Conscience Clause — Reality Check

I’ve followed a conversation on another birth blog about religion, and someone brought up the “conscience clause” which prevents people from being forced to perform or recommend certain services or medications against their consciences. The general feeling among the commenters was that people should check their religion at the door, not allow their religion to dictate their actions, and/or be forced or required to go against their consciences and/or religion in certain matters. Whether you are for or against people being able to conscientiously refuse to participate in abortions, or with drugs that may be abortifacient, you need to read the rest of this article, because believe it or not, it does affect you.

With drugs like “the morning after pill” and chemical abortions and abortifacients available, plus the very popular hormonal birth control in various forms (pills, patches, rings, shots), not to mention IUDs and surgical abortions, gynecologists as well as pharmacists are having to invoke this “conscience clause” to keep from having to act against their conscience and beliefs.

Many people wonder “what’s the big deal?” and also point out that all the above things are perfectly legal, and many people think that the woman’s “right to choose” overrides the physician’s or pharmacist’s right to choose.

Here’s the deal — a new human life begins at conception — when a living human sperm fertilizes a living human egg, a new human being begins. That is an undeniable scientific and medical fact — the only people who try to deny it are either ignorant of basic science or so caught up in their religion of abortion that they refuse to believe the truth. When that life ought to be protected is a philosophical or religious discussion. But that the fertilized egg is a new human creature is undeniable.

Those who invoke the conscience clause do so because they take the fact that a new human life begins at conception and combine it with their belief that human life should be protected. Many times this belief comes from a religious source, but some agnostics and atheists also believe that human life should be protected at every stage of life. (These people will also be completely opposed to the death penalty, as an example; although some may allow the death penalty as a just punishment for certain crimes.) And since human life begins at conception, these people (whether religious or not) will be firmly against abortion, or any form of “birth control” that may possibly allow conception without allowing the pregnancy to continue — which every form of birth control other than true contraceptives (such as wearing a condom) does carry that possibility. To ask such a person to prescribe birth control which has a back-up function of not allowing the conceptus to implant into the uterine wall is to ask that person to participate in the destruction of a human life.

What if religion weren’t involved? What if it were solely based on one’s personal conscience and belief, apart from religion? What if abortion (and potentially abortifacient birth control methods) weren’t the topic? What if it were something else that some people’s consciences revolt from? What if a doctor who disliked circumcision was required to perform them? What if someone who conscientiously objected to killing animals and/or eating meat was going to be forced to participate in their slaughter and/or eat meat? What if you as a parent had decided that you didn’t want to give your child any vaccine, or only select vaccines on your own timetable, but were going to be forced to comply with industry “recommendations” against your conscientious decision? What if a doctor who objected to the death penalty was going to be required to administer the lethal dose of drugs to the convicted murderer? Would you think his conscience should be overridden, simply because the death penalty is legal, and many people think it is a good thing to have? What if a doctor or pharmacist who objected to euthanasia was going to be required to prescribe, dispense, or administer a lethal dose of medication to someone else? Should the person’s “right to die” override the doctor’s or pharmacist’s conscience not to be involved in his or her death?

While you may be very mad that doctors are not required to participate in abortions, or at least to refer their patients out to someone else who does, you should be glad that they are not required to do things against their consciences. And here’s an analogy, if you still think that they should be required to at least tell their patients where they can go to get an abortion, if they themselves won’t perform one: What if a gun dealer wouldn’t sell somebody a gun or ammunition because he was threatening to kill somebody, but he was required to tell that person where he could go to get the lethal weapon or ammo? He would still have facilitated a murder, even if he did not perform it himself, nor was a direct accomplice to it.

Requiring doctors and pharmacists to prescribe or dispense medications, or to perform or refer out for abortions, when they believe that dispensing those medications or having an abortion is murder, because it is the willful destruction of a human life, is requiring them to become either a murderer or an accomplice to murder in their own minds and consciences. I daresay you would not want to feel like a murderer, so you shouldn’t want them to feel that way, either. If you try to eliminate their conscience clause today, you may very well find that your conscience clause is eliminated tomorrow — and you wouldn’t want that!

