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WASHINGTON LETTER Mar-23-2007 (890 words) Backgrounder. xxxn
Conscience rights at risk: States, doctors consider what's at stake
By Nancy Frazier O'Brien
Catholic News Service
WASHINGTON (CNS) -- Although a proposal to protect the conscience rights of health care providers and institutions that don't want to participate in certain medical procedures isn't getting much action in Congress, the issue of conscience protection is a hot topic in several states and within the medical community.
The Abortion Nondiscrimination Act of 2007, sponsored by Sen. David Vitter, R-La., has gotten no co-sponsors since its Jan. 22 introduction and no hearings have been scheduled on it by the Senate Committee on Health, Education, Labor and Pensions.
Meanwhile, battles are heating up in various parts of the country over proposals that Catholic leaders say would violate health care providers' rights -- as affirmed in official American Medical Association policy -- to decline to participate in actions that conflict with their own "personal, religious or moral beliefs."
The prestigious New England Journal of Medicine also raised the topic of conscience protection in a recent issue by publishing the results of a survey on how doctors' moral or religious beliefs affect patient care.
Connecticut legislators are considering a proposal that would require all hospitals receiving public funds -- including the state's four Catholic hospitals -- to offer emergency contraception to rape victims, without performing a test to ascertain whether the woman is already pregnant.
That would mean the emergency contraception, marketed as Plan B, could cause an abortion and its use would violate the Catholic stand on life.
A note on the Web site of the Connecticut Catholic Conference says Catholic hospitals "should not be forced to violate their religious beliefs, especially those concerning the human dignity of every person, no matter at what stage of life."
The legislation was at the top of the agenda when Connecticut Catholics descended on the state Capitol in Hartford March 22 for Catholic Concerns Day 2007.
Across the country, the Oregon Catholic Conference was fighting a similar battle over a bill that would require all health plans paying for prescription drugs to also cover prescription birth control. The legislation also mandates that all hospitals in the state provide emergency contraception to rape victims.
Testifying on behalf of the Oregon Catholic Conference, Kelsey Wilson offered to help the House Committee on Human Services and Women's Wellness draft a conscience clause.
"If House Bill 2700 passes as is, the state would force us into violating our fundamental moral and religious teaching," Wilson said, adding that without a conscience clause all prescription coverage might have to be withdrawn for the approximately 2,000 Oregonians employed by dioceses, parishes, schools and other Catholic organizations in the state.
In the U.S., 26 states mandate contraceptive coverage. Of those, 11 offer a religious exemption to employers.
Emergency contraception raises similar questions of conscience.
Guided by the "Ethical and Religious Directives for Catholic Health Care Services," which state that a sexual assault victim "should be able to defend herself against a potential conception from the sexual assault," most Catholic hospitals will provide emergency contraception to rape victims as long as conception has not occurred. A luteinizing hormone urine dip test, or LH test, usually is administered to make that determination.
In the Minnesota Legislature March 20, a House committee approved legislation that would require hospitals to tell sexual assault victims that emergency contraception is available but would permit Catholic facilities to continue testing to see if the woman is pregnant.
Discussions in the states might become moot if the U.S. Congress acts on the Prevention First Act, which the U.S. bishops' Secretariat for Pro-Life Activities opposes. The bill would mandate contraceptive coverage and the provision of emergency contraception to sexual assault victims in all states; as written, it contains no religious exemptions or conscience protection.
The study published Feb. 8 in the New England Journal of Medicine offers some insights into how the medical community views conscience rights.
"The medical profession appears to be divided on this issue," said the report on the study. "In the wake of recent controversies over emergency contraception, editorials in leading clinical journals have ... challenged the idea that physicians may deny legally and medically permitted medical interventions, particularly if their objections are personal and religious."
The study by researchers at the University of Chicago concluded that "most physicians do not consider themselves obligated to disclose information about or refer patients for legal but morally controversial medical procedures." It did not look at how physicians' beliefs affect patient care but only at what the doctors said they believed.
A recent issue brief on "professionalism and conscience" by R. Alta Charo, a professor of law and bioethics at the University of Wisconsin Law School, called the debate over conscience clauses "the latest struggle with regard to religion in America" and came to a conclusion that could send a chill up the spines of those fighting for conscience protection.
Describing conscience protection clauses as "artifacts of the abortion wars," Charo said, "By failing to abide by the standards set by their own professions, those practicing refusal without the necessary accompanying assistance at informing patients of their options and providing referrals or other alternatives are not merely denying a discretionary benefit to the consumer but rather are affirmatively violating a duty to their patients."
- - -
Contributing to this story was Ed Langlois in Portland.
END
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