Tag: American College of Obstetricians and Gynecologists (ACOG)

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.

A matter of conscience

Washington Times
17 December, 2008

Reproduced with permission

Jonathan Imbody*

Americans blanch at abortion coercion in China, where population control agents force mothers to end the lives of their unborn babies who exceed the mandated limit of one child per couple. Yet few Americans realize that abortion-related mandates are also threatening to U.S. health care professionals who follow medical standards such as the Hippocratic Oath.

Conscientious physicians and other health care professionals are being pressured, under threat of job loss, to violate medical ethics standards by performing abortions and referring patients to abortion clinics to do the deed.

Abortion advocates have been lobbying vociferously to cast abortion as standard medical care and to mandate abortion participation by all health care professionals. Only a tiny fraction of U.S. physicians otherwise are willing to violate the Hippocratic Oath, which has guided medicine for well over two millennia, by participating in abortions.

The abortion mandate strategy may be ill-conceived, but unfortunately it is not ill-fated.

Abortion, which neither heals nor comforts, does not qualify as standard medical care under historical medical standards; it has only recently and politically infiltrated health care. Since American health care professionals have long enjoyed a measure of autonomy in making professional decisions, mandating participation in a procedure prohibited by long-standing medical ethics standards seems likewise implausible.

But abortion ideology and zeal have a way of trumping all notions of ethics and professionalism.

Aggressive abortion mandate advocates dominate the American College of Obstetricians and Gynecologists (ACOG), a highly politicized medical specialty group with vast influence over the profession of obstetrics and gynecology. Last November, ACOG issued an official ethics statement tellingly entitled, “The Limits of Conscientious Refusal in Reproductive Medicine.” The ACOG statement ignores the role of objective standards in conscientious objections to abortion. ACOG instead denigrates conscience as a mere subjective “sentiment.” In reality, however, health care professionals who object to abortion do so not because of subjective feelings but because killing the unborn contravenes Hippocratic, biblical and other life-affirming objective ethical standards.

By contrast, abortion ideology rests on the subjective, unanchored notion of “privacy” and “patient autonomy.” By ripping conscience from its foundation of objective standards and demoting it to the level of subjective feelings, ACOG paints abortion objections as a clash between a physician’s feelings and a patient’s autonomy. With autonomy elevated as the ethical trump card, physicians and all ethical standards must bow in submission.

Having demoted conscience to the subjective realm and elevated patient autonomy to a position of unchallengeable supremacy, ACOG opposes faith-based ethical standards as “an imposition of religious or moral beliefs on patients.”ACOG even incredibly contends that pro-life obstetricians should not only be required to perform or refer for abortions; they should also relocate their practices close to abortionists to make such referrals more convenient.

Given the official link between ACOG ethics positions and physician board certification, obstetricians who refuse to follow ACOG’s abortion mandate now presumably stand to lose their hospital privileges and their livelihood. Medical ethics thus would be turned upside down, as life-honoring physicians lose the ability to practice medicine simply for following the Hippocratic Oath.

Meanwhile, the abortion mandate movement will soon tap potentially irrepressible numbers in Congress and powerful advocates in the White House and the administration.

President-elect Barack Obama, Sen. Hillary Clinton and other abortion advocates have strenuously opposed a modest U.S. Department of Health and Human Services (HHS) regulation that would ensure freedom of conscience in health care. The regulation would finally implement over 35 years of federal civil rights law aimed at protecting health care professionals from abortion-related coercion.

The HHS regulation, expected to be finalized before Dec. 20, could be overturned by a pro-abortion Congress and president, either through new legislation or a new regulation.

Mandating abortion participation in health care is rife with irony. Most Americans easily recognize the hypocrisy of forcing “pro-choice” ideology on all health care professionals. The injustice of ending the lives of innocent unborn children has only persisted in this country, where most citizens oppose abortion on demand, under the smokescreen of choice.

By driving out pro-life obstetricians and gynecologists who refuse to participate in abortions, abortion mandates would ironically decrease women’s access to some of the most conscientious and compassionate physicians in America, many of whom volunteer free medical services to poor women. Abortion mandates threaten to shut down thousands of life-affirming, faith-based hospitals and clinics that provide care in some of the nation’s most underserved communities.

Maybe that’s what it will take for Americans to penetrate the fog of abortion propaganda and recognize that breaching the foundational right to life imperils all other rights.