News Commentary 2006
The Oregonian
June 23, 2006
Reproduced with permission
Jonathan Imbody
Senior Policy Analyst
Christian
Medical Association
The editorial, "Pushing back on
'morning-after' access" wrongly casts an
unconscionable decision by the Oregon Board of
Pharmacy as a valiant attempt to "push back
against efforts to restrict access to the
'morning-after pill.'"
Newspaper editors may not
recognize a drug's dangers, but they should
readily recognize threats to our First Amendment
freedoms--our rights of free speech and the
right to freely exercise our religious beliefs.
If a state pharmacy board
can force pharmacists to violate their own
religious beliefs by filling or referring a
prescription for a potential abortifacient like
the "morning-after pill", what meaning does
religious freedom have?
If a pharmacy board can
forbid pharmacists from what is snidely labeled
"sermonizing to patients" about negative aspects
of the pill, what meaning does free speech have?
How does muzzling the pharmacist serve the
interest of a patient who deserves full
disclosure of all the facts?
Wherever one stands on the
abortion debate, it should be clear that
restricting the rights of free speech and free
religious expression of one group of citizens
represents a threat to all citizens. If we allow
such selective abridgements of freedoms, we may
wake up the next morning only to find our own
rights stolen as well.
News and Views
Christian Medical and Dental Associations
6 April, 2006
Reproduced with permission
RedNova. March 28, 2006--Dr. Joanna Stacey,
who has a small practice at Carilion Gynecology
in Roanoke, has made a conscious decision never
to perform an abortion. Salem oncologist William
Fintel counsels about one patient a year against
the idea of physician-assisted suicide. John
Reuwer, an emergency room doctor at Carilion New
River Valley Medical Center, said when women
come in for emergency contraception -- even in
the case of sexual assault -- and he is the only
doctor on duty, he will refer the case to
another doctor who has less of a problem
dispensing what is commonly known as the
morning-after pill. Stacey, Fintel and Reuwer
are members of the Christian Medical & Dental
Associations.
Faith and values, and their implications, are
factors in emergency rooms, family practices,
residency programs, hospital bioethics
committees and operating rooms in the Roanoke
and New River valleys. Issues of conscience are
coming up increasingly as medical developments
in reproductive technology and at the end of
life raise ethical concerns. Some of the doctors
interviewed for this story said they make
decisions based on their conscience about issues
such as emergency contraception, referrals for
abortions and end-of-life care. But some people
question whether patients are ill-served when
health care providers make decisions based on
their conscience.
The right of conscience has recently made
headlines. Pharmacists in Illinois have sued
Walgreens for firing them for not dispensing
emergency contraception. Anesthesiologists in
California have refused to participate in an
execution. Should a health care provider decide
not to treat a patient, however, a claim of
abandonment could arise, according to a Roanoke
attorney who specializes in health law. The
question of whether future doctors plan to learn
how to perform an abortion comes up early in
their medical careers. Problems arise when
patients have not made their wishes clear in
legal documents such as advance directives and
living wills.
Gene Rudd, MD: "Right of
conscience: the freedom to act based on what
we believe is right and wrong. Imagine a
society in which this right is taken away.
But we do not need to labor our
imaginations; we need only recall the sad
state of cultures that have done this.
"God first came up with this idea. Many
Scriptures address the importance of
conscience - weak and guilty versus good
conscience. While we are reminded of the
consequences (bad and good) of acting on
consciences (weak and good), I could find
nothing to suggesting that God would deny us
that right.
"CMDA does not deny the right of
conscience to its members. To become
members, we sign a Statement of Faith saying
that we agree on a few basic tenets of the
Christian faith (e.g., Father, Son, Holy
Spirit, and the Bible), but we are free to
follow our conscience concerning the many
positions taken by the Associations. Our
most fundamental positions, the CMDA Ethical
Statements (also called Standards for Life),
are voted on by the representative bodies of
the membership. Nevertheless, we are free to
disagree and behave as such.
"But some in our society want to take
away that right from those who provide
healthcare. Two of the many dangers of doing
this are highlighted by these questions: Do
we really want to be cared for by doctors
who are forbidden from standing by their
convictions? Secondly, if society can take
away this right from one class of citizens,
who will be next?"
[Ref. Jen McCaffery.
"Guided By Conscience." RedNova. March 28, 2006.
Also "Guided
By Conscience" in the Roanoake Times, 25
March, 2006]
BreakPoint
March 20, 2006
Printed with permission of
Prison
Fellowship
Heather Williams spent five years working
as a pharmacist at a Target store in St.
Louis. During that time, Target accommodated
Williams's desire not to take part in
dispensing the morning-after pill-the drug
that causes the abortion of an embryonic
human being. But then Planned Parenthood
threatened to boycott the Target chain over
Williams's employment-so Target fired her.
