Equality Act’s Attack on Religious Liberty, Medical Conscience

National Review

Reproduced with permission

Wesley J. Smith

President Biden said during the campaign that he supported the Equality Act, which is being sold as a means of guaranteeing equality for LGBT people.

But it does more than that. It would destroy medical conscience by removing existing protections that permit doctors and nurses to refuse participation in abortion, and it would gut the Religious Freedom Restoration Act.

The Charlotte Lozier Institute’s associate scholar Richard Doerflinger explains in a white paper he authored on the bill. From “The ‘Equality Act’: Threatening Life and Equality:”

The Equality Act’s new freestanding ban on pregnancy discrimination . . . adds the new requirement for women to receive “treatment” for pregnancy that is as “favorable” as treatment for any other “physical condition” . . . . It provides rules of construction indicating that the new requirement should be interpreted as broadly as possible. . . . And it negates the existing religious freedom law that allows believers to seek an exemption from such requirements based on sincere religious beliefs such as respect for human life.

That’s the end of medical conscience, an aspect of freedom of religion that permits doctors and nurses to refuse to participate in the termination of pregnancies.

That’s not all. The bill guts the Religious Freedom Restoration Act as a defense against acts deemed discriminatory in the bill. Among other wrongs, this could force Catholic hospitals to permit sterilization, contraception, abortion, and transgender surgeries on premises despite their being prohibited by Catholic moral teaching.

Interestingly the ACLU once understood the importance of protecting Catholic hospitals from such impositions. It now supports the Equality Act:

It is notable that in 1992 the ACLU recognized a religious hospital’s right to decline involvement even in contraception. This is also a service related to pregnancy, so would presumably be required of religious hospitals under the Equality Act – as would removal of a woman’s healthy uterus, surgically sterilizing her, to facilitate her transition to a male gender identity.

As noted above, the Equality Act’s mandates and its elimination of any defense under the Religious Freedom Restoration Act would also reverse the outcome of Supreme Court cases on the Affordable Care Act, subjecting the Little Sisters of the Poor and other religious entities to a mandate for contraceptive and early abortifacient  coverage.

Read the whole paper. It is a sobering assessment.

The Equality Act is a blatant act of cultural imperialism and a high-priority agenda item for the new administration and the Democrat-controlled Congress. So much for “unity.”

Medical conscience for me, but not for thee

Promoting a one-way conscience right favouring the medical intelligentsia

National Review

Wesley J. Smith*

Medical conscience for me, but not for theeThe New York Times has published an opinion column by cardiologist Sandeep Jauhar that decries the Trump administration’s increased enforcement of medical conscience. But he actually promotes a one-way conscience right that favors protecting the predominate ideological views of the medical intelligentsia, while forcing dissenters to sacrifice their own religious and moral beliefs. . . [Full text]

Doctor Fired after Suing Catholic Hospital over Assisted Suicide

National Review

Wesley J. Smith

Colorado doctor Barbara Morris wants to assist her patient’s suicide. She works at Centura Health, a Catholic/Seventh Day Adventist-owned hospital that prohibits its employees from participating in assisted suicide, legal in Colorado.

Morris sued to be allowed to participate in her patient’s suicide by doctor — which would not happen in the hospital. The hospital responded by firing Morris for violating the terms of her contract by seeking to engage in acts in the context of her employment that violate the hospital’s religiously based moral beliefs.

Morris contends she can’t be prohibited from assisting her patient’s suicide because the Colorado law only allows health care facilities to opt-out if the suicide will occur on-site. The hospital is seeking shelter in the Trump administration’s medical conscience protection policies.

Expect more of these kinds of disputes as many U.S. hospitals are Catholic or otherwise religiously affiliated with churches that reject abortion and assisted suicide doctrinally. From the Kaiser Health News story:

More doctors and patients in the country are providing and receiving health care subject to religious restrictions. About 1 in 6 acute care beds nationally is in a hospital that is Catholic-owned or -affiliated, said Lois Uttley, a program director for the consumer advocacy group Community Catalyst. In Colorado, one-third of the state’s hospitals operate under Catholic guidelines.

The ACLU has already sued several Catholic hospitals over the last few years seeking to force them to violate Church doctrine on issues ranging from sterilization, to abortion, to sex-change surgeries.

Medical conscience disputes are going to become far more common as health care becomes immersed in our accelerating cultural conflicts and vexing questions of federalism. Bottom line: The ultimate goal of those who seek to force medical professionals and institutions to violate their religious beliefs, I believe, is to drive pro-lifers and Hippocratic Oath-adherents out of medicine.

Opposing Medical Conscience with a Soft Touch

National Review
Reproduced with permission

Wesley J. Smith

When the Department of Health and Human Services announced its intention to create a new office to emphasize the protection of medical conscience, the screaming from the usual suspects was so loud one would have thought Roe v. Wade had been overturned.

Now, The New England Journal of Medicine has published an abstruse opinion piece by one Lisa Harris, a professor concerned with “issues along the reproductive justice continuum,” whatever that means.

I bring this up because medical conscience is a burning issue for pro-life medical professionals and those who believe in Hippocratic medicine. The issue is whether doctors, nurses, pharmacists, and others can be forced to participate in requested interventions with which they have a strong religious or moral objection — such as abortion, assisted suicide, and suppressing normal puberty in children with gender dysphoria.

