Most state legislative sessions have ended for 2008, and the results in the area of rights of conscience are fairly depressing. A disturbing 60 percent of all conscience-related bills considered this year were compulsion bills. In other words, these were not bills aimed at protecting the conscientious and moral beliefs of healthcare providers; instead, these were bills aimed at forcing pharmacists and other healthcare providers to provide drugs and treatments contrary to their moral beliefs.
Clearly, abortion advocates are not pulling any punches when it comes
to advancing their ultimate agenda: forcing all healthcare providers to
choose between providing abortion-on-demand and any other morally
problematic procedures or drugs, or leaving the profession. And for a
nation already facing a healthcare crisis caused by an insufficient
number of healthcare providers to account for our ever-growing demand,
that is a dangerous ultimatum.
This ultimatum—compromise your beliefs or get another job—cannot be
dismissed as mere “rhetoric” put forth by those in the pro-life
community. It is more of a battle cry that is growing not only in the
pro-abortion movement, but even among certain medical groups. Several
months ago, the American College of Obstetricians and Gynecologists
(ACOG) issued an ethics opinion that completely disregarded the fact
that physicians have conscience rights guaranteed under federal law.
The American Board of Obstetrics and Gynecology (ABOG) subsequently
issued a statement basically adopting ACOG’s position, and potentially
forcing physicians to either violate their conscience by referring for
abortions, or risk losing their board certification.
Fortunately, these actions did not go unnoticed by the U.S. Department
of Health and Human Services (HHS). In August, HHS Secretary Mike
Leavitt announced a proposed regulation that would increase awareness
of, and compliance with, three separate federal laws that protect the
rights of conscience of federally funded healthcare providers. These
federal laws include the Church Amendments, which protect healthcare
providers from discrimination by recipients of HHS funds on the basis
of their refusal to perform or participate in any lawful health service
or research activity; section 245 of the Public Service Health Act,
which prohibits federal and local governments from discriminating
against individuals and institutions who refuse to receive training in
or perform abortions; and the Hyde-Weldon Amendment, which prohibits
the provision of HHS funds to any federal, state, or local government
agency or program that discriminates against individuals or
institutions for failing to provide or pay for abortion.
Again, these are federal laws that are already in place. HHS issued
the proposed regulation because individuals and entities like ACOG and
ABOG seem completely unaware of—or potentially utterly dismissive
of—these federally-guaranteed conscience rights. The proposed
regulation will increase awareness of and compliance with these federal
laws by, among other things, requiring recipients of HHS funds to
certify compliance with the laws; designating an office to receive
complaints of discrimination; and charging HHS officials with ensuring
that the federal rules are followed. The goal: ensuring that the
public and members of the medical community understand that healthcare
providers do not have to compromise their beliefs in pursuing their
profession.
As Secretary Leavitt stated, “This proposed regulation is about the
legal right of a health care professional to practice according to
their conscience…. Doctors and other health care providers should not
be forced to choose between good professional standing and violating
their conscience. Freedom of expression and action should not be
surrendered upon the issuance of a health care degree.”
Unfortunately, the Supreme Court of California doesn’t appear to agree,
and in August issued an opinion in demonstrating the dire need not only
for compliance with federal law, but also the enactment of solid
conscience protections at the state level. The case, North Coast
Women’s Care Medical Group v. Benitez, was brought by a lesbian woman
who claimed that two physicians at North Coast refused to provide a
certain nonessential, artificial insemination treatment because of her
sexual orientation. Truth be told—and the physicians tell it well in
this case—the physicians told the women at the forefront of her medical
care that, based upon their moral and religious beliefs, they could not
provide that insemination process to any single woman, regardless of
her sexual orientation.
Ms. Benitez sued. In her legal arguments, Ms. Benitez actually
compared physicians and medical facilities to skating rinks and barber
shops. Basically, her line of reasoning goes something like this: if a
skating rink or barber shop opens, the owner can’t discriminate against
the patrons who enter the facilities. Likewise, physicians can’t
“discriminate” against patients who show up in their offices demanding
nonessential treatments—no matter how morally problematic those
nonessential treatments may be. Using terms such as “for-profit
medical practice,” “business establishment,” “marketplace,” and
“commercial opportunity,” Ms. Benitez denigrates the noble practice of
medicine to a mere business transaction.
And again, the battle cry was the same: provide whatever nonessential
and morally problematic treatment I demand, or get out of the
business. Only this time, Ms. Beneitez couched her battle cry in terms
of “accommodation.” Physicians can be “accommodated” in their beliefs
by choosing a different line of work—medical or otherwise. Few would
argue that this could ever qualify as a rational “accommodation.”
Instead, it is just a re-packaged version of the “compromise or get
out” ultimatum. And of course, Ms. Benitez failed to acknowledge that
physicians have free exercise rights guaranteed by the federal
Constitution. In other words, it was Ms. Benitez that demonstrated
complete intolerance for the lifestyle decisions of her physicians.
And the California Supreme Court bought it—hook, line, and sinker. The
Court adopted her extreme position that, once entering the profession,
physicians must treat every patient that comes in their door with any
nonessential treatment that patient demands—regardless of moral or
religious beliefs. This holding leaves no room for good faith medical
judgment or a check on demanding patients, leaving physicians at the
whim of patients who could claim discrimination in just about any
conceivable scenario. No room is left for a balancing of physician and
patient rights. Patient “rights” trump, no matter what: Patient
“rights” trump physician rights. Patient “rights” trump moral
beliefs. Patient “rights” trump the guarantee of free exercise under
the federal Constitution.
But as HHS Assistant Secretary of Health, Admiral Joxel Garcia, M.D.,
stated, “[H]ealth care providers shouldn’t have to check their
conscience at the hospital door.” The current federal administration
“gets it.” The conscience rights of physicians and other healthcare
workers must be protected. Now is the time for states to enact laws
protecting the conscience of all healthcare providers in all healthcare
settings—and especially in the setting of nonessential medical
treatment—before another state court fails to “get it.” And public
health in this nation suffers for it.
Mailee R. Smith, Staff Counsel, Americans United for Life
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