall is director of
domestic-policy studies at the Heritage
Foundation and author of
and Not Yet: Making Sense of Single Life in the Twenty-First Century
The Kansas City Star
2 August, 2007
Reproduced with permission
Executive Vice President,Cato Institute
Freedom means freedom for everyone. In a free society, customers
shouldn't be forbidden by law from purchasing products except in very
And in a free society, proprietors and employers shouldn't be forced to
sell any particular product.
Government should not intrude into the conscience of citizens. So the
answer to the question is: Yes, pharmacists should be free to dispense and
sell the products they choose.
Some pharmacists have moral objections to birth control and especially to
morning-after pills. You might say they're conscientious objectors to what
they see as murder.
We may not agree with them, but we should not use the power of government
to force them to do something that violates their conscience. In a country
of 290 million people and 14 million businesses, we should let these issues
sort themselves out in the marketplace.
4 June, 2007
Reproduced with permission
U.S. President Dwight Eisenhower once observed that in free countries,
"the agent may never become the master." If human rights and freedoms are to
flourish, he said, "government must operate with its powers sharply defined
and limited by the governed."
Presumably that would apply to the Canadian Medical Association as well,
which, as an agent for Canada's physicians, is now under pressure to remove
doctors' freedom of conscience on abortion.
How often have we seen this type of coercion before:
- Homosexual "rights," for instance, quickly evolve into an obligation
for others, in schools, employment, and even in the home.
- Euthanasia, where it has become a right, turns into societal and
economic pressure on patients and doctors to go along with it.
- Pharmacists who object to dispensing pills that cause death are
constantly struggling not to be compelled to comply with patients'
Now Canada's doctors are being pressured to put the interests of women
who want abortions ahead of their own religious and moral convictions.
The furor began about a year ago when the Canadian Medical Association
Journal published a guest editorial from two lawyers. They criticized
pro-life doctors who refuse to refer women to abortionists, accusing them of
"malpractice," a word guaranteed to make many doctors sit up and think twice
about their position.
The editorial generated a barrage of letters on the topic, until the
April 24, 2007, issue of the magazine, in which the CMA's director of ethics
made clear what the CMA's position is: doctors are under no obligation
either to perform an abortion or to refer patients to an abortionist.
Now the National Abortion Federation, a U.S. lobby group, is pressuring
the CMA to change its policy and remove the freedom of doctors to follow
their religious and moral beliefs. In short, they would be required to refer
Dr. Colin McMillan, the president of the CMA, has responded to the
abortion federation, saying the CMA policy on "induced abortion does not
violate our Code of Ethics ... nor does it treat women unfairly or impede
their access to critical health care," (which may be the first time ending a
baby's life has been termed "critical health care").
Canadian Physicians for Life also wants none of the abortion lobbyists'
objectives. Considering what's likely coming down the road with respect to
reproductive technologies and euthanasia, now is certainly not the time to
weaken conscience protection for health care workers, says Dr. Will
Johnston, a Vancouver family physician and president of the Canadian
Physicians for Life.
Far from being content with the present policy, Physicians for Life wants
the CMA to actually strengthen protections for doctors who don't want to be
implicated in any way with abortion.
So all's well that ends well? Not necessarily. Dr. Jeff Blackmer, the
CMA's ethics officer, told the National Post that the CMA's policy could be
re-evaluated if there was a groundswell from the membership one way or
another, a legislative review of the issue by government, or a significant
decrease in abortion access.
That should prove disconcerting to pro-life doctors and Canadians who
want a doctor who isn't involved in abortion.
So here we have a U.S.-based abortion lobby organization trying to
further liberalize Canada's abortion lawlessness. Canada's medical body
deserves to hear from Canadians, who every poll shows are opposed to
unrestricted abortion on demand. Conscience protection is too important an
issue, especially on an issue as significant as abortion.
Long before Eisenhower commented on rights and freedoms, Pope Leo XIII
noted that "man precedes the State." Presumably he precedes the Canadian
Medical Association too.
Following is contact information on this issue:
Physicians for Life:
Christian Medical Dental Associations
News and Views
18 May, 2007
Reproduced with permission
Excerpted from "California ex. rel. Bill Lockyer v. United States of
America, Docket C-05-00328-JSW (N.D. Cal.)."
