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.
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 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.
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 (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. ), which
[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.