News Commentary 2011
Mary Meets Dolly
17 December, 2011
Reproduced with permission
The moral conscience of health care providers is under attack.
Increasingly they are being forced to provide medical services that go
against their moral beliefs
Wesley J. Smith has
a great piece in the Daily Caller on how laws
all over the world are making it harder for medical professionals to opt out
of procedures that go against their moral code. Smith focuses on Australia
where where all doctors are required to perform abortions or refer to a
doctor who will and The Netherlands where there is a push to require doctors
to comply with requests for assisted suicide, and Washi
It is becoming increasingly clear that medical professionals who wish
to continue in the Hippocratic tradition will face increasing pressure
to yield their consciences to the desires of patients and the reigning
moral cultural paradigm.
Progressives likely cheer erosions of conscience protections for health
care providers because emergency contraception, abortion and assisted
suicide are issues they champion. But I want to look farther into the future
to see how a lack of conscience clauses will affect the medical profession.
When cloning becomes a reality, there will be a cry to make reproductive
cloning or cloning-to-produce children a reality. IVF clinics will be
bombarded with requests to clone patients. Some IVF doctors
are already cloning for research, they have the eggs
needed and the facilities so it would be natural that they clone to make
babies as well. They are in the baby-making business after all. And some
people think cloning is their reproductive right:
"My decision to clone myself should not be the government's business,
or Cardinal O'Conner's, anymore than a woman's decision to have an
abortion is. Cloning is highly significant. Its part of the reproductive
rights of every human being." -Randy Wicher, cloning activist
But what if an IVF practitioners doesn't want to clone babies? What if
they find it morally repugnant? Get rid of conscience clauses and that IVF
doctor has no legal right to refuse to clone whoever walks through the
What happens in the future when transhumanism has taken hold?
Transhumanism is a movement that would use technology not to cure or treat
disease but to enhance otherwise healthy individuals beyond normal human
abilities. Transhumanists would like nothing more than to chop off their
perfectly good limb and replace it with an artificial one that performs
better. They would love to have unlimited access to cognitive enhancing
drugs or be able to genetically engineer themselves or their offspring.
But what if a surgeon doesn't want to amputate a healthy limb and replace
it with an artificial one? What if that surgeon thinks making a healthy
person into cyborg is morally wrong?
What if a pharmacist doesn't want to dispense cognitive enhancing drugs
to healthy people because he or she knows the risks of such drugs? What if
he or she believes cognitive enhancements for normal individuals is morally
What if doctors who perform gene therapy for muscle wasting diseases are
asked to genetically alter a normal man to have an unnatural amount of
muscle? What if that doctor is asked to enhance children the same way? What
if he or she believes that genetically altering healthy people or children
without informed consent is morally wrong?
Take away conscience protections and these medical professionals will
have no choice but to comply with their patient's requests. Even if they
know these procedures are dangerous and carry great risks, doctors, nurses,
and pharmacists may be compelled to participate. Or if they are morally
opposed to operating on healthy people, they will no longer have a choice
simply because their "patient's rights" trump their right to make moral
Conscience clauses are not just about contraception, abortion and
assisted suicide. Their importance is far greater than that. We must give
health care providers the ability to listen to their conscience or we maybe
forcing them to participate in cloning, enhancements, or whatever else
biotechnology has in store. Be careful what you wish for. Those who support
removing conscience protections now, may have cloning, cyborgs, genetically
enhanced children and other morally repugnant technologies shoved down their
throats in the future.
9 August, 2011
Hannah C. Smith*
Last week, the U.S. Department of Health and Human Services issued new
federal regulations that run roughshod over the moral conscience of many
Promulgated under the health care reform act commonly referred to as
"Obamacare," the new regulations would require an employer to have a health
plan that covers sterilization and contraception - which could include drugs
that cause abortion - as part of a larger set of "preventative services" for
women. These practices are morally repugnant to many Americans - for some,
because it directly contradicts their faith. For example, the doctrine of
the Catholic Church, which includes roughly a quarter of Americans,
explicitly prohibits such practices.
HHS, apparently recognizing the regulations' tension with religious
belief, did include an exemption from the new regulations for a "religious
employer." But close examination reveals that the exemption may actually
cover very few religious employers. So the rule may force out of existence
those social service and educational organizations that are the core
manifestations of the Catholic doctrine to serve the poor and needy among
us. . . . [read
The Heartland Institute
30 March, 2011
Reproduced with permission
and Anna Franzonello*
An issue of paramount importance for medical professionals is the
protection of their right to conscience-their freedom to refuse or decline
to do practices they oppose on religious or moral grounds. A February
decision by the Obama administration, however, sweeps aside conscience
protections instituted under President Bush.
