Obama Administration Guts Healthcare Conscience Regulation

National Right to Life News
21 February 2011
Reproduced with permission

Jonathon Imbody*

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.

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.


Christian Medical Association: Contraception mandate fits pattern of assaults on conscience and religious liberty

NEWS RELEASE

Christian Medical Association

Washington, DC–February 9, 2012: The 16,000-member Christian Medical Association today issued a statement asserting that the government’s mandate of contraception coverage nationwide fits a growing pattern of assaulting and restricting First Amendment freedoms of conscience and faith.

CMA CEO Dr. David Stevens noted, “The government contraception mandate violates the First Amendment rights and sensibilities of any individual or organization morally committed to life-honoring faith principles. The coercion likewise tramples the conscience rights of health care professionals ethically committed to the historic Hippocratic oath. And it fits a deplorable pattern of disregard for First Amendment freedoms.

“In the past three years, people of faith and conscience have witnessed the gutting of the only federal regulation protecting the exercise of conscience in health care; the denial of federal grant funds for aiding human trafficking victims because a faith-based organization refused to participate in abortion; the administration’s lobbying of the Supreme Court to restrict faith-based organizations’ hiring rights; and a coercive contraceptive mandate that imposes the government’s ideology on the faith-based and pro-life communities.

“The contraception mandate’s affront to religious freedom actually extends well beyond the Catholic Church, since many physicians and patients outside the Catholic tradition hold that it is morally or ethically wrong to risk ending the life of a developing human being by using pills such as ella and the morning-after pill. These pills are falsely promoted as ordinary contraceptives despite clear FDA label warnings that ‘ella may also work by preventing attachment (implantation) to the uterus’ and that the morning-after pill (Plan B) “may inhibit implantation by altering the endometrium.'”

“To force every American to subsidize an ideological agenda that many find morally or ethically abhorrent is the antithesis of American First Amendment freedoms of religion and conscience.

“The First Amendment issue of religious and conscience liberty impacts Americans of all political stripes. Conscience freedoms protect Americans left, right and center, on issues ranging from abortion to the death penalty, from participation in war to the right to protest political actions such as we are witnessing now.

“Every American, regardless of political persuasion, should be protesting these assaults on our freedoms and contacting legislators to enact conscience-protecting legislation such as the Respect for Rights of Conscience Act, introduced in the House by Jeff Fortenberry (R-Neb. 1st) and in the Senate by Roy Blunt (R-Mo.).

“As Dr. Martin Luther King reminds us, ‘Injustice anywhere is a threat to justice everywhere.'”

To remedy the assault on religious liberty and conscience freedoms, the Christian Medical Association supports the following legislation:

Christian Medical Association calls HHS regulation an assault on First Amendment

The 16,000-member Christian Medical Association has protested the Obama admininstration’s plan to force objecting employers to provide insurance coverage for surgical sterilization, contraceptives, and  embryocidal drugs.  CMA CEO Dr. David Stevens said that the regulation “violates the First Amendment rights and sensibilities of any individual or organization morally committed to life-honoring faith principles,” adding that it  “tramples the conscience rights of health care professionals” and  “fits a deplorable pattern of disregard for First Amendment freedoms.” [News release]

 

CMA Physicians, former HHS Asst. Secretary decry Obama administration’s regulatory action on conscience and discrimination.

NEWS RELEASE

Christian Medical Association

Washington, DC, February 18, 2011 — The 16,000-member Christian Medical Association (CMA, www.cmda.org) today protested the decision of the Obama administration to weaken the only federal regulation protecting the exercise of conscience in health care.

Dr. J. Scott Ries, a board-certified family physician and CMA’s vice president for Campus & Community Ministries, said, “The administration has made changes in a vital civil rights regulation without evidence or justification. The administration presented no evidence of any problems in healthcare access, prescriptions or procedures that have occurred in the two years since the original regulation’s enactment that would justify any change in this protective regulation.

“The administration, for example, contends that a rule change is necessary to protect access to contraception, but absolutely no evidence is presented to justify any such concern. In the process, the administration blatantly ignores the scientific evidence that certain controversial prescriptions that abortion advocates promote as contraception are actually potential abortifacients, ending the life of a living, developing human embryo. This is a critical concern for pro-life patients, healthcare professionals and institutions.”