Now, there are more than three hundred
other pharmacies in St. Louis. So this was
not a matter of great public concern.
Pharmacists are not the only health-care
providers under attack for obeying the
demands of their conscience. Catholic
hospitals are pressured to offer abortion
services. And at some medical schools,
students are told it's not enough to learn
how to remove a deceased fetus from a
patient: They must also take part in the
abortion of live fetuses-even
though they are learning nothing new,
because the procedure is identical. The
reason? It's indoctrination.
Now, here's the great irony: These
attacks on pharmacists are coming at the
very time that the California Medical
Association is attempting to bar doctors
from getting involved in death-row
executions-even if the doctors have no
objections to taking part. You can't kill
murderers, but you must kill babies.
Health-care providers, it appears, are
allowed to have a conscience, so long as
those consciences object only to politically
correct moral evils.
Some observers, like the Washington
Post, argue that the moral objections
of pharmacists must be sacrificed if they
interfere in medical decisions made between
doctors and patients. This argument is both
ethically confused and false. For every
pharmacist who refuses to dispense the
morning-after pill, there are hundreds who
will. So what is really going on here?
What's going on is an effort to silence
any reminder, any public witness, that
abortion is a moral evil, an offense against
God. On some level, you see, abortion
advocates know that killing unborn children
is wrong. In Romans, Paul says that even the
pagans know God's moral law because it is
"written on their hearts, their consciences
also bearing witness." Those who become
incensed at the witness of people like
Heather Williams are caught up in the
age-old rebellion of the human race against
its Creator. They cannot bear even the
mention of the God whom they have rejected,
or of His laws.
That is why it's not enough for abortion
promoters that the morning-after pill is
legal and readily available. In order to
live with their own consciences, they need
unanimous assent that abortion is a moral
good. And that means silencing those whose
words and actions testify otherwise.
But freedom of conscience goes to the
very heart our form of free government. This
is why we need legislation to protect the
rights of those who object to getting
involved, not only in abortion, but in
embryonic research, cloning, assisted
suicide, and assisted reproduction.
You can find out what your own state
needs to do to protect the conscience rights
of health-care workers by visiting our
BreakPoint website (www.breakpoint.org).
And explain to your neighbors what's really
going on when abortion advocates try to shut
down those who act out of conscience: Those
who do are an uncomfortable reminder to
others that they are violating the most
basic laws of God and of human decency.
Comment:The commentary refers to the morning-after
pill as an abortifacient, without further
qualification. The drug can prevent the
implantation of an embryo and thus cause its
death, which many objectors consider to be
the moral equivalent of abortion. However,
it can also act by preventing ovulation and
by interfering with sperm transport so as to
prevent conception, in which case it has a
contraceptive rather than abortifacient
effect. The distinction does not affect the
principle espoused in the commentary - that
freedom of conscience ought to be respected
- nor the author's opinions about some of
the reasons for opposition to freedom of
conscience. [Administrator]
20 March, 2006
Frances Kissling, who, for political
purposes, purports to have some
association with the Catholic Church,
poses the rhetorical question, "Does
Church doctrine trump rape victims'
needs?" (Hartford Courant, 19
March, 2006). The title of her column
illustrates the old problem of getting
the wrong answers by asking the wrong
questions.
Catholics who are faithful to the
teaching of their Church are not the
only religious believers who object to
the use of post-coital drugs or devices
when it is possible that they may cause
the death of an early embryo. Indeed,
such objections could be made by avowed
atheists or agnostics who believe, for
non-religious reasons, that the
existence of a human embryo is a factor
to be considered along with the needs of
a rape complainant. For conscientious
objectors, the key point is not Catholic
doctrine, but the possible presence of
another human individual and the moral
obligations added by that
circumstance to their obligations to the
complainant.
Ms. Kissling would have her readers
believe that this is not an issue,
citing unidentified "scientific and
medical evidence" that what she calls
emergency contraception "acts before a
pregnancy occurs." Leaving aside the
definition of 'pregnancy,' Ms. Kissling
does not disclose that this statement
involves at least one of two
presumptions, one false, the other
unexamined: that post-coital drugs and
devices act only by preventing
fertilization, and that the presence of
an early embryo prior to implantation is
of no moment in moral reasoning.
In fact, post-coital drugs like
'Plan-B' may not prevent fertilization,
but may cause the death of an early
embryo by altering the endometrium and
preventing implantation.1
This is even more clearly so
in the case of the copper Intrauterine
Device (IUD),2
which is installed for so-called
'emergency contraception' up to five
days after ovulation.3
Conscientious objection does not
normally arise in cases involving rape
complainants if it can be established
that ovulation has not taken place or
that fertilization has not occurred,
because it is then unnecessary to
consider the needs of an embryonic human
individual in addition to the needs of
the complainant. Only when conception
may have occurred does a health care
provider face the question: is one
justified in deliberately or negligently
killing the embryo at the request of the
complainant?
