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Protection of Conscience Project

Service, not Servitude
Repression of Conscience

Incidents in the United States 1989-2008

Sean Murphy*

A federal protection of conscience regulation  was promulgated in December, 2008 by the U.S. Department of Human Services.  In March, 2009, the Obama administration announced that it would revoke the regulation following a period of public comment that ended on 9 April, 2009. 

In response, a number of American groups are gathering evidence to demonstrate the need for protection of conscience legislation like the HHS rule.  The following examples are drawn from a document prepared by  Health care workers or students who have experienced coercion or other forms of discrimination can report the incidents on a Personal Stories page hosted by the group.

ca. 1989

Medical student accused by professor of "abandonment" for no abortion referral
USA, April, 2008

J. Wesley Earley: "I am a third-year medical student. In my second semester, we take a Medical Ethics course. On numerous occasions, I was repudiated by the professor for my unwillingness to profess as acceptable her position that all physicians MUST refer a patient wishing an abortion to an abortion provider (since I obviously was unwilling to perform one myself). The professor's point was that the woman desiring the abortion was my patient and I was ethically bound to refer her in order to meet my ethical obligation of 'non-abandonment' once I had accepted her as a patient. My response to her was that I was ethically and morally beholden to defend the life of the unborn child, and that my vow of placing my patient's well-being before all else took precedent in preserving the child's life over terminating the pregnancy for the woman's convenience."

Personal email to Christian Medical Association from J. Wesley Earley, April 27, 2008

Family medicine physician forced out over contraceptives for unmarried patients

San Antonio, Texas, U.S.A.
May, 2008

Dr. Shelley Phillips, a family medicine physician practicing in San Antonio, Tex. under a not for-profit university hospital group, University Health System reported in May 2008 that the corporation that runs her practice was insisting that she provide contraception in all cases. Dr.Phillips restricts contraception prescriptions to married patients. After several patients allegedly complained, her medical director informed Dr. Phillips that the hospital administration demanded that all the physicians in the clinic prescribe contraception for any and all reasons. Dr. Phillips resigned.

Personal emails and phone calls to Christian Medical Association from Dr. Shelly Phillips, April 24-May 29, 2008.

Medical student afraid to pursue Ob-Gyn career due to abortion pressure
USA, April, 2008

Trevor K. Kitchens: "I am a first year medical student in the beginning stages of deciding which specialty I would like to pursue. I am currently very interested in OB/GYN, but I am afraid of the relationship between this field and abortion. By the way, I am 100% against abortion, and there is no way I would perform one. Moreover, there is no way I would tell a patient that abortion is an option under any circumstance, because I do not believe it is an option.

My concern is that I will start a residence and would subsequently be required at some point to give a patient the option of abortion, which I would refuse. My fear is that taking this stand would cost me my residence position.

"Now, if that is what it comes down to, I will be glad to take the stand for Jesus Christ and give up my position. However, I would really like to be able to avoid this situation and complete my residence so that I could go on and serve the Lord in that field. So I guess my question is, Can an institution take action against a resident for taking this type of a stand against abortion? And are there any institutions in particular that would be understanding of my beliefs and not ask me to compromise them"

Personal email to Christian Medical Association from Trevor K. Kitchens, April 22, 2008.

Nurse practitioner terminated over abortion referral

USA, 2006

Stanley Koleszar, CRNP: "I am a Family Nurse Practitioner who has been discriminated because of my beliefs on the job. I do not refer patients for abortions, and at my previous place of employment I was reprimanded for doing this, and then placed on probation. I was told I was not a good fit for the company and that I had better look for a job elsewhere because I was going to lose mine. In all of this I repeatedly asked if there was something I needed to do to improve, if I was doing something wrong and if I needed to grow in certain clinical areas. I was told that this was not the case and that we just did not work together. I believed that this was probably a violation of my contract with them, but I really don't want to work at a place where people don't want me."

Personal email to Christian Medical Association from Stanley L Koleszar, October 10, 2006.

Family medicine physician deemed "too Catholic" for medical license

Kansas City, Kansas, USA
April, 2004

"Dr. Leslie Chorun is one of six health care professionals who have formed Fertility Care Center of Kansas City, a medical practice focusing on the Creighton Model of natural family planning. 'I was told at one point that by not referring women for abortions or contraception, that was below the standard of care for physicians,' Chorun said."

"The pressure on Chorun was increasing from the supervisors of her residency program.  Eventually, Chorun was forced to resign from the residency program months before completion. Though she was able to obtain licenses to practice in both Kansas and Missouri, her insistence on building her practice based solely on natural methods continued to cause her problems. When she applied for her Missouri license, a friend attempted to intervene with one of her residency supervisors to help Chorun get a good reference. The supervisor told her friend, 'She's too Catholic,' Chorun said."

"'Humanae Vitae' changes course of resident doctor's practice," Catholic Key, April 9, 2004.

Secretary refused employment by county because of abortion stance

DeKalb Co., Illinois, USA

Court case: "Plaintiff, a part-time secretary in DeKalb [County's] WIC program, applied for a position as a full-time secretary. During the interview process, plaintiff, who is bilingual, was asked if she would be able to translate for Family Planning, another program of DeKalb, and specifically if she would be able to translate the option of abortion as an option for an unwanted pregnancy. Plaintiff said she would find it very difficult to do this because of her moral and religious beliefs against abortion. On September 4, 2002, Zucher advised plaintiff she had not been hired for the full-time position because of her stand on abortion.