Updated May 15, 2007--The Weldon Amendment is a federal law passed in
2004 and renewed each successive year that prohibit recipients of certain
federal funds from discriminating against healthcare workers and
institutions that do not perform or refer for abortions.
Just six weeks after the Weldon Amendment became law, California's
Attorney General Bill Lockyer, backed by Planned Parenthood of California,
challenged it in a California federal district court. Lockyer alleged that
by withholding funds from states that discriminate against pro-life
healthcare workers the Weldon Amendment violates California's "sovereign
right" to enforce California laws that provide civil and criminal penalties
for medical professionals and facilities that do not perform "emergency"
abortions. The definition of "emergency" in the California law - as a result
of cases protecting the right to an abortion even when the pregnancy could
affect "familial" and "emotional health" -- is so broad that it would
encompass virtually any abortion. Thus, according to the California Attorney
General's interpretation of California law, were the Weldon Amendment
invalidated, pro-life physicians, physician assistants, and other medical
professionals would be subject to the threat of criminal prosecution and
civil lawsuits for refusing to perform almost any abortion. California
claims that the Weldon Amendment violates women's rights to procure an
abortion by interfering with California's ability to criminally prosecute
and civilly sanction medical professionals who choose not to provide
In June 2005 the Center for Law and Religious Freedom filed a motion to
intervene in the case on behalf of the Christian Medical Association, AAPLOG
and the Fellowship of Christian Physician Assistants, three organizations
that together represent over sixteen thousand pro-life medical professionals
nationwide and over one thousand in California alone. The District Court
denied this motion to intervene in November 2005, saying that the medical
groups did not have a sufficient interest in the outcome of the case to
allow them to participate as parties. CLRF attorneys took an emergency
expedited appeal of this decision to the Ninth Circuit Court of Appeals. In
June 2006 a unanimous Ninth Circuit panel reversed the District Court and
ordered that CMA, AAPLOG and FCPA be permitted to participate as parties in
the case to defend the constitutionality of the Weldon Amendment.
CMDA Chief Executive Officer David Stevens, MD, MA (Ethics):
"If some have their way, you will either have to amputate your
conscience or get out of healthcare. They see doctors as vending
machines for every and all legal health interventions. Put in your
money; get your therapy."
"Right of conscience is under a coordinated attack from Planned
Parenthood, NARAL and the ACLU. Planned Parenthood's website states, 'Health
related decisions made between a provider and patient should be made on
the personal welfare and healthcare needs of the patient - not the
morals or belief of the caregivers.' As a PP lawyer stated in a
recent NPR debate with me, 'If you aren't willing to provide all
legal healthcare options, you shouldn't be a doctor.'"
"How can you defend your fundamental right to practice healthcare
according to your deeply held religious, moral, or ethical convictions?
Right of conscience is protected by the 1st amendment of the Bill of
Rights. 'Congress shall make no law respecting an establishment of
religion, or prohibiting the free exercise thereof.' The original
version proposed by James Madison was even more explicit before it was
edited to a shorter version: 'The Civil Rights of none shall be
abridged on account of religious belief or worship, nor shall any
national religion be established, nor shall the full and equal rights of
conscience be in any manner, nor on any pretext be infringed.'
Forty-five states have some sort of right of conscience law. Find out
about your state's by going to
www.consciencelaws.org. There are also federal protections in the
Health Services, Medicare and Medicaid Acts and of course the Weldon
Amendment mentioned above has the broadest protections."
"Unfortunately, these protections are not enough. They are a
hodgepodge that deals mainly with abortion. They don't protect
pharmacists or doctors from being forced to prescribe/dispense the
morning after pill that has post fertilization effects on the embryo but
is touted as not being an abortifacient. They do not protect healthcare
professionals on a host of other conscience issues from
physician-assisted suicide to human cloning."
