Essay 15: Medicine needs challengers

History shows that the medical community too often tragically
has failed to police itself, leading to the loss of lives and to grave,
 irreversible injustices. Courageous conscientious objectors
can help challenge a failed system and end the injustice.

As noted in previous essays, a New England Journal of Medicine opinion piece entitled, "Physicians, Not Conscripts — Conscientious Objection in Health Care,"[1] by Obamacare architect Dr. Ezekiel Emanuel and University of Pennsylvania professor Ronit Stahl, advocates for limiting the exercise of conscience objections. The rare ethical issues for which they would countenance conscience freedom are only those issues for which the "healthcare community" has not yet developed a consensus:

"There is, however, a specific role for conscientious objection. It provides limited recourse in professionally contested interventions — that is, interventions about which the health care community is debating whether participation is appropriate or not. For example, physician-assisted suicide is currently legal in five states, and whether physicians should participate in it is at the center of a robust ethical debate among health care professionals. (Conversely, although abortion is politically and culturally contested, it is not medically controversial…)."[2]

If a Supreme Court decision were to unilaterally make assisted suicide on demand legal nationwide, as it did in 1973 with abortion on demand, presumably Emanuel and Stahl's grudging conscience allowances regarding assisted suicide would evaporate.

Essay 14: Edict aimed at pro-life Ob-Gyn's shows what "Choose, you lose" looks like in practice

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?

U.S. Dept. of HHS: No, Hawaii, you can't make pro-life pregnancy centers refer for abortions

Thankfully, the U.S. Dept. of Health and Human Services is enforcing federal conscience laws. The press release below details one example of how the agency, unlike in previous administrations, is holding states accountable for illegal discrimination.

FOR IMMEDIATE RELEASE
March 22, 2019

Contact: HHS Press Office202-690-6343media@hhs.gov

OCR Issues Notice of Resolution to the State of Hawaii After Hawaii Takes Action in Safeguarding Conscience Protections for Pregnancy Care Centers

The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) announced today that it issued a Notice of Resolution to the State of Hawaii after Hawaii took corrective action in response to OCR’s investigation of complaints of discrimination by the state against non-profit pregnancy resource centers.

Complainants, Aloha Pregnancy Care and Counseling Center, Inc. and Calvary Chapel Pearl Harbor, filed a complaint with OCR alleging that Hawaii engaged in impermissible discrimination under one or more of federal conscience laws when Hawaii enacted the notice requirements of Act 200, a 2017 law which required them to disseminate a government-scripted notice that promotes abortion – a service for which they do not offer, counsel, recommend, or refer. The Complainants are pro-life and dedicated specifically to providing women options other than abortion.

OCR’s new Conscience and Religious Freedom Division initiated an investigation into the allegations under OCR’s authority to enforce the Weldon and Coats-Snowe Amendments. As a result of OCR’s investigation, on March 15, 2019, Hawaii’s Attorney General issued a memorandum to the Department of the Attorney General for the State of Hawaii, which is charged with enforcing Act 200, stating that it will not enforce Act 200’s notice provisions against any limited service pregnancy center.

The Hawaii Attorney General also committed to notify Hawaii’s legislature of its decision not to enforce Act 200’s notice provisions against any limited service pregnancy center.

Hawaii’s actions follow the Supreme Court’s ruling in National Institute of Family & Life Advocates v. Becerra, 138 S. Ct. 2361 (2018) (NIFLA), which held that a California law similar to Hawaii’s Act 200 likely violated pregnancy resource centers’ Free Speech rights.  The action also follows stipulated permanent injunctions, entered by the U.S. District Court for the District of Hawaii against Act 200 in separate litigation in September 2018, against Hawaii enforcing the Act against the plaintiffs in the lawsuits.  Hawaii’s action in response to OCR’s investigation commits the state to respect the rights of every pro-life pregnancy resource center in the state, not just the particular parties covered by the injunctions. As a result, OCR now considers the complaints before it as satisfactorily resolved, and will be closing the matter.

