Lisa H. Harris
In January, the U.S. Department of Health and Human Services (HHS) announced the creation of its Conscience and Religious Freedom Division, explaining that it will allow HHS’s Office of Civil Rights to “more vigorously and effectively enforce existing laws protecting the rights of conscience and religious freedom” and will ensure that “no one is coerced into participating in activities that would violate their consciences, such as abortion, sterilization or assisted suicide.”1 Responses were as expected: religious conservatives hailed the new division as a needed intervention; public health and clinical leaders and advocates decried it, worrying about its impact on access to care and harm to patients. . .
Harris LH. Divisions, New and Old — Conscience and Religious Freedom at HHS. N Engl J Med 2018; 378:1369-1371. DOI: 10.1056/NEJMp1801154
Obstetrician Lisa Harris, whose column in the New England Journal of Medicine asserted that protection of conscience laws fail to recognize that abortion providers are motivated by conscientious convictions, repeated her arguments in an interview with the New Scientist magazine. While she admitted that the circumstances of the death of Savita Halappanavar in Ireland are not clear, she speculated that the Halappanavar might not have died had an abortion been provided. She stated that similar problems arise in denominational hospitals in the United States. She described the case of a woman who was referred to her with a “septic abortion ” because the foetus was still alive, and the religiously affilicated hospital where she was first treated would not induce an abortion. [New Scientist]
N Engl J Med 2012; 367:981-983
The exercise of conscience in health care is generally considered synonymous with refusal to participate in contested medical services, especially abortion. This depiction neglects the fact that the provision of abortion care is also conscience-based. The persistent failure to recognize abortion provision as “conscientious” has resulted in laws that do not protect caregivers who are compelled by conscience to provide abortion services, contributes to the ongoing stigmatization of abortion providers, and leaves theoretical and practical blind spots in bioethics with respect to positive claims of conscience — that is, conscience-based claims for offering care, rather than for refusing to provide it.[Full Text ]