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11 Responses

  1. Well said, Kathy!

  2. Beautifully said, as always, Kathy! Wonderfully put!

  3. How is this even a point of contention? People are so confused.

  4. I personally am pro-choice as in I do not have the right to make a choice for an others even if I disaggree.

    Doctors and others should have the right to live and practice in a manner that fits their personal beleif systme as long as they are open to where they stand on certain issues that affect my choices.

    As a consumer I want to be able to pick a health care provider as well as other business that fit my standards, my goals.

    Its such a shame that people now days are shamed and scared into hiding their faith, their opinions ect so nobody is offended. If I disagree strongly enough I have the CHOICE to listen, take part in, take action in response to or ignore their stance.

  5. I agree that any medical practitioner should be able to choose what procedures they want or don’t want to perform, what medication they will and will not prescribe or any other decision they want to make about their practicing of medicine. However, just as it is important to preserve the rights of the medical provider the patients have rights as well. What we need is more transparency.

    Medical care is expensive and patients should be able to acquire a full list of the things they will not do or offer referrals for from a physician/nurse/etc before choosing them as a care provider. No one should have to spend hundreds of dollars and many hours in appointments with doctors to question them about every every possible treatment or procedure they might ever need or end up with a doctor who will not provide the necessary care, regardless of the reason. If patients had all the information about a providers ability to care for them and could make informed decision on which provider to see. I for one would not want to see an OB/GYN who would refuse to operate on an ectopic pregnancy because of the infinitesimal chance that it could survive to viability. Or a family medicine doctor who would refuse to prescribe an OCP to a woman with PCOS because of the possibility it might stop the implantation of a fertilized egg. I am all for them make the choice they feel is appropriate for their conscience/soul/morals/ethics/religion or whatever but I have a choice as well. They should be open, honest and upfront with their self imposed limitations allow patients to have their choice as well.

    Employers should have the right to this information as well from potential employees. It is reasonable for a hospital or clinic to require a potential employee to reveal any part of the job that they refuse to take part in for any reason. The employer should be able to decide if they want to hire someone who refuses to perform all the duties the position requires.

  6. I agree with you, although, one way a lot of people get around the abortion issue with birth control, is that they use the definition of conception at the time of implantation, not when egg and sperm meet. This is the actual scientific definition of pregnancy used today. It doesn’t make sense to most people when they realize it. So “scientists” do not consider people pregnant until implantation. I hope what I said made sense….

    • Erin,

      Yes, I actually read this in a book a few months ago, which really just twists the words and meanings in common usage (the book said that this change in definition took place in the 70s). Conception is when egg and sperm meet — end of story! Or it should be, anyway. But, by using the term “contraception” to denote an agent that works to prevent either conception or implantation, they have a lot of people who say they are “pro-life” and who would not use a contraceptive if they really knew what it did. One of my friends considered using a Mirena IUD, which was recommended to her by her pro-life doctor, who told her that it was not abortifacient. [This friend overheard a conversation the doctor had with another patient, in which the patient asked about her abortion options should the prenatal screen/test indicate a fetal abnormality. The doctor said that not only would she not perform such an abortion, but would not refer her to anyone who would. So, she’s obviously pro-life.] But the Mirena website — like all chemical birth control — says that while it may prevent pregnancy by stopping ovulation or hampering the ability of the sperm to reach the egg, it has a back-up function of preventing implantation, should ovulation and fertilization (conception) occur. To someone as strongly pro-life as myself and my friend, this is an abortifacient function, regardless of how doctors choose to define the terms.

      I think a lot of doctors like the vagueness (or else have not really thought much on it), because it allows pro-life physicians and nurse-practitioners to prescribe and dispense medications that are “not abortifacient” — although if they believe that life begins at conception (which is what embryology textbooks teach) and really think about it and understand, they will inexorably come to the conclusion that by interfering with implantation, they are not just preventing a life from being created, but preventing a life that has already begun from continuing. Quite a difference, in my mind.

