By Wesley J. Smith
Healthcare is quickly becoming about much more than the provision and reception of medical treatment. To a disturbing degree, healthcare public policy is becoming a means of imposing a secularist, anti–sanctity-of-life ideology on all of society.
Consider the following examples of this accelerating trend:
Erasing pharmacists’ conscience rights in Washington: In 2007, Washington state’s Board of Pharmacy—at the prompting of the governor and Planned Parenthood—promulgated a regulation requiring pharmacies to stock and dispense all FDA-approved medications. But because there are so many of these drugs, certain exceptions were made. For instance, a pharmacy may refuse to stock a drug due to low demand. In those cases, the refusing dispenser may refer patients to a pharmacy that does carry the prescribed drug.
If a pharmacy refuses to stock a drug for reasons of religion or of moral conscience, however, referral is not an option. Indeed, the governor was so intent on stomping on conscience rights that he threatened to fire and replace regulators when an initial version of the rule contained a conscience exemption.
After the rule went into effect, one small pharmacy chain owned by Stormers Inc. continued to refuse to carry Plan B—the “morning-after pill”—because of studies that indicate it might act as an abortifacient. The company’s owners sued the state to be exempted from the regulation on grounds of the First Amendment’s Free Exercise Clause. (Washington does not have a Religious Freedom Restoration Act–type law like the one that protected Hobby Lobby from being forced to cover the morning-after pill in its employee health-insurance policies.)
At first, things looked good for the company. A trial concluded that the rule violated the religious liberty of Stormers (and similarly situated religious objectors) by requiring religiously opposed companies “to choose between their First Amendment rights and their ability to provide for their families.” But the Ninth Circuit Court of Appeals reversed the decision, since the law applies equally and “neutrally” to all pharmacies—to those whose owners object to dispensing the drug, and to those whose owners don’t. Therefore, in Washington, if a pharmacy refuses to stock Plan B due to business considerations, it acts within the law, but if the same pharmacy refuses to stock the drug because of conscience concerns, it could face legal repercussions. (The Supreme Court recently refused to review the case.)
ACLU sues to force Catholic hospitals to violate Church teaching: Directive 45 of the “Ethical and Religious Directives for Catholic Health Care Services,” published by the United States Conference of Catholic Bishops, states explicitly that
[a]bortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo.
In our anti–sanctity of life era, it is no surprise that Catholic hospitals adhering to their Church’s teachings on abortion are being targeted. A suit that sought to prevent Trinity Health Corporation from obeying the Ethical and Religious Directives was dismissed earlier this year; the dismissal was based on a procedural issue and prevented a principled ruling based on First Amendment rights.
A similar case was recently filed in California after administrators of Mercy Medical Center, a Catholic hospital operated by Dignity Health, refused to permit a requested sterilization because of Catholic moral teaching that such a procedure is “intrinsically immoral.” Indicating the anti–religious liberty bias in healthcare, the California Medical Association has joined the ACLU in trying to force the hospital to violate Church teaching.
Forcing pro-life crisis-pregnancy centers to provide abortion information: Many pro-life crisis-pregnancy centers provide women with information about pregnancy issues and non-termination options for an unwanted pregnancy. The state of California, in a major hit to free speech, recently passed a law requiring such pro-life centers to advertise where abortion information could be obtained. Specifically, the law requires that
[a] licensed covered facility shall disseminate to clients on site the following notice in English and in the primary threshold languages for Medi-Cal beneficiaries as determined by the State Department of Health Care Services for the county in which the facility is located.
(1) The notice shall state:
“California has public programs that provide immediate free or low-cost access to comprehensive family planning services (including all FDA-approved methods of contraception), prenatal care, and abortion for eligible women. To determine whether you qualify, contact the county social services office at [insert the telephone number].”
Needless to say, abortion clinics have no concomitant obligations to advertise where pro-life counseling can be accessed.
These few examples reflect a growing trend of opposition to pro-life and religious conscience rights in healthcare. Quebec’s Minister of Health successfully ordered a palliative care center at the McGill University Hospital Medical Center to perform euthanasia. California now requires religious institutions to include elective abortion coverage in their health-insurance plans as a “basic health service.”
In Australia, physicians who object to abortion must procure an abortionist for a woman requesting a termination or they will face professional discipline. At least one doctor was so sanctioned when he refused to refer for a sex-selection abortion. The ACLU is suing to prevent Catholic hospitals that follow Church teaching from receiving federal funds.
Most recently, in Vermont, Alliance Defending Freedom has filed a lawsuit to try to prevent state authorities from forcing doctors to counsel their terminally ill patients about assisted suicide (which is legal in the state) even if they consider it a profound moral wrong to participate in doctor-prescribed death.
This is the message being sent by the secularist attempt to stifle medical conscience: Sanctity of life has no place in healthcare. If you are pro-life, get out of medicine. If these legal and regulatory efforts succeed, only those who willingly cooperate with the culture of death will be welcomed in the medical field.
Editor’s note. This appeared at First Things. Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism. His new book, Culture of Death: The Age of “Do Harm” Medicine, was just published by Encounter Books.