But reading Harris, you would think it was just about “partisans” not understanding the gray areas and nuances of contentious social issues. From, “Divisions Old and New–Conscience and Religious Freedom at HHS”:

I feel an angry argument building in response to HHS’s one-sided framing. But I resist it. Because my challenge these days is to avoid further entrenching polarized positions and to reject the divisiveness that poisons contemporary life. Is it possible, once again, to hold in tension seemingly opposite ideas about abortion? Can we understand abortion as both something that “stops a beating heart” and a fundamental right, rather than insisting it’s only one or the other?

But the conscience issue isn’t about whether we can all just get along and understand people have differences of opinion. It isn’t about “holding in tension seemingly opposite ideas.” It is about protecting doctors from being forced to take a human life or engage in another act in the clinical setting that is violative of their faith or moral beliefs.

Harris just doesn’t get it — or doesn’t want to:

Abortion and parenthood are not mutually exclusive; loving children and ending pregnancies are compatible in patients’ lived experience.

So is loving abortion work and questioning it: abortion providers might express an enormous sense of pride, purpose, and fulfillment in their work, and also say they felt weak-kneed the first time they saw a second-trimester abortion. Some feel sad that in different circumstances, many women would continue their pregnancies, in particular if poverty and economic strain were not issues. There is sometimes a point at which, when pressed, ardently pro-choice caregivers become uncomfortable with abortion. For some, it is a matter of pregnancy duration; for others, the circumstances of an abortion, such as sex selection.

Conversely, some caregivers whose religious beliefs lead them to strongly oppose abortion nevertheless offer assistance. Some religious nurses give medications and offer comfort, compassion, and care during an abortion because they see these tasks as shared purposes of nursing and religion. Sometimes doing so requires “sitting with discomfort in real time” and holding “the tension of two contradictory positions simultaneously.”

To which I respond, bully for them, but so what?

Harris should read Ezekiel Emanuel’s article in the NEJM from not too long ago advocating that doctors who refuse to participate in a legal procedures requested by the patient should be kicked out of medicine. No balancing of “tensions” and “sitting with discomfort in real time” for him!

And there is nothing in Harris’s piece to make me think she isn’t just as opposed to medical-conscience rights as Emanuel. She just says it indirectly, in a passive-aggressive manner, and with a softer touch.

I believe the real reason the medical establishment, the secular Left, and bioethicists like Emanuel and (I believe) Harris oppose strong legal conscience protections is precisely due to the powerful moral message sent when a respected doctor or nurse says to a patient: “No. I can’t do this thing you request. It is wrong.”

There is an old saying in pro-abortion advocacy: “If you don’t believe in abortion, don’t have one.”

To which I add a medical-conscience corollary: If you want an abortion, don’t force a doctor to give you one.

Sometimes comity requires living with unambiguity too.

‘Medical Conscience’ Is Becoming a Partisan Controversy

National Review
Reproduced with permission

Wesley J. Smith

Should doctors and nurses be forced to participate in interventions they find morally abhorrent or unwarranted? As one example, should ethical rules require pediatricians to medically inhibit normal puberty as demanded by parents to “treat” their child’s gender dysphoria — even if they are morally opposed to the concept and/or the supposed treatment?

Some say yes. Thus, influential bioethicist Ezekiel Emanuel argues that medical professionals are obligated to accede to the patient’s right to receive legal interventions if they are generally accepted within the medical community — specifically including abortion. Emanuel stated doctors who are morally or religiously opposed, should do the procedure anyway or procure a doctor they know will accede to the patient’s demands. Either that, or get out of medicine.

Supporters of “medical conscience” argue that forcing doctors to participate in interventions they find morally abhorrent would be involuntary medical servitude. They want to strengthen existing laws that protect doctors, nurses, and pharmacists’ who refuse participation in legal interventions to which they are morally or religiously opposed.

Now, medical conscience looks to become another battlefront in our bitter partisan divide. After the Trump administration announced rules that will place greater emphasis on enforcing federal laws protecting medical conscience, Democratic state attorneys general promised to seek a court order invalidating the new rule. From the New York Law Journal story:

But 19 state attorneys general, led by New York’s Eric Schneiderman, argue that it is the patients who will be discriminated against under the proposed rule. This is particularly true, they argue, in the cases of marginalized patients who already face discrimination in trying to obtain health care, such as lesbian, gay, bisexual and transgender patients and male patients seeking HIV/AIDS preventative medications, according to the comments filed in opposition to the rule.

“If adopted, the proposed rule … will needlessly and carelessly upset the balance that has long been struck in federal and state law to protect the religious freedom of providers, the business needs of employers, and the health care needs of patients,” they state.

The stakes can only increase as moral controversies in health care intensify in coming years. As just two examples, some bioethicists are lobbying to enact laws that would give dementia patients the right to sign an advance directive requiring nursing homes to starve them to death once they reach a specified level of cognitive decline. There are also increasing calls to do away with the dead-donor rule in transplant medicine so that PVS patients can be organ-harvested while still alive

If these acts become legal, should doctor and nurses who practice in these fields be forced to participate? If Emanuel’s opinion prevails, the answer could be yes. If medical professionals are protected by medical conscience legal protections, the answer would be no.

Medical conscience is not just important to personally affected professionals. All of us have a stake. Think about the potential talent drain we could face if we force health-care professionals to violate their moral beliefs. Experienced doctors and nurses might well take Emanuel’s advice and get out of medicine — while talented young people who could add so much to the field may avoid entering health-care professions altogether.

Comity is essential to societal cohesion in our moral polyglot age. Medical conscience allows patients to obtain morally contentious procedures, while permitting dissenting medical professionals to stay true to their own moral and religious beliefs. I hope the Democrats’ lawsuits are thrown out of court.