"Defendant's motion to dismiss is granted as to the claims under 42 U.S.C. § 300a-7, the Title VII claims against the individual defendants, and the official capacity claims against the individuals under Section 1983. The claims for punitive damages against DeKalb County are stricken. Otherwise, defendants' motion to dismiss is denied."

Moncivaiz vs. Dekalb, (03 C 50226), United States District Court For The Northern District Of Illinois, March 12, 2004, Decided. 2004 U.S. Dist. LEXIS 3997.

Medical professor threatened with job loss over embryocides
Dallas, Texas, USA

Dr. Rebecca Lavy: "I was employed in a teaching position at the University of Texas Southwestern in Dallas, TX from 1999 – 2001. While I was there, the faculty was required to take in house night call. This included performing the sexual assault examinations – all of which for Dallas County were referred to our ER. It was not uncommon to be called to perform 2-3 of them in a night.

One of the things the department said was required was that we prescribe for these women the post-coital use of oral contraceptives (Erroneously, in my opinion, called the ‘post-coital contraceptive’) I refused to prescribe it and was told, 'This may be an employment issue.' The obvious, not-so-subtle implication was that I would be fired if I refused. We went round and round. Since I didn’t agree with simply calling someone else in (one of the residents) to prescribe the medication (if prescribing them is ethically wrong, asking someone else to do it for me is equally wrong).

Personal email to Christian Medical Association from Dr. Rebecca Lavy, October 07, 2006

Ob-Gyn physician's malpractice insurer insists on lesbian insemination

Sonoma County, California, USA

Vicki L. Duncan, MD FACOG: "I recall receiving a call to see if I would perform intrauterine insemination for a lesbian couple in the late 90's. I contacted my malpractice carrier for legal advice, and was told that if I refused for them, but did so for a married, heterosexual couple, I would likely be sued, and they would not provide coverage. It also extended to a non-married couple. That was when I decided to no longer perform intrauterine inseminations. This occurred in Sonoma County, California. The insurance carrier was Norcal."

Personal email to Christian Medical Association from Vicki L. Duncan, MD FACOG, October 7, 2006. 

Military physician forced to refer for abortions

US Military, ca. 1989

Donald F. Thompson, MD, MPH&TM: I entered the practice of medicine from a deep commitment to serve my fellow man, and have been discouraged recently as I have been required to participate in activities that violate my personal convictions.

As a physician with over a quarter century of service in the U.S. military, I take my vows very seriously. Twenty-six years ago I swore an oath to protect and defend the Constitution of the United States, not realizing then that my commitment would include extensive life threatening service in Afghanistan and Iraq in recent months.

I continue to fulfill this commitment gladly and without hesitation. Twenty-two years ago, I took the Hippocratic Oath when I graduated from medical school, but regrettably was required by military regulations to violate it within my first few years of practice by participating in referring women for abortions.

Letter from Dr. Thompson to The Honorable Michael 0. Leavitt, July 23, 2008

Ob-Gyn intern loses privileges for refusing to perform abortions

Sandy Christiansen, MD: "As an intern, the opportunity to get into the OR was a great privilege, as most of our time was spent in L&D or the clinic. I was the only intern who declined to perform elective abortions, and I made it clear that it was because of my Christian beliefs.

One of my fellow interns was frequently given the privilege of scrubbing in on Gyn cases. I questioned my chief resident as to why I wasn’t being given that opportunity and she replied that Susie was working hard doing the abortions and had earned this privilege whereas I had ‘refused’ to do this work and hence did not get the 'perk.'"

Ob-Gyn physician reamed out over refusal to perform abortion

Sandy Christiansen, MD: "I was the chief of the obstetrical service and was thus responsible for the care and management of all of the obstetrical patients on the clinic service. We had a patient, at the time, whose baby was diagnosed with Down’s syndrome and the mother had decided to abort. Since she was so far along, she was to have labor induced and was to be managed on the obstetrical floor. I spoke with my attending physician and told her that I did not feel comfortable being involved with this patient’s abortion because of my Christian beliefs and I had spoken with another resident who was willing to oversee this patient’s care in my stead.

"The attending proceeded to reprimand me loudly in front of my team of residents, interns and medical students. She accused me of abandoning my patient, of shirking my responsibilities and being insensitive to my patient. Not once did she acknowledge that I had a legitimate reason to take such a stand. During private practice, I have not experienced such blatant examples of religious discrimination, but have certainly felt ‘snubbed’ or dismissed for my beliefs. In general, there has not been a collegiate atmosphere of mutual respect for differing stances."

Personal email to Christian Medical Association from Sandy Christiansen, MD, October 24, 2006

In-vitro physician faced ethics charges for embryo-saving stance


Dr. Jeffrey A. Keenan: "Earlier in my career, I was basically brought up on ethics violation charges because I refused to work with patients who would destroy embryos. Even though there were other MD's in the community and even in our department who did destroy embryos, I was forced to basically be confronted with these charges in public and endure the 'hearing'. I won out in the end of course, but it was still very disturbing."

Personal email to Christian Medical Association from Jeffrey A. Keenan, October 10, 2006. 

Anesthesiologist must anesthetize for abortion as employment condition


Frank Block, Jr., MD: "One place that I interviewed for a job told me in no uncertain terms that while they would try to keep me away from the abortions but that I would, in fact, have to provide anesthesia for abortions if I went there. (I didn't go there.) My whole career path has been focused upon finding places where I would have minimal hassles over my beliefs. I am happy to defend them, but I am not happy to have an ongoing issue over them."

Personal email to Christian Medical Association from Frank Block, Jr., MD, October 08, 2006.


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