Category: Procedures & Services

HHS and Religious Liberty

National Catholic Reporter
Distinctly Catholic
1 November, 2011

Reprinted by permission of National Catholic Reporter,
115 E Armour Blvd, Kansas City, MO 64111

Michael Sean Winters*

In this case, according to the Post story, career staff, that is non-political appointees, at HHS strongly urged the grant be renewed because the USCCB did a better job than other agencies in caring for the victims of human trafficking, but they were over-ruled by political appointees who wanted to insist that the contracts only be awarded to those organizations that would provide access to contraception and abortion services.

The issue of religious liberty is fast becoming a central concern among the nation’s bishops. The proposed interim rule from the Department of Health and Human Services regarding mandated coverage for contraception and sterilization in insurance plans struck many as a direct assault on religious, especially Catholic, institutions. The Department of Justice’s brief in the Supreme Court case Hosanna-Tabor Evangelical Lutheran Church and School v. EEOC is viewed by the bishops as an even more dangerous attack on religious liberty. Last week, Bishop William Lori, chairman of a new ad hoc committee on the religious liberty, testified on the subject before Congress. (I wrote about Lori’s testimony here.)

This morning, a front page, above-the-fold, article about tensions between the Obama administration and the Catholic Church casts a new spotlight on the issue of religious liberty. The article focuses on the decision of HHS not to renew a contract with the USCCB for the provision of services to survivors of human trafficking.

What is going on? Are the alarm bells warranted? Is the Obama administration hell-bent on constricting the Church’s traditional social mission and/or coercing certain Church organizations and programs to choose between following Church teaching and accessing government funds? Or, is this just another case of the Church adopting a defensive posture towards the culture, giving voice to a populist concern, amplified ad nauseum by the people at Fox News, about “cultural elites” that are seeking to strip America of its religious heritage?

In the case of the denial of HHS funding for the USCCB’s efforts to aid the victims and survivors of human trafficking, a grant that amounted to some $4.5 million, some of the language from the USCCB is a bit over-the-top. If the Obama administration really were adopting an “anybody but Catholics” approach, as my friend Sr. Mary Ann Walsh claimed, she must explain why other grants from HHS’s Office of Refugee Resettlement to the USCCB increased from $27 million in fiscal year 2010 to some $32 million in fiscal 2011. But, social service providers gain and lose contracts all the time. Is there a religious liberty issue at stake here?

There are many aspects to the issue of religious liberty. Today, I should like to focus on precisely what the issue is, and what it isn’t. The issue of religious liberty has two principal aspects: 1) Is someone being coerced to do something against their conscience? And 2) Is someone being discriminated against unfairly on account of their religious beliefs or practices?

HHS has every right to set certain requirements for grants. Nor does the Church have a First Amendment right to a government grant. If HHS wants to require all grant recipients provide access to contraception and abortion services, it can do so, but HHS must then demonstrate why such a requirement is more important than other considerations in awarding grants. And, it must be fairly public about making such an argument: A few political appointees at HHS should not be able to decide these issues behind closed doors. In this case, according to the Post story, career staff, that is non-political appointees, at HHS strongly urged the grant be renewed because the USCCB did a better job than other agencies in caring for the victims of human trafficking, but they were over-ruled by political appointees who wanted to insist that the contracts only be awarded to those organizations that would provide access to contraception and abortion services. Does HHS really want to be in the position of arguing that contraception and abortion is so important that it trumps all other considerations regarding support services for the victims of human trafficking? It is not an argument that I would want to make.

So, where is the religious liberty issue in all this? If HHS intentionally discriminated against the Catholic Church in the awarding of grants, that violates the First Amendment. If, however, HHS set a requirement, and the Church feels it is unable to meet that requirement for its own moral reasons, I do not discern a religious liberty issue: Again, the Church does not have a “right” to a government contract. But, it is incumbent upon HHS officials to make it clear what motivated them and a series of congressional hearings on the matter would certainly help illuminate what is now hidden.

