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Friday, May 18, 2018

CMA doctors support administration proposal to keep federal funds separate from abortion

CMA CEO Dr. David Stevens: "Taxpayers want their money to support healthcare, and abortion is not healthcare."

Washington, DC—May 18, 2018--The 19,000-member Christian Medical Association (CMA, www.cmda.org) today expressed support for administration plans to disentangle taxpayer funds from abortion as a method of family planning.
CMA CEO Dr. David Stevens noted, "Taxpayers want their money to support healthcare, and abortion is not healthcare.
"The 'Protect Life Rule' proposed today should go a long way to ensuring that our tax dollars are not illegally propping up the abortion industry. Planned Parenthood is a billion-dollar industry that gets half a billion of our tax dollars and performs nearly a third of a million abortions per year, according to its own annual reports.
"Importantly, the new proposal also is expected to stop mandated referrals for abortions. Most pro-life physicians such as our members cannot refer for abortion, because of conscience and because abortion violates longstanding medical ethics such as the Hippocratic oath.
"True healthcare promotes health, healing and comfort. Abortion doesn’t maintain or improve the health of the mother or unborn child. Even in rare cases when a pregnant woman for health reasons may need her baby delivered early, it should never be done with the intent to kill her child."
"These tax dollars can go to many fine community and rural healthcare centers, which far outnumber the Planned Parenthood abortion clinics and provide a vast array of quality, non-controversial and life-affirming healthcare services."

Background

Congress authorized the Title X program in 1970 to provide family planning services to low income women. The authorizing statute drew a bright line of separation between family planning and abortion: “None of the funds appropriated under this subchapter shall be used in programs where abortion is a method of family planning.”
Current regulations in place since the Clinton administration require Title X grantees to refer pregnant women for abortion, and Title X grantees may be located in the same location as an abortion clinic. Title X is Planned Parenthood’s second-largest stream of federal funding. A 2018 GAO report indicated that Planned Parenthood receives approximately $56 million taxpayer dollars through Title X alone annually.
Today, the Office of Management and Budget (OMB) posted a notice that it is reviewing a proposed rule governing the “statutory program integrity requirements” of the Title X family planning program. The text of the proposed rule is not yet available but reportedly requires a bright line of physical as well as financial separation between Title X programs and any program (or facility) where abortion is performed, supported, or referred for as a method of family planning.

Friday, April 27, 2018

Abortion and sex issues incite opposition to conscience freedom rule

Note: This is the eighth essay in a series on conscience in healthcare, by Jonathan Imbody, Vice President for Government Relations for the Christian Medical Association and Director of Freedom2Care.

In an April 2018 editorial published in The Hill[i] protesting the conscience freedom protection rule proposed by the U.S. Department of Health and Human Services (HHS)[ii], American Nurses Association president Pamela Cipriano and American Academy of Nursing president Karen Cox outline the typical "no tolerance" policy of conscience freedom opponents. As usual, they cite a "duty to patients" that allegedly overrides any other moral or ethical obligation, most notably the Hippocratic oath, biblical principles and pro-life conscience convictions.
Also as usual, they claim that pretty much everyone in medicine shares their view.
"Many medical societies and professional associations all agree that the provider’s right to conscientiously refuse to provide certain services must be secondary to his or her first duty, which is to the patient.
"Should there be a justifiable situation when a health-care worker believes it is necessary to withdraw from any participation in a patient’s care, then there is an obligation to provide for that patient’s safety, and assure that others make the care available to the patient, but never to deny services outright."
"Never deny services outright" means that ultimately, whatever the patient wants, the patient gets. No room for conscience, ethics or even professional medical judgment.
That may fit the authors' notion of whom they label "health-care workers," but it hardly comports with the long-standing notion of a healthcare professional—i.e., an individual who, having met objective standards of technical training, publicly professes fealty to objective moral and ethical standards.
The authors go on to reveal the real reason for their outrage about the HHS conscience freedom rule:
Discrimination in health care settings remains a grave and widespread problem for LGBTQ populations and women — particularly those seeking reproductive services — that leads to increased negative health outcomes from delayed or denied care.
Somehow protests over conscience freedom always come down to a belligerent drive to force all health professionals to adopt a radical political and ideological view on sexuality and abortion. That's why every health professional who upholds Christian, life-affirming, sex-within-marriage principles now senses that conscience convictions may someday jeopardize his or her medical career.

