Conscientious Objection and the Duty to Refer

When the Trump administration announced a new department of Conscience and Religious Freedom, the pushback from abortion and assisted suicide proponents like Planned Parenthood and Compassion and Choices was immediate and accompanied by apocalyptic predictions of harm to patients.

Now the term “conscientious objection” is increasingly being used rather than “conscience rights” when it comes to health care professionals. I believe this is not accidental. The term “conscience rights” is a powerful and accepted term about individual rights while “conscientious objection” is associated with the traditional definition of  “A person who refuses to serve in the military due to religious or strong philosophical views against war or killing” and who “may be required to perform some nonviolent work like driving an ambulance.” (Emphasis added)

Nevertheless, in a March 30, 2018 Medscape (password protected) article titled “Should Clinicians With Conscientious Objections Be Protected?”, well-known ethicist Arthur L. Caplan, PhD criticizes the new Conscience and Religious Freedom Division as an expensive “overreaction” that can be mediated by allowing health care professionals to refuse to provide a legal act (like abortion or assisted suicide in certain areas NV) but requiring them “to tell patients where they can go and how they can go about getting it.”

This echoes last year’s New England Journal of Medicine article “Physicians, Not Conscripts — Conscientious Objection in Health Care” by Dr. Ezekiel Emanuel (one of the architects of Obamacare) and Ronit Y. Stahl, PhD. who insist that medical professionals “cannot completely absent themselves from providing these services” and are still required to convey “accurate information” and provide “timely referrals to ensure patients receive care.”

The authors even state that:

“Health care professionals who are unwilling to accept these limits have two choices: select an area of medicine, such as radiology, that will not put them in situations that conflict with their personal morality or, if there is no such area, leave the profession. “ (Emphasis added)

Their rationale for this extreme position is that “the patient comes first, which means the patient’s conscience and autonomy receive priority over those of the physician.”  (Emphasis added)

However, this could now conflict with the recently amended federal Affordable Care Act (aka Obamacare) that states:

 “No qualified health plan offered through an Exchange may discriminate against any individual health care provider or health care facility because of its unwillingness to provide, pay for, provide coverage of, or refer for abortions.”

and

“The Federal Government, and any State or local government or health care provider that receives Federal financial assistance under this Act (or under an amendment made by this Act) or any health plan created under this Act (or under an amendment made by this Act), may not subject an individual or institutional health care entity to discrimination on the basis that the entity does not provide any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.” (All emphasis added)

THE DUTY TO “CONVEY ACCURATE INFORMATION” AND “REFER”

Ironically, do groups like Planned Parenthood and Compassion & Choices really want to require a medical professional opposed to abortion and/or assisted suicide to convey accurate information?

First of all, medical referrals require a measure of trust. For example, no doctor or nurse would knowingly refer a patient to another doctor or organization that he/ she considers incompetent or unethical or for a procedure the medical professional considers harmful to the patient. When a patient asks for procedures like abortion or assisted suicide, the medical professional should be free to refer the patient to support services like crisis pregnancy centers, etc. or to an ethical palliative care specialist, mental health expert, etc. The medical professional should also be free to convey accurate information regarding abortion such as  how abortions are performed, potential physical and emotional complications, fetal development, etc.  With assisted suicide, the medical professional should be free to discuss such issues as the potential complications of a lethal overdose, the potential effects on family and friends, the criminal/ civil immunity of the assisted suicide doctor if the assisted suicide goes awry, etc.

Medical professionals should also have the right to be honest and tell patients if they personally don’t know any doctor or organization that they would recommend to provide a referral for abortion or assisted suicide.

Patients, especially those in distress, need a well-informed medical professional who really listens to their concerns and responds with facts and helpful options rather than one who just hands out a “politically correct” referral.

CONCLUSION

The so-called duty to perform/participate in a life-ending procedure or refer for one is not really about conscience rights but rather another way to extinguish resistance to abortion and assisted suicide, normalize such procedures into standard medical practice and discourage/bully ethical health care professionals into leaving or never entering the medical professions.

Those of us who believe in medical ethics as, first and foremost, doing no harm to patients must actively fight this for the sake of our professions and for the safety of the public that puts their lives in our hands.

If we don’t speak up for our medical professions and our patients, who will?

 

What You Need to Know About Medical Abortion and Abortion Reversal

This month Governor Butch Otter signed a law making Idaho the fifth state to mandate that women getting a medical (drug-induced) abortion be told that the abortion may possibly be stopped after the first dose if the woman changes her mind about having the abortion. This abortion reversal process  involves taking the hormone progesterone to counteract the first abortion drug mifepristone and before taking the second drug misoprostol 36-72 hours later that causes expulsion of the unborn baby. There is now a website at www.abortionpillreversal.com for information on abortion reversal that includes a hotline phone number at 1-877-558-0333.

