Project Logo

Protection of Conscience Project

Service, not Servitude
Subscribe to me on YouTube

News Commentary 2011

Conscience Clauses Needed Worldwide for Medical Professionals

Mary Meets Dolly
17 December, 2011
Reproduced with permission

Rebecca Taylor*

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 clinic door.

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 wrong?

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 decisions.

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.

New birth control requirements are a loss for conscience

Desert News
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 Americans.

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 more]

Obama Administration Rejects Conscience Protections

The Heartland Institute
30 March, 2011
Reproduced with permission

 William Saunders* 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.

Protection Removed

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. 

Obama Administration Guts Healthcare Conscience Regulation

National Right to Life News
21 February 2011
Reproduced with permission

Jonathon Imbody

On February 18 the Obama administration gutted the only federal regulation protecting conscientious healthcare professionals from discrimination.

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 rightful place."

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 underserved areas.

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, Freedom2Care

Conscience Protection at Risk

The Catholic Thing
17 February 2011
Reproduced with permission

William Saunders*

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 easily.

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 to perform.

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.

Protect conscience clause

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]