Imagine yourself, a senior in college, sitting in the middle of your dream medical-school interview. Because you have done your homework, the interview is going exceedingly well. You seem to have established a rapport with the interviewer, and your answers are crisp, clear and intelligent. It’s going so well that you are starting to feel confident regarding your chances of gaining admission.
That is, until the interviewer hits you with this question: “Suppose a young pregnant woman and her boyfriend come to you seeking an abortion. What would you do?”
What would you do? How would you answer? For pro-life medical-school candidates, there is only one answer: You counsel the couple not to have an abortion. The problem is that, in some cases, this answer could ruin the candidate’s chance of admission.
It is routine for medical-school admission interviews to include open-ended questions on ethical issues. Primarily, these questions are included in the process to see if students can articulate clearly and defend adequately their thoughts on complex issues. If this were the sole reason for their inclusion, questions about abortion and abortion access could play a legitimate role in the interview process. But that is often not the intent of such questions.
The reality is that many schools are using abortion-related questions to screen out pro-life candidates. This is despite the fact that federal law prohibits medical schools that receive federal funding from discriminating against candidates based upon their views on abortion. While the law prohibits explicit discrimination against pro-life candidates, it does not prohibit schools from inquiring about abortion during the interviewing process. Unfortunately, this situation creates a loophole big enough to drive a truck through.
While no systematic study has been done — largely because many medical schools would be unwilling to take part — anecdotal evidence compiled over the last three decades by groups such as the Catholic Medical Association indicate that abortion-related questions are being used as a covert litmus test for admissions at some schools. For example, when it becomes apparent from an applicant’s answer that he is pro-life, interviewers can find other reasons to deny the candidate admission rather than explicitly stating that he should not be admitted because he is pro-life.
Pro-life candidates can be labeled as “naive” or “rigid” in their thinking. They can be written off as “overly religious” or “intolerant” and not likely to play nice with others. This is enough to sink an applicant’s chances of admission. As a result, the school can claim that they did not deny the candidate admission because he or she was ostensibly pro-life, but rather because of some derogatory label that is foisted upon any pro-life candidate.
The result of this screening is having its effect. A 2007 survey of medical students found that 40% of students identified themselves as liberals, while only 26% identified themselves as conservatives. Not surprisingly, this percentage of liberals in medical school is considerably higher than the numbers of self-identified liberals in the general U.S. population. Only 30% of 18- to 24-year-olds identify themselves as liberal, while only 23% of 25- to 38-year-olds do. Clearly, a higher percentage of liberals are making their way into medical school, and it is hard to believe that the screening out of pro-life candidates, most of whom describe themselves as conservative, is not contributing to this discrepancy.
What makes matters even more troubling is that the bias against pro-lifers doesn’t stop in the admissions process, but continues throughout medical-school training and beyond. Pro-life students are routinely denied OB-GYN residencies if they are unwilling to perform abortions. Those who do get residencies are often harassed or punished with poor letters of recommendation as a result of their pro-life stance. Likewise, family-practice residents have encountered similar situations in which they are marginalized for not assisting in abortions.
Even when they make it into practice, there is still discrimination against pro-life doctors. Pro-life doctors have been denied E.R. privileges for refusing to administer abortifacient drugs. They have been forced out of jobs for counseling patients to remain abstinent until marriage or for refusing to refer patients for abortions. In fact, the American College of Obstetricians and Gynecologists has stated that pro-life ob-gyns must “practice in proximity to individuals who do not share their views or ensure that referral processes are in place [for abortions].” If they fail to do so, the threat of board decertification looms.
Given the climate of discrimination, particularly in the OB-GYN field, it is essential that strong conscience-protection laws are put in place and that these laws are vigorously enforced. Unfortunately, the U.S. is moving in the wrong direction, as the Obama administration’s dilution of conscience regulations earlier this year demonstrates. Among other problems, the watered-down regulations do not protect doctors or pharmacists who morally object to prescribing or dispensing contraceptives, and they do not protect doctors who refuse to refer patients who request abortions. While it seems to protect doctors who morally object to performing abortions, it is unclear if the regulations will be enforced vigorously by a Department of Justice that is run by appointees of a pro-abortion president.
The Need to Speak Out
This situation makes it imperative that the pro-life community speaks out to Congress and encourages the passing of strongly worded conscience-protection laws for health-care workers. It is also important that Catholic medical schools lead the way in this regard by 1) advocating for stronger conscience protections, 2) informing their medical students regarding the conscience protections that exist currently, and 3) facilitating the education of the wider medical profession in this regard.
If this underhanded discrimination of pro-life medical-school applicants and doctors continues to go unchecked and the conscience-protection laws continue to be assaulted, the numbers of committed pro-life doctors will certainly decline. The resultant lack of strong pro-life voices in the medical profession will affect both the type of medical care that is available to patients and the procedures (abortion, contraception, euthanasia) that are promoted as viable and necessary.
It is time for Catholics, both as individuals and as institutions, to assist our pro-life physicians and medical students in their effort to provide truly life-affirming care. If we do not, the practice of medicine will be altered fundamentally in the coming years, and not for the better.
Daniel Kuebler, Ph.D, is a professor of biology at Franciscan University of Steubenville, Ohio.