The first abortion reversal  was performed by Dr. Matthew Harrison in 2007 and by 2015, he claimed that more than 213 babies had been saved. Although not always successful, abortion reversal has resulted in hundreds more babies alive today. Last December, the California Board of Registered Nursing finally notified Heartbeat International that it can now grant continuing education units (CEUs) to nurses who study the life-saving process known as Abortion Pill Reversal.

Planned Parenthood and other abortion groups are not pleased.

As I wrote in my February 16, 2017 blog “Are Mail Order Abortions Coming?” , medical abortions rates now rival surgical abortion rates while abortion clinics are closing at a record pace because of factors like “economic difficulties”, “a generally hostile atmosphere and declining demand”. Thus, the medical abortion procedure has become more appealing to groups like Planned Parenthood and now there are even efforts to provide more medical abortions by telemedicine even though a 2014 study found more complications with medical abortions than surgical ones.

THE PROMOTION AND CHANGING CRITERIA FOR MEDICAL ABORTION

In a disturbing March 27, 2018 Medscape article Medical Abortion in Very Early Pregnancy” (password protected),  Peter Kovacs, MD, PhD touts a study that allegedly shows medical abortion is now safe even “as soon as early pregnancy is diagnosed” and even before an ultrasound can show if the unborn baby is developing outside the womb. This abnormality is called an ectopic pregnancy and, if not detected early, can result in life-threatening complications and surgery.  Ectopic pregnancy occurs in 1-2% of  all pregnancies.

But as even Dr. Kovacs admits:

“Under well-controlled conditions using sedation and appropriate pain control, surgical termination of pregnancy is associated with minimal bleeding or pain. However, it can be associated with surgical complications (trauma, heavier bleeding, infection), which can lead to further interventions.

Medical abortion can be more painful because the products of conception have to be expelled from the uterus, and it is accompanied by prolonged bleeding. Still, medical abortion obviates surgical complications and is significantly cheaper.” (Emphasis added)

He recommends  “(A)propriate patient selection (no increased risk for or symptoms of ectopic pregnancy, appropriate follow-up to confirm successful abortion, patient compliance)” as obviously important. (Emphasis added)

CONCLUSION

Planned Parenthood tells women that having a medical abortion (at home, of course) is just “kind of like having a really heavy, crampy period” with large clots and that “(a)ny chills, fevers, or nausea you have should go away pretty quickly”.

And that:

“People can have a range of emotions after having an abortion. Most people feel relief, but sometimes people feel sad or regretful. This is totally normal. If your mood keeps you from doing the things you usually do each day, call your doctor or nurse for help” along with numbers to call for “free, confidential, and non-judgmental emotional support after an abortion.” (Emphasis added)

But two things Planned Parenthood does not tell women about is medical abortion reversal and the availability of real assistance with a problematic pregnancy including crisis pregnancy centers that now outnumber abortion clinics in the US.

Women need-and have a right-to know about both these alternatives.  It’s up to all of us to make sure as many women as possible know this.

Should Nurses or Other Non-Physicians Be Allowed to Perform Abortions?

When abortion was legalized in the 1973 Roe v Wade decision, we were told that abortion should be a private decision between a woman and her doctor.

Now there is a lawsuit by Planned Parenthood and the American Civil Liberties Union to force the state of Maine to allow abortions by non-physicians such as nurses and midwives.

Why? Although Planned Parenthood and the ACLU claim that this is about the safety of first-trimester abortion and the lack of enough accessible abortion clinics as well as “threats of violence”, the truth is that it is getting harder and harder to find doctors willing to do abortions.

This new expansion of abortion is part of a larger movement to remove restrictions on abortion. According to the liberal Public Leadership Institute, already “California, Montana, New Hampshire, Oregon and Vermont allow trained and licensed APCs (advance practice clinicians like nurses and physician assistants) to perform aspiration abortions.”

The Institute even provides model legislation for states called the ““Qualified Providers of Abortion Act” and cites the American College of Obstetricians and Gynecologists as recommending “expanding the pool of non-obstetrician/gynecologist abortion providers by training advanced-practice clinicians (APCs)—nurse practitioners, certified nurse-midwives and physician assistants—to perform aspiration (aka suction or vacuum) abortions.”

 ABORTION AND SAFETY

The source cited for the claim of safety for non-physician abortions is a new National Academies of Sciences, Engineering and Medicine report, “The Safety and Quality of Abortion Care in the United States.”