This is a moral question
forced upon us by scientific knowledge
and medical capabilities. For Ms.
Kissling, the answer is clearly, "Yes,"
and she expects all "decent people" to
agree with her. Indeed, she is so
confident of the infallibility of her
moral judgement that she would impose it
even on health care workers who
disagree. This is a most peculiar
position for someone who publishes a
quarterly called Conscience and
who claims to be an advocate for freedom
of conscience.
Perhaps, in Ms. Kissling's view,
freedom of conscience belongs only to
people who are decent enough to agree
with her. A more generous and
enlightened approach is preferable in a
liberal democracy.
Sean Murphy, Administrator
Protection of Conscience Project
Notes
1. "Postcoital birth control pills
('morning after pills')
may be prescribed in an emergency (e.g.,
following sexual abuse). Ovarian
hormones (estrogen) taken in large doses
within 72 hours after sexual intercourse
usually prevent implantation of the
blastocyst, probably by altering tubal
motility, interfering with corpus luteum
function, or causing abnormal changes in
the endometrium. These hormones prevent
implantation, not fertilization.
Consequently, they should not be called
contraceptive pills. Conception occurs
but the blastocyst does not implant. It
would be more appropriate to call them
'contraimplantation pills'. Because the
term 'abortion' refers to a premature
stoppage of a pregnancy, the term
'abortion' could be applied to such an
early termination of pregnancy." Keith
L. Moore and T.V.N. Persaud, The
Developing Human: Clinically Oriented
Embryology (6th ed.) Philadelphia:
W.B. Saunders Company, 1998, p. 532.
Quoted in
A One-Act Drama: The Early Human
Embryo:'Scientific' Myths and Scientific
Facts: Implications for Ethics and
Public Policy, Medicine and Human
Dignity, note 23. "International
Bioethics Conference, 'Conceiving the
Embryo'"Centre Culturel, Woluwe-St.
Pierre, Brussels, BelgiumSunday, October
20, 2002. Revised 23 October, 2002.
"The 2 most common
types of hormonal EC used in the US are
the Yuzpe regimen (high-dose ethinyl
estradiol with high-dose levonorgestrel)
and Plan B (high-dose levonorgestrel
alone). Although both methods sometimes
stop ovulation, they may also act by
reducing the probability of
implantation, due to their adverse
effect on the endometrium (a
postfertilization effect). The available
evidence for a postfertilization effect
is moderately strong, whether hormonal
EC is used in the preovulatory,
ovulatory, or postovulatory phase of the
menstrual cycle." Kahlenborn, C,
Stanford, JB , and Larimore, WL,
Postfertilization Effect of Hormonal
Emergency Contraception. The
Annals of Pharmacotherapy: Vol. 36,
No. 3, pp. 465-470. (Accessed 9 January,
2003). The findings are not uncontested.
For example, see Marions L, Hultenby K,
Lindell I, Sun X, Stabi B, Gemzell
Danielsson K., "Emergency contraception
with mifepristone and levonorgestrel:
mechanism of action." Obstet Gynecol.
2002 Jul;100(1):65-71. PMID: 12100805.
"Plan B is believed
to act . . . principally by preventing
ovulation or fertilization (by altering
tubal transport of sperm and/or ova). In
addition, it may inhibit implantation
(by altering the endometrium." Drugs.com
Prescription Drug Information for
Consumers and Professionals,
PDR Drug Information for Plan B Tablets.
(Accessed 2005-08-23)
2. "There are many varied mechanisms
whereby IUDs exert their antifertility
actions. Most of these mechanisms act
simultaneously to achieve the desired
effect. The following two sections
present the principal contraceptive
actions."
"Inflammatory
reaction to foreign body. . . denatures
endometrial enzymes, interferes with
implantation of blastocysts and modifies
endometrial metabolism of glycogen.
Copper bearing IUDs. . . inflammatory
response: qualitatively the same as with
non-medicated IUDs. . . interferes with
glycogen metabolism by endometrial
cells; interferes with uptake of
estrogen by endometrial cells; modifies
content of DNA in endometrium. Progestin
bearing IUDs: suppresses endometrium,
impairs implantation of blastocysts."
Connell, EF, Tatum, HJ, Women's
Reproductive Health Care. Shaw, E.
