Wednesday, March 19, 2008

Michael O. Leavitt Cares For Pro-Life Doctors

Health and Human Services Secretary Michael Leavitt worries about the well-being of doctors who refuse to treat a woman who wants an abortion or emergency contraception. He is very worried about the fate of those doctors whose ethical qualms are such that they will not even refer the patient to another provider. Poor doctors! Surely they won't be punished for violating the rule that a medical provider with ethical qualms must refer the patient in a timely manner to someone who can help her?

Don't believe me? Here's the rule:

In November, the American College of Obstetricians and Gynecologists (ACOG) issued new ethics guidelines. Members who have a moral objection to performing abortions are now required to refer their patients to another provider:

Physicians and other health care providers have the duty to refer patients in a timely manner to other providers if they do not feel they can in conscience provide the standard reproductive services that patients request. In resource-poor areas, access to safe and legal reproductive services should be maintained.

And here is what Mr. Leavitt just wrote to ACOG:

I am writing to express my strong concern over recent actions that undermine the conscience and other individual rights of health care providers. Specifically, I bring to your attention the potential interaction of the American Board of Obstetrics and Gynecology's (ABOG) Bulletin for 2008 Maintenance of Certification (Bulletin) with a recent report (Opinion Number 385) issued by the American College of Obstetricians and Gynecologists (ACOG) Ethics Committee on November 7, 2007 entitled "The Limits of Conscience Refusal in Reproductive Medicine".

The ACOG Ethics Committee report recommends that in the context of providing abortions, "Physicians and other health care professionals have the duty to refer patients in a timely manner to other providers if they do not feel that they can in conscience provide the standard reproductive service that patients request." It appears that the interaction of the ABOG Bulletin with the ACOG ethics report would force physicians to violate their conscience by referring patients for abortions or taking other objectionable actions, or risk losing their board certification.

As you know, Congress has protected the rights of physicians and other health care professionals by passing two non-discrimination laws and annually renewing an appropriations rider that protect the rights, including conscience rights, of health care professionals in programs or facilities conducted or supported by federal funds. (See 42 U.S.C. § 238n, 42 U.S.C. § 300a-7, and the Consolidated Appropriations Act, 2008, Pub. L. No. 110-161, 121 Stat. 1844, § 508). Additionally, threats to withhold or revoke board certification can cause serious economic harm to good practitioners.

I am concerned that the actions taken by ACOG and ABOG could result in the denial or revocation of Board certification of a physician who -- but for his or her refusal, for example, to refer a patient for an abortion -- would be certified. These actions, in turn, could result in certain HHS-funded State and local governments, institutions, or other entities that require Board certification taking action against the physician based just on the Board's denial or revocation of certification. In particular, I am concerned that such actions by these entities would violate federal laws against discrimination.

In the hope that compliance of entities with the obligations that accompany certain federal funds will not be jeopardized, it would be helpful if you could clarify that ABOG will not rely on the ACOG Ethics Committee Report, "The Limits of Conscience Refusal in Reproductive Medicine" when making determinations of whether to grant or revoke board certifications.

Thank you very much for your assistance in this matter.

Michael O. Leavitt

Get it? It's discrimination (discrimination!) to require the provider to refer the patient to someone else, even if she is, say, the victim of rape and needs emergency contraception. And it's not fair to make the provider have any consequences from such a refusal. So.

Never mind the patients. It's quite ok to discriminate against them based on nothing but the provider's conscience or political ideology or whatever.