Pro-life nurses coerced to participate in abortion

Despite the testimonies of pro-life nurses like Fe Vinoya (left) 
and Cathy DeCarlo (right) who suffered abortion coercion,
professional nurses associations continue to lobby
against conscience protections.
Nurse Cathy DeCarlo certainly sensed that threat when her employer forced her to participate in a gruesome abortion despite her protests based on conscience. The legal firm Alliance Defending Freedom describes nurse Cathy's dilemma:
When she was hired in 2004, Cathy made it clear: “I don’t do abortions.” At the time, the hospital assured her she would never have to compromise her devout Catholic faith, but times changed. One morning five years later, Cathy prepared for a common procedure following a miscarriage, only to realize that the procedure was going to be performed on a live pre-born baby at 22 weeks. Horrified, she called the resident doctor on duty, then her supervisor, who told her to call her supervisor.
When that supervisor informed her that Cathy would have to assist with the abortion, Cathy reminded her in tears about her agreement with the hospital. She pointed out that the surgery was labeled a Category II, meaning it could take place anytime over the next six hours – plenty of time to call another nurse. But the supervisor insisted that this was an emergency -- the mother’s life hung in the balance. If Cathy didn’t assist in this life-or-death situation, she told her, she would be charged with insubordination and abandoning her patient. Her career would be over.
Cathy decided to trust her supervisors, but as soon as she saw the patient, she knew she made a mistake. The woman’s life was clearly not in danger, but at that point, there was no going back. She watched in horror as the doctor dismembered and removed the bloody limbs, and then she had to account for all the pieces.
“It was like something out of a horror film,” she said.[iii]
The Alliance Defending Freedom took up Cathy's case and filed complaints against her supervisors for forcing her to violate her faith. Following an investigation, Mount Sinai Hospital revised its policies to protect the rights of all medical personnel to object to participating in abortions, including in an emergency.
Another nurse, Fe Esperanza Racpan Vinoya, testified in Congress regarding the abortion coercion she experienced along with 11 nurse colleagues:
My name is Fe Esperanza Racpan Vinoya, a nurse of 26 years, and I represent the 12 nurses who were ordered to assist in abortion six years ago in a Same Day Surgery Unit in New Jersey. I became a nurse to help people--not to do harm. Participating in the destruction of human life is not only a violation of my religious convictions; it also conflicts with my calling as a medical professional to protect life, not to end it.
Despite our numerous pleas to our superiors due to our religious beliefs, we were required to be trained to participate in the preparation, delivery, and disposal of the baby. Our jobs were threatened if we were not to follow their directives.
Protecting our conscience serves our patients well. I will not participate in abortion. Period. So no amount of compulsion against me would have succeeded. But forcing me and my colleagues out of our jobs would have denied all of my patients access to the services we perform on a daily basis. And no one should want medical professionals, with the power of life and death in their hands, to be forced to set aside their moral convictions.[iv]
In the case of Fe Vinoya and the 12 nurses, the Alliance Defending Freedom obtained a court order preventing their employer from implementing coerced abortion training. Just days before trial, the judge announced that a settlement had been reached. The hospital agreed not to force the women to participate in abortions or to retaliate against them by replacing them.
These legal victories for nurses DeCarlo, Vinoya and their colleagues help counter the lamentable lobbying against conscience protections by the American Nurses Association and the American Academy of Nursing. Instead of protecting their members, these organizations persist in pushing a political agenda and radical ideology that would force pro-life nurses like Cathy and Fe to participate in abortion.
Nurses DeCarlo and Vinoya have lobbied the U.S. Congress to pass the federal Conscience Protection Act (S 301, HR 644), which would strengthen the ability of health professionals to sue in court to redress discrimination on the grounds of conscience. The Act also would make permanent current federal law that now requires annual Congressional reauthorization.