The U.S. Department of Health and Human Services indicated in 2008 in its final rule, “We have found no evidence that these regulations will create new barriers in accessing contraception unless those contraceptives are currently delivered over the religious or moral objections of the provider in such programs or research activities.”

Dr. Ries added, “The Obama administration’s regulatory action today diminishes the civil rights that protect conscientious physicians and other healthcare professionals against discrimination. Any weakening of protections against discrimination against life-affirming healthcare professionals ultimately threatens to severely worsen patient access to health care.

“Losing conscientious healthcare professionals and faith-based institutions to discrimination and job loss especially imperils the poor and patients in medically underserved areas. We are already facing critical shortages of primary care physicians, and the Obama administration’s decision now threatens to make the situation far worse for patients across the country who depend on faith-based health care.”

National survey results show that over nine of ten faith-based physicians, who are among the most likely to be serving the poor and those in medically underserved areas, indicate they would rather leave the profession if denied the ability to practice medicine according to conscientiously held ethical standards. Survey results also indicate that 20% of faith-based medical students say they are “not pursuing a career in Obstetrics or Gynecology” because of perceived discrimination and coercion in that field.

Dr. Ries added, “Stories told to me by medical students across the country indicate that the threat of being forced to participate in abortion procedures and violate their moral integrity is enough to steer them in the opposite direction. That means even fewer physicians for women in the future in this specialty that is already facing critical shortages.

Former U.S. Assistant Secretary of Health Dr. Joxel Garcia noted, “Especially in physician shortage states such as Texas, Georgia, Alabama, Mississippi, Oklahoma, Utah, Nevada, Idaho and Delaware, losing just one physician can erase healthcare access for thousands of patients.

“Pushing conscientious physicians out of medicine is a significant step toward a healthcare system controlled by the state that moves away from the ethical roots of medicine. In the new governmental utilitarian model, the ‘common good’ defined by the state supersedes any moral, religious or ethical principle such as embodied in the Hippocratic Oath, which has protected patients for millennia.”

As the second-in-command under Sec. Mike Leavitt at the U.S. Dept. of Health and Human Services (HHS), Dr. Garcia oversaw the development and implementation of the conscience regulation and continues to work closely with the CMA and others to protect conscience rights. He currently serves as President and Dean at the Ponce School of Medicine & Health Sciences, where CMA provides a medical student ministry, as it does on over 90 percent of the nation’s medical and dental school campuses.

Dr. Ries’ clinical career has included faculty appointments at Indiana University School of Medicine and Butler University; he has also served as medical consultant to NBC, CBS, FOX and ABC network affiliates.

A matter of conscience

Washington Times
17 December, 2008

Reproduced with permission

Jonathan Imbody*

Americans blanch at abortion coercion in China, where population control agents force mothers to end the lives of their unborn babies who exceed the mandated limit of one child per couple. Yet few Americans realize that abortion-related mandates are also threatening to U.S. health care professionals who follow medical standards such as the Hippocratic Oath.

Conscientious physicians and other health care professionals are being pressured, under threat of job loss, to violate medical ethics standards by performing abortions and referring patients to abortion clinics to do the deed.

Abortion advocates have been lobbying vociferously to cast abortion as standard medical care and to mandate abortion participation by all health care professionals. Only a tiny fraction of U.S. physicians otherwise are willing to violate the Hippocratic Oath, which has guided medicine for well over two millennia, by participating in abortions.

The abortion mandate strategy may be ill-conceived, but unfortunately it is not ill-fated.

Abortion, which neither heals nor comforts, does not qualify as standard medical care under historical medical standards; it has only recently and politically infiltrated health care. Since American health care professionals have long enjoyed a measure of autonomy in making professional decisions, mandating participation in a procedure prohibited by long-standing medical ethics standards seems likewise implausible.

But abortion ideology and zeal have a way of trumping all notions of ethics and professionalism.

