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| The Ob-Gyn specialty in particular stands to lose many physicians by undermining conscience protections for pro-life doctors. |
In a New England Journal of Medicine opinion
piece entitled, "Physicians, Not Conscripts — Conscientious Objection in
Health Care," Obamacare architect Dr. Ezekiel Emanuel and University of Pennsylvania professor
Ronit Stahl advocate ridding healthcare of conscience protections. [1]
Eliminating
conscience protections effectively would rid healthcare of doctors, nurses and
other health professionals who rely upon those protections. Polling indicates
that ethically driven physicians will leave medicine altogether, avoid the
Ob-Gyn specialty or restrict their practices rather than compromise their
consciences.[2] The results of nationwide
polling by The Polling Company, Inc., for Freedom2Care in 2009:
· Over nine of ten (91%) faith-based
physicians agreed, "I would rather stop
practicing medicine altogether than be forced to violate my
conscience."
· "When asked how rescission of
the [Bush-era] conscience rule would affect them personally, fully 82% said it
was either 'very' or 'somewhat' likely that they personally would limit the scope of their practice of
medicine. This was true of 81% of medical professionals who practice mainly in
rural areas and 86% who work full-time in serving poor and
medically-underserved populations."
· 33% of faith-based physicians
surveyed "Considered not pursuing a career in a particular medical
specialty because of attitudes prevalent in that specialty that is not
considered tolerant of your moral, ethical or religious beliefs." Of those
33%, 81% identified Ob-Gyn as the
intolerant specialty.
Given
these risks, on what grounds do Emanuel and Stahl justify removing conscience
rights from physicians?
First, Emanuel
and Stahl allege a fundamental difference between the assertion of conscience
freedom for military conscripts versus for physicians. They highlight the obvious
difference that military conscripts have no choice over becoming soldiers,
whereas physicians choose their
profession. They do not, however, highlight the obvious shared conscientious
objection to killing--by pacifists who will not kill by participating in war
and by pro-life physicians who will not kill by participating in abortion.
According to
Emanuel and Stahl, the right to follow one's conscience—the principle that
compelled our forebears to seek America and which the founders emblazoned in
the First Amendment to the U.S. Constitution—apparently ends upon entering
medical school. When you choose a career to serve the public, you sacrifice
your rights.
"Choose,
you lose."
Second, Emanuel
and Stahl assert that patient autonomy means that patients may not be denied any
legal medical procedure or prescription. Thus the doctor, stripped not only of conscience
freedom but also of professional judgment, either complies with patient demands
or gets booted out of medicine. A self-ruling medical body—in the words of
Emanuel and Stahl, "collectively, the profession—not politicians,
judges, or individual practitioners"—determines who gets booted out.
The
Hippocratic oath is replaced by a new, vacuous mantra: "Whatever the
patient wants, the patient gets." No more conscientious objection, no more
professional judgment, no more objective ethical standard.
The
majority rules and the minority leaves.
Since the
purging of objectors is a mark of totalitarianism and not democracy, one might
hope that such a radical, intolerant view would be dismissed out of hand in the
United States. Unfortunately, Emanuel and Stahl are not alone in urging a purge
of conscientious objectors from healthcare. An alarming number of academics,
abortion advocates and others are echoing the "choose you lose" view.
Even major
medical bodies have attempted to actually implement the draconian policy.
ACOG mocks and marginalizes abortion objectors
In 2007,
the aggressively pro-abortion American College of Obstetricians and
Gynecologists (ACOG) strikingly illustrated what "choose you lose"
looks like in practice.
ACOG issued
an official ethics opinion that broadcast its goal in the title: "The
Limits of Conscientious Refusal in Reproductive Medicine." The ACOG
establishment sought to forcefully limit and corral conscience, concluding that
all Ob-Gyns must perform or refer patients for abortions.
First, the
ACOG elite mocked conscientious conviction as amounting to little more than
feelings and conscience claims as motivated by shallow preferences and cowardly
self-interest.
"An
appeal to conscience would express a sentiment such as "If I were to do
`x,' I could not live with myself/I would hate myself/l wouldn't be able to
sleep at night.'"
"Claims
of conscience are not always genuine. Providers who decide not to perform
abortions primarily because they find the procedure unpleasant or because they
fear criticism from those in society who advocate against it do not have a
legitimate claim of conscience.
"Positions
that are merely self-protective do not constitute the basis for a genuine claim
of conscience."[3]
Then, ACOG
moved to publicly marginalize pro-life physicians, asserting that they must be publicly
labeled, Scarlet Letter-style, as
objectors:
"Where
conscience implores physicians to deviate from standard practices, including
abortion, sterilization, and provision of contraceptives, they must provide
potential patients with accurate and prior notice of their personal and moral
commitments."[4]
ACOG also issued a gag order to bar pro-life Ob-Gyns from
discussing with patients the reasons for life-affirming views.
"In the
process of providing prior notice, physicians should not use their professional
authority to argue or advocate these positions." [5]
Asserting
abortion to be "standard practice" as if it were beyond challenge,
ACOG insisted that even pro-life Ob-Gyns who refuse on moral grounds to
participate in abortions still must send their patients to abortionists to do
the deed.
"Physicians
and other health professionals have the duty to refer patients in a timely
manner to other providers if they do not feel that they can in conscience
provide the standard reproductive services that their patients request."
