Christian Conscience on the Critical List

Religious Liberty Facing Rough Road in Health Care

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By Father John Flynn

ROME, MARCH 4, 2007 (Zenit.org).- The right of doctors, pharmacists and hospitals to not provide treatments that violate their moral principles is increasingly under threat. The issues involved in this area were examined by the Pontifical Academy for Life, in a congress entitled "The Christian Conscience in Support of the Right to Life," held Feb. 23-24.

Bishop Elio Sgreccia, president of the academy, described as an "emergency" the current situation regarding the formation of the conscience in subjects involving human life.

In his address, posted in Italian on the Vatican's Web page, Bishop Sgreccia explained that a democratic society should allow sufficient space for the expression of a person's liberty and responsibility in living out key social values. Defending human life is the first of these values that are at the core of any society, he argued.

Bishop Sgreccio added that until recently conscientious objection on life issues was limited to the matter of abortion. In more recent years, however, the field has greatly expanded, with the addition of issues such as euthanasia, abortive pills and the use of embryos in research.

In fact, a recent survey carried out in the United States illustrated the importance many physicians place on the role of conscience. A study carried out by researchers at the University of Chicago found that about 1 out of 7 doctors feel they have no ethical obligation to inform patients about medical treatments that the physicians oppose on moral grounds, the Baltimore Sun reported Feb. 8.

The New England Journal of Medicine published the results of the survey. The treatments mentioned ranged from abortion to euthanasia, and prescribing contraceptives for adolescents.

Ethical integrity

Dr. David Stevens, head of the Christian Medical Association, commented on the survey in a press release issued Feb. 9. He noted that the study suggested many doctors may feel pressured to violate their ethical integrity by referring patients to other physicians who will perform the morally objectionable practices.

"We need laws that protect physicians' rights of conscience, and we need education to encourage doctors to stand firm on strong moral and ethical principles," said Stevens.

An example of the pressures doctors are facing was quickly provided by the New York Times. In an editorial Feb. 13, the paper admitted that doctors have a right to not carry out morally objectionable practices, but denied their right to not present such practices as a valid option for their patients to consider.

"Any doctors who cannot talk to patients about legally permitted care because it conflicts with their values should give up the practice of medicine," was the editorial's harsh conclusion.

Not only doctors, but Catholic organizations face increasing pressure. Last year the Court of Appeals in the state of New York ruled that social service agencies run by the Catholic Church must provide health insurance coverage for contraceptives to their employees, the Associated Press reported Oct. 19. The decision affected Catholic Charities and nine other groups.

Richard Barnes, speaking for the Catholic organizations involved, argued that the conflict was not over contraception, but about religious liberty. In comments quoted by the New York Times on Oct. 20, Barnes said he feared that the judgment would lead the state to make laws even more offensive to religion.

Pharmacists in trouble

Another facet of the conflicts over conscience regards pharmacists. In recent years they have frequently run into conflicts when it comes to providing contraceptives and abortion pills. In one judgment last year, a federal judge upheld the legitimacy of Wal-Mart's dismissal of a Catholic pharmacist who refused to fill prescriptions for contraceptives, reported the Minneapolis Star Tribune on June 2. Judge John Shabaz dismissed a lawsuit brought by Neil Noesen, fired from his post at a Wal-Mart store in Onalaska, Wisconsin.

On Aug. 23 the Washington Times newspaper reported that in nearly half of the nation's legislatures, bills had been introduced in the current session to allow pharmacists not to fill prescriptions for so-called emergency contraception, which are known abortifacients, or birth control medicines based on their religious or moral objections.

According to information on the Web site of the National Conference of State Legislatures, four U.S. states -- Arkansas, Georgia, Mississippi and South Dakota -- have passed laws allowing a pharmacist to refuse to dispense emergency contraception drugs. In addition, Colorado, Florida, Maine and Tennessee have broad refusal clauses that do not specifically mention pharmacists.

By contrast, Illinois has passed an emergency rule obliging pharmacists to give out contraceptives approved by the Food and Drug Administration. In California, pharmacists have a legal duty to dispense prescriptions, including contraceptives, and can only refuse to do so if their employer approves the refusal and the woman can still access her prescription in a timely manner. The information on the Web site was current as of last October.

Catholic hospitals criticized

In Canada, Catholic hospitals faced criticism last year on the issue of sterilizations. According to a Sept. 27 report in the National Post newspaper, St. Elizabeth's Hospital in Humboldt, Saskatchewan, decided to stop performing tubal ligations.

After the decision patients filed complaints with the Saskatchewan Human Rights Commission, and, according to the article, opponents of the move are considering taking legal action.

Since 2001, after a human rights complaint, the hospital had carried out tubal ligations in some cases. But last June the hospital's board decided to stop the procedure. Some of the operations were being done purely for contraceptive reasons, declared Shirley McNeil, the hospital's chief executive officer, to the National Post.

The issue of moral objections to some medical procedures has also recently affected some Catholic institutions in Australia. The John James Memorial Hospital, located in the national capital Canberra, was bought last year by the Little Company of Mary Health Care.

After the ownership change, the hospital stopped providing certain services to the Canberra Fertility Center. In an article dated Jan. 9, the newspaper The Australian reported that there were concerns over the effect the spreading influence of Catholic institutions is having on health care.

On Jan. 12, the newspaper returned to the subject, reporting that the president of the Australian Medical Association, Mukesh Haikerwal, wants state governments to stop contracting the operation of public hospitals to the Catholic Church unless it agrees to provide all services including in vitro fertilizations (IVF), abortions and sterilizations.

Auxiliary Bishop Anthony Fisher of Sydney, episcopal vicar for Life and Health, commented on the matter in a report published in the Jan. 21 issue of Catholic Weekly, the Sydney archdiocesan newspaper.

He said: "The fact is that most hospitals in Australia -- including state hospitals, Catholic public hospitals, and private hospitals -- do not offer IVF services.

"People do not go to Catholic hospitals if they are looking for abortion or sterilization or IVF."

Further discussion on the role of Catholic institutions followed a report by the Australian newspaper on Jan. 11 on a code of ethical standards published by the organization Catholic Health Australia. The code recommends that Catholic hospitals not refer women who have been raped to crisis centers where they will be given the morning-after pill, which is a known abortifacient.

In his address on Feb. 24 to participants in the congress organized by the Pontifical Academy for Life, Benedict XVI declared that Christians are called to confront the continual attacks on human life.

The fact many now have to struggle for the right to defend human life is a measure of how much society has changed in the short time since abortion was legalized. A change whose fruits are still being collected.