Aggressive abortion mandate advocates dominate the American College of Obstetricians and Gynecologists (ACOG), a highly politicized medical specialty group with vast influence over the profession of obstetrics and gynecology. Last November, ACOG issued an official ethics statement tellingly entitled, “The Limits of Conscientious Refusal in Reproductive Medicine.” The ACOG statement ignores the role of objective standards in conscientious objections to abortion. ACOG instead denigrates conscience as a mere subjective “sentiment.” In reality, however, health care professionals who object to abortion do so not because of subjective feelings but because killing the unborn contravenes Hippocratic, biblical and other life-affirming objective ethical standards.

By contrast, abortion ideology rests on the subjective, unanchored notion of “privacy” and “patient autonomy.” By ripping conscience from its foundation of objective standards and demoting it to the level of subjective feelings, ACOG paints abortion objections as a clash between a physician’s feelings and a patient’s autonomy. With autonomy elevated as the ethical trump card, physicians and all ethical standards must bow in submission.

Having demoted conscience to the subjective realm and elevated patient autonomy to a position of unchallengeable supremacy, ACOG opposes faith-based ethical standards as “an imposition of religious or moral beliefs on patients.”ACOG even incredibly contends that pro-life obstetricians should not only be required to perform or refer for abortions; they should also relocate their practices close to abortionists to make such referrals more convenient.

Given the official link between ACOG ethics positions and physician board certification, obstetricians who refuse to follow ACOG’s abortion mandate now presumably stand to lose their hospital privileges and their livelihood. Medical ethics thus would be turned upside down, as life-honoring physicians lose the ability to practice medicine simply for following the Hippocratic Oath.

Meanwhile, the abortion mandate movement will soon tap potentially irrepressible numbers in Congress and powerful advocates in the White House and the administration.

President-elect Barack Obama, Sen. Hillary Clinton and other abortion advocates have strenuously opposed a modest U.S. Department of Health and Human Services (HHS) regulation that would ensure freedom of conscience in health care. The regulation would finally implement over 35 years of federal civil rights law aimed at protecting health care professionals from abortion-related coercion.

The HHS regulation, expected to be finalized before Dec. 20, could be overturned by a pro-abortion Congress and president, either through new legislation or a new regulation.

Mandating abortion participation in health care is rife with irony. Most Americans easily recognize the hypocrisy of forcing “pro-choice” ideology on all health care professionals. The injustice of ending the lives of innocent unborn children has only persisted in this country, where most citizens oppose abortion on demand, under the smokescreen of choice.

By driving out pro-life obstetricians and gynecologists who refuse to participate in abortions, abortion mandates would ironically decrease women’s access to some of the most conscientious and compassionate physicians in America, many of whom volunteer free medical services to poor women. Abortion mandates threaten to shut down thousands of life-affirming, faith-based hospitals and clinics that provide care in some of the nation’s most underserved communities.

Maybe that’s what it will take for Americans to penetrate the fog of abortion propaganda and recognize that breaching the foundational right to life imperils all other rights.

Don’t doctors deserve a choice on abortion?

Letter to the Editor
Baltimore Sun

13 November, 2008

Reproduced with permission

Jonathan Imbody*

The acerbic editorial “Bush rules” (Nov. 11) ironically accuses the Bush administration of attacking “personal rights” and then lambastes the U.S. Department of Health and Human Services for proposing a regulation to protect the civil rights of health care professionals.

The Baltimore Sun protests “extending the right to refuse to participate in an abortion to include an array of health care workers.” Which medical professionals does the paper deem unworthy of civil rights so that they should be forced to violate their conscience and the Hippocratic Oath?

Thankfully, shortly after the Supreme Court in Roe v. Wade wrested decision-making control from the states and the people, a prescient Congress began passing laws to prevent coercion and discrimination against health care professionals on both sides of the abortion debate. Yet three major civil rights laws have never been implemented. Meanwhile, “pro choice” advocates, provoked by the fact that the vast majority of physicians refuse to perform abortions, have resorted to seeking to require participation in abortion.

A recent official statement of the American College of Obstetricians and Gynecologists not only requires that physicians perform or refer for abortions but also demands that pro-life physicians relocate in order to refer patients to nearby abortion clinics. Our members report losing jobs and promotions over their commitment to life-affirming standards. The proposed HHS regulation is urgently needed to protect compassionate and conscientious physicians who are simply extending the life-affirming ethic and patient protections of the Hippocratic Oath.