[i] Pamela Cipriano and Karen Cox, "HHS proposed rule lowers the bar for care and discriminates against certain people," The Hill, April 4, 2018, accessed online 4/27/18 at http://thehill.com/opinion/healthcare/381596-hhs-proposed-rule-lowers-the-bar-for-care-and-discriminates-against.
[ii] "Protecting Statutory Conscience Rights in Health Care; Delegations of Authority, A Proposed Rule by the Health and Human Services Department on 01/26/2018," accessed online 4/27/18 at https://www.federalregister.gov/documents/2018/01/26/2018-01226/protecting-statutory-conscience-rights-in-health-care-delegations-of-authority.
[iii] " Cathy DeCarlo," Alliance Defending Freedom web page accessed April 27, 2018 at https://www.adflegal.org/detailspages/client-stories-details/cathy-decarlo.
[iv] Testimony of Fe Vinoya, U.S. House Energy and Commerce Committee,  July 8, 2016, accessed online April 27, 2018 at https://energycommerce.house.gov/sites/republicans.energycommerce.house.gov/files/documents/114/Vinoya_Remarks.pdf




Thursday, March 29, 2018

Conscience freedoms protect against ideological agendas


Note: This excerpt is the seventh in a series of essays on conscience in healthcare, by Jonathan Imbody, Vice President for Government Relations for the Christian Medical Association and Director of Freedom2Care.
------
With pro-life individuals increasingly targeted,
conscience laws can help protect both
patients and professionals from discrimination.
On January 26, 2018, the U.S. Department of Health and Human Services (HHS) proposed a conscience protection rule designed to enforce and educate regarding "a long history of providing conscience-based protections for individuals and entities with objections to certain activities based on religious belief and moral convictions. "[i]
The rule specifically cited over two dozen existing federal statutes protecting the exercise of conscience in healthcare, both for patients and professionals. Included in the laws are:
·       Conscience protections related to abortion, sterilization, and certain other health services to participants in programs—and their personnel—funded by the Department (the Church Amendments);
·       Conscience protections for health care entities related to abortion provision or training, referral for such abortion or training, or accreditation standards related to abortion (the Coats-Snowe Amendment);
·       Protections from discrimination for health care entities and individuals who object to furthering or participating in abortion under programs funded by the Department's yearly appropriations acts (e.g., the Weldon Amendment and others);
·       Conscience protections under the Patient Protection and Affordable Care Act (ACA) related to assisted suicide, the ACA individual mandate, and other matters of conscience;
·       Conscience protections for objections to counseling and referral for certain services in Medicaid or Medicare Advantage;
·       Conscience protections related to the performance of advanced directives;
·       Conscience protections related to Global Health Programs to the extent administered by the Secretary (e.g., Helms Amendment and others);
·       Exemptions from compulsory health care or services generally, and under specific programs for hearing screening, occupational illness testing; vaccination, and mental health treatment; and
·       Protections for religious nonmedical health care.
The Department invited public comment on the proposed rule by March 27, 2018.

