Protecting doctors' choices and consciences

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A doctor's right to choose--not to participate in abortion--is an essential part of the life and choice debate, says one Catholic scholar.

By Guest Blogger Christopher Kaczor

"Irish Need Not Apply" read many storefront signs in the United States during the 19th century. Today, almost everyone disapproves of racial, ethnic, or religious discrimination. Yet important segments of our society support a different sort of discrimination which prevents conscientious objectors to abortion, including many Catholics and others for good will, from participating on an equal footing in the field of medicine. 

At the upcoming Conference on Life & Choice in the Abortion Debate, held at Princeton University, I plan to talk about the importance of protecting the right of conscience by looking at the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion #385 entitled, "The Limits of Conscientious Refusal in Reproductive Medicine."

This report, issued in November of 2007, attempted to "maximize accommodation of an individual's religious or moral beliefs while avoiding imposition of these beliefs on others or interfering with the safe, timely, and financially feasible access to reproductive health care that all women deserve."  

Unfortunately, the balance struck in the report between respecting personal conscience and facilitating "reproductive autonomy" (including abortion) forces some physicians to act against their best ethical and medical judgments. For example, the report holds that a physician unwilling to perform abortions must refer patients to other providers, even when abortion is judged by the physician not to be in the best medical interests of a patient. By contrast, in defending partial birth abortion, ACOG champions the judgment of the individual doctor about what is best for a particular patient. 

The report also recommends that conscientiously objecting physicians provide prior notice to their patients that they do not provide abortion, but at the same time these doctors may not "argue or advocate" their views. Opinion #385 thus puts pro-life physicians in the precarious bind of being forced to reveal what they believe, but forbidden to relate why they believe it. In other contexts, ACOG opposes "gag rules" that restrict communication between physician and patient. 

The committee also recommends that pro-life doctors "practice in proximity to individuals who do not share their views." The report mentions no concern about a pro-life physician serving patients in a rural community whose wellbeing would be jeopardized by the loss of a local doctor.  

The report even demands that conscientiously objecting physicians themselves perform abortions if not doing so would be detrimental to the physical or mental health of the person seeking abortion. Since "mental health" is customarily used in these discussions to cover virtually any circumstance in which not providing abortion would cause mental anguish for the woman desiring it, the report essentially vacates any conscience protection. 

Unless conscience protections remain protected by law, the ACOG ethics report could be the end of the pro-life doctor and the Catholic hospital--a serious loss of providers and institutions which would make health care even more expensive.


Guest Blogger Christopher Kaczor, Ph.D., is Professor of Philosophy at Loyola Marymount University and author of The Ethics of Abortion: Women's Rights, Human Life, and the Question of Justice.

Posts from other pro-life advocates will be posted throughout Respect Life Month (October) at uscatholic.org/pro-life.

Guest blog posts express the views of the author. They do not necessarily reflect the views of U.S. Catholic,its editors, or the Claretians.