The decision is not unexpected-the Obama administration initiated the
process to rescind the Bush regulations on March 10, 2009. Unfortunately, it
comes at a time when pressure to violate one's conscience or leave the
medical profession is not theoretical but very real.
Obama Rejects 'Conscientious Refusal'
One such recent threat comes from the American College of Obstetrics and
Gynecology (ACOG), which reviewed and reaffirmed its 2007 Ethics Committee
Number 385, titled "The Limits of Conscientious Refusal in Reproductive
Medicine" in November 2010.
Rule number 385 categorizes a conscience objection as a "refusal,"
describing elective abortion and other controversial reproductive medical
procedures and services as "standard." The opinion states, "In some
circumstances, respect for conscience must be weighed against respect for
particular social values."
On balance, according to ACOG's rule, abortion is a social value that
outweighs any conscientious objection. It requires prolife physicians to
refer individual for abortions and even suggests they relocate their
practices to better refer patients to nearby abortionists.
Could Strip Certification
The effect of the ACOG committee opinion is that otherwise qualified
health care providers specializing in obstetrics and gynecology may lose
their board certification solely because of their prolife values. According
to the 2011 Bulletin for Basic Certification in Obstetrics and Gynecology
from the American Board of Obstetrics and Gynecology (ABOG), an individual
can have his or her board certification revoked if he or she acts in
"violation of ABOG or ACOG rules and/or ethical principles."
Without Board certification, a doctor is subject to discrimination by
other entities. State and local governments, hospitals, or other
institutions that require Board certification may take action against the
physician. Thus, refusing to conform to the ACOG recommendations on abortion
could result in the loss of a health care provider's livelihood.
In finding that abortion is a circumstance where conscientious objection
"can and should be overridden in the interest of other moral obligations
that outweigh it," ACOG's subjection of conscience to patient autonomy
leaves patients paying the ultimate price. Access to essential reproductive
health care will be limited as prolife doctors are forced out of the field.
ACOG Threat Prompted Rule
When ACOG first issued its threat, then-Secretary of Health and Human
Services (HHS), Michael Leavitt issued a letter to Norman F. Gant, executive
director of ABOG, stating such discrimination would seem to violate federal
laws protecting the right of conscientious objection to abortion.
ABOG and ACOG refused to change their policy, and the Bush administration
enacted the "Regulation Ensuring that the Department of Health and Human
Services Funds Do Not Support Coercive or Discriminatory Practice in
Violation of Federal Law" in December 2008. The regulation required
certification from entities receiving federal funds from HHS that they will
comply with the established federal conscience protection laws.
A recent case demonstrated the importance of the Bush rule. A nurse at
Mt. Sinai hospital in New York, Cathy DeCarlo, was forced to participate in
an abortion despite her conscientious objection. A federal court dismissed
her claim, saying she cannot bring suit by herself. HHS then ruled the court
can pursue the case because of the Bush regulations.
Now that President Obama has revoked the rule, conscience rights will
likely have little protection against threats from ACOG and ABOG. It is
unlikely Congress (particularly the Senate) has the votes to convert the
revoked guidelines into a binding statute. For this reason, Americans United
for Life has drafted a model bill to protect conscience at the state level,
blocking discriminatory practices such as "refusal of board certification."
Health care professionals face serious ethical issues on a daily basis.
The Obama administration's rejection of conscience protection ought to
concern both health care providers and patients.
National Right to Life News
Reproduced with permission
On February 18 the Obama administration gutted the only federal
regulation protecting conscientious healthcare professionals from
While three long-standing federal conscience-protecting laws remain
intact, the conscience-protecting regulation had been promulgated under the
Bush administration to remedy documented pervasive discrimination against
pro-life physicians and others in disregard of the anti-discrimination laws.
U.S. Dept. of Health and Human Services (HHS) Secretary Kathleen Sebelius
effectively eviscerated a sensible Bush-era regulation that had finally put
teeth to bipartisan federal civil rights laws enacted over the past three
decades. Those anti-discrimination laws were passed, all after the Supreme
Court's 1973 Roe v. Wade abortion ruling, as a way to keep physicians,
nurses, hospitals and others from being forced out of medicine simply for
following life-affirming ethical standards such as the Hippocratic oath.
