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.

Conflicts of Conscience in Health Care: An Institutional Compromise

Conflicts of Conscience in Health Care: An Institutional Compromise (Basic Bioethics)Holly Fernandez Lynch

Review by Sean Murphy*  |. . .[the author] is seeking a compromise that will provide “maximal liberty for all parties.” She believes that freedom of conscience for physicians and the provision of legal medical services are both important social goals, and that they are not incompatible. . . . However, it is necessary to acknowledge what the author herself admits. In her view, the heart of the conscience clause debate is patient access to services. She has written a book about how to help patients obtain services when some of the gatekeepers who control access to them are uncooperative. It is not a book about freedom of conscience. . . . [Fulll text]

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.

Rights Commission threat “blasphemy against the human spirit”

College of Physicians secrecy said unacceptable

Protection of Conscience Project

For Immediate Release

“Blasphemy against the human spirit.” That is how the Protection of Conscience Project describes a threat by Ontario’s Human Rights Commission to punish doctors who refuse to do what they believe to be wrong. The rebuke is found in a submission to the College of Physicians and Surgeons of Ontario.

Citing writers and philosophers in the democratic tradition, as well as the landmark Morgentaler decision of the Supreme Court of Canada, the Project argues that to force doctors to act against their conscientious convictions is “to deprive them of their essential humanity.” It calls the proposed policy “profoundly offensive and demeaning.”

“To abandon one’s moral or ethical convictions in order to serve others is prostitution,” states the submission, “not professionalism.”

The brief denies that doctors who refuse to do what they believe is wrong are violating the Human Rights Code. It explains that they are concerned about “complicity in wrongdoing,” not race, sex or other patient characteristics.

The Project submission addresses the College draft policy, Physicians and the Ontario Human Rights Code. Deadline for comment on the policy was extended to 12 September following protests when news of it became public.

The President of the College told the National Post that the draft has been revised, but refuses to make it public. Project Administrator Sean Murphy finds College secrecy unacceptable.

“At least two substantial briefs reached the College only on Friday,” he said. “The National Post story appeared Saturday. It seems very unlikely that College officials could have considered either submission before revising the draft. This brings into question the validity of the consultation process.”

“But the more important issue,” he said, “is that decision-making that impacts fundamental freedoms should be conducted transparently, not secretly. Why keep the revised draft secret? Is there something to hide?”

-30-

Project Submission to the College of Physicians and Surgeons of Ontario

Re: Physicians and the Ontario Human Rights Code

(11 September, 2008)

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.

Moral Safeguards for Patients, Too

Letter to the Editor
The Washington Post

4 September, 2008

Reproduced with permission

Jonathan Imbody*

The misunderstanding expressed in the Aug. 26 letter, “Health Care’s Conscientious Objectors,” illustrates the need for the conscience-protecting regulation recently proposed by the Department of Health and Human Services.

The regulation would implement 35 years of civil rights laws passed by Congress to protect health-care professionals from discrimination, coercion and job loss for adhering to life-affirming ethical standards. The regulation would simply disallow forcing professionals to perform elective abortions and other procedures that violate millennia of medical ethics codes.

Contrary to the letter’s assertion, health-care professionals would continue to care as always for wounded soldiers, AIDS patients, post-abortive teenagers, felons and drunk drivers. In fact, the regulations would protect patient access to the compassionate, conscientious health-care professionals who are among the most dedicated to caring for such individuals.

Abortion Article Was Incorrect

Letter to the Editor
The Daily News,

Harrisonburg, VA
2 September, 2008

Reproduced with permission

Jonathan Imbody*

Shirley Kirkwood’s recent Open Forum wrongly suggests that a regulation proposed by the U.S. Department of Health and Human Services is somehow aimed at blocking contraception use (“Abortion Is A Religious Right,” Aug. 21).

That’s nearly as implausible a stretch as the notion that ending human lives is a religious right. The agency this year alone will spend over $1.6 billion on “family planning” programs.

What has been long established is the right to follow one’s conscience according to the dictates of faith and ethics.

That’s what the regulation will protect, as health care professionals push back against a culture that devalues life and work to restore life-affirming values such as those expressed in the Hippocratic Oath, the Judeo-Christian Scriptures and standards applied to medical ethics.