Conscience protection laws require education and enforcement

The following excerpt of a comment on the HHS proposed rule, submitted by the Christian Medical Association and its conscience-focused entity, Freedom2Care, outlines the need for and benefits of the rule:
Representing combined constituencies of nearly 50,000 individuals who are committed to the moral and ethical practice of medicine, [we] heartily applaud this proposed rule. We laud the Department for producing an outstanding tool to enforce existing conscience protection law and to educate regarding our most cherished principles of freedom.
The proposed rule clearly and thoroughly lays down the legal and rational foundation for the Department's enforcement of and education about existing federal law that protects the exercise of conscience and religious convictions in healthcare, both for patients and for professionals. Given the priority of conscience and religious freedom in our nation's founding, in our Constitution and in our legal tradition, the case could not be clearer for restoring the rightful place of these freedoms among other civil rights laws and principles.
Only willful political corruption and ideologically driven assaults on these core founding principles can explain why in 2018 the universal integration of conscience and religious freedom in healthcare remains incomplete. Therefore the proposed rule offers a welcome, if long overdue, course correction to get the nation back on track on the principles on which this democratic republic depends.
While the proposed rule offers hope of a renaissance of a political, cultural and professional commitment to freedom of conscience and religious exercise, ideological forces within government, academia and the healthcare community continue to subvert these freedoms. As a survey of medical and academic publications will indicate, abortion advocacy and a strong undercurrent of intolerance for faith-based and pro-life commitments would sweep out of medicine any and all health professionals who hold to such ideals. A radical and authoritarian ideology that marches under the false flag of "patient autonomy" would force all professionals to participate in any legal procedure or prescription, regardless of professional judgment, medical ethics or moral convictions.
The result of such intolerance and coercion, left unchecked by federal law, court action and regulatory enforcement, would be a catastrophic loss of healthcare for millions of American patients. Hardest hit by the loss of pro-life and faith-based professionals and institutions would be the poor, the marginalized and the medically underserved.
By enforcing the freedom of pro-life and faith-based health professionals to continue to practice medicine, the proposed rule protects patient access to a diverse pool of health professionals and institutions. In the process, the rule also upholds and advances core American values of freedom.[ii]

Polling evidences the need for conscience protections

At a national press conference, then-pollster Kellyanne Conway
explained how patients want physicians who share their values and
how without conscience protections, faith-based physicians would
be forced out of medicine--resulting in lost access for patients.
The comment of the Christian Medical Association and Freedom2Care also provided polling evidence to answer HHS's request for "comment on information … about the occurrence or nature of coercion, discriminatory conduct, or other violations of the Federal health care conscience and associated anti-discrimination laws." HHS also requested evidence on "the general knowledge, or lack thereof, of the protections established by the Federal health care conscience and associated anti-discrimination provisions."
A survey conducted for CMA's Freedom2Care[iii] by The Polling Company, Inc. revealed that 92 percent of faith-based physicians said they would be forced to leave medicine if coerced into violating the faith tenets and medical ethics principles that guide their practice of medicine. Faith-based health professionals do not, and cannot, separate the faith principles that motivate them to serve the needy from the faith principles that uphold the sanctity of human life.
The survey also found that 39 percent have “experienced pressure from or discrimination by faculty or administrators based on [their] moral, ethical, or religious beliefs.”
Conscience rights impact not only health professionals but also the patients they serve. In Freedom2Care's nationwide polling of American adults, 88% said it is important to them that they share a similar set of morals as their doctors, nurses, and other healthcare providers.
The Polling Company, Inc., also found that only 38 percent of Americans realize that physicians may not legally be coerced into violating standards of medical ethics and their own conscientiously held moral convictions by requiring them to perform abortions or refer patients for abortions.
From several decades of communicating with health professionals on conscience issues, my sense is that those opposed to conscience protections are more aware of such protections than the pro-life and faith-based professionals who currently need them most. Many abortion activists and advocates, including those in the medical community, have focused on an agenda of mandated abortion participation and have accurately identified conscience protections as a primary roadblock to achieving their goal.

Medical schools too often undermine conscience


 Polling showed that 23% have “experienced
discrimination  during the medical school or
residency application and interview process
because of moral, ethical or religious beliefs.”
Meanwhile, medical school curricula often are so tightly packed with technical instruction that little room remains for information and discussions about conscience protections. Given the current pressure from some within medical academia to do away with conscience protections, medical school instructors may not even be a reliable source of accurate and unbiased information on this topic.
In communications over the years with physicians who have experienced job loss and other forms of discrimination over conscience issues, it is clear that some are not only unaware of legal protections but also not necessarily inclined to fight for their rights. Medical training can involve a fair amount of pressure to conform to institutional requirements. Medical education also tends to focus on training about how to follow procedures and protocols rather than about how to challenge the system.
The Polling Company, Inc.'s survey of 2,865 members of faith-based medical organizations found that when faith-based health professionals (primarily physicians) were asked to assess their educational experiences:
·       33% have “considered not pursuing a career in a particular medical specialty because of attitudes prevalent in that specialty that is not considered tolerant of [their] moral, ethical or religious beliefs.”
·       23% have “experienced discrimination during the medical school or residency application and interview process because of [their] moral, ethical or religious beliefs.”[iv]In light of the threats to conscience protections, a general lack of awareness of legal protections and recourse and a disinclination to "challenge the system" makes the education of the medical community an urgent priority. Such education should include not only an outline of specific legal protections but also an education about why conscience protections are an important part of medicine and American values.

