The Conscience Wars

There was an interesting piece in the Washington Post this Sunday about the recent increase in doctors, pharmacists, and other health workers who decline to provide the full range of care and information to their patients based on their political or religious beliefs. Funnily enough, women’s health issues seem to evoke a disproportionate number of these so-called crises of conscience. For example, check out the lead:

In Chicago, an ambulance driver refused to transport a patient for an abortion. In California, fertility specialists rebuffed a gay woman seeking artificial insemination. In Texas, a pharmacist turned away a rape victim seeking the morning-after pill. 

There was an interesting piece in the Washington Post this Sunday about the recent increase in doctors, pharmacists, and other health workers who decline to provide the full range of care and information to their patients based on their political or religious beliefs. Funnily enough, women’s health issues seem to evoke a disproportionate number of these so-called crises of conscience. For example, check out the lead:

In Chicago, an ambulance driver refused to transport a patient for an abortion. In California, fertility specialists rebuffed a gay woman seeking artificial insemination. In Texas, a pharmacist turned away a rape victim seeking the morning-after pill. 

Just another day in America, where “conscience clauses” are a new and popular loophole for providers who feel the need to be the emergency last line of defense between their patients and Eternal Damnation. It’s now become relatively commonplace for pharmacists to refuse to fill women’s prescriptions for birth control pills or emergency contraception, and several state legislatures have passed or introduced conscience clauses to protect a pharmacist’s right to preach from the drug counter (read more about federal legislation that would resolve this dilemma here).

Worse, conscience clauses aren’t just popping up in the States—a few years ago, they took the international scene by storm in the form of the Smith amendment to the President’s Emergency Plan for AIDS Relief (PEPFAR), Bush’s 5-year, $15-billion dollar HIV/AIDS initiative targeting 15 countries worldwide. At that time, conscience clauses—which gave PEPFAR-funded faith-based organizations the right to deny people information about condoms and other prevention strategies if it was not in line with their religious beliefs—were a clever trick to funnel more money into unproven, ineffective “abstinence-until-marriage” programs (read more about legislation that would solve this dilemma here). We’re still pouring hundreds of millions into these “abstinence-only” programs at home and abroad, despite tons of evidence that they don’t work, and conscience clauses are freeing up even more money for them. 

Okay. I support freedom of religion, and I support the idea that people should be able to live their beliefs, but why is it that these conscience clauses, in practice, seem to discriminate most regularly and intensely against women and young people trying to make basic decisions about their sexual and reproductive lives—decisions that unfortunately require either information or services from a qualified health professional?

If everyone could prescribe their own birth control pills and make their own condoms and do their own safe and legal abortions and mix their own emergency contraception after being raped, then cool, believe whatever you want. But until that day, we all have different roles and rights and responsibilities to each other in this democratic society, and as empowered as I want to be, my ability to freely exercise my rights is still dependent on someone else’s commitment to not violating them. And when you as a health professional decide it’s your moral obligation to deny me something legal that I need, to withhold information about it, and to refuse me a referral on top of all that, then maybe you should consider changing careers to something that’s more in line with your moral beliefs.