(CNSNews.com) – As the period ends Thursday for public comment on a controversial new HHS rule aimed at protecting health care workers who refuse to participate in abortions, the issue is also causing a stir in Australia, where pending abortion legislation makes it mandatory for a doctor who objects to abortion to refer a patient to a physician who doesn't.
Catholic leaders in the Labor-governed state of Victoria are warning that if the bill is voted into law early next month, Catholic-run hospitals may close their maternity departments – or even shut down completely – rather than comply.
About one-third of all births in Victoria, Australia’s second most-populous state, take place in hospitals run by the church, Catholic Archbishop Denis Hart of Melbourne noted in a pastoral letter.
Hart is leading the church’s opposition to the bill, which seeks to decriminalize abortion, legalizing it up to 24 weeks’ gestation, and permitting it beyond 24 weeks, provided two doctors agree that this is medically indicated.
While the church’s objections are many, of particular concern is clause eight, which while allowing a pro-life doctor to decline to perform an abortion, requires him or her to refer the patient to another doctor who the referring doctor knows does not have objections to carrying out the procedure.
Hart has written to state lawmakers, urging them to reject the bill. It passed Victoria’s lower house on Sept. 11 – by a 49-32 vote – and is due to be voted on by the upper house on Oct. 7.
He has also called for a day of intercession against the legislation on the Sunday before the vote.
In his pastoral letter, Hart called the bill an attack on long-held beliefs, saying it was “clearly intended to require Catholic hospitals to permit the referral of women for abortions. It is an insidious irony that this coercion of conscience is being carried out in the name of choice.”
“Catholic hospitals will not perform abortions and will not provide referrals for the purpose of abortion,” he stressed. If the provision is passed, it will place pro-life staff in a position of breaking the law if they act in accordance with their moral convictions.
“This bill poses a real threat to the continued existence of Catholic hospitals. Under these circumstances, it is difficult to foresee how Catholic hospitals could continue to operate maternity or emergency departments in this state in their current form.”
Beyond the mandatory referral clause, the bill also requires medical staff, notwithstanding their conscientious objection, to perform an abortion in a case where the procedure is deemed necessary to preserve the mother’s life.
Backing Hart’s stance, Catholic Health Australia, which represents 75 Catholic hospitals around the country, issued a statement this week declaring that the hospitals “do not and will not offer abortions.”
“Importantly, our hospitals do not offer formal referral to abortion services,” said CEO Martin Laverty, after convening a meeting Tuesday of the heads of Victoria’s 15 Catholic hospitals.
Laverty said the organization hoped to test whether the mandatory referral aspect of the bill contravened the state’s own 2006 human rights legislation, which upholds the protection of conscience and freedoms of belief.
‘Breaking the truce’
While the Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) is backing the bill, the church is getting support from an unexpected quarter – the country’s leading health advocacy organization, the Australian Medical Association (AMA).
“We are supporting legalizing abortion, but have a concern around clause eight,” AMA spokeswoman Fronscesca Jackson-Webb said Wednesday.
“We would like the new legislation to reflect the existing law on conscientious objection.”
Jackson-Webb provided a copy of a letter from AMA Victoria President Dr. Douglas Travis to the state’s premier, John Brumby.
“Medical practitioners’ views on termination of pregnancy are as diverse as views among the rest of the community,” Travis told the premier.
“Respect for a conscientious objection is a fundamental principle in our democratic country, and doctors expect that their rights in this regard will be respected, as for any other citizen.”
Among groups backing the bill is the state’s civil liberty body, Liberty Victoria, which says it supports freedom of religion but does not believe personal religious beliefs should govern public policy.
“Those who oppose abortion need not seek to have an abortion,” the group said in a statement. “They do not have the right to prevent others from making their own decisions in respect of reproduction.”
But Dr. David van Gend, spokesman for the World Federation of Doctors who Respect Human Life, described the bill’s clause eight as a willful breaking of a “truce” currently in place – “where those who want abortion can access it, and those who oppose it have the consolation of laws that nominally defend the ‘silent innocence of the unborn’.”
“But the present political leaders in Victoria … intend to crash through our fragile truce and declare an escalation in the culture wars. So be it, but if they succeed, history will remember who broke the truce on abortion,” he said.
“And history will show that the naked violence of such a lawless abortion regime, as in the U.S. [in the 1973 Roe vs. Wade decision], provoked more Australians than ever before to enlist in the struggle for a society where every child is welcomed in life and protected in law.”
Limiting conscientious refusal
In the U.S., Thursday marks the end of a period for public comment on a new HHS regulation which clarifies that federal law protects the rights of institutions and individuals not to participate in procedures they object to on religious or moral grounds. Noncompliance could lead to the withholding of federal funds.
The rule was proposed last month by Health and Human Services Secretary Mike Leavitt, who said “doctors and other health-care providers should not be forced to choose between good professional standing and violating their conscience.”
The rule prompted strong criticism from reproductive rights groups, which say it could seriously undermine women’s access to reproductive health services, including abortion or birth control. They urged supporters to let the administration know their objections.
On Thursday, the American College of Obstetricians and Gynecologists (ACOG) said the proposed new rule “could limit women’s access to appropriate, complete, and accurate reproductive health information and services and seriously jeopardize the doctor-patient relationship.”
Last November, ACOG issued an “ethics opinion” entitled
The Limits of Conscientious Refusal in Reproductive Medicine.
“Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a patient’s health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities,” it said.
As with the Australian proposals, the ACOG opinion said physicians have a duty to refer patients.
And, “In an emergency in which referral is not possible or might negatively have an impact on a patient's physical or mental health, providers have an obligation to provide medically indicated and requested care.”
Asked Thursday to clarify the status of the opinion, ACOG provided a statement which explained that the opinion is not referred to in the college’s Code of Professional Ethics and “cannot affect an individual’s initial or continuing Fellowship in ACOG.”
The Catholic Medical Association has called on ACOG to rescind the opinion, saying it constituted a “denial of conscience rights and religious freedom.”