Conscience protections build a wall against intolerance and coercion

Faith-based professionals and institutions are
"often the very ones providing care for marginalized,
under-served and poor populations."
The Christian Medical Association / Freedom2Care comment concluded,
The Department has crafted a rule consistent with decades of federal conscience law and American values of freedom.
Education about and enforcement of these laws has long been neglected, allowing a culture of intolerance and coercion to fester within the medical community. Those subject to job loss, loss of privileges, being barred from educational opportunities and other forms of discrimination include pro-life and faith-based health professionals and institutions. These individuals and institutions are often the very ones providing care for marginalized, under-served and poor populations who otherwise would have few or no options for healthcare.
Enforcing existing law and educating the healthcare community regarding conscience protections will not only protect life-affirming healthcare professionals dedicated to longstanding medical ethics principles; it will also protect the millions of patients who share their values and depend upon their continued service.

[i] "Protecting Statutory Conscience Rights in Health Care; Delegations of Authority, A Proposed Rule by the Health and Human Services Department on 01/26/2018," accessed online 3/29/18 at https://www.federalregister.gov/documents/2018/01/26/2018-01226/protecting-statutory-conscience-rights-in-health-care-delegations-of-authority.
[ii] Public comment of CMA and Freedom2Care, submitted March 26, 2018 by Jonathan Imbody. Full text of the comment is available at https://docs.wixstatic.com/ugd/809e70_bf59a9129e9e411a94083eab93bb8889.docx?dn=CMA%20comment%20-%20HHS%20proposed%20conscience%20protection%20rule%202018.docx.
[iii] Polling details available at https://www.freedom2care.org/polling.
[iv] Online Survey of 2,852 Members of Faith-Based Medical Associations, by the polling companyTM, inc./WomanTrend, on behalf of the Christian Medical Association. Field Dates: March 31-April 3, 2009. Summary available at https://docs.wixstatic.com/ugd/809e70_2f66d15b88a0476e96d3b8e3b3374808.pdf.

Monday, March 26, 2018

Comment by March 27 on new HHS conscience rule that erects a wall against ideologically driven assaults

Action: Submit your comment by Tuesday, March 27 to protect conscience in healthcare

Today I submitted a document to the U.S. Department of Health and Human Services outlining the reasons why a new proposed conscience protection rule serves the interests of health professionals and their patients:

TO: Department of Health and Human Services, Office for Civil Rights RIN 0945-ZA03
FROM: Christian Medical Association and Freedom2Care - Jonathan Imbody
RE: RIN 0945-ZA03 or Docket HHS-OCR-2018-0002
DATE: March 26, 2018

Protecting Statutory Conscience Rights in Health Care; Delegations of Authority

The following narrative offers answers to specific requests for comments (marked below with numbers and quotations) outlined in the text of the proposed rule.

·       "Comment on all issues raised by the proposed regulation."

