“Choose, You Lose” Scheme Threatens All Ethical Professionals

Jonathon Imbody

The increasingly aggressive discrimination in recent years against religious and pro-life healthcare professionals and students[1] parallels a concentrated effort by abortion proponents to undermine the rationale for conscience protections in healthcare. Desperate abortion advocates apparently have concluded that the way to counter the medical community’s resistance to abortion is through coercion.

Coercion appeals to some activists because coercion is much quicker than persuasion in effecting change. If abortion activists can eliminate conscience protections, then health professionals can be forced to participate in abortion or else sacrifice their careers. .

American principles protect conscience even at a price

Affordable Care Act architect Dr. Ezekiel Emanuel and University of Pennsylvania professor Ronit Stahl lay the foundation for getting rid of healthcare conscience protections, in a New England Journal of Medicine opinion piece entitled, “Physicians, Not Conscripts — Conscientious Objection in Health Care.”[2]

Their message is simple: Choice is a one-way street. Patients get to choose; doctors don’t—at least not after they enter the medical profession.

Emanuel and Stahl attempt to establish this radical principle by postulating a sharp distinction between conscience accommodations for military draftees and conscience accommodations for physicians.

Emanuel and Stahl write,

Although this [conscience healthcare protection] legislation ostensibly mimics that of military conscientious objection, it diverges considerably. Viewing conscientious objection in health care as analogous to conscientious objection to war mistakes choice for conscription, misconstrues the role of personal values in professional contexts, substitutes cost-free choices for penalized decisions, and cedes professional ethics to political decisions.”[3]

In the United States, a pacifist opposed to the military draft can receive a conscientious exemption from combat duty, even during a time of war when every other able-bodied citizen his age is expected to fight to defend the national interest. The cost to the country is high if counted in terms of fewer soldiers available for active duty.

Yet the authors would countenance no such rights, no such accommodation of cost, to a pro-life physician who cannot on the basis of conscience end the life of a developing baby in an elective abortion. While permitting the pacifist draftee a conscientious objection to killing, the authors contend, government must deny the same objection by a health professional.

Why? According to Emmanuel and Stahl, the reason is that physicians choose their professions, whereas draftees do not choose to join the military. . .[Full text]

Contraceptive Coverage and the Balance Between Conscience and Access

Ronit Y. Stahl,PhD; Holly Fernandez Lynch, JD, MBE

When the Obama administration included contraception in the essential benefits package to be covered by employer-sponsored health insurance plans under the Affordable Care Act, it sought to preserve access for women while addressing the concerns of employers with religious objections. Although the accommodations and exemptions were not enough for some employers, balance was the ultimate goal. This also was reflected in Zubik v Burwell, the Supreme Court’s most recent decision on the matter; on May 16, 2016, the justices remanded the litigants to the lower court so they could be afforded the opportunity to reach a compromise between religious exercise and seamless contraceptive coverage. No further compromise was forthcoming.

Now the Trump administration has rejected balance as a worthwhile goal.1 Its new contraceptive coverage rules, released on October 6, 2017, prioritize conscientious objection over access.2,3 The rules take effect immediately, and new legal challenges, this time on behalf of patients rather than objecting employers, have already begun.4 The new rules preserve the default requirement that employers must include free access to contraceptives as part of their insurance plans. However, the rules now exempt employers with religious or moral objections to contraceptives, without requiring any alternative approaches to ensure that beneficiaries can obtain contraceptives at no cost.2,3
[Full Text]


Stahl RY, Lynch HF. Contraceptive Coverage and the Balance Between Conscience and Access. JAMA. Published online October 19, 2017. doi:10.1001/jama.2017.17086

New England Journal of Medicine publishes “attack on medical conscience”

Pro-Lifers: Get Out of Medicine!

First Things

Wesley J. Smith

Doctors in the United States cannot be forced to perform abortions or assist suicides. But that may soon change. Bioethicists and other medical elites have launched a frontal assault against doctors seeking to practice their professions under the values established by the Hippocratic Oath. The campaign’s goal? To force doctors, nurses, pharmacists, and others in the health field who hold pro-life or orthodox religious views to choose between their careers and their convictions.

Ethics opinions, legislation, and court filings seeking to deny “medical conscience” have proliferated as journals, legislative bodies, and the courts have taken up the cause. In the last year, these efforts have moved from the relative hinterlands of professional discussions into the center of establishment medical discourse. Most recently, preeminent bioethicist Ezekiel Emanuel—one of Obamacare’s principal architects—coauthored with Ronit Y. Stahl an attack on medical conscience in the New England Journal of Medicine, perhaps the world’s most prestigious medical journal. When advocacy of this kind is published by the NEJM, it is time to sound the air raid sirens. . . [Full text]

 

Physicians, Not Conscripts — Conscientious Objection in Health Care

Ronit Y. Stahl, Ezekiel J. Emanuel

Conscientious objection laws give health care professionals the legal right to refuse, on the basis of personal beliefs, to perform certain procedures or care for particular patients. The authors argue that professional societies should declare conscientious objection unethical.

 

 


Stahl RY, Emanuel EJ.  Physicians, Not Conscripts – Conscientious Objection in Health Care. N Engl J Med 2017; 376:1380-1385 April 6, 2017 DOI: 10.1056/NEJMsb1612472