Protecting the Right to Say 'No'
Conscience in Jeopardy in Catholic Health Care
BY Sue Ellin Browder
May 31-June 6, 2009 Issue | Posted 5/22/09 at 10:03 AM
COLINSVILLE, Ill. — President Obama told University of Notre Dame students and faculty May 17 that the federal government should "draft a sensible conscience clause." Catholics hope their consciences count.
During his three years on the job, Illinois pharmacist John Menges estimated he filled more than 71,000 prescriptions. He saw only three prescriptions for Plan B, the so-called "emergency contraception" (morning-after) pill. Yet when he failed to sign an "emergency contraception policy" that violated his religious beliefs, he was fired.
A public-health nurse in Louisiana declined to give women Plan B on the grounds the pills could terminate innocent human life — and was threatened with losing her job.
A new Oregon law requires that all hospitals, including Catholic hospitals, provide Plan B to rape victims in emergency rooms — or face fines up to $1,000.
Such cases are increasingly common. As activists demand new "rights" to Plan B, abortion, euthanasia and other procedures, health-care providers who object as a matter of conscience have come under increasing attack.
"Right now, it's a very difficult time for Catholic health care, and we should all be very much aware that these conscience threats have escalated and are very, very real," said Marie Hilliard, director of bioethics and public policy at the National Catholic Bioethics Center. The center has set up a 24-hour hotline to counsel people who believe their conscience rights have been violated.
Meanwhile, federal conscience-protection rules, put into place in the Department of Health and Human Services by the Bush administration, may soon be gone.
"The Bush Conscience Protection Rule, which the Obama administration most likely will severely water down, if not kill, didn't create new conscience protections. All it did was provide mechanisms, such as definitions, certification of compliance and enforcement provisions, to enforce current federal laws on the books," explained ethicist John Brehany, executive director of the Catholic Medical Association.
The U.S. Conference of Catholic Bishops has opposed gutting the conscience regulations. It filed comments March 23 with Health and Human Services, saying that when faced with a lack of conscience protections, health-care providers and institutions opposed to abortion or sterilization could be forced out of business, reducing access to health care.
In April, the conference released a nationwide poll. Of adults surveyed, 87% believe it is important to "make sure that health-care professionals in America are not forced to participate in procedures and practices to which they have moral objections."
If the Bush rules fall, the next federal conscience-protection target in the activists' crosshairs is the Weldon Amendment, a rider attached to a spending bill Congress has to pass annually and which can be stripped out in any year.
In California, only the Weldon Amendment stands between physicians and a state law that makes it a criminal offense for a doctor to refuse to perform an abortion on an "emergency" basis.
"I am convinced the day is coming when physicians will be in a position of having to choose either between practicing according to their conscience or leaving the practice altogether," said obstetrician-gynecologist Dr. Sandy Christiansen of Frederick, Md., national medical director of CareNet, an organization of more than 1,160 pregnancy-resource centers.
Christiansen is especially concerned about a 2007 "ethics committee opinion" issued by the American College of Obstetrics and Gynecology. The opinion states that if member physicians refuse to do abortions themselves, they must relocate near an abortion provider to whom they can refer women. The college's board also requires doctors to abide by these new abortion-on-demand rules to obtain or retain their board certification.
As a result, pro-life obstetrician-gynecologists "may not be permitted to become board-certified or recertified, which is a requisite for hospital privileges and practicing medicine in general," Christiansen said.
"As people of faith, we are all in jeopardy of being considered outside of the standard of care."
Catholics closely observing conscience threats say there's much more going on here than meets the eye. An enormous global coalition of pro-abortion groups that include Planned Parenthood, the Kaiser Foundation, the Alan Guttmacher Institute, Catholics for a Free Choice, Population Services International, the Center for Reproductive Rights and dozens of others are chipping away at conscience rights on state, federal and international levels.
Linked through the International Consortium of Emergency Contraception (founded in 1995 with Rockefeller Foundation money) and the American Society for Emergency Contraception, this coalition is well funded and well organized.
"They maintain sophisticated planning operations that select the best venues for various initiatives, and they put boots on the ground when legislative committees hold hearings," said Connecticut's assistant attorney general, Tom Davis, a Catholic deacon.
Davis witnessed this powerful consortium in action when they arrived like a "Plan B tsunami" and rammed through a state law mandating Plan B for all rape victims in Connecticut hospital emergency rooms.
Despite ongoing concerns that Plan B may impair a woman's long-term fertility or cause very early-stage abortions, Connecticut legislators refused to amend the law to give Catholic hospitals a religious exemption. Connecticut's bishops have agreed that Catholic hospitals will abide by the law for now, but will revisit the issue if Plan B is scientifically shown to cause early abortions.
According to a running tally kept by NARAL Pro-Choice America, 13 other states also require access to Plan B in the ER. They are Alaska, California, Colorado, Illinois, Massachusetts, Minnesota, New Jersey, New Mexico, New York, Oregon, South Carolina, Washington and Wisconsin.
Why such a huge global push for Plan B, one relatively unprofitable drug among the many thousands that the pharmaceutical industry manufactures?
According to Hilliard, Plan B is simply "the wedge issue" to undermine Catholic hospitals' religious freedom rights to set their own policies and to eventually force them to provide early-abortion services or close their doors.
The pro-abortion movement's agenda has always been "incremental," Hilliard observed. Plan B legislation is just one small step in a long-term strategic assault.
Obstetrician-gynecologist Dr. Kathleen Raviele, past president of the Catholic Medical Association, agreed. "Anti-life activists have gotten Plan B legalized for over-the-counter use. Now they've dropped down the age [one can get the pill without a prescription] to 17. Every couple of years or so, they'll drop the age down another year," Raviele said.
Eventually, she explained, "Plan B will disappear, and RU-486, called Plan C or whatever, will become the new 'emergency contraceptive.' By then it will be legal in Catholic hospitals. It will be given in emergency rooms. And doctors will be very comfortable recommending it."
State laws regarding "emergency contraception" are often based on the American Civil Liberties Union boilerplate. Legislators who pass them seldom make distinctions between Plan B and other chemical concoctions that might one day usurp the "emergency contraception" label.
Therefore, lawmakers who broadly mandate "EC in the ER" for rape victims unwittingly leave the gates wide open for any number of more abortive "emergency contraceptives" that come barreling down the road.
Despite all this bad news, there's evidence the heroes on the front lines aren't caving in as easily as the EC Consortium might wish they would.
One reporter's requests merely for the package insert on Plan B — not for the pill itself — were met by stony-faced pharmacists, one after another, who replied firmly through tight lips, "No, we don't carry that."
In 2005 in Illinois, former Gov. Rod Blagojevich issued an executive order to require all pharmacists in the state to dispense Plan B, no questions asked. Pro-life pharmacists like John Menges fought back. The American Center for Law and Justice (ACLJ) filed a lawsuit on their behalf, asking that the order be struck down for violating, among other things, the pharmacists' First Amendment rights. The pharmacists won. The executive rule was overturned.
"So even though the governor's original order was a disaster for our side, it wasn't the end of the story," said ACLJ senior counsel Francis Manion, who handles many conscience-clause cases.
Jubilant over the recent Illinois victory, the attorney said, "When we fight, we win."
Sue Ellin Browder writes
from Willits, California.
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