HHS is not the only one having difficulty deciding where and how the issue of religious liberty manifests itself. Last week, Bishop William Lori testified before a House subcommittee on the subject of religious liberty. I wrote about his testimony here. But, in the question period, Bishop Lori got dragged into a discussion of same sex marriage that has nothing to do with religious liberty, in fact, the religious liberty argument probably works against the Church’s stance on same sex marriage. The Church opposes same sex marriage because, we believe, marriage means something specific, one man and one woman for one lifetime, open to the possibility of pro-creation, committed to a mutual love so stunning it warrants comparison to the love between Christ and His Church. Religious liberty issues only come up when, for example, the Church feels it cannot award custody of a child in foster care to gay parents, or when same sex couples expect the Catholic Church to treat them the way the Church treats a married couple in terms of employee benefits and the like. Unwittingly, Bishop Lori got dragged off-message by Cong. Steve King, who seemed intent on demonstrating the sacramental significance of marriage, which is a fine thing, but a thing that has no bearing on our constitutional understanding of liberty.

Here is another example of someone intruding non-germane concerns into the religious liberty pot. My friend Sally Steenland, of the Center for American Progress, wrote this regarding the HHS mandates for health care coverage:

“Those on the other side argue that religious organizations such as Notre Dame that choose to operate in a pluralistic secular democracy must respect the religious liberty and consciences of their employees, many of whom are not Catholic—or religious at all. For virtually all these workers, contraception is not a sin but an essential part of moral responsibility around creating a family and parenting. To deny them access to such a basic health service is to unfairly impose a particular set of theological beliefs on people who believe differently.”

To be clear, the HHS mandate, if it does not expand the conscience exemption, would coerce Notre Dame to do something that violates its conscience, forcing the university to either cover contraception and sterilization in its health care plan or to stop providing health care to its students and employees. Steenland’s concern about the consciences of Notre Dame’s employees is admirable but it is misplaced here: No one has a constitutional right to be employed at Notre Dame, nor a constitutional right to receive free contraceptive coverage in their health care plan. Steenland may want, as a matter of public policy, to provide more contraception to more people, but that has nothing to do with religious liberty.

The founders obviously considered religious liberty an important issue: As colonists, they had long raised their objections to British rule as a defense of their civil and ecclesiastic liberties. The founders therefore gave religious freedom a specific mention in the First Amendment. I do not think the historical record warrants the conclusion that the founders saw religious freedom as “primary” in the way Pope Benedict XVI does. Certainly, they did not share the Pope’s anthropological assumptions, and those politicians, mostly from the right, who insist on blurring the differences in order to paint the American founding as a religious event distort the historical record.

To be clear, one of the founders’ principal objectives was to avoid excessive entanglement between religious institutions and government. It is true that the phrase “wall of separation” does not appear in the Constitution, but it does express accurately the ideological concerns of some of the founders. They had seen what a union of throne and altar looked like, and they rejected it. In our day, and especially in the area of providing social services, our nation has concluded that entanglement is a good idea, that we want the government to provide moneys to religious organizations that help the poor, the indigent, the immigrant, the survivor of sexual slavery. These religious organizations tend to do a better job with fewer resources than their secular counterparts, and none do a better job than the Catholic Church. The Obama administration recognizes this. Otherwise, why would it have increased funding for a range of social services provided by the Catholic Church? From 2009 to 2010, government funding for Catholic Charities USA was increased by some $110 million.

There are some “wall of separation” absolutists who oppose such funding. The ACLU has filed a lawsuit against HHS because of its funding of contracts to the USCCB and the consequent result that those funds do not include abortion and contraceptive services. Of course, the ACLU would be on firmer moral ground if it provided services to the victims of human trafficking or opened its own hospitals or ran its own schools. The Catholic Church is on the frontlines of the fight against poverty and other social ills. We should not be penalized because our moral convictions require that we not include contraception and abortions services in our outreach to the poor. Those same moral convictions are what propel us to care for the poor in the first place. There is a moral poverty in our culture’s approach to “reproductive freedom” that is every bit as abhorrent as the socio-economic poverty visited upon too many refugees, immigrants and citizens in our midst. The government demands too much if it demands that we abandon one half of our moral concern in our effort to fulfill the other half.

