Certifying Board Has Standards for Certifying, Anti-Abortion Doctors Object

Oh, nice. What a wonderful thing when listening to NPR on the way to work makes you end up feeling even more stabby than you already did. In November, the American College of Obstetricians and Gynecologists issued an ethics opinion directing physicians who don't want to perform a given standard healthcare procedure to refer their patients to other physicians who will perform it. Fair enough, right? Wrong. The administration finally noticed it last Friday.

The Bush administration says new ethics guidelines written by the American College of Obstetricians and Gynecologists may violate federal "conscience" laws.

Of course the Bush administration says that. Abortion is the obvious bone of contention, but if conscience laws are put into play, emergency contraception, standard contraception, and prenatal care for lesbians and quite possibly unmarried straight women turn into pawns in the religious conservatives' power game.

"I'm not going to refer someone to a hit man to put to death someone that's inconvenient in their life," says Joseph DeCook, a retired Ob/Gyn from Holland, Mich., and vice-president of the American Association of Pro-life Obstetricians and Gynecologists. "I wouldn't do that. This is the very same thing. I'm not going to refer a pregnant woman to a physician who will purposefully terminate her pregnancy — better known as purposefully kill the unborn child. I'm just not going to do it."

The forced-birth contingent is concerned that refusing to refer their patients to other doctors so that they can obtain a legal and standard medical procedure will lead to the ACOG stripping them of their board certification, which will put them out of business. Cry me a river? The administration is doing just that.

On Friday, Health and Human Services Secretary Mike Leavitt sent a letter challenging the policy to both the certifying board and ACOG.

"We had great concerns that technically competent, skilled, highly trained physicians could be denied board certification solely on the basis of refusing to refer for abortions, something that might be against their moral compass or ethical standard," says Don Wright, HHS principal deputy assistant secretary.

The entire kerfuffle may ultimately be posturing anyway, since the ethics opinion isn't part of the formal code and is nonbinding. Be that as it may, the ACOG is rightly more concerned about technically competent, skilled, highly trained physicians unilaterally denying women access to legal procedures, legal medications, and legal care that fall outside the umbrella of the physicians' personal religious beliefs. The government should share those concerns.

The ACOG should take the additional step of requiring full disclosure on the parts of the doctors. Every OB/GYN and primary care physician in the country should be required to prominently post a sign on their doors detailing the limits their religious beliefs place on the services they will provide, and the same information needs to go to the HMOs to put in their provider guides so that women don't enter into professional relationships with doctors who will, down the road, not only refuse to fulfill their legitimate medical requests but will refuse to issue the sacred referral required for them to acquire the services elsewhere. In this era of plan-specific providers and long waits to find physicians who are taking new patients, no one can afford to waste their time.

Those of us in urban areas with more doctors available--even with some who take our insurance and have openings!--are inconvenienced by these goons. Women in small towns or rural settings with one doctor per hundred square miles are facing involuntary life-changing situations if the one guy available won't refer them to the clinic in the city four hours away. If they're raped and he refuses to keep emergency contraception on hand, they're assaulted twice. Think back on every story the Bush administration has told about the Muslim oppression of women who do not conform to the religious standards of the men around them, stories used in part to justify the invasion of Iraq, and then ask why the same administration is leaping to the defense of Christian men who refuse to provide services to women whose needs do not conform to the men's religious standards. Men who, dare I say it, are asking for special rights exempting them from the standards set for their jobs.