This report cites a 2013 study “Safety of Aspiration Abortion Performed by Nurse Practitioners, Certified Nurse Midwifes, and Physician Assistants Under a California Legal Waiver”  that dismissed the result of twice the number of complications for the non-physicians vs physicians as not “clinically relevant”.

But finding any true statistics on complications of abortion (including death) is already virtually impossible because according to the national Centers for Disease Control (CDC)  “states and areas voluntarily report data to CDC for inclusion in its annual Abortion Surveillance Report. CDC’s Division of Reproductive Health prepares surveillance reports as data become available. There is no national requirement for data submission or reporting.” (Emphasis added)

In addition, abortion clinic health inspections are often lax or ignored. As the Washington Free Beacon reported last October, according to the 2016 “Unsafe-How the Public Health Crisis in America’s Abortion Clinics Endangers Women report from the pro-life advocacy group Americans United for Life, “between 2008 and 2016, 227 abortion clinics were cited for over 1,400 health and safety deficiencies.”

According to Arina Grossu, a bioethicist and the director of the Center for Human Dignity at the Family Research Council, “Restaurants and tanning salons and vet clinics, they’re all more closely regulated than the abortion industry.”

This, of course, does not take into account the physical, spiritual and emotional toll of abortion on women that I have seen both personally and professionally.

CONCLUSION

In the 2016 US Supreme Court’s Whole Women’s Health v. Hellerstadt at decision held that:

“Two provisions in a Texas law – requiring physicians who perform abortions to have admitting privileges at a nearby hospital and requiring abortion clinics in the state to have facilities comparable to an ambulatory surgical center – place a substantial obstacle in the path of women seeking an abortion, constitute an undue burden on abortion access, and therefore violate the Constitution.”

Abortion supporters cheered and are now emboldened to go farther in their quest for tax-payer funded abortion on demand without restrictions.

But all is not lost.

The number of abortions is declining and there are now more crisis pregnancy centers than abortion clinics.  and more lives are being saved. Programs like Project Rachel are helping even more women and men suffering from the tremendous psychological damage caused by abortion.

Most women are choosing life after viewing an ultrasound of their baby and more  people are opposing taxpayer funding of groups like Planned Parenthood, especially after the scandal of selling aborted babies’ body parts.

But most importantly, we must keep working towards a society that once again views abortion as unthinkable.

The New Federal Conscience and Religious Freedom Division

As a nurse threatened with termination for refusing to participate in an unethical health care decision years ago, I have a special interest in conscience rights for health care professionals.

Over the past several decades, new threats to conscience rights have widened from refusing to participate in abortions to other deliberate death decisions like withdrawal of feedings from people with serious brain injuries, VSED (voluntary stopping of eating and drinking), terminal sedation and physician-assisted suicide.

Thus, I am pleased that the Trump administration just announced the new Conscience and Religious Freedom Division  in the department of Health and Human Services’ Office for Civil Rights (OCR) to enforce “federal laws that protect conscience and the free exercise of religion and prohibit coercion and discrimination in health and human services”. The division specifically mentions “issues such as abortion and assisted suicide (among others) in HHS-funded or conducted programs and activities” and includes a link to file a conscience or religious freedom complaint “if you feel a health care provider or government agency coerced or discriminated against you (or someone else) unlawfully”.

Predictably, both Compassion and Choices and Planned Parenthood immediately condemned the new department.

In a recent fundraising email, Compassion and Choices states that:

 “This office (OCR) is not about freedom; it’s about denying patient autonomy. Under their proposed rules, providers are encouraged to impose their own religious beliefs on their patients and withhold vital information about treatment options from their patients — up to, and including, the option of medical aid in dying. And your federal tax dollars will be used to protect physicians who make the unconscionable decision to willfully withhold crucial information regarding their care from a patient and abandon them when they are most vulnerable.” (Emphasis added)

Planned Parenthood is just as adamant and includes other issues in their reaction:

“OCR is an important office within the HHS that’s meant to protect health care for marginalized communities, including LGBTQ people and underserved women. But the creation of the new “Conscience and Religious Freedom Division” paves the way for discrimination against people for a variety of reasons — be it their gender identity, sexual orientation, or decision to access a safe, legal abortion.” (Emphasis in original)

A SHORT RECENT HISTORY OF FEDERAL CONSCIENCE RIGHTS PROTECTIONS

In response to declining numbers of doctors willing to do abortions in the 1990s, efforts began to mainstream abortion into the health professions such as requiring abortion training for OB/GYNs, shifting training and practice into teaching hospitals and  integrating abortion into regular health care.

