SPRINGFIELD, Ill. — A battle is under way over conscience rights and health care in the Illinois Legislature that has pro-life groups on one side, the American Civil Liberties Union and Planned Parenthood on the other, and the Illinois Catholic Conference standing neutral on the sidelines.
The ACLU of Illinois has proposed a change to Illinois’ broad legal protections for the conscience rights of health-care workers with S.B. 1564, which has already passed the state senate but whose defeat the pro-life groups are urging in the state house.
If health-care facilities or personnel decline to provide services for reasons of conscience — such as abortions or sterilizations — the bill’s protocols would require them either to make referrals for such services or to provide information about other places where they are likely to be available.
“This is simply an intrusion on people of faith, people of conviction and the right of conscience,” said state Rep. Ron Sandack, R-Downers Grove, at a May 5 media conference held by an umbrella of state pro-life groups known as the Illinois Women’s Health and Life Alliance at the Illinois State Capitol. The lawmaker described the bill as “unnecessary” and “a solution seeking a problem.”
Dr. Mary Keen, president of the Chicago guild of the Catholic Medical Association, also said the bill would force her and other medical professionals “to go against our best professional and medical judgment, compelling us to provide information [on abortion] that is not in our patients’ best interests.”
“This bill would force me and others like me to violate our patients’ trust and recommend a procedure that is both harmful to women and unborn children alike,” she said.
Even Princeton professor Robert George has weighed in, writing an open letter noting that the bill violates conscience rights.
The ACLU Bill
The bill was drafted by ACLU of Illinois in response to two high-profile situations: One involved a woman who was miscarrying but denied an abortion at a Catholic hospital and experienced considerable delay in being transferred to another health-care provider. Another involved a woman who planned to undergo a tubal ligation after delivering her child but found out during labor that her doctor had neglected to mention that he could no longer offer her the procedure since he had transferred his practice to a Catholic health system.
According to Lorie Chaiten, director of ACLU of Illinois’ Reproductive Rights Project and author of the model legislation behind the bill, S.B. 1564 primarily is “about making sure no one is withholding information from the patient.”
“The law says that if a health-care provider won’t provide a service in place, the protocols require a referral or a transfer, or they can simply give information about other health-care providers they reasonably believe may offer the services provided,” she said. “There’s no referral requirement.”
State Rep. Peter Breen, R-Lombard, countered at the May 5 media conference that while it “was wrong” that a woman had been misled by her doctor, he was urging his colleagues on both sides of the aisle to reject the bill, calling it “dangerous” and imprecise, owing to “many unforeseen consequences which we are starting to bring forward.”
One of the issues is that the bill would make the rights of a health-care worker, such as a maternity-ward nurse, “subject to whims of institutions,” Breen said.
“I think any of us would be happy to draft a bill to make sure that doesn’t happen again. The problem is that S.B. 1564 is not that bill.”
The State Bishops’ Conference
In the debate about the bill, pro-life groups and the Illinois Catholic bishops’ conference have split on its implications as currently worded. Neither group likes the bill, but the Catholic Conference of Illinois has declared its neutrality as a consequence of negotiations that brought about changes it believes are acceptable but that pro-life groups say are insufficient.
Zachary Wichmann, the conference’s director of government relations, explained that they would rather see no changes to the existing law but had to make the best of the political reality in Springfield.
“What we did is negotiate the bill to a point where our ethicists and lawyers said, ‘This is acceptable … [and] reflects what is in Catholic health care now,’” he said.
Wichmann said the original version drafted by the ACLU was much worse and “completely gutted the Health Care Right of Conscience Act.”
“With the amendment we’ve worked out with them, it’s not gutted,” he said. “What happens now is that when a right of conscience is invoked, there is an information protocol that goes into effect that allows our health-care facilities or health-care professionals, whichever the case may be, to continue to do what they’ve always done: Counsel against the objectionable service, tell the patient what the problems are with it, but if the patient continues to insist on it, to say, ‘Look, we don’t do that here; here is a list of medical providers: Maybe one of them can help you.’”
“That, in our minds, is not a morally objectionable referral,” he said.
Pro-Life Groups’ Perspectives
However, pro-life groups see things differently.
“The Catholic conference, I think, has very good intentions, but I don’t think they’ve fully considered the ramifications of the bill,” said Anna Paprocki, staff counsel for Americans United for Life and an Illinois resident.
Paprocki said S.B. 1564’s suggested protocols turn the state’s existing conscience protections into “a false promise.”
“You can have a conscientious objection to abortion, but you still have to tell patients about abortion and the so-called benefits of abortion,” she said.
Paprocki explained that the consensus among pro-life organizations is that the law’s requirements would involve pro-life health professionals and facilities promoting abortion by giving such information.
“You have to reasonably believe that these people may perform abortions when you give out this information,” she said. “So now we’re asking crisis-pregnancy centers to hand out information on places they reasonably believe will perform abortions, and that violates their consciences and violates the core mission of crisis-pregnancy centers.”
Three Views on Protocols
The ACLU, the state Catholic conference and the pro-life groups have varying opinions about when the proposed law’s protocols actually kick in.
Wichmann said it takes effect “when the patient asks about or when this morally objectionable service comes into play — it’s not just in general that when you come in we have to tell you what we do and don’t do.”
But according to the ACLU, the new law’s protocols require a doctor to inform the patient of the full range of legal treatment options.
“So if that provider has a patient who is facing, for example, a health risk as a result of her pregnancy, they would not be permitted to withhold information that ending the pregnancy is one of the options for preserving that woman’s health,” said Chaiten. “They cannot withhold that information.”
And Paprocki said the pro-life groups believe the protocols require pro-life health-care providers treating pregnant women to discuss “abortion with all pregnant women immediately and at any juncture and any kind of new situations throughout the pregnancy, reminding her about the legal treatments of abortion and the benefits of abortion.”
Paprocki added that while the Illinois Catholic Conference may not believe there are any “benefits” to abortion that pro-life medical personnel must discuss, that interpretation runs counter to senate members who expressed the view in voting for the bill that there were “objective medical benefits to abortion that you have to talk to a patient about.”
When Do They Apply?
The ACLU’s Chaiten asserted that the protocols effectively do not apply to specifically pro-life medical practices or clinics that make clear up front they do not provide abortion services, contraception or other procedures that violate their conscientious beliefs.
“But as soon as you hold yourself out as somebody who is going to discuss all options with a patient, then the common law of Illinois imposes certain duties.”
But Paprocki said Catholic hospitals, ob-gyns and medicalized pro-life pregnancy-resource centers still do not appear to be exempt, even if they advertise clearly about services they don’t provide.
“There is no clause in here that says, ‘Because they’ve advertised that they are Catholic and pro-life, they no longer have to comply with that law,’” she said.
“It absolutely applies to them. Maybe that wasn’t foreseen by the ACLU when they wrote it, but it absolutely is a consequence of the language as written.”
Peter Jesserer Smith is the Register's Washington correspondent.