At the urging of Planned Parenthood, the Nevada state Assembly approved an amendment in April 2003 to stop pharmacists with religious objections from refusing to fill prescriptions for any drug, including abortifacient contraceptives and the so-called "morning after" pill. 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.
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.