The National Abortion Federation along with Medical Students for Choice, pushed for change and in 1995, the Accreditation Council for Graduate Medical Education ruled that OB/GYN residency programs must include abortion training or lose accreditation.

That was overturned the next year with the Coats Amendment passed by Congress but  efforts to marginalize pro-life medical professionals continued, especially with newly passed physician-assisted suicide laws and well-publicized withdrawal of feeding tube cases like Terri Schiavo’s.

In 2008, the Christian Medical Association compiled a list of dozens of real-life cases of discrimination in health care, including doctors, medical students, nurses and pharmacists.

That same year, President Bush strengthened the HHS rules protecting the conscience rights of doctors and nurses to refuse to perform abortions.

In 2011, the Obama administration dismantled key provisions of the Bush administration conscience rights rules.

That same year, 12 New Jersey nurses faced firing for refusal to participate in abortion and had to rely on groups like Alliance Defending Freedom to bring a  lawsuit defending their rights. They were finally vindicated in 2013.

Right now, Wisconsin is considering a physician-assisted suicide bill that states a doctor’s refusal to prescribe the lethal drugs or refer the patient to a willing doctor “constitutes unprofessional conduct”.

Obviously, conscience rights cannot depend just on litigation, conflicting state laws or professional organization positions like the American Medical Association’s  or American Nurses Association’s that don’t vigorously defend conscience rights.

As explained on the Dorsey Health Care group website ,

“In January 2018, OCR announced a proposed rule to strengthen conscience-based protections for individuals and entities with objections to certain activities based on religious belief and moral convictions.”

“OCR now proposes to return much of 45 CFR part 88 to its 2008 Bush-era form, adding a requirement that certain recipients of HHS funds certify they comply with conscience protection laws and notify individuals of their rights thereunder”, enhance investigative and enforcement abilities and expands its enforcement authority to more conscience-protection laws than the 2008 or 2011 iterations. It will also “handle complaints [both formal and not], perform compliance reviews, investigate, and seek appropriate action,” including terminating funding and requiring repayment. OCR states “that a more centralized approach to enforcement of conscience protections is necessary in part due to rapidly rising complaints.” (Emphasis added) Comments on this proposed rule can be submitted by March 27, 2018.

CONCLUSION

Health care professionals with pro-life views have been under attack for decades. It’s more than just not being “politically correct”; the very existence of such health care professionals threatens the appropriation of health care by groups dedicated to promoting abortion, assisted suicide and euthanasia as civil rights.

Without strong conscience rights protections like a successful Conscience and Religious Freedom Division, they will succeed in making health care termination-friendly.

But in the end, enforcement of the most basic civil right of health care professionals to provide care for patients without being required to participate in life-destroying  activities should not be determined by politics or popularity polls but by the acceptance of the universal principle of respect and protection for human life.

 

Planned Parenthood Branches Out

When I first read the article “Planned Parenthood’s New Low: Teaching Transgender Ideology to 4-Year-Olds”, I was skeptical.

Although I have long had no illusions about Planned Parenthood since the 1973 Roe v. Wade US Supreme Court decision legalizing abortion, its’ promotion  of “comprehensive sex education” in schools, its’ fight against the partial birth abortion ban and the most recent scandal of selling body parts of aborted babies for “research, I was surprised by this new development.

I went to the Planned Parenthood website to see for myself.

There I found not only the online advice for teaching children as young as preschoolers about transgender issues but also a list of Planned Parenthood facilities across the nation that offer medical services including hormone treatment to people with transgender issues.

But why would Planned Parenthood take on this controversial issue now?

Could money be at least part of the reason?

Not only are some states moving to defund Planned Parenthood of taxpayer money  states along with efforts to defund it federally of the now over half a billion taxpayer dollars annually, but also abortion clinics are shutting down in many states. For example, just in California, three Planned Parenthood abortion facilities closed in June.

And not surprisingly, the most recent scandal about selling body parts of aborted babies has been devastating to Planned Parenthood’s self-proclaimed image as an altruistic dispenser of women’s health services and possibly its’ fundraising efforts.

Another reason for taking on this new issue of transgender identity, which is controversial even among medical experts,  could be that Planned Parenthood portrays itself as an expert on issues of sexuality. And if you regularly read the news, many activists and most mainstream media now seem almost obsessed with the politics surrounding transgender issues.

However, when I was a teenager in the 1960s,  I remember being told that Planned Parenthood was just about contraception and that it said abortion ended the life of a baby before it was born and could impair a woman’s future fertility.

