Hannah C. Smith
Last Friday, the Trump administration revised rules implementing the Affordable Care Act in a way that expands protections for religious and moral objectors to the contraception mandate — achieving the common-sense balance that religious organizations have sought for the past six years. These revisions allow religious nonprofits — like the Little Sisters of the Poor — to avoid millions of dollars in fines because their employee health insurance plans exclude coverage for contraception, a practice contrary to Catholic doctrine on respecting human life.
Judging by some media hyperbole, however, you would think that the federal government had just abolished the ACA’s birth control mandate altogether. Headlines that claim the federal government’s move “reverses” or “scraps” or “ends” the mandate are all wrong.. . .The vast majority of women in America will continue to receive free birth control, and religious objectors will not be forced into providing services that violate their conscience. . . [Full text]
Not so long ago, President Trump’s new guidelines for the Department of Health and Human Services for protecting freedom of religious faith would have been superfluous and unnecessary. A casual observer might have read them in puzzlement, as if the government had reaffirmed its opposition to robbery or murder.
But all that was before the Obama administration sought to bring those of religious faith to heel, ordering employers to pay for contraception devices and abortion-inducing drugs, even if it violated the conscience of employers. Under pressure, the Obama administration grudgingly exempted churches from its mandate, but employers affiliated with religious groups still were required to pay through third-party administrators.
The new guidelines, drawn up by the U.S. Justice Department, change that. The order does not prohibit employers paying such benefits, and many employers will continue to do so. Nor will anyone be deprived by the government of their condoms, diaphragms and other birth-control devices. But “going forward,” as the cliche goes, an employer will not be required by the U.S. Government to violate his conscience for the convenience of those hostile to religious faith. . .[Full text]
A new abortion law has been enacted in Bolivia as part of the revision of the country’s Penal Code. Section 153 of the Penal Code now permits abortion of any girl under the age of 20 for any reason and at any point in gestation, when pregnancy results from rape, incest or involuntary artificial reproduction. Abortion is also allowed at any point in gestation in the case of present or future risk to the life or “overall health” of a woman, and (when pregnancy is under 8 weeks gestation) the woman is a student or has the care of a disabled relative.
The protection of conscience provision prohibits “the national health system” from asserting conscientious objection and insists that conscientious objection is limited to individual medical personnel “directly involved in the accomplishment” of the procedure, and must be stated in advance. “The national health system” is not defined in the law. It would appear from this that private or denominational health facilities (if they exist) cannot establish policies prohibiting abortion.
The fact that abortion is permitted as an exception to a general prohibition should mean that medical personnel or institutions of the opinion that a women does not qualify for an abortion under one of the legal criterion (such as risk to “overall health”) cannot be compelled to participate. This would not constitute conscientious objection and could not be stated in advance.
Governor’s attempt to force referral overridden by Senate
A bill concerning the regulation of genetic counselling in Virginia has been enacted with the original protection of conscience provision intact. Identical versions of the bill had been passed unanimously by the Virginia House and Senate, but Governor Terry McAuliffe, apparently in response to lobbying from the American Civil Liberties Union (ACLU) and Planned Parenthood, attempted to insert a mandatory referral provision into the bill. This was rejected by the Senate. The law now requires an objecting counsellor to offer “to direct the patient to the online directory of licensed genetic counselors maintained by the Board.” [Family Foundation]
The Reproductive Health (Access to Terminations) Bill 2013 passed the Tasmanian Legislative Council 9-5 on 21 November [ The Examiner] and received Royal Assent today. Abortions after 16 weeks will require the approval of two physicians. The new Act includes a protection of conscience provision that exempts those who object to the procedure from participating in it, except when necessary to save the life of a woman or prevent serious physical injury. There is no requirement for referral, but an objecting physician must provide a woman “seeking a termination or advice regarding the full range of pregnancy options” a “list of prescribed health services” from which she may seek advice. Since, subject to the content of the list, this does not seem to be the equivalent of referral for abortion, the requirement may not be problematic for those concerned about indirect moral complicity.
What is not clear is whether or not the Act actually prohibits an objecting physician from providing information or advice about pregnancy options beyond the “prescribed” list. Section 7(4) states that an objecting physician may continue to “provide treatment, advice or counselling, in respect of matters other than a termination or advice regarding the full range of pregnancy options” (emphasis added) which could be taken to imply that an objecting physician is not permitted to offer a woman anything other than the prescribed list.
Representative Becky Nordgren of Alabama, is proposing a Health Care Right of Conscience Act in the state legislature. The bill is intended to protect all health care providers from being compelled to participate, directly or indirectly, in abortion, human cloning, human embryonic stem cell research, and sterilization if they object to the procedures for reasons of conscience. A health care provider must give an employer no less than 24 hours written notice of an objection. An exception is made in the case of a procedure necessary to save the life of a patient. Patricia Todd, a Representative apparently hostile to freedom of conscience for health care workers, asked “[W]hy are you in the health care profession if you don’t want to provide health care?” adding that there had been no attempts to regulate male impotence drugs or prostate exams. [Anniston Star]
Protection of Conscience Provision
The Protection of Life During Pregnancy Act 2013 became law in July, 2013. The protection of conscience provision is provided here in full within an abbreviated presentation of the entire act. Paraphrased parts of the bill are in italics. Mouseover the red text to see government comments that were provided in the “heads of bill” relevant to the text. Links to other information relevant to the law are in the first column to the right.
The following is the protection of conscience provision found in an assisted suicide
law. There is limited protection provided for health care facilities, which can prohibit their physicians from prescribing lethal medications for residents who wish to use them on their premises, but not from prescribing them for those who intend to use them elsehwere. [Protection of conscience provision]
The Act legalizing abortion in Uruguay, passed in the fall of 2012, includes two protection of conscience provisions.
Section 10 provides protection for existing health care institutions that are part of the National Integrated Health System if they had ideological objections to abortion at the time the law was enacted. They are not required to provide abortion, but “may” reach an agreement with the Ministry of Public Health to arrange for their patients to have abortions elsewhere. If “may” is understood to mean that such arrangements are optional, institutional freedom of conscience will not be compromised. However, it appears that all hospitals that are part of the National Integrated Health System that are opened from this point on will be required to provide abortions.
Section 11 allows conscientious objection by health care workers, but this is limited by the meaning given to “health” in Section 6A.
[Protection of concience provisions: Spanish/English]