The Christian Medical Association and Freedom2Care, representing combined constituencies of nearly 50,000 individuals who are committed to the moral and ethical practice of medicine, heartily applaud this proposed rule. We laud the Department for producing an outstanding tool to enforce existing conscience protection law and to educate regarding our most cherished principles of freedom.
The proposed rule clearly and thoroughly lays down the legal and rational foundation for the Department's enforcement of and education about existing federal law that protects the exercise of conscience and religious convictions in healthcare, both for patients and for professionals. Given the priority of conscience and religious freedom in our nation's founding, in our Constitution and in our legal tradition, the case could not be clearer for restoring the rightful place of these freedoms among other civil rights laws and principles.
Only willful political corruption and ideologically driven assaults on these core founding principles can explain why in 2018 the universal integration of conscience and religious freedom in healthcare remains incomplete. Therefore the proposed rule offers a welcome, if long overdue, course correction to get the nation back on track on the principles on which this democratic republic depends.
While the proposed rule offers hope of a renaissance of a political, cultural and professional commitment to freedom of conscience and religious exercise, ideological forces within government, academia and the healthcare community continue to subvert these freedoms. As a survey of medical and academic publications will indicate, abortion advocacy and a strong undercurrent of intolerance for faith-based and pro-life commitments would sweep out of medicine any and all health professionals who hold to such ideals. A radical and authoritarian ideology that marches under the false flag of "patient autonomy" would force all professionals to participate in any legal procedure or prescription, regardless of professional judgment, medical ethics or moral convictions.
The result of such intolerance and coercion, left unchecked by federal law, court action and regulatory enforcement, would be a catastrophic loss of healthcare for millions of American patients. Hardest hit by the loss of pro-life and faith-based professionals and institutions would be the poor, the marginalized and the medically underserved.
By enforcing the freedom of pro-life and faith-based health professionals to continue to practice medicine, the proposed rule protects patient access to a diverse pool of health professionals and institutions. In the process, the rule also upholds and advances core American values of freedom.

To read the rest of the document, click here.

To learn how to quickly (30 seconds) submit your own comment on the proposed rule (deadline Tuesday, March 27) using a pre-written, editable form, click here.

To watch a quick video explanation, click here.


Friday, March 16, 2018

Use our ready-made comment form to voice your view on a new healthcare faith and conscience rule

Action: Use this form to voice your view on the new healthcare faith and conscience rule

We have a brief window of opportunity to protect conscience and religious freedom in healthcare.
The U.S. Dept. of Health and Human Resources (HHS) has proposed-and asked for our comments on-a new rule that would strongly protect the religious and conscience rights of health professionals and patients.

Whom does the new rule protect?

The new rule will help protect pro-life, faith-based and morally concerned health professionals and patients from discrimination, loss of physician, coercion, job loss, loss of healthcare access, license revocation, demotions, loss of educational opportunity, forced training and much more.

What if I've experienced discrimination?

The new rule also gives us a defender-the HHS Office of Civil Rights-to  take up complaints of discrimination, educate the health community about conscience and enforce 25 federal laws related to faith and conscience freedom in healthcare.
Also on the Freedom2Care legal hep web page, you also can take legal steps to address the discrimination you experienced.

How do I submit a comment?

The quick action you can take right now is to visit our Freedom2Care web page and follow the very simple steps to submit your comment. You can also learn more there about the proposed rule.
Then just push the button and submit your comment.

Why bother?

By submitting your comment, you will be protecting your God-given, constitutionally asserted rights to choose what to believe and to act on your beliefs. You also will be protecting the rights of other health professionals, patients and all Americans to do the same.

What's the deadline for my comments?

The deadline is March 27.
Important: You can also include in your comment any discrimination in healthcare, because of conscience or faith, that you have experienced or witnessed.
(For legal help and reporting discrimination, click here.)

Thank you for taking advantage of this rare opportunity.

Npte: On the Freedom2Care web page, you can choose a quick and simple response or also a more detailed response to specific questions if you prefer.
Alternatively, you can submit your comment directly to HHS via regulations.gov here.

Thursday, February 22, 2018

New HHS division, conscience freedom laws and policies protect patients and physicians



The new HHS division implements 25 federal conscience laws
Note: This excerpt is the sixth in a series of essays on conscience in healthcare, by Jonathan Imbody, Vice President for Government Relations of the Christian Medical Association and Director of Freedom2Care.
Essay #1: "Choose, you lose" prescription threatens the conscience rights of every professional"
Essay #2: "Autonomy quickly translates to tyranny"
Essay #3: "Medical ethics: Bedrock oaths versus zeitgeist barometers"
Essay #4: "'Patient autonomy' – The Trojan Horse assault on conscience freedom in healthcare"
Essay #5: "Are healthcare conscience laws needed?"

