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The Miscellany News > Opinions

Concept of pro-choice applies to physicians, too

By Joseph Coniglio

Guest Columnist

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Published: Wednesday, April 29, 2009

Updated: Wednesday, July 15, 2009

About two months ago, President Barack Obama and his administration began to reverse what is known as the “conscience rule,” which was solidified under former President George W. Bush’s administration.


The rule was developed to protect healthcare workers from being forced to provide services toward which they may have moral or religious objections—services, for example, such as abortion and birth control.


In short, persons who hold moral and/or religious objections toward a “health service” are legally protected from any repercussions should they refuse to partake in such an action.
For a man whose spoken intent is to unify the American people, pushing to rescind such a rule is baffling—abortion is, of course, a very divisive issue, and to infringe on the rights of people who conscientiously choose to not provide such a procedure would seem, at least prima facie, to be a direct and blatant violation of some Americans’ First Amendment rights.


Wasn’t the pro-choice movement focused on the idea of individual choice regarding the decision of abortion? Why then would they not allow for health care providers to choose not to give an abortion?


Given this, what is it then about such a rule that is so objectionable to the Obama administration and to the predominately pro-choice groups that are pushing for the invalidation—or at least restructuring—of the conscience rule?


Opponents have expressed concerns that some women—seeking abortions or birth control—will not have access to those types of procedures in certain circumstances, especially if they are from low-income backgrounds and with limited economic means.
In reported cases of rape, for example, which amount to around one percent of all women who seek abortions in 2004 according to the Guttmacher Institute, a division of Planned Parenthood, some see the conscience rule as perhaps too limiting for a woman’s access to birth control and abortion.


“A concern is a situation in which a rape victim showing up in an emergency room and not being told that contraception is still an alternative,” was the language used by Lori Lamerand, President of Planned Parenthood of Middle and South Michigan.


To such an argument, I think the pro-choice movement has itself ironically provided a response. In A Defense of Abortion, Judith Jarvis Thomson argues that one’s rights do not go so far as to infringe on the autonomy and individual rights of another. An unborn child, whom she grants is a person for the sake of argument, does not have the right to the life support of his or her mother. Neither does the government have the right to force her to support the right to life of the child.


Therefore, it seems analogous to say that a woman’s right to an abortion does not force others to provide an abortion for the mother—because a woman seeking an abortion does not have the right to force others to provide an abortion for her.


Neither would it seem that the government has the right to force people to choose against their consciences. Since I do not think the pro-choice side as a collective whole is willing to stand against Thomson’s argument, something which seems to be fundamental to the entire pro-choice movement, I think that it is best they cease their objections to the conscience rule on the grounds which it seems they are currently arguing against it.


If the unborn child’s right to life does not require a mother to provide life support, then why should a woman’s right to an abortion require others to provide an abortion for her?
Now, not much has been out in the news recently about this move by the Obama administration—hopefully the administration has chosen to rethink their decision, which seems at least in principle to stand against everything that it means to be “pro-choice.”
It strikes me as odd, however, that President Obama would even begin to consider reversing such a rule, even if he hopefully ceases from any further action.


Are we really to say to health care providers that they are forced to provide abortions even if they view—for moral and religious reasons— such a procedure as the termination of an innocent life?


Suppose that I said that everyone who worked in a prison could not refuse—if they were ordered to do so—giving a lethal injection to someone on death row?


I cannot be sure, but I strongly believe that the Obama administration would be vehemently opposed to such an idea. Why then is it any different in the case of abortion and with the conscience rule?


Americans have the fundamental right to not be discriminated against based on their beliefs and should be allowed—given these freedoms—to be able to work in America’s healthcare industry without being obligated to provide a service which they sincerely believe to be the murder of the innocent.


 

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10 comments

read something
Wed May 6 2009 07:05
birth control is not "abortifacient". every current form of birth control available does one of two things: prevents fertilization of an ovum or prevents a fertilized ovum from implanting in the uterine wall. as pregnancy is medically defined as the implantation of a fertilized ovum in the uterine wall, what birth control does is prevent pregnancy.

birth control does not cause abortion.