Tomorrow: The legal aspects of religious liberty arguments.

Equality legislation used to defend conscientious objection to abortion

 (United Kingdom: 2011)

  • John Smeaton* | The two nurses . . .were employed at a hospital for ordinary nursing duties. They were then allocated to work once a week at an abortion clinic in the hospital. The abortion process did not involve surgical abortion but the increasingly common process of “early medical abortion” . . .When they became aware that they were participating in abortion they told their management that they did not want to continue but were then told that they had no choice in the matter. . . Full Text

Obama Administration Rejects Conscience Protections

The Heartland Institute

30 March, 2011
Reproduced with permission

William Saunders and Anna Franzonello

An issue of paramount importance for medical professionals is the protection of their right to conscience—their freedom to refuse or decline to do practices they oppose on religious or moral grounds. A February decision by the Obama administration, however, sweeps aside conscience protections instituted under President Bush.

The decision is not unexpected—the Obama administration initiated the process to rescind the Bush regulations on March 10, 2009. Unfortunately, it comes at a time when pressure to violate one’s conscience or leave the medical profession is not theoretical but very real.

Obama Rejects ‘Conscientious Refusal’

One such recent threat comes from the American College of Obstetrics and Gynecology (ACOG), which reviewed and reaffirmed its 2007 Ethics Committee Number 385, titled “The Limits of Conscientious Refusal in Reproductive Medicine” in November 2010.

Rule number 385 categorizes a conscience objection as a “refusal,” describing elective abortion and other controversial reproductive medical procedures and services as “standard.” The opinion states, “In some circumstances, respect for conscience must be weighed against respect for particular social values.”

On balance, according to ACOG’s rule, abortion is a social value that outweighs any conscientious objection. It requires prolife physicians to refer individual for abortions and even suggests they relocate their practices to better refer patients to nearby abortionists.

Could Strip Certification

The effect of the ACOG committee opinion is that otherwise qualified health care providers specializing in obstetrics and gynecology may lose their board certification solely because of their prolife values. According to the 2011 Bulletin for Basic Certification in Obstetrics and Gynecology from the American Board of Obstetrics and Gynecology (ABOG), an individual can have his or her board certification revoked if he or she acts in “violation of ABOG or ACOG rules and/or ethical principles.”

Without Board certification, a doctor is subject to discrimination by other entities. State and local governments, hospitals, or other institutions that require Board certification may take action against the physician. Thus, refusing to conform to the ACOG recommendations on abortion could result in the loss of a health care provider’s livelihood.

In finding that abortion is a circumstance where conscientious objection “can and should be overridden in the interest of other moral obligations that outweigh it,” ACOG’s subjection of conscience to patient autonomy leaves patients paying the ultimate price. Access to essential reproductive health care will be limited as prolife doctors are forced out of the field.

ACOG Threat Prompted Rule

When ACOG first issued its threat, then-Secretary of Health and Human Services (HHS), Michael Leavitt issued a letter to Norman F. Gant, executive director of ABOG, stating such discrimination would seem to violate federal laws protecting the right of conscientious objection to abortion.

ABOG and ACOG refused to change their policy, and the Bush administration enacted the “Regulation Ensuring that the Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Practice in Violation of Federal Law” in December 2008. The regulation required certification from entities receiving federal funds from HHS that they will comply with the established federal conscience protection laws.

Protection Removed

A recent case demonstrated the importance of the Bush rule. A nurse at Mt. Sinai hospital in New York, Cathy DeCarlo, was forced to participate in an abortion despite her conscientious objection. A federal court dismissed her claim, saying she cannot bring suit by herself. HHS then ruled the court can pursue the case because of the Bush regulations.