I was an experienced RN by the time the US Supreme Court legalized abortion in the 1973 Roe v. Wade decision and I discovered about Planned Parenthood’s involvement in abortion years before that decision.

Later, I personally found out that the “comprehensive sex education” that Planned Parenthood promotes was in my children’s public schools and I wrote about this in a 2001 article titled “What About Sex Ed?”. I also joined other concerned parents in objecting to the often biased and inaccurate information our children were receiving. The schools tried to reassure us that our concerns would be addressed in the near future.

But it wasn’t long before we realized that this was a delaying tactic to last until our children graduated. In my case, it was over a decade before my youngest finally graduated but I made sure to teach them myself about the medical, moral and emotional issues surrounding sexuality and health.

Now, this very same school district my now adult children attended is proposing to change its’ curriculum to teach even the very young grade school students  “about topics like gender roles and gender re-assignment” despite many parents publicly and strongly objecting.

CONCLUSION

The Planned Parenthood Federation of America now takes in almost $1.3 billion in total revenue with $528 million in government taxpayer funding and is listed in the top 50 of the largest U.S. charities .

But is Planned Parenthood really a charity needing massive government taxpayer funding or rather more of an enormous business enterprise with strong political ties and an expansive, society-changing agenda that should stand on its own without government funding?

We need the answer to that question as soon as possible.

 

Are Mail Order Abortions Coming?

Abortion clinics have been closing at a record pace. Since 2011, at least 162 abortion clinic have shut or stopped offering the procedure while just 21 have opened. Five states now have just one abortion clinic still open.

New pro-life laws regulating safety and standards are part of the reason but as feminist Madeleine Schwartz writes, even in liberal states “the combination of the economic difficulties of operating a clinic, a generally hostile atmosphere and declining demand means that many clinics are shutting down.

It should be no surprise that telemedicine medical abortion has also become appealing to Planned Parenthood because it reduces the cost burden of the clinics.

Not to mention that abortion has also become increasingly concentrated among the poor with 49% of aborted women patients having a family income below the federal poverty level.

MEDICAL ABORTION AND TELEMEDICINE

Although abortion was legalized in 1973, it wasn’t until 2000 that the U.S. Food and Drug Administration (FDA) approved the first oral abortion drug mifepristone (also known as RU-486) for medical abortions within 7 weeks of pregnancy (In March 2016, the FDA changed its guideline to allow medical abortion up to 10 weeks into pregnancy.)

Back in 2000, the “early abortion” procedure involved 3 clinic visits. The first session was with a doctor and taking the mifepristone dose to stop the progesterone necessary to establish and maintain the attachment of the unborn baby and placenta to the womb.  Two days later and if still pregnant, the expectant mother had to return to the clinic for the dose of misoprostol to cause expulsion of the preborn baby. Two weeks after the first clinic visit, the mother must return to the clinic to confirm that the pregnancy was ended.

In 2008, a Planned Parenthood affiliate in Iowa initiated the first formal telemedicine abortion program in the U.S. for abortion clinics not regularly staffed by a physician. In this situation, a physician in another location reviews prior labs and imaging to estimate the length of pregnancy and potential contraindications before speaking by a webcam to the pregnant woman.

The doctor is never physically present. Instead, he consults with the pregnant woman via the webcam about her medical history and tests, explains the procedure and then remotely activates a drawer that opens to dispense the abortion pills.

Now rates of medical abortions rival surgical abortions in the U.S.

However by citing safety concerns, 37 states currently require clinicians who perform medication abortions to be licensed physicians and 19 states require that the clinician providing a medication abortion be physically present during the procedure, thereby prohibiting the use of telemedicine to prescribe medication for abortion remotely.

NOW MEDICAL ABORTIONS BY MAIL?

A new study has been started in 4 states (Hawaii, New York, Oregon and Washington) to allow women to terminate a pregnancy by telemedicine and mail-order drugs.

Although the telemedicine medical abortions by email are touted as especially a boon for women in rural areas without a close abortion clinic, the process does not allow women to avoid the doctor’s office entirely. Using a video hookup on a home computer, a woman first consults a physician (or other clinician such as a nurse practitioner) at one of three participating abortion clinics who evaluates her medical history, explains how to take the abortion pills and what to expect. The woman then must get medical tests including ultrasound and blood work at a medical facility.

The study is being conducted by Gynuity Health Projects in the hope that good results will encourage the FDA to stop restrictions on mifepristone in pharmacies.

IS MEDICAL ABORTION EVEN PHYSICALLY SAFE?

