Physician Conscience Rights
Physician conscience rights in medical decision making has become a core issue in medical ethics. AAPLOG is committed to the individual right of conscience for each physician, especially in decisions involving moral values. Right of refusal to do or to refer for abortions is under attack in ACOG’s recent Ethics Committee Opinion No. 385. ABOG has long required compliance to an Ethics Standard for doctors seeking Board certification, and AAPLOG strongly agrees with that principle. However, since the ACOG Ethics Committee opinion #385 release, important questions remain unanswered: Do the ethics committee opinions bind ACOG members in any way, or is it simply “opinion”? If it does bind ACOG members, then because of the PREEXISTING wording of the ABOG documents, does this mean that doctors can be denied standing with the Board (even if they are not ACOG fellows) because they are not in compliance with ACOG ethical standards? At the end of 2008, AAPLOG continues to seek firm answers to these questions.
HHS has established a new regulation, to become effective January 20, 2009. The purpose of this new regulation is to increase awareness of, and compliance with, the following three separate laws protecting federally funded health care providers’ right of conscience:
First, in the 1970s, the Church Amendments were enacted at various times in response to debates over whether receipt of federal funds required recipients to provide abortions or sterilizations. The Amendments also protected health care providers and other individuals from discrimination by recipients of HHS funds on the basis of their refusal, due to religious belief or moral conviction, to perform or participate in any lawful health service or research activity.
Second, in 1996, section 245 of the Public Health Service Act was enacted to prohibit the federal government and state or local governments that receive federal financial assistance from discriminating against and institutional health care providers, including participants in medical training programs, who refused to, among other things, receive training in abortions; require or provide such training; perform abortions; or provide referrals for, or make arrangements for, such training or abortions.
Third, the Weldon Amendment to the Department’s fiscal year 2005 appropriations act, and to subsequent years’ appropriations acts, prohibited the provision of HHS funds to any state or local government or federal agency or program that discriminates against institutional or individual health care entities on the basis that the entity does not provide, pay for, provide coverage of, or refer for abortion.
The following links are letters from AAPLOG, ACOG, ABOG, HHS which will flesh out the issue for you.
July 26, 2012: The recent history of conscience rules
1973: The Church Amendment states that hospitals and individuals receiving federal funds will not be forced to participate in abortion or any othe…
September 3, 2011: AAPLOG Statement on HHS Aug 1, 2011, "Contraceptive Mandate"
The American Association of ProLife Obstetricians and Gynecologists presents its Position Statement on the US Dept HHS “Contraceptive Mandate” ann…
September 9, 2008: AAPLOG's response to ABOG, copy to ACOG
...regarding the above letters, and the issue as we see it to date.…
September 5, 2008: ACOG answer to Fellow's letter
...objecting to Ethics Committee Opinion #385. See if you can understand what ACOG is actually saying to you.…
August 22, 2008: ABOG's Dr. Gant to HHS Sec. Leavitt
...regarding the 8-21 News Release, with complaints of "grossly untrue and unfair allegation….."…
August 21, 2008: HHS News Release entitled "Regulation Proposed to Help Health Care Providers From Discrimination"
Press Release from US Department of Health and Human Services: August 21, 2008: HHS News Release entitled "Regulation Proposed to Help Health Care …
April 7, 2008: AAPLOG to ABOG's Dr. Gant, asking for further clarification
The American Association of Pro-Life Obstetricians and Gynecologists appreciates the recognition the American Board of Obstetrics and Gynecology has given to the diversity of opinion regarding the abortion issue among its Diplomates. We are also grateful that more than a decade ago, in deference to this fact, the Board removed abortion from the list of cases to be used in oral exams.…
March 26, 2008: Letter from then ACOG President Noller to Fellows
Please note that the "the Executive Committee has instructed the Committee on Ethics to hold a special meeting as soon as possible to reevaluate ACOG Committee Opinion #385." This meeting was held in April, but no action was announced…
March 19, 2008: ABOG's Dr. Gant responds to HHS Sec. Leavitt's 3-14-08 letter
Response: ABOGDrGant to Leavitt Response3.19.08…
March 14, 2008: HHS Secretary Leavitt to ABOG's Dr. Gant
Regarding the potential for interaction between ACOG Ethics Opinion #385 and ABOG's new Maintenance of Certification requirements to eventuate in discrimination against prolife ObGyns.…
February 6, 2008: The AAPLOG response to Opinion #385
ACOG Committee Opinion #385 is in opposition to 2500 years of accepted Hippocratic ethical medical tradition. Legal elective abortion made a unique arrival in the late 1960s in the United States as part of a legal-societal initiative, rather than as the culmination of a scientific process in biomedicine. The acceptance of elective abortion in American medical practice was contrary to the historic ethical position of Western medicine with regard to abortion.…
January, 2008: Part one of new Maintenance of Certification requirements
Final Version 2007 under the section "Limitation and Revocation of Diplomate Status" the following statement is found: "3.0 Disqualification or Diplomate revocation also may occur whenever:...3.6 the physician shall have violated any of The Ethical Considerations in the Practice of Obstetrics and Gynecology currently published by The American College of Obstetricians and Gynecologists and adhered to by the ABOG."…
November 2007: The Limits of Conscientious Refusal in Reproductive Medicine
ACOG Ethics Committee Opinion #385, may be accessed at:…
News Release: Statement on ACOG Letter Urging U.S. Senators to Violate the Rights of Conscience of Physicians
In a letter to United States Senators dated August 30, 2005, Dr. Michael Mennuti, writing as President of the American College of Obstetrics and Gynecology (ACOG), has requested the United States Congress to “require doctors with moral objections to refer for abortions.” Urging the Senators to alter the current Abortion Non-Discrimination Act, Mennuti states, “Doctors who morally object to abortion should be required to refer patients to other physicians [for an abortion].”…