But abortion advocates hyperventilated when it appeared that those laws
would actually be implemented and enforced by the conscience protection
regulation, which took effect in January 2009.
Cecile Richards of the Planned Parenthood Federation of America had said,
"It is going to cause chaos among providers across the country."
Then-Sen. Hillary Rodham Clinton had said: "It threatens the health and
well-being of women and the rights of patients across the country."
Of course, none of their doomsday predictions even faintly materialized
in the over two years since the original regulation took effect. In
explaining Friday's regulation change, HHS presented no evidence whatsoever
of any hindrance to any patient, procedure or prescription.
The complete lack of evidence didn't seem to matter a whit, despite
President Obama's vow in his Inaugural Address to "restore science to its
The administration's radical action again suggests tone deafness to the
American public. Of the over 300,000 comments HHS received regarding
rescission, twice as many opposed rescission as supported it. The Polling
Company in 2009 conducted a nationwide scientific polling of the public and
also of faith-based healthcare professionals. The results revealed that:
- An overwhelming 63% of the public supported the conscience protection
regulation whereas only 28% opposed the conscience protection regulation.
- Only 30% indicated support for the Obama administration's plan to get
rid of the regulation, whereas 62% opposed the administration's plan.
- 88% of American adults said it is either "very" or "somewhat" important
to them that they share a similar set of morals as their doctors, nurses,
and other healthcare providers.
- Nine of ten faith-based physicians agreed, "I would rather stop
practicing medicine altogether than be forced to violate my conscience."
In other words, faith-based healthcare professionals and institutions are
ready to walk away from medicine if denied the ability to practice medicine
according to conscientiously held ethical standards.
I tried to drive home that point in a meeting I had at the White House in
2009 with Obama officials regarding the conscience regulation and abortion
in general. I pointed out that Mr. Obama and his officials never provided a
concrete reason for trashing the reg, that the reg merely implemented
existing federal law, and that it was crucial to preserving patient access
to the pro-life physicians, hospitals and clinics across the country that
depend upon conscience protections to practice medicine.
Especially in states already facing critical physician shortages-such as
Texas, Georgia, Alabama, Mississippi, Oklahoma, Utah, Nevada, Idaho and
Delaware-losing just one physician can erase healthcare access for thousands
of patients. Hardest hit are poor patients and those who live in medically
The recent regulatory action makes all the more vital passing bills
pending in the 112th Congress to protect healthcare access with conscience
protections. For example, the No Taxpayer Funding for Abortion Act (H.R. 3),
offered by Rep. Chris Smith (R-NJ); the Protect Life Act (H.R. 358), offered
by Rep. Joe Pitts (R-Pa.); and the Abortion Non-Discrimination Act (H.R.
361) offered by Rep. John Fleming (R-La.), all forbid discrimination related
to abortion, in certain contexts.
Abortion ideology has taken root in much of medical academia and
healthcare institutions and has resulted in both overt and subtle
discrimination that laws alone cannot adequately address. Civil rights laws
by themselves, it should be remembered, did not protect minorities from many
forms of discrimination.
True civil rights protection requires cultural change. A long-term
program of education within the medical community and in the public is
needed to help build awareness among conscientious healthcare professionals
of their civil rights and a respect for those rights by all. Only then will
we begin to restore medicine to its ethical moorings and protect the
patients who depend upon ethical and compassionate healthcare professionals.
The author serves as Vice President for Government Relations for the
Christian Medical Association and
manages a coalition of conscience-supporting organizations,
The Catholic Thing
17 February 2011
Reproduced with permission
In October, at a central European meeting
with pro-life colleagues, I learned that in a few days there was
going to be a vote in the Parliamentary Assembly of the Council of
Europe concerning rights of conscience. The vote was on the
"McCafferty Report," which strongly recommended significant
restrictions on rights of conscience. For instance, the Report
"oblige[s] the healthcare providers to provide" (emphasis
added) abortion in cases of "emergency." "Emergency" here does not
mean what you and I would think; rather the term was defined in the
Report to include any threats to the woman's "health." "Health" is,
in turn, an endlessly elastic term stretched by courts to include
any situation, no matter how insignificant. In essence, the Report
would have required the sacrifice of conscience rights whenever an
abortion was vigorously sought.