The list of contraindications for medical abortion include ectopic pregnancy, chronic adrenal failure, chronic corticosteroid use and blood clotting problems. If tests do not reveal such problems or if a pregnant woman does not know or tell the doctor about certain conditions, the results could be deadly.

Complications of medical abortions include infection, heavy or prolonged bleeding in an estimated 1% of women and in an estimated 2% to 5% of medical abortions, the unborn baby is not completely expelled from the womb. When the unborn baby is not completely expelled, a surgical abortion is done to prevent infection or other problems

In December 2014, the University of California-San Francisco (UCSF) released an extensive study on Medicaid abortions in California. While its press release was titled “Major Complication rate after Abortion is Extremely Low”, Stanford University Ph.D. Michael New and his team found something quite different when they analyzed the data. They found that the study confirmed the finding that telemedicine abortions have “four times more risk of complications”.

A NURSE’S PERSPECTIVE

Although Planned Parenthood calls medical abortion “similar to a miscarriage”, it’s not.

Years ago, I had a miscarriage at 10 weeks with complications. I had a doctor who knew my medical history before he gently told me that my baby had died in my womb. When I had complications at home during my miscarriage, he met me in the emergency room and took care of the problem. It was my doctor who reassured me when I was hospitalized overnight. That kind of physical and emotional support is not possible with a medical abortion from a clinic.

Now imagine a young woman afraid to tell anyone she is pregnant and who visits an abortion clinic to get the abortion pills. Will anyone be with her or even know when she goes home and experiences what Planned Parenthood says is “kind of like having a really heavy, crampy period” with large clots and that “(a)ny chills, fevers, or nausea you have should go away pretty quickly”? Will she recognize the signs of a complication? Will anyone follow up if she doesn’t return to the clinic to be checked after the abortion?

There is a big difference between medical abortion and miscarriage physically, emotionally and spiritually because abortion is NOT health care.

Could St. Louis Become a Sanctuary City for Abortion?

The St. Louis Planned Parenthood became the last abortion clinic in Missouri in November, 2015 after an abortionist lost her “refer and follow” hospital admitting privileges in Columbia, Mo.

Now two St. Louis aldermen in partnership with NARAL Pro-Choice Missouri started an effort  in December 2016 to “make the city a sanctuary for reproductive rights, i.e. abortion, by adding “reproductive health decisions” to the city’s anti-discrimination ordinance.

Their new bill, BB 203, adds “reproductive health decisions”, defined as “any decision related to the use or intended use of a particular drug, device, or medical service, including the use or intended use of contraception or fertility control or the planned or intended initiation or termination of a pregnancy” to the already protected categories of race, color, religion, sex, age, disability, marital status, familial status, sexual orientation, gender identity or expression, national origin or ancestry, or legal source of income.

Penalties under the current Civil Rights Enforcement Agency ordinance include up to $500 in fines and up to 90 days in jail but already a veteran pro-life activist was arrested on New Year’s Eve morning at the clinic and charged with alleged “domestic terrorism”.

In addition, as Samuel Lee of Campaign Life Missouri points out about BB 203: “There are no exemptions for churches, religious organization or for any person with a conscientious objection.”

Furthermore, he lists some possible acts that could be considered unlawful “discrimination” if BB 203 becomes law:

  • A Catholic hospital refusing to lease medical office space to a doctor who wants to perform abortions.
  • A doctors’ medical group rejecting as an employee, a physician who wants to prescribe abortion pills to his or her patients.
  • A property owner declining to lease office space to the CEO of Planned Parenthood.
  • The Archdiocese of St. Louis or Catholic Charities (at least as applied to their City of St. Louis employees), failing to include in their employees’ health benefit plans, coverage for abortion (at any time for any reason throughout pregnancy), contraception, sterilization or artificial reproduction.
  • A pastor in a pro-life church demoting or reassigning the youth minister because he encouraged and paid for his girlfriend’s abortion, because that is an “adverse employment action” (as defined in the bill) against the employee.
  • A maternity home, pregnancy resource center, Catholic Charities agency, etc., firing a counselor or social worker who referred a client for an abortion.
  • A mom or dad to denying parental consent for their minor daughter to get an abortion, because the parent would be “interfer[ing] with any person in the exercise or enjoyment of, or on account of his having exercised or enjoyed, rights granted and protected by this ordinance.”

Perhaps not surprisingly, Planned Parenthood’s new efforts to pass such an ordinance come after much bad publicity for the St. Louis Planned Parenthood clinic, including multiple safety violations discovered by Operation Rescue and 60 ambulance responses to the Planned Parenthood clinic since 2009 and observed by pro-life activists at the clinic.

