Conscience Clauses: What They Are and Why You Should Care

A "conscience clause" is a term used to describe the right of physicians or health care providers to refuse to provide certain services, such as abortion, contraception, sterilization, the withholding or withdrawing of life sustaining treatment, or physician-assisted suicide, because of moral or other personal beliefs. After the passage of Roe v. Wade in 1973, many states enacted conscience clauses to allow physicians to follow their conscience and not perform or participate in legalized abortion.

Conscience clauses are a much discussed topic today amidst the health care debate. Just prior to the end of President George W. Bush's term, Bush strengthened already existing federal conscience clauses by putting penalties on institutions that receive federal funds for subjecting physicians and other healthcare workers to discrimination for refusing to perform abortions. In March 2009, President Obama rescinded Bush's executive order. This did not, however, completely rescind federal conscience law, it simply rescinded Bush's attempt to strengthen existing law.

Catholic and other religious hospitals are also protected under existing state and federal law. This allows catholic institutions to refuse to perform sterilization procedures, abortions and distribution of birth control.

This issue of conscientious objection is much larger than as it relates to female reproductive issues. Oregon law currently allows physician-assisted suicide. An Oregon conscience clause does provide for a physician's right to refuse participation in physician assisted suicide.

With a public health insurance option still on the table, the conscience clause issue is not likely to disappear any time soon. Proponents of conscience clause legislation maintain that physicians and health care workers should have every right to refuse to participate in a procedure they find to be morally repugnant. Opponents of conscience clause laws believe that they inhibit a person's access to healthcare.

No matter what your stance on abortion or physician assisted suicide, I find it difficult to argue that a physician does not have the right to refuse to perform a procedure based on moral objections. We allow citizens conscripted into military service to claim their conscientious objection by refusing to fight in war against their moral objection. As long as a physician does not prevent a person from seeking a procedure elsewhere, which would infringe upon their rights as a patient, the physician's rights should also not be trampled.

I do not want to live in a country that would force any physician to take the life of another with intent or participate in that process in any way if that physician has a moral objection. Further, if I were a patient seeking a procedure, it only stands to reason that my first choice would not be a physician who was morally opposed to performing said procedure.

In the course of my research for this article, I came across the oldest binding document in history, written by Hippocrates: the Hippocratic Oath. This sacred oath is still taken by physicians and upon it the very foundation of the field of medicine lies. According to MedicineNet.com, there are several translations of the Hippocratic Oath and many more recently written, modern versions of the original oath written by Hippocrates. Read here for the full oath, presented in both the "Classic" version and "Modern" version by MedicineNet.com. I would like to highlight a paragraph from one translation of the original oath and then the same paragraph from a modern version.

Classic:

"I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art."

Modern:

"I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God."

Interesting, no?

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Sources:

http://www.lifenews.com/nat4176.html

http://www.cnn.com/2009/POLITICS/02/27/conscience.rollback/

http://inglis.house.gov/issues.asp?content=sections/issues/current/abortion_pro_life_timeline

http://www.medterms.com/script/main/art.asp?articlekey=20909