Now that President Obama has revoked the rule, conscience rights will likely have little protection against threats from ACOG and ABOG. It is unlikely Congress (particularly the Senate) has the votes to convert the revoked guidelines into a binding statute. For this reason, Americans United for Life has drafted a model bill to protect conscience at the state level, blocking discriminatory practices such as “refusal of board certification.”

Health care professionals face serious ethical issues on a daily basis. The Obama administration’s rejection of conscience protection ought to concern both health care providers and patients.

ADF rebuts NY hospital’s claim that pro-life nurse can’t sue

ADF attorneys respond to claims of Mount Sinai Hospital

NEWS RELEASE
19 August, 2009

Alliance Defense Fund

NEW YORK — Alliance Defense Fund attorneys submitted a brief in federal court Monday in response to the claim of New York’s Mount Sinai Hospital that a pro-life nurse who sued the hospital has no right to defend herself in court.  ADF filed suit after the hospital forced senior nurse Cathy Cenzon-DeCarlo to participate in a late-term abortion procedure.

“Pro-life nurses shouldn’t be forced to assist in abortions against their beliefs.  Nonetheless, Mount Sinai Hospital is multiplying its injustices against nurse Cathy Cenzon-DeCarlo,” said ADF Legal Counsel Matt Bowman.  “First it disregarded Cathy’s conscience; now it argues she can’t go to court to defend her rights.  Mount Sinai Hospital does not have the right to disregard federal law and then refuse to face the consequences of its actions.”

Administrators at Mount Sinai Hospital threatened Cenzon-DeCarlo with disciplinary measures if she did not honor a last-minute summons to assist in a scheduled late-term abortion.  Despite the fact that the patient was apparently not in crisis at the time of the surgery, the hospital insisted on her participation in the procedure on the grounds that it was an “emergency,” even though the procedure was not classified by the hospital as such. ADF attorneys filed suit on behalf of Cenzon-DeCarlo in the U.S. District Court for the Eastern District of New York on July 21.

Attorneys for the hospital submitted a brief to the court Aug. 10 arguing that the lawsuit should be dismissed because the federal law at issue “does not grant individual litigants a private right of action.”

ADF attorneys responded to the brief Monday, noting, “Mount Sinai’s compulsion violates 42 U.S.C. § 300a-7(c), ‘the Church Amendment’ (named after Senator Frank Church).  This law provides that no recipient of federal health funds may discriminate in the employment or privileges of its health care personnel because of their religious objection to abortion.  The law contains no exception letting Mount Sinai compel assistance based on their unbridled judgment that abortion is an ‘emergency.’  Mount Sinai’s actions are a quintessential example of discriminating in employment and privileges on condition that Mrs. DeCarlo violate her objection to abortion.”

The ADF brief goes on to explain that “Mount Sinai compounds its contempt of the law” by denying that the law allows Cenzon-DeCarlo to defend her conscience rights.  The brief points out that a federal court just this year “not only recognized an individual right, but allowed the plaintiff (in that case an abortion supporter) to seek punitive damages.”  It also points out that the federal law involves all of the factors that the U.S. Supreme Court has used to recognize such rights and that Congress obviously intended to protect individuals from discrimination under the law it created.

New York ADF-allied attorneys Joseph Ruta and Piero Tozzi are serving as local counsel in the case, Cenzon-DeCarlo v. The Mount Sinai Hospital.  The court will hold a pre-trial conference on Sept. 10.

Contact: ADF MEDIA RELATIONS  (480) 444-0020

ADF is a legal alliance of Christian attorneys and like-minded organizations defending the right of people to freely live out their faith. Launched in 1994, ADF employs a unique combination of strategy, training, funding, and litigation to protect and preserve religious liberty, the sanctity of life, marriage, and the family.