.Archbishop Robert J. Carlson of St. Louis is also speaking out against BB 203 and states that  “the Archdiocese of St. Louis cannot and will not comply with any ordinance like Board Bill 203 that attempts to force the Church and others to become unwilling participants in the abortion business. There is no room for compromise on such a matter.”

Instead, Archbishop Carlson proposes that “St. Louis should be a sanctuary for life and compassion, especially compassion for mothers and their developing children.”

We must continue to challenge Planned Parenthood’s desperate efforts to shield its abortion business whenever and wherever such efforts occur.

Why New Indiana Law Bans Abortions Based on Race, Sex or Disabilities like Down Syndrome

Just three days after World Down Syndrome Day, Governor Mike Pence of Indiana signed a law that, among other provisions, bans abortion doctors from knowingly aborting an unborn baby solely because of an unborn baby’s race, sex, or genetic disability such as Down Syndrome.

Predictably, there was an immediate backlash from groups like Planned Parenthood, the mainstream media and others.

A Bit of History

In 2008, the  Prenatally and Postnatally Diagnosed Conditions Awareness Act was signed into law by President George W. Bush. This law, co-sponsored by Senators Edward Kennedy (D-MA) and Sam Brownback (R-KS), was meant to provide parents receiving a pre- or post-natal diagnosis of Down syndrome or other disabilities – like cystic fibrosis and spina bifida – more information and support than had been available in the past. It was inspired by the words and actions of Brian Skotko , who has a sister with Down Syndrome and who is now a board-certified medical geneticist and Co-Director of the Down Syndrome Program at Massachusetts General Hospital.
Among other provisions, the law was written to:

coordinate the provision of, and access to, new or existing supportive services for patients receiving a positive diagnosis for Down syndrome or other prenatally or postnatally diagnosed conditions, including—

the establishment of a resource telephone hotline accessible to patients receiving a positive test result or to the parents of newly diagnosed infants with Down syndrome and other diagnosed conditions

the establishment of a national registry, or network of local registries, of families willing to adopt newborns with Down syndrome or other prenatally or postnatally diagnosed conditions, and links to adoption agencies willing to place babies with Down syndrome or other prenatally or postnatally diagnosed conditions, with families willing to adopt

the establishment of awareness and education programs for health care providers who provide, interpret, or inform parents of the results of prenatal tests for Down syndrome or other prenatally or postnatally diagnosed conditions, to patients. (Emphasis added)

However, the law was never funded due to disputes among members of Congress “over how the topic of abortion would be handled in the materials accepted for distribution.”

But while such positive initiatives went unfunded, funding has been no problem for companies developing prenatal screening tests that can be done ever more easily and earlier in pregnancy. Currently, there is a “cell-free DNA” blood test for expectant mothers that can be done as early as 10 weeks into a pregnancy that claims near perfect accuracy in detecting Down Syndrome and other conditions.

However, a three month examination of these unregulated tests by the non-profit New England Center for Investigative Reporting reported

“companies are overselling the accuracy of their tests and doing little to educate expecting parents or their doctors about the significant risks of false alarms.”

And the Center also noted that “prenatal screening tests prompt abortions”.

Even the abortion-supporting American Congress of Obstetrician and Gynecologists’ (ACOG) current position expresses concerns and states that :

“Given the potential for inaccurate results and to understand the type of trisomy  for recurrence-risk counseling, a diagnostic test should be recommended for a patient who has a positive cell-free DNA test result.”

and

“Management decisions, including termination of the pregnancy, should not be based on the results of the cell-free DNA screening alone.” (Emphasis added)

Nevertheless, a recent study showed that abortion after prenatal diagnosis of Down Syndrome reduced the Down Syndrome community by 30%.

“Disclosing Down Syndrome to Pregnant Patients: Must You Give an Upside?”

In this rather offensively titled opinion article by Arthur Caplan, PhD. who heads the Division of Medical Ethics at NYU’s Langone Medical Center, he criticizes laws like Indiana’s:

One reason that women seek abortions is because they don’t want to have a child with Down syndrome. Recently there has been a movement among people who have had children with Down syndrome to say, “That rate of abortion indicates bias. It’s not really choice. It’s fear of Down syndrome. It’s prejudice against Down syndrome.” Some families who have had children with Down syndrome say that they mean a lot to their family; that it has been a great experience to have a child even though the child has Down syndrome; they accomplish a lot, they’re happy, and people have the wrong view about it.

Some have gone further and started to change state laws to say that when you get a positive test for Down syndrome, you are required to get in touch with the Down syndrome associations in your state and get the message that balances the bias that no one wants a kid with Down syndrome.

