At the urging of Planned Parenthood, the Nevada state Assembly approved an amendment in April to stop pharmacists with religious objections from refusing to fill prescriptions for any drug, including abortifacient contraceptives and the so-called “morning after” pill.
The Implications of Conscience
New York City hospitals now require abortion training for all their OB/GYN resident doctors unless they invoke a narrowly written conscience clause. The Oregon Nursing Association has issued guidelines for assisted suicide that prohibit nurses from making “unwarranted, judgmental comments or actions” to patients, families or other colleagues when patients decide to kill themselves with doctor-prescribed lethal overdoses.
Slowly but surely, more and more pro-life doctors, nurses and other healthcare professionals are getting the message that they and their views are unwelcome in today's health care system. But these public items tell only a small part of the story. Intimidation, harassment and coercion are becoming increasingly common as pro-life health care providers try to advocate for both their patients and their professional ethics.
For example, a nurse was threatened with firing after she refused to follow a doctor's verbal order to increase an intravenous morphine drip “until he stops breathing” on a patient who continued to survive despite having a ventilator removed. An OB/GYN physician was told by other doctors that they would no longer refer patients to him if he continued to sign an annual pro-life ad. Three California nurses were suspended after they reported a doctor who later admitted giving a lethal injection to a child. An insurance company executive speaking on ethics committees at a conference recommended that such committees avoid appointing “family values” members.
Unfortunately, these reprehensible acts are not confined to just secular health care institutions.
A dedicated nurse who cared for elderly nuns in a Catholic facility for over a decade was told she could resign when she objected to the slow starvation and dehydration deaths of two of her beloved nuns. Several doctors and nurses working at Catholic hospitals have personally told me about similar incidents, including other supposedly prohibited actions such as sterilizations, referrals to Planned Parenthood and even some abortions. Amazingly, hospital administrators often told them that these procedures were ethically allowed according to some prominent Catholic ethicists.
Years ago when I was the co-chair of the St. Louis Archdiocesan Pro-Life Committee, I was asked by the late Archbishop May why I didn't work as a nurse at a Catholic institution. He was shocked when I told him that I felt safer at a secular institution that at least understood the implications of conscience rights rather than at a Catholic institution, which could try to talk me out of them.
I wasn't kidding.
The Slippery Slope
Before the invention of the Pill and the legalization of abortion, medical ethics principles were relatively simple, unambiguous and, with few exceptions, followed by doctors and nurses. The Hippocratic oath prohibiting abortion and euthanasia was a mainstay of medical education.
However, the beginnings of a drastic change started with the furor over the invention of the Pill and accelerated when the American College of Obstetricians and Gynecologists (ACOG) allowed the redefinition of conception from fertilization to the later implantation of the embryo into a woman's uterus, thus blurring the distinction between contraception and abortion by ignoring scientific fact.
The American Medical Association (AMA) softened its long-standing opposition to abortion as state laws on abortion were being relaxed in the 1960s and 1970s. After the 1973 Roe v. Wade decision, the AMA declared abortion to be an ethical healthcare procedure and now opposes almost any restrictions on abortion practice.
With legality rather than principle becoming a deciding factor in medical ethics, the standard of the Hippocratic oath had to be revised and now it is rarely used at all. Both the prohibition of abortion and euthanasia in the oath as well as the sacred commitment of the doctor to the individual patient were seen as obstacles to a more “enlightened” and modern healthcare system. Healthcare is now seen by many as an important part of societal reform to a more “inclusive” and less “judgmental” culture.
Thus, it is not surprising that pro-life health care providers are now portrayed as divisive to their professions and even a threat to patients' rights when they refuse to conform to the Culture of Death.
When the infamous Roe v. Wade decision on abortion was handed down, it was assumed that healthcare providers would not be forced to participate in abortion. However, the reality of legalizing abortion soon led many states to pass conscience rights legislation on abortion to protect doctors and nurses who object. Unfortunately, this still has not adequately protected doctors and nurses from intimidation, harassment or from obstacles to career advancement because they do not provide what is now called “full service” on “reproductive rights”.
Many pro-life healthcare providers thought they would be safe if they chose a specialty other than OB/GYN or labor and delivery. But with the court decisions and laws legalizing the withdrawal of basic medical treatment, the acceptance of terminal sedation as comfort care, the legalization of assisted suicide in Oregon and the push for such laws in other states, etc., there is now almost no area of medicine where a pro-life healthcare provider can avoid ethical dilemmas.
And instead of unity, the medical professions have now become virtual war zones with many ethical doctors and nurses reluctant to even express their views or reveal that they are pro-life. Unfortunately, the healthcare professions, which rely on universal standards to protect both their members and the public, cannot long be trusted when their members can have diametrically opposed views on life and death. Coexistence of such disparate views ultimately becomes impossible because, as the Bible says, a man cannot serve two masters and must eventually choose one over the other. Thus, conscience rights help but they are not enough.
The Thin White Line
Pro-life healthcare providers are becoming a thin, white-coat line trying to protect both their patients and the public from an ever-expanding Culture of Death. And without such people of principle, there is no possibility of maintaining a pro-life movement.
With the current “politically correct” view that people should not judge the actions of others and the rise of moral relativism in all areas of personal ethics, far too many people are being intimidated into silence or despair. But we must remember that we are called to be persistent and that the ultimate success is God's.
And there are already glimmers of hope. For example, the efforts of disability, pro-life and other organizations have so far helped to defeat efforts to legalize Oregon-style assisted suicide in other states. The courage of Jill Stanek, the nurse who exposed the scandal of neglecting newborn abortion survivors to death in her hospital and was finally fired, has led to President Bush signing the Born-Alive Infant Protection Act this year. The incident of the nurse who refused to increase a morphine drip to euthanize a patient opened many eyes among her colleagues and recently an entire division of nurses refused to follow a doctor's order to use morphine to terminally sedate a patient and the doctor backed down.
The reform of medical ethics has to come from both inside the medical profession and from the public. It is only when the highest standards are insisted upon that the ongoing corruption of the healthcare professions can be stopped and trust restored.
But first we must all accept the fact that evil never limits itself and always seeks to expand. Now is the time to make truly ethical healthcare the norm and stop the Culture of Death. Otherwise, we all can become an endangered species.
Copyright © 2003 Women for Faith & Family
Nancy Valko, a registered nurse, is president of Missouri Nurses for Life, a spokesperson for the National Association of Pro-life Nurses and a Voices contributing editor.