Project Logo

Protection of Conscience Project

Service, not Servitude
Subscribe to me on YouTube

News Commentary 2007

Conscience, Plan B: More than a nicety

Milwaukee Journal Sentinel
18 December, 2007
Reproduced with permission

Patrick McIheran

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 wall.

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 conceived.

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 powerful."

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]

Freedom to Choose: Clear-conscience health reform

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: conscience concerns.

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 limited.

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 Now and Not Yet: Making Sense of Single Life in the Twenty-First Century (Multnomah 2007).

Can pharmacists refuse to handle prescriptions for moral reasons? YES

The Kansas City Star
2 August, 2007
Reproduced with permission

David Boaz
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 restricted circumstances.

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.

Deadly Prescription for Canadian Doctors

BC Catholic
4 June, 2007
Reproduced with permission

Paul Schratz

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' wishes.

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 to abortionists.

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:

Right to Refuse to Participate in Abortions: Comment on the Weldon Amendment

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 abortions.

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 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 healthcare."

Doctors Sued for Refusing Insemination on Conscience Grounds
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."

Jiminy Cricket Need Not Apply

The Florida Catholic
30 March, 2007
Copyright © 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.

Christopher Gunty
Associate Publisher