Letters & Op-Eds 2016

Catholics for Choice: Making Doctors Mad: Providers’ Conscience and Religious Freedom

Recently, a presidential candidate said abortion providers should be punished ifRoe v. Wade were ever overturned. Just a few days before, a colleague at the Center for Reproductive Rights and I spoke at a local university about existing limitations on reproductive health provision. Just like the Medical Students for Choice I met at their conference last October, these forty medical students and future doctors are fierce, smart, dedicated, compassionate, curious, and full of enthusiasm despite grueling schedules. Many will become the abortion providers of tomorrow. I feel confident that we are in good hands with them. They remind me of what is at stake when the ongoing attacks on reproductive rights and religious freedom interfere with healthcare.

Catholic hospitals, for instance, have already substituted religious doctrine for medical science under a distorted definition of religious liberty, and they’re pushing for more interference into providers’ judgment. When students learn this they are at first confounded, then outraged:

“What do you mean Catholic hospitals and religiously-affiliated healthcare institutions can take taxpayer dollars and not provide patients with the full range of medical services?”

“What if the doctor wants to use a particular treatment sanctioned by medical guidelines rather than doctrine? They can force the doctor to choose between her job and what is best for her patient?”

“Do you mean to say that I would be legally obligated to provide my patient with information that is medically inaccurate?”

Sadly, I had to reply, “Yes.” While some students are aware of injustices like these, most are outraged when they first learn about such blatant violations of freedom of conscience in healthcare. It is our task as advocates to educate, and then activate that outrage to help stem the tide of bad laws and wrong-headed policies being enacted across the US.

Religious freedom is under siege. The US Conference of Catholic Bishops (USCCB) and its conservative allies are attempting to redefine religious liberty to mean a frighteningly vague right to discriminate against basically anyone who makes life choices with which they don’t agree. The true conviction at stake is the hierarchy’s business interests.

Catholic healthcare and nonprofit organizations that serve the public are multi-million dollar businesses. They have large investments with federal contracts that should bring some expectation of playing by larger society’s rules. But in 2011, the USCCB created the Ad Hoc Committee for Religious Liberty for the express purpose of redefining what religious liberty means in this country. The goal? Rewriting policy so they could have their federal dollars and discriminate, too. The bishops’ wish list for the government included the ability to:

  • Grant religiously-affiliated employers (at least) the “right” to deny benefits for services to which they object;
  • Concede special rules for certain religious grantees seeking federal social service contracts;
  • Ignore the court-ordered respect for marriage equality and individuals’ right to marriage and related benefits, regardless of sexual orientation; and
  • Lessen the requirement for comprehensive strategies, like reproductive health services, in international relief and development programs, even when using funds from federal grants.

This wish list is a blatant distortion of real religious liberty. Real religious liberty does not carve away the rights of some and call it freedom, nor does it let powerful institutions trample the rights of individuals.

Religious liberty is a fundamental American principle that belongs to each individual, not to institutions safeguarding their pocketbook at the expense of women, workers, LGBTQ individuals, students and others.

The bishops’ argument is that conscience rights are being violated through laws meant to protect everyone from discrimination. This is an offensive misuse of the term conscience. Catholicism holds that each person has a conscience, an inviolable inner core that informs our decision- making and compels each of us to act in the way that we have decided is morally correct. Other ethical systems, both religious and secular, have similar values. Whether in religion or in public life, we all understand the notion of conscientious objection—sometimes people of good will cannot, in good conscience, just “follow orders.” Any solution is to be negotiated with the keeper of that conscience, the individual.

But, in the face of these widely accepted principles, the bishops attempt to evade established rules and policies that exist to protect the very people the Catholic tradition should seek to protect. The hierarchy asserts that a hospital, a university and an HMO all have a conscience that can be offended, and thus, the law does not apply to them.

In the world as the bishops would have it, the conscience of the doctor who wants to provide necessary care for a patient is ignored, whether for providing a voluntary tubal ligation, attending to the wishes of a dying patient or providing IVF to patients seeking to start or expand a family. Patients’ conscience is also subjugated to the dictates of powerful institutions. Moreover, many patients are unaware that their hospital does not follow recommended medical standards, leaving them in the dark about services they could be denied because of the hospital’s retrograde policies. Policies and practice that compromise the conscience rights of patients and doctors are an affront to real religious freedom and jeopardize people’s health. This is what’s really at stake in the bishops’ conscience wars.

The Coalition for Liberty & Justice (CLJ), over 60 different organizations from a wide variety of disciplines and areas of interest, works to make sure that religion is not used as a tool for discrimination or to undermine equality. The CLJ has a strong contingent of medical organizations like the Association of Reproductive Health Professionals, Medical Students for ChoiceNursing Students for ChoiceReproductive Health Access Project and other organizations working to improve access to healthcare. These organizations understand firsthand the injustice and dangers of institutions being allowed to trample on the conscience of individual medical professionals.

It‘s a powerful moment: Watching the light bulb of understanding switch on for a medical student realizing that the current religious liberty battles affect them personally and professionally. It is a powerful moment when an OB/GYN resident connects her choices for her residency program with the procedures, medication, information and referrals she will be allowed to perform and prescribe in particular programs. It is powerful moment when a medical professional encounters the misinformation she is sometimes obligated to give because those with power think they can insert themselves where they do not belong—in the exam room. As advocates for real religious liberty, we believe that religious freedom that encourages individual beliefs is tempered by the obligation not to infringe on another’s exercise of their belief. Our work at getting doctors, patients and everyone else riled up about their freedom is just beginning.

This piece first appeared as a post on the Hamilton and Griffin on Rights blog.

Catholics for Choice