In January 2018, the U.S. Department of Health and Human Services announced the creation of a new division within its Office of Civil Rights—the Conscience and Religious Freedom Division.[i] The new division now serves as a center for information on 25 federal conscience laws, outlined on the division's website, including:[ii]
·       The Church Amendments, enacted in the 1970s "to protect the conscience rights of individuals and entities that object to performing or assisting in the performance of abortion or sterilization procedures if doing so would be contrary to the provider’s religious beliefs or moral convictions."
·       Public Health Service Act § 245, which "prohibits the federal government and any state or local government receiving federal financial assistance from discriminating against any health care entity on the basis that the entity refuses to undergo training in the performance of induced abortions" and related actions.
·       The Weldon Amendment, which prohibits government "discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions."
The HHS division will help victims like nurse Cathy DeCarlo,
forced to participate in an abortion against her conscience.
The new HHS conscience and religious freedom division also serves as a recipient of complaints of discrimination on the basis of conscience.
"We are thankful to see these vital conscience freedoms restored in healthcare," noted Christian Medical Association Senior Vice President Gene Rudd, MD in a news release. "For millennia, medical ethics have provided for conscientious opposition to abortion by physicians who took up the practice of medicine as a healing art never to be used for the destruction of human life. And until recently, our government reinforced those ethical principles with conscience protections. We are heartened to see our government heading back in the direction of these vital freedoms that protect patients, medicine and freedom in our country."
In that news release, I added, "As Americans who have inherited a nation founded upon freedom of faith, conscience and speech, we can agree that the government must never force individuals to violate their deepest held beliefs on vital and extremely controversial issues such as abortion. When our leaders forget these principles, and take to forcing nuns to participate in matters they consider wholly immoral, the American people realize that our fundamental freedoms are in jeopardy. If the government can take away the rights of one group, then no one is safe from government coercion.
"These actions today by the administration are an important step back in the direction of freedom and respect for one another, and we look forward to more actions in the future, including restoration of the conscience rule for health professionals that President Obama gutted."
While many lauded the new division as protecting fundamental conscience freedoms and First Amendment rights, some political activists issued "hair-on-fire" statements condemning the division as devaluing humanity and promoting religious bigotry.
"This is the use of religion to hurt people because you disapprove of who they are," asserted Harper Jean Tobin, the National Center for Transgender Equality's director of policy, in a statement published by The Washington Post.[iv]

No one's objecting to treating "particular classes of patients"

Contrary to unsubstantiated claims of conscience freedom
covering bigotry, faith-based professionals often actually
seek out  marginalized and stigmatized patients.
The accusation by some LGBT and abortion activists, that health professionals will use conscience claims to discriminate against certain patients, unfortunately also finds expression in the medical community.
Writing in the New England Journal of Medicine, Obamacare architect Ezekiel Emanuel and Penn Professor Ronit Stahl also equate conscience objections with bigotry, asserting,
"No matter how sincerely held, objections to treating particular classes of patients are indefensible — regardless of whether the objections are based on race, gender, religion, nationality, or sexual orientation."[v]
Well, sure, that would be indefensible—if it were actually happening. But, of course, the authors provide no examples of such insidious discrimination. It's just useful for stirring up an emotional response: " I don't want to be labeled a bigot, so let's get rid of these conscience laws that legalize bigotry!"
When President Obama gutted a two-year-old Bush-era conscience protection regulation, an opponent of conscience rights exclaimed to the Washington Post, "Without the rescission of this regulation, we would see tremendous discrimination against patients based on their behavior and based just on who they are.  We would see real people suffer, and more women could die."[vi]
Of course, no real-life examples were cited, and apparently none occurred in the years after the conscience protections took effect.
The truth is that conscience protections do not allow physicians to refuse to treat "particular class of patients." In fact, faith-based health professionals (who depend on conscience protections against coercion) in particular have gone to great lengths to purposefully reach out to the marginalized, the stigmatized and victims of discrimination.