  7. I have a problem with the concept of ‘life begins at conception.’ From a scientific point of view that is an ridiculous claim because technically the two cells that joined at conception were alive before they came together. Life is a continuum and it seems disingenuous and crass to assign the same meaning and value to a single cell or a collection of a couple hundred and a fully formed organism. That one cell is no different in value than the two that joined to make it (and at least one of those is sacrificed every month).

    The other point about something preventing implantation being an abortifaciant is factually incorrect. An abortion is the discontinuation of a pregnancy (naturally, aka miscarriage or artificially). Since a woman is not pregnant until the blastocyst has implanted in the unterus so something that inhibits implantation is not causing an abortion because there was never a pregnancy.

  8. Kela,

    In regards to the use of the term abortifacient — as I pointed out in the comment above, it depends on the definition of the term.

    I also agree with you… sort of… about life just continuing at conception, but I reach the opposite conclusion. Yes, as I said in the post, “a living sperm reaches a living egg,” yet many who call themselves “pro-choice” would say that the conceptus is not alive, and therefore can be removed from the uterus without any moral or ethical complications. Because these two living cells join together to make a completely different human (with all the genetic information that controls things like sex, eye color, hair color, skin color, etc.) configured and set at that time, I think it is disingenuous and crass to say that, yes, it is a new human… but it shouldn’t be valued as much as bigger humans. Because when those two cells joined into one, it does give that one cell much greater value than the two that joined it — even though an egg is “sacrificed” as you say every month, and thousands of sperm die every day.

    The egg will die within 24 hours if it is not fertilized; sperm will die within an hour after ejaculation, unless within the woman’s uterus, and may live 3-5 days (perhaps a bit longer) there if conditions are right. The life expectancy of each gamete by itself is, obviously, not long. Ah, but put the two together, and the life expectancy can be as long as 100 years, or even more! The value of the sum is more than the value of the parts.

    After conception, the only thing added to the conceptus is time, nutrition, and oxygen — the same things that you and I need to continue to live, and without which we would surely die.

  9. Kathy,
    I know, I am always surprised at how many people do not truly understand the way hormonal birth control and IUDs work. There are more than a handful of people that I know have stopped using them after learning (from me) how they work. I agree that a lot of doctors like the gray area.

    • I knew a pharmacist who didn’t know for years about the way it possibly could work; when he found out, his wife went off birth control, because they were pro-life. But he still didn’t have a problem with dispensing birth control pills, and even mentioned having been a hospital pharmacist working when a rape victim came in, and he didn’t have a problem with giving her a double-dose of birth control pills so that she wouldn’t get pregnant. I had been a pharmacy tech for years before I found out the possibility of post-conception interference, but even after I found out, I didn’t have a problem with my job, including selling/dispensing/handing over birth control pills. My boss was, I think, basically pro-life, and didn’t have a problem with birth control, but refused to stock the “morning after pill” or any variant…although I heard him on at least one occasion tell a customer who called up freaking out that she had accidentally skipped a day of birth control, telling her to just take two that night, and she shouldn’t get pregnant.

      What I learned at the pharmacy was enough to make me say that I never want to be on chemical birth control (unless I needed it because my hormones went wacky or something), but I don’t sit in judgment of those who take birth control. I do have a problem with those who should know better and don’t or, even worse, won’t.

      Another argument I’ve heard, typically advanced by those who are pro-life, in order to feel comfortable with believing that life begins at conception yet drugs that may interfere with implantation are okay, is that “it is mostly theoretical that the drugs interfere with implantation as a backup function, and drug companies have to put that information in their package insert, but nobody really knows for sure. And since birth-control pills work to suppress ovulation, that’s what causes the thin/hostile uterine lining. If there is breakthrough ovulation, the body produces a good enough lining to support the baby, so it doesn’t really interfere with implantation.” And that may be true in some cases, but not in others — and particularly with today’s low-dose and ultra-low-dose birth control pills — the incidence of breakthrough ovulation is a lot higher than that of the first-generation birth control pills, but the rate of pregnancy remains the same. But this allows some pro-lifers to salve their conscience.

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