The Parliamentary Assembly's vote would not, under
European laws, bind any state. But the political propaganda value of
such a vote against conscience would be immense. With a favorable
vote in hand, anti-life forces would be able to badger governments
to restrict conscience rights based on the argument that such a vote
represented a "European consensus." And, of course, anti-life
collaborators within those governments would readily agree that it
did. (This argument based upon an alleged "European consensus" has
been used by anti-life forces in other contexts as well, including
the recently-decided ABC v. Ireland abortion case.) My
pro-life European friends expected the McCafferty Report to pass
In the event, however, the vote turned out
to be a minor miracle. Instead of adopting the anti-conscience
recommendations of the Report, pro-life parliamentarians succeeded
in adopting recommendations much more favorable to conscience
rights. Yet they still required that healthcare providers refer
patients for those procedures to which "the patient is legally
entitled" (which includes abortion), but which the provider refuses
I recount all this to illustrate that
attacks on rights of conscience in health care are not limited to
the United States. They are going on everywhere. And I think it is
no exaggeration to see such rights as being dangerously at risk.
In the United States, we can expect conscience
rights to be restricted very soon. In December, in a lawsuit challenging the
conscience protection regulations enacted by the Department of Health &
Human Services (HHS) at the end of the Bush administration, but which remain
in effect and thus bind the Obama administration, government attorneys, on
behalf of the administration, informed the court, in writing, that HHS would
issue its "revision" of the Bush regulations by the end of this month - in
other words, by the end of February. The administration had issued an
"intent" to revoke those regulations in the first weeks of Obama's
presidency, but had not so far done so. Thus, the court forced the Obama
administration to make its intention clear. Now the question is whether the
Obama administration will "revoke" or "revise" or, as many think likely,
pretend to revise while doing so in a way that amounts to revocation. We
shall soon see.
Conscience protections under U.S. federal law are
disorganized and haphazard, consisting of three separate provisions, enacted
years apart. HHS under President Bush wished to clear up misunderstanding
about the extent of federal conscience protection and make sure HHS would
have regulatory authority to enforce it; its solution was to issue the
conscience protection regulations, which Obama is moving to rescind.
The mere existence of the regulations, however, is
no guarantee they will be enforced. For instance, Obama's HHS
seems disinclined to do so in a particularly egregious case, the case of
Nurse Cathy Cenzon-DeCarlo. She was required to participate in an abortion
despite conscience objections. A federal court, in a suit brought by
DeCarlo, held that individuals whose conscience rights under the federal law
were violated, nevertheless lack the right to sue to enforce those
laws. Enforcement, in other words, is left to HHS. So
far Obama's HHS has declined to do so.
Nurse DeCarlo is also pursuing a case in state court
in New York. In the United States as well as many other countries,
conscience protection is not left solely to national law. In the absence of
national law, the individual states are free to enact conscience
protections. Americans United for Life and other organizations have
developed model laws that can be adopted by state legislatures. Idaho
adopted AUL's comprehensive conscience protection model law last year,
though efforts are already underway by anti-life forces to amend it so that
healthcare providers must assist suicide, if Idaho legalizes it. Of all the
states, Alabama is most in need of enacting conscience protection laws.
The issue of conscience protection reduces to this:
should someone involved in healthcare (including institutions) be required
to perform - or to assist in, or to refer a patient to someone else who will
perform - a procedure he or she believes is morally wrong? With the
legalization of abortion and assisted suicide, anti-life advocates argue
that it is only reasonable that healthcare professionals should be required
to perform "legal medical procedures," and, unfortunately, much of the
public will agree, not recognizing the conscience issues hidden therein.
Freedom of conscience needs all the help it can get these
days, both within and outside the United States. Anti-life forces are
determined that freedom of conscience be eliminated. In this context, it was
regrettable that the Bush administration waited until the last days of its
eighth year to issue federal regulations. But it would be much worse if, as
expected, the Obama administration revokes them altogether.
Deseret News Editorial
13 January, 2011
Should healthcare providers be required to engage in
medical procedures, such as abortions, that violate their
individual moral or religious convictions?
The editorial opens with this question and compares
the approach taken by the Parliamentary Assembly of the
Council of Europe in affirming freedom of conscience
with current attempts in the United States "to dismantle
such rights of conscience protections." [Read
the full editorial]