Roger Severino, director of OCR stated, “Although Hawaii should never have burdened the rights of nonprofits seeking to provide pregnant women life-affirming options, we commend Hawaii for committing to not enforcing Act 200’s notice provisions against anyone, in response to our investigation.” Severino continued, “OCR takes allegations of conscience violations seriously.  We encourage other states to take a hard look at their own laws and make sure that they do not violate federal conscience and religious freedom statutes in health and human services.”

View OCR’s Notice of Resolution to Hawaii - PDF.*

Christian Medical Association Asks Supreme Court to Review and Uphold Indiana's Ultrasound Requirement for Abortion

Washington, DC—March 6, 2019--The Christian Medical Association (CMA, www.cmda.org), the nation's largest faith-based medical association, today joined a brief urging the U.S. Supreme Court to review a decision by the U.S. Court of Appeals for the Seventh Circuit. The brief defends Indiana's statutory requirement that women receive the benefit of ultrasound information when considering an abortion procedure.

• CMA CEO Dr. David Stevens said, "As our brief explains, offering ultrasound imaging provides an opportunity for truthful and essential medical information about a woman’s pregnancy. We, physicians, hold a responsibility to provide our patients with information relevant to the procedures they are considering, and abortion requires the woman's informed consent. What better way to be informed about the biological reality of her unborn child than to see an actual image of that child?"
• CMA Executive Vice President Dr. Mike Chupp added, "Offering ultrasound provides a pregnant woman the opportunity to have vital information that is relevant and necessary to her decision on whether or not to undergo an abortion procedure. Providing the opportunity for this information is required for her informed consent."
• CMA Vice President for Government Relations Jonathan Imbody said, "The grand jury report [p. 12] in the Kermit Gosnell born-alive infant murder case in Pennsylvania shows what happens when politics leave abortion clinics virtually unregulated by states. Polling shows that Americans on both sides of the life issue want and expect abortion clinics to be regulated. With the requirement for offering ultrasound information, Indiana is following its responsibility to apply reasonable medical standards for abortion, just like the state does for any other medical procedure."

Americans United for Life (AUL) filed today's Petition for Writ of Certiorari amici curiae brief with the Court in the case of Kristina Box, Commissioner, Indiana Dept. of Health, et. al. v. Planned Parenthood of Indiana and Kentucky, Inc., et. al, on behalf of the Christian Medical Association and other medical and pregnancy care organizations. AUL's Steven H. Aden (202) 741-4917, Steven.Aden@aul.org served as attorney of record.

Christian Medical Association lauds new Title X family planning rule

Washington, DC - February 22, 2019: The 19,000-member Christian Medical Association (CMA, www.cmda.org) in a statement today enthusiastically welcomed a final new rule that will govern tax funds awarded for family planning purposes under the Title X program administered by the U.S. Department of Health and Human Services.

The following statement may be attributed to VP for Govt. Relations Jonathan Imbody (JI@Freedom2Care.org), who also serves as Director of Freedom2Care (www.Freedom2care.org) and its over 30,000 constituents.

"Practically speaking, the new rule now opens the door to many more health organizations, which should translate into more and better options for patient care. Many life-affirming, full-service health organizations nationwide had been shut out of the program by the previous administration's abortion-related requirements.

"Our polling, cited in the final rule document, showed that 91 percent of faith-based health professionals will leave medicine rather than bow to pressure to compromise their life-affirming convictions.

"As the new rule document notes while citing this polling (p. 268), 'With the final rule’s added emphasis on protecting rights of conscience, more individuals may enter the Title X family planning program, helping to meet that unmet need for care.'

"The program remains open to any organization willing to respect the statutory separation of abortion from Title X family planning funds and operations. The only organizations shut out of the Title X family planning program will be those who insist on mingling abortion with Title X funds and programs. So Title X will no longer serve as an exclusive  funding pipeline for the abortion industry while shutting out pro-life health programs.

"This new rule finally brings the Title X family planning program in line with federal Title X law that forbids funds for abortion as a family planning method—a principle that reflects the values of the American people."