Health policy will always reflect opinions

Hypocrisy: Abortion advocates agitate to force pro-life physicians
to participate in abortion. Then they accuse conscientious objectors
of forcing their personal opinions on others.
The Washington Post article on the new HHS conscience and religious freedom division also quoted Sarah Warbelow, legal director for the Human Rights Campaign, who asserted that the policy seeks to "devalue the humanity of LGBTQ people. Every American deserves access to medically necessary health care, and that health care should not be determined by the personal opinions of individual health care providers or administrative staff."[vii]
While real-life examples of medical professionals "devaluing the humanity of LGBTQ people" are scarce or nonexistent, examples of personal opinions impacting healthcare are ubiquitous. It's also notable that at the same time that Ms. Warbelow argues to disallow the "personal opinions" of health professionals from influencing healthcare, she argues that her own personal opinion, her group's own ideology, must direct healthcare.
Opponents of conscience protections frequently assert the mantra that conscientious health professionals are forcing their opinions on others. But prolife physicians do not force their patients or anyone else to adopt a prolife view; they simply seek exemption from coercion to kill.
Yet intolerant abortion advocates cannot seem to countenance diversity of opinion in healthcare. They would force prolife physicians to perform or refer for abortions or else sacrifice their careers. Then they complain with straight faces about prolife physicians forcing their opinions on others.
The idea that health professionals must ignore their moral and ethical convictions and perform any and all legal procedures is, in itself, a personal opinion expanded into an ideology—"an orientation that characterizes the thinking of a group or nation."[viii]

The conscience debate will impact the future of healthcare

In a free society, we can and should debate the question: Would eliminating conscience freedoms be good or bad for healthcare, for patients, for health professionals, for the country?  But to assert that health professionals who base their practice of medicine on certain ethical prohibitions are uniquely forcing their "personal opinions" on others is patently hypocritical.
Healthcare policies always reflect opinions; they are conceived and implemented by individuals who have personal opinions and by groups that have ideologies. Our democratic republic is designed to debate opinions freely and then translate the best opinions into laws that benefit society. We elect lawmakers who share our opinions and will translate those opinions into laws and policies.
For example, the law that imposed Obamacare on the nation clearly reflected the opinions and big-government ideology of Democrats. The repeal and replacement of Obamacare clearly reflected the opinions and small-government ideology of Republicans. Even if Congress decided to get out of healthcare altogether, that decision to disengage would be a policy formed by opinions and ideology.
The real question is not whether a policy reflects someone's opinions
but rather which opinion, which policy is best and should prevail?
The real question is not whether a policy reflects someone's opinions but rather which opinion, which policy is best and should prevail?
For millennia, medicine and law have provided room for conscience freedom--differing convictions on controversial issues--among health professionals. Many would continue that long-standing policy of tolerance for reasons both pragmatic and philosophical:
·       Tolerance maximizes healthcare access by enabling a breadth of professionals to practice medicine;
·       Tolerance comports with professionalism and professional judgment (a health professional being one who professes to adhere to an ethical standard that guides his or her practice of medicine);
·       Tolerance offers patients the ability to choose health professionals in line with the patient's own values;
·       Tolerance reflects core American principles of freedom of conscience, faith and speech.
The current debate, then, is not about "imposing opinions"; it is about whether or not our long tradition of tolerance for a range of ethical positions should be continued or discontinued. The result of that debate will significantly impact the future of medicine, healthcare access and religious freedom.



[iii] CMA news release, "Christian Medical Association physicians laud new federal conscience rule as protecting patient access to healthcare," January 19, 2018. Accessed online Feb. 20, 2018 at https://www.cmda.org/resources/publication/christian-medical-association-physicians-laud-new-federal-conscience-rule-as-protecting-patient-access-to-healthcare.
[v] Stahl and Emanuel, p. 1383.
[vi] "Obama administration replaces controversial 'conscience' regulation for health-care workers," Washington Post, February 19, 2011. http://www.washingtonpost.com/wp-dyn/content/article/2011/02/18/AR2011021807443.html accessed 9/21/17.
[vii] Ibid.
[viii] Advanced English Dictionary definition.