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.