Diogenes
Tue May 5 2009 18:54
Deleting comments because you lack the capacity to answer the uncomfortable questions that those comments pose? How very, very sad.
Idea
Tue May 5 2009 13:06
Just because it is legal to sell alcohol from a supermarket or deli does not mean that I can demand that a specific supermarket or deli acquire a license to sell alcohol, nor can I demand that they sell my favorite alcoholic beverage.

Oh, and in Roe vs. Wade, it was made clear that only licensed doctors could perform abortions or provide chemicals that would cause one, and that individual states had the right to determine licensing. Forcing pharmacy employees to do what they are not qualified to do might just create the test of Roe vs. Wade that the right-wing anti-abortion fanatics have been waiting for.

With Supreme Court Justice David Souter retiring, would this be a desirable outcome?

Maybe we ought to stop trampling on other people's rights in the name of exercising our own?

Idea
Tue May 5 2009 12:54
"The right to swing my fist ends where the other man's nose begins."
-- Supreme Court Justice Oliver Wendell Holmes, Jr.

To me this means that, while I have the right to talk about Jesus in my valedictorian address, the school is not required to provide the microphone, amplifier, and speakers that are necessary to broadcast my voice to the hundreds of assembled people listening to me. I have the right to smoke a cigarette, but I cannot smoke that cigarette in the neo-natal wing of Vassar Hospital. I have the right to an abortion, but I don't have the right to demand a specific doctor to provide one for me. I have the right to drink alcohol, but not while strolling across the grounds of an elementary school. I have the right to drive my car, but not across the White House lawn. I have the right to abortifacient "birth control" medication, but I do not have the right to demand that a specific employee sell it to me, nor do I have the right to demand that my insurance provider pay for it, nor do I have the right to demand that a specific pharmacy even stock it. I do have the right to choose to frequent only those pharmacies and hospitals that provide the services I desire. I do have the right to choose an insurance company that provides all of the benefit I want.
(Capitalism and the free market will provide what is desired, if enough people want it. All that remains is for the people who want a product or service to locate and frequent the companies that provide that product or service.)
What I don't have, as a consumer, is the right to decide how a specific employee does their job, nor how a specific company operates their business.

Freedom of speech and expression exists even in the workplace.

The right to an abortion emanates from the right to privacy, which emanates from the 1st, 3rd, 4th, 5th, 9th, and 14th amendments to the Constitution of the United States. That does not give it precedence over 1st amendment rights; on the contrary, I maintain that it must take a back seat to the rights granted by the 1st amendment.

Feel free to disagree, but please explain the error in my reasoning if you choose to do so.

Alum ´07
Tue May 5 2009 10:26
Hi Joe,

Thanks for the thoughtful conservative critique. You´re a brave man to print this on Vassar campus! Still, I have to disagree with your basic argument that physicians should be allowed to ¨choose¨ which health care services they want to provide, according to their moral conscience. A doctor (or a nurse), etc., is a job, like anything else. You have certain responsibilities written into your job description, and you don´t get to just pick and choose which ones you fulfill. Should Biblical literalist biology teachers be allowed to opt out of teaching evolution? Should elementary school teachers who are extreme feminists or anti-racism activists who believe in the concept of ¨hate speech¨ be allowed to opt out of teaching the First Amendment? You fill your job prescription, and you keep your morals at home. You don´t like it - get another job. We all have to decide which jobs we can morally take on, and which ones we can´t. That is why many Vassar liberals decide to stay out of the business sector -- because they realize they can´t just become big CEO millionaires and say ¨Well I don´t agree with the idea that my chief job is to make money for shareholders, I would like to donate some to the poor.¨ As long as birth control and abortion are legal in this country, health-care providers should be required to offer them.