Proposed rule would protect doctors from discrimination

The Hill
24 September, 2008

Reproduced with permission

Jonathan Imbody*

The uproar over a modest proposal by the Department of Health and Human Services (HHS) reveals a widening culture chasm in healthcare, created by disparate views of medical ethics and civil rights.

When HHS recently proposed a regulation to finally implement 35 years of civil liberty laws protecting conscience rights in health care, opponents railed against an alleged conspiracy to “deny women access to contraception.”

That’s quite an implausible protest against an agency that this year will spend over $1.6 billion on “family planning” programs.

The real reason for the abortion lobby’s protest stems from years of frustration in attempts to persuade physicians to violate their commitment to heal and to the Hippocratic Oath’s prohibition on abortion and the mandate to “do no harm.” The last remaining strategy to achieve their goal of involving more physicians is to literally force them to perform or refer patients for abortions, through state laws and medical organization policies forbidding the exercise of conscientious objection.

The only thing standing in the way of that coercive agenda is implementation of federal civil rights law.

Ironically, coercive laws and policies, though instigated in the name of insuring access to women’s healthcare, in fact threaten to significantly decrease access — by eliminating physicians who hold to life-affirming standards of medical ethics.

Discrimination and coercion appear to be infiltrating many sectors of medicine. Over 40 percent of our members report having experienced pressure to compromise their commitment to medical ethics standards. Medical school applicants with life-affirming values report discrimination in entrance interviews. Residents report being denied clinical learning opportunities because they refused to perform abortions. Physicians report the loss of jobs and academic promotions based on their life-affirming stances.

The public likewise remains ignorant of existing federal civil rights protections. A scientific national survey by The Polling Company Inc. revealed that 42 percent of American adults incorrectly believe that federal law obliges a physician to either perform or refer for abortions.

The HHS regulation is urgently needed to remedy discrimination and coercion in healthcare before patients lose access to some of our bestand most compassionate medical professionals.

By implementing existing conscience-protecting laws and by initiating education, the regulation can take a vital step toward restoring a culture in medicine that honors professional standards and respects civil rights.

Re: Sept. 8 editorial “Leavitt should drop proposed health care rule.”

Letter to the Editor
Austin American Statesman

15 September, 2008

Reproduced with permission

Jonathan Imbody*

The editorial characterizes as “a back-door way to limit access to contraceptives” a regulation recently proposed by the U.S. Department of Health and Human Services to protect conscience rights in health care.

The regulation in no way prohibits access to either contraception or abortion. The regulation merely implements 35 years of civil rights laws to protect health care professionals from discrimination merely for adhering to life-affirming medical ethics such as the Hippocratic Oath.

More than 40 percent of our members — physicians and medical students — report that they have experienced pressure to violate standards of medical ethics. Medical students report eschewing careers in obstetrics and gynecology for fear of coercion to do abortions.

This regulation is urgently needed to prevent forcing these principled professionals out of their careers through discrimination and coercion, which results in less access to health care for women.

Rules let care workers practice medical ethics

Letter to the Editor,
Detroit News,

6 September, 2008

Reproduced with permission

Jonathan Imbody*

Laura Berman’s Aug. 26 column, “Keep the choice in hands of patients,” mischaracterizes a conscience-protecting regulation recently proposed by the U.S. Department of Health and Human Services as somehow pitting “health care workers with strong religious and moral beliefs against women needing care.”

The regulation would finally implement 35 years of civil rights laws passed by Congress to prevent discrimination and coercion against health care professionals who adhere to life-affirming standards of medical ethics such as the Hippocratic Oath. Such standards not only affirm the inherent value of the unborn and the elderly; they also aim to protect patients from sexual abuse, financial exploitation and violation of privacy in healthcare.

Two of five of our members report being pressured to violate standards of medical ethics. Residents report being denied clinical privileges for refusing to perform abortions. Medical students report switching out of obstetrics and gynecology for fear of reprisals and coercion to do abortions. The pro-abortion American College of Obstetricians and Gynecologists recently issued a position statement that all obstetricians are obliged to participate in abortion. Conscientiously objecting physicians face an implicit threat of loss of licensure.

The real threat to choice comes from perpetuating these violations of healthcare professionals’ civil rights, which ultimately results in patients losing access to their most compassionate and conscientious physicians.