(Ed.) London, Ont.: Creative Infomatics,
1992, p. 94-95
3. Malleson, Roey M., Emergency
contraception: A simple, safe, and
effective approach to preventing
pregnancy after unprotected intercourse
or contraceptive failure. BC Medical
Journal, Vol. 44, No. 1,
January/February, 2002, p. 32-33
Christian Medical Association commentary
The Washington Times
18 February, 2006
Reproduced with permission
Jonathan ImbodySenior Policy Analyst
Christian Medical AssociationAn imperious
Massachusetts state pharmacy board dropped a
bomb on private enterprise and individuals
rights this week, ordering Wal-Mart to stock the
controversial "morning-after pill" ("Wal-Mart to
sell morning-after pill," Nation/Politics,
Tuesday). The "morning-after pill" sometimes
prevents pregnancy and can also end the life of
a developing human embryo.
Massachusetts' move to expand abortion rights
into abortion mandates further advances this
curious campaign of "pro-choice" abortion
advocates. "Morning-after pill" mandates snuff
out the choice of businesses like Wal-Mart and
of individual pharmacists, who apparently are
expected to check their consciences at the
pharmacy door.
One of the successful plaintiffs in the
Massachusetts suit, Dr. Rebekah Gee, summed up
her case by asserting, "My patients should not
have to shop around." Abortion advocates have
found yet another new right in the
Constitution--the right not to have to shop
around.
That would be news, of course, to the
Massachusetts delegation to the Constitutional
Convention in 1787. In an age of despotism,
those revolutionary thinkers dared to declare
that no one should be "deprived of life,
liberty, or property, without due process of
law; nor shall private property be taken for
public use, without just compensation."
With its heavy-handed ruling, the state is
poised to be hoisted by its own petard.
Businesses eventually relocate when overburdened
with crooked conditions of commerce. Individual
pharmacists will take refuge in other states
when they recognize that the ink seems to be
fading on the Bill of Rights in Massachusetts.
Christian Medical and Dental Associations
News & Views
2 February, 2006
Reproduced with permission
The Washington Post, Jan. 30, 2006--More than
a dozen states are considering new laws to
protect health workers who do not want to
provide care that conflicts with their personal
beliefs, a surge of legislation that reflects
the intensifying tension between asserting
individual religious values and defending
patients' rights. About half of the proposals
would shield pharmacists who refuse to fill
prescriptions for birth control and
"morning-after" pills because they believe the
drugs cause abortions. But many are far broader
measures that would shelter a doctor, nurse,
aide, technician or other employee who objects
to any therapy. That might include in-vitro
fertilization, physician! -assisted suicide,
embryonic stem cells and perhaps even providing
treatment to gays and lesbians.
Because many legislatures have just convened,
advocates on both sides are predicting that the
number debating such proposals will increase. At
least 18 states are already considering 36
bills. The flurry of political activity is being
welcomed by conservative groups that consider it
crucial to prevent health workers from being
coerced into participating in care they find
morally repugnant -- protecting their "right of
conscience" or "right of refusal."
"This goes to the core of what it means to be
an American," said David Stevens, executive
director of the Christian Medical & Dental
Associations. "Conscience is the most sacred of
all property. Doctors, dentists, nurses and
other health care workers should not be forced
to violate their consciences.
The swell of propositions is raising alarm
among advocates for abortion rights, family
planning, AIDS prevention, the right to die,
gays and lesbians, and others who see the push
as the latest manifestation of the growing
political power of social conservatives.
Dave Stevens, MD: "CMDA has
spoken out concerning the right of
conscience as Christian healthcare
professionals come under increasing attack
from groups trying to force them to violate
their beliefs. It is ironic that those who
march under the banner of "choice" and
"rights" are eager to trample on the civil
liberties of others. Pharmacists in IL have
already been fired for refusing to dispense
the morning after pill. The "right" of a
patient's convenience has trumped the
pharmacists' religious beliefs even though
the first amendment to the Bill of Rights
says, "Congress shall make no law respecting
an establishment of religion, or prohibiting
the free exercise thereof…" What does
freedom of religion mean if you can't follow
your conscience? Thomas Jefferson saw this
when he wrote, "I consider the government of
the U.S. as interdicted by the Constitution
from intermeddling with religious
institutions, their doctrines, discipline,
or exercises."
Just because we have taken
a professional license doesn't mean we must
abandon our personal morality. If a
physician can be forced to dispense an
abortifacient or do IVF for a homosexual
couple, then how can he or she refuse to
perform an execution or euthanasia? If we
stand by while the constitutional freedoms
of pharmacists and other healthcare
professionals are denied, there will be no
one to stand with us when we are in the
crosshairs.
I encourage you to speak out in your
professional organizations and to your state
government on this issue. We dare not lose
this battle."
[Ref: Rob Stein. "Health
Workers' Choice Debated: Proposals Back Right
Not to Treat." The Washington Post January 30,
2006]