A nurse formerly employed at Mt. Sinai Hospital in New York describes being coerced to participate in abortion. The story illustrates the need for protection of conscience legislation and policies as well as the kind of experience that can cause health care workers to refuse to participate in abortion for reasons of conscience.
Mount Sinai Hospital in New York has agreed to additional policy and procedure changes to protect the conscience rights of pro-life nurses and other employees as a result of a federal investigation.
In 2009, the hospital allegedly forced a Catholic pro-life nurse to assist in an abortion in violation of the nurse’s religious beliefs. Read more . . .
A newly completed U.S. Department of Health and Human Services investigation of New York’s Mt. Sinai Hospital has resulted in additional policy and procedure changes to ensure that medical personnel are not forced to participate in abortions. Alliance Defending Freedom attorneys representing a Mt. Sinai nurse requested the HHS Office of Civil Rights investigation after the hospital forced her to assist in an abortion in violation of her religious beliefs in 2009.
The changes come in addition to a new policy the hospital adopted after Alliance Defending Freedom attorneys filed a lawsuit on behalf of the nurse, Cathy Cenzon-DeCarlo.
“Pro-life medical personnel shouldn’t be forced to participate in abortions, and the new policies and procedures at Mt. Sinai reflect that,” said Senior Legal Counsel Matt Bowman. “The hospital seems to have decided to do the right thing and respect the conscience rights of its employees, who are protected by both federal and state law. We will continue to monitor the situation to make sure that the new policy is followed.”
Mt. Sinai’s policy revision states, “It is the legal right of any individual to refuse to participate in these procedures.” The policy applies regardless of whether the abortion is classified as an elective or emergency procedure and provides a process for “alternative coverage” in the event a staff member opts not to participate.
As a result of the HHS investigation, Mt. Sinai agreed to go further by putting in writing that it will abide by federal conscience protection laws, train employees about the hospital’s obligation to those laws and how to properly keep records of those who are objecting or not objecting to participating in abortions, and update a Human Resource policy to state that the hospital will not engage in any form of employment discrimination based on an employee’s refusal to participate in an abortion.
Administrators at Mt. Sinai Hospital threatened DeCarlo with disciplinary measures in May 2009 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. The hospital has known of the Catholic nurse’s religious objections to abortion since 2004.
Alliance Defending Freedom attorneys asked HHS to investigate in March 2010 and filed, together with lead counsel and allied attorney Joseph Ruta, the lawsuit Cenzon-DeCarlo v. The Mount Sinai Hospital in Kings County Supreme Court the following month. The lawsuit argues that Mt. Sinai violated state conscience laws as well as state laws against religious employment discrimination and intentionally inflicting emotional distress on an individual. The suit, which is still ongoing, also includes five other claims based on DeCarlo’s coerced participation in the abortion. A federal court dismissed Cenzon-DeCarlo’s federal suit filed in July 2009.
30 March, 2011
Reproduced with permission
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.
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.