Your name
Mon May 4 2009 12:03
Also, a pharmacist should not be able to refuse to fill a prescription for birth control or sell the morning after pill because of their religion.
Joe Coniglio
Fri May 1 2009 10:42
Hey Evan,

To your first comment, when you say that the unborn child does not have a right to life, you are operating out of the framework of Thomson's argument. That is the whole point of the article. You can say that the unborn child does not have a right to life just like I can say a woman has no right to an abortion. The point is that Thomson grants that the unborn child has a right to life. She does not deny this in her argument. The idea is that the right to life, which she grants, does not equal life support from the mother. Similarly, the right to an abortion, which even if I grant, does not equal others to support a mother's right to an abortion. I am using Thomson's logic. That was my argument. Also, the Hippocratic Oath can be very easily used against abortion rights, not for it- I would even say the latter is a much rarer and dubious implication.

To deal more directly with the conscience rule, you are right, the only people who perform abortions are people in abortion clinics- this is fundamentally because of laws like the conscience rule, which allows people to practice health in the way they morally see fit. If we overturn the conscience rule, many hospitals, such as Catholic ones, may be forced to provide services which they have serious moral objections to. In this country, people should not be discriminated against in the workplace based on their moral beliefs. People should be allowed to work in health care with a clear conscience. If a person wants medical information or services, they can go somewhere else. As Thomson argues, the right to life of the unborn child does not mean that others are forced against their will to support that right. Hence, a right to an abortion or birth control does not force others to provide support for that right. If you wish to discuss the unborn child's "person-hood" you are not dealing with my article. However, I would be interested to hear if you can provide me a morally relevant way to justify abortion without infanticide or the killing of the comatose.

To the Jesuit nurse, she simply does not perform the procedure, another physician does. However, if it is a Jesuit hospital, it seems clear that Thomson's argument is for their right to choose. Do you disagree with Thomson's argument then.

Finally, to the other comment. I understand your concern. Frankly though, I do not think any people who would argue on such grounds would ever work for an abortion provider. If they tried to sneak in on false grounds, a court would throw them out I expect. But, still a fair point made.

Evan Fredericksen
Fri May 1 2009 00:39
"If the unborn child’s right to life does not require a mother to provide life support, then why should a woman’s right to an abortion require others to provide an abortion for her?"

Yikes. Maybe it's because a fetus isn't a human being, whereas a sentient woman is, and thus has the federally protected right to an abortion? And, that being the case, it's the job of medically trained professionals to perform that operation. The fact that you justify a rape victim not being informed of contraception options is simply disgusting.

Not to be too much of a dick, but have you even heard of Roe v. Wade or the Hippocratic Oath?

Evan Fredericksen
Fri May 1 2009 00:29
The issue of abortions is really a red herring. . The only doctors who perform abortions are those who, you know, work in abortion clinics. If you work in an abortion clinic and refuse to perform abortions, then it's probably best that you seek employment elsewhere. Your run-of-the-mill family doctor does not perform abortions. I suppose emergency room surgeons may also perform abortions if the woman's life becomes endangered, but such a requirement also seems to fall squarely under the job description of a surgeon.

The bigger issue, though less frequently cited since arguing for it results in poorer soundbytes for the media, is whether doctors should be compelled to provide birth control information to patients. I have yet to hear a rational argument about how a doctor's right to religious freedom outweighs a patients right to proper medical information in this context. Should a hospital not have the right to fire a Jesuit nurse who refuses to draw a patient's blood for a blood transfusion?

Your name
Thu Apr 30 2009 01:59
The "conscience rule" extended the right to choose for physicians to janitors and other staff who work in clinics but do not perform procedures. That was actually the exact example used in the language of the rule to define its scope. It is not appropriate for the janitor to have veto power over a clinic's procedures, especially when it is illegal for the clinic to take that person's religious convictions against a procedure into account in the hiring process. By getting rid of this rule, the Obama administration is not in any way limiting the already-established right of physicians to choose their procedures. Rather, it is rejecting an over-extension of that right that trivialized the importance of their choice.






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