Last month, the American College of Obstetricians and Gynecologists released a statement , “The limits of conscientious refusal in reproductive medicine,” [PDF] which is meant to outline “a framework for defining the ethically appropriate limits of conscientious refusal in reproductive health contexts.”
The statement provides several examples of “conscientious refusals,” such as a lesbian couple refused intrauterine insemination, refusal of pregnancy termination, and denial of prescriptions to emergency contraception. It also urges providers to consider that they may be imposing religious/moral beliefs on patients with differing views, effects on patient health, scientific integrity, and the potential for discrimination.
Ultimately, several recommendations are made by the ACOG ethics committee authoring the statement, including the duty to provide scientifically accurate information, refer patients to other providers in a timely manner, and consider the effects in resource-poor areas, such as whether there are other providers able to fulfill the patients needs and requests. It also notes that:
“In an emergency in which referral is not possible or might negatively affect a patient’s physical or mental health, providers have an obligation to provide medically indicated and requested care regardless of the provider’s personal moral objections.”
In response, the Christian Medical Association and other organizations (such as the Family Research Council, Concerned Women for American, Christian Coalition, and Focus on the Family) have issued a letter [PDF] to ACOG asking that they “repudiate and withdraw” the statement. In it, they argue that anti-choice physicians should be free to refuse to refer patients to other providers, and, with regards to resource-poor areas “ACOG would actually require a pro-life physician to relocate his or her practice to be close to an abortion facility.”
What ACOG actually says on this topic is that physicians who intend to refuse treatment, in order to ensure care for women, should either be in proximity to providers who do not share their views or ensure that a referral process is in place; it does not “require” that physicians relocate their practices.
The letter’s authors argue that ACOG is sending “a message of ideological intolerance and religious discrimination” by singling out anti-choice providers. I wonder if the signees have considered that refusing care (and referrals to care) to women sends that very same message.