"We must defend the laws on the books and advocate for better
protection for all in healthcare professionals. For talking points and
sound bites on this critical issue, download a free CMDA resource
here. Our healthcare system is in need of more conscience-driven,
not ethically neutered doctors. If we lose this battle, all other
ethical battles will be lost. There won't be any conscience in
Comment on Benitez v. North Coast Women's Care Med Grp
Christian Medical Dental Associations
News and Views,
18 May, 2007
Reproduced with permission
CMDA Senior Vice President Gene Rudd, MD:
"CMDA has followed this case from early along, first praying for our
colleagues caught in this crucible, and then supporting their case in
court. If the plaintiff prevails, it will be a severe blow to the rights
of all physicians who seek to follow their conscience."
"The facts seem clear and should provide for a favorable verdict for
the doctors. From the beginning, the doctors made it clear that their
refusal to inseminate the patient was based on her being unmarried.
Nevertheless, homosexual discrimination was subsequently claimed. A
recent California law prohibiting discrimination based on sexual
orientation fueled the judicial fires. Moreover, the prosecution claims
this law takes priority over the doctors' right of conscience as
established in the 'free exercise' clause of the Bill of Rights.
Fundamental liberty issues are at stake for these doctors, you, me, and
everyone else in society."
"Let's continue to pray for Drs. Brody and Fenton, and pray for
righteousness to prevail."
The Florida Catholic
30 March, 2007
Copyright Â© 2007 The Florida Catholic Inc.
Used with permission.
Around the country, state legislatures are threatening to
remove conscience clauses that have allowed religious institutions as well
as individuals to be exempt from providing services they find objectionable
on religious and moral grounds. Conscientious objection to military service
has a long history in the United States and other countries. Lately, the
debate has heated up in the medical arena as well.
In the animated movie classic, Jiminy Cricket inspired
Pinocchio to "let his conscience be his guide." More and more these days,
that's becoming harder to do.
Pharmacists with moral objections to artificial birth
control have been fired for refusing to dispense contraceptives or the
morning-after pill. Catholic hospitals also have been battle grounds for
conscience-clause exemptions from certain practices often required of public
or other private hospitals.
For Catholic hospitals, treating rape victims has always
been a balance between the pastoral and the practical. Guided by the
"Ethical and Religious Directives for Catholic Health Care Services," which
state that a sexual assault victim "should be able to defend herself against
a potential conception from the sexual assault," most Catholic hospitals
will provide emergency contraception to rape victims as long as conception
has not occurred. A luteinizing hormone urine dip test, or LH test, usually
is administered to make that determination, according to a report by
Catholic News Service.
However, Connecticut legislators are considering a proposal
that would require all hospitals receiving public funds - including the
state's four Catholic hospitals - to offer emergency contraception to rape
victims, without performing a test to ascertain whether the woman is already
pregnant. That would mean the emergency contraception, marketed as Plan B,
could cause an abortion and its use would violate the Catholic stand on
life. And in the Minnesota Legislature March 20, a House committee approved
legislation that would require hospitals to tell sexual assault victims that
emergency contraception is available but would permit Catholic facilities to
continue testing to see if the woman is pregnant.
Also, in Oregon, that state is considering requiring all
health plans that pay for prescription drugs to also cover prescription
birth control; it also mandates that hospitals in the state provide
emergency contraception to rape victims. The Oregon Catholic Conference
objects to the legislation as it stands now because it has no exemption for
religious or moral concerns. Officials of the conference have offered to
help draft a conscience clause. Oregon Catholic officials say without the
conscience clause, they might have to remove prescription coverage from
health plans for diocesan and Catholic school and agency employees.
A national "Prevention First Act" has been proposed that
could render all these state issues moot; it does much of what the Oregon
legislation would and has no conscience clause either.
Our country and society value all that the church and its
agencies have to offer. They rely on Catholic hospitals to serve segments of
the population that are often underserved or neglected. Catholic health care
is one of the longest and finest traditions in this country. From the same
set of values and teachings that come the social service comes the desire -
the need - to defend and protect all life. Why should our government on one
hand gratefully accept the service these institutions provide and then
denigrate the basis from which it comes?
The conscience of Catholic institutions goes
hand-in-(latex)-glove with the teachings of the church. A conscience
exemption is vital to protect the work that hospitals, dioceses and
charitable agencies provide to our communities.