In case it
wasn't clear how just how far ACOG was prepared to go in forcing pro-life
physicians into submission, the radical abortion advocacy group also actually
asserted where pro-life physicians must
live in order to practice medicine:
"Providers
with moral or religious objections should either practice in proximity to
individuals who do not share their views or ensure that referral processes are
in place so that patients have access to the service that the physician does
not wish to provide. Rights to withdraw from caring for an individual should
not be a pretext for interfering with patients' rights to health care
services."[6]
After the
abortion mandate, the objector labeling, the gag order and the forced
relocation, the only thing missing from the ACOG edict was requiring pro-life
physicians to wear on their lab coats a yellow star.
Ob-Gyn accrediting board ties a noose for the necks
of conscientious objectors
Ob-Gyn physicians depend upon the
American Board of Obstetrics and Gynecology (ABOG) for accreditation, which in
practice helps determine an Ob-Gyn physician's ability to practice medicine. In
2007, the same year that ACOG issued its missive limiting conscience rights,
ABOG made clear that physicians would lose their ABOG privileges upon
"violation of ABOG or ACOG rules and/or ethics principles…."[7]
Enforcing
that declaration would have tied a noose around the necks of all pro-life
Ob-Gyn physicians who declined to perform or refer for abortions, which violated
the ACOG conscience-limiting ethics declaration.
Thankfully
the Bush administration, led by Secretary of Health and Human Services (HHS) Mike
Leavitt and Assistant Secretary for Health Dr. Joxel Garcia, challenged the
ACOG and ABOG scheme. The Christian Medical Association and others supported
and assisted in this effort. HHS issued a new regulation to publicize and enforce
longstanding federal conscience laws that preclude abortion coercion.
Otherwise,
the "choose you lose" scheme would have advanced inexorably toward abortion
advocates' covert goal: a medical profession cleansed of pro-life
obstetricians.
That dream
of pro-abortion homogeneity in medicine has already advanced in countries that
have stripped health professionals of conscience freedom and compelled them to
comply with pro-abortion ideology. Authors Emanuel and Stahl celebrate such tyranny:
"Indeed,
Sweden, Finland, and Iceland do not allow public health care professionals to
deny 'a legal medical service for reasons of [conscientious objection] when the
service is part of their professional duties.'"[8]
Doctors' judgment can protect patients from harm.
Compelling
physicians to accommodate whatever a patient demands not only eradicates
conscience freedom; it also eviscerates professional judgment.
For
millennia, when a physician's judgment has diverged from a patient's preference,
the physician has not been censured for trampling patient autonomy but instead affirmed
as a professional who can offer helpful counsel based on years of research and experience.
Sometimes
patients have bad ideas. In some cases, those bad ideas can cause the patient
grave harm and even death. Professional medical judgment can protect patients
from those consequences.
One might argue
philosophically, of course, that absolute truth does not exist, that autonomy
is the only rule and that judging anyone else's views or actions is
unacceptably intolerant.
Actually, biology
and reality are not tolerant. Gravity brings things down, regardless of what we
hypothesize. Bodily testing an alternative theory is not recommended.
Patients acting
on ideas misaligned with biology and reality can lead to their harm, misery and
death. Just ask any emergency physician or medical examiner.
A patient
who persists in a demand that runs counter to the physician's professional
judgement and counsel has two reasonably simple options: Get a second opinion
or change doctors.
But the
"choose you lose" scheme dismisses these reasonable alternatives and instead
forces the physician to either cave to the patient's demands or leave the
profession.
A medical "Star Chamber" threatens the careers of pro-life health
professionals.
Abortion rights activists and abortion clinics would delight in
the prospect of no more Capitol Hill hearings featuring pro-life Ob-Gyns highlighting
the harms of abortion. Planned Parenthood--a billion-dollar business that rakes
in over half a billion dollars in government funds while performing nearly a
third of a million abortions a year--would delight in eliminating life-affirming
clinics from government grants competition.
Abortion
activists know that in the absence of compelling reason or evidence or
rightness of cause, the only way to secure ideological victory and financial profit
is to eliminate their opponents by decree. That is why Emanuel and Stahl insist
that "collectively, the profession—not politicians, judges, or
individual practitioners" will determine who may practice medicine, what
procedures they must do and what prescriptions they must fill.
The idea of an unaccountable ruling elite parallels the
infamous "Star Chamber" established in England in the late 15th
century. Although promoted as a vehicle to advance justice, the secretive extra-judicial
chamber instead oppressed whole classes of people through its arbitrary rulings
and unilateral abuses of power.
As Lord Acton famously observed, "Power corrupts, and
absolute power corrupts absolutely."
If
pro-life and faith-based health professionals do not stand up and speak out to
protect their rights and their patients' access to principled healthcare, they
may soon find themselves ejected from the profession by a self-proclaimed medical
Star Chamber.
“The only thing necessary for the triumph of evil is for
good men to do nothing.”
[1] "Physicians, Not
Conscripts — Conscientious Objection in Health Care," Ronit Y. Stahl,
Ph.D. and Ezekiel J. Emanuel, M.D., Ph.D., New England Journal of Medicine
376;14, April 6, 2017.
Stahl and
Emanuel, p. 1384.
[2] See, e.g., nationwide
polling by The Polling Company, Inc., for Freedom2Care in 2009, detailed at https://www.freedom2care.org/polling.
[3] "The Limits of
Conscientious Refusal in Reproductive Medicine," ACOG Committee
Opinion No. 385, Nov. 2007, p. 2.
[5] ACOG., p. 5.
[6] ACOG, p. 5
[7] ABOG Bulletin for 2008 Maintenance of Certification,
Rev. 11/2007, p. 10.
[8] Stahl and Emanuel, p. 1382.
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