In November 2007, the Committee on Ethics of the American College of Obstetricians and Gynecologists (ACOG) published Committee Opinion # 385 entitled, “The Limits of Conscientious Refusal in Reproductive Medicine.” The committee opinion sought to “maximize accommodation of an individual’s religious or moral beliefs while avoiding imposition of these beliefs on others or interfering with the safe, timely, and financially feasible access to reproductive health care that all women deserve.”
Unfortunately, the balance struck by the committee between the right of conscience of physicians and the reproductive health care of women so emphasizes patient autonomy that it turns physicians into medical automatons forced to act against their best ethical and medical judgment. As pointed out on March 14, 2008, by Health and Human Services secretary Mike Leavitt: “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.” Put simply, committee Opinion 385 could be the end of the pro-life doctor.
I am not an OB-GYN doctor. I was trained and board certified as a family physician. But, it was this sort of thinking that made it very easy to walk away from clinical medicine. (this sort of thinking coupled with dealing with insurance companies and the ever present threat of lawsuits) As part of an Air Force family on the move I was never in a position to set up my own practice. I was always an employee. I wanted to practice medicine in a way that left me free to be the mother I wanted to be and to be true to my Catholic principles. After we made our last move I just didn’t see the point of collecting yet another state license (I’ve had eight so far) when the prospects of finding a part-time out-patient only job that would allow me to adhere to my conscience were virtually non-existent. You can’t just walk in and say, “I want to work part-time; you pay the malpractice coverage and the tail coverage; I am not going to prescribe contraceptives or refer patients for vasectomies and tubal ligations. I won’t refer for abortions. I won’t prescribe the morning-after pill; etc.” From all accounts, my previous employers and patients thought I was a great doctor. But I wasn’t great enough to go anywhere and make those kinds of demands.
I have no regrets. It was the right time in our lives for me to leave clinical practice. I have moved to the writing and teaching mode and hopefully will be getting some advanced training in the field of bioethics. However, I worry about the younger doctors that follow me. Actually, I worry more about the bright, principled potential doctors who turn away from this profession because they don’t see it as compatible with their ethical standards. The Catholic Medical Association offers support and serves as a voice for Catholic physicians. But I don’t think the controlling forces of America’s medical machine are listening.
St. Luke, Pray for us!