The problem is that far too many medical professionals themselves seem to have a negative bias when it comes to conditions like Down Syndrome and see no “upside” to Down Syndrome versus abortion. New or expectant parents deserve better, especially when that professional is giving them their baby’s diagnosis.

I found that out personally not only when I had my daughter Karen but also when I talked to other parents who encountered negative attitudes from some medical professionals.

Eventually, we developed an educational program for hospital maternity divisions about how to help new parents of children born with disabilities. I always brought a child with Down Syndrome and his or her parent to these programs and the reaction was amazing. Doctors and nurses who only saw upset parents before now heard from these same parents about the challenges and very real joys of life with their child. Even better, these professionals were charmed by meeting the children themselves.

We found that changes in attitudes and information can change future outcomes for the better for children and their parents.

Conclusion

It is natural to feel shocked and overwhelmed when you are told either before or after birth that your baby has a condition. Panic and fear is not uncommon.

But it is at this vulnerable time that parents especially need the accurate information, resources and support that the Kennedy-Brownback law was designed to provide.

Unfortunately, we have groups like Planned Parenthood that demand legalized abortion at any time during pregnancy for any or no reason at all as a civil right. However, that must not stop us from continuing to strive for a compassionate society that protects every human life, promotes accurate information and fights discrimination at the same time.

“David Daleiden Refuses Plea Deal for Probation: ‘What We Want is an Apology’”

I was glad to read the LifeNews.com article by Steven Ertelt about this response to the Houston grand jury indictment of David Daleiden and Sandra Merritt, especially one day after reading an outrageous USA Today op-ed titled “The great deception behind the anti-Planned Parenthood videos: Column” by Dawn Laguens, Executive Vice President and Chief Experience Officer for Planned Parenthood Federation of America.

Ms. Laguens’s op-ed claims that

“Daleiden, working in concert with other well-known anti-abortion extremists including Troy Newman of Operation Rescue, who has documented ties to violence, spent nearly three years creating a fake company, creating fake identities (including fake government IDs), obtaining a credit card using a fake name and information, trespassing onto private property and illegally recording conversations without consent with the express goal of finding a way to attack Planned Parenthood and the health care services we provide.”

Unfortunately, almost all mainstream media have supported the Planned Parenthood explanation of the surprising Houston grand jury’s indictment of Mr. Daleiden and Ms. Merrit rather than investigating whether a Houston Planned Parenthood clinic had sold the organs of aborted babies, the original purpose of the grand jury.

Journalism and Ethics

As a former reporter myself, I am constantly amazed by the lack of investigative reporting on abortion-related as well as other “politically incorrect” issues.

The Cambridge Dictionary defines investigative journalism as “a type of journalism that tries to discover information of public interest that someone is trying to hide.”

The mission statement for the Center for Medical Progress that was founded by David Daleidan shows how important this is:

The Center for Medical Progress is a group of citizen journalists dedicated to monitoring and reporting on medical ethics and advances. We are concerned about contemporary bioethical issues that impact human dignity, and we oppose any interventions, procedures, and experiments that exploit the unequal legal status of any class of human beings. We envision a world in which medical practice and biotechnology ally with and serve the goods of human nature and do not destroy, disfigure, or work against them.

Investigative journalism itself has had a long and mostly proud history and for many years there has even been a Pulitzer Prize for Investigative Reporting.

While Planned Parenthood criticizes David Daleiden’s and his Center for Medical Progress’ “deception” in making the undercover videos about selling fetal tissue from aborted babies, the Society of Professional Journalist’s Code of Ethics states that journalists should:

Avoid undercover or other surreptitious methods of gathering information unless traditional, open methods will not yield information vital to the public. (Emphasis added)

The Center for Medical Progress’ undercover investigation undoubtedly meets this criteria.

Planned Parenthood has long gone to great lengths to keep negative information about its activities from the public while taking over $500 million dollars a year in taxpayer money. Planned Parenthood is now endorsing Hillary Clinton for president and its’ “advocacy and political organizations have plans to spend at least $20 million in the upcoming election cycle”.

It seems the real problem with the undercover investigation of Planned Parenthood is not really the alleged “crimes” of the investigators but rather a fear of damaging information undermining Planned Parenthood’s carefully crafted public façade as a benevolent, “top-ranked non-profit” organization that helps women and families.

But even the threat of a lawsuit such as Planned Parenthood’s against the Center for Medical Progress has caused many individuals and organizations to settle cases rather than potentially be imprisoned and/or bankrupted by legal fees. It takes a lot of courage to stand up to such intimidation tactics by an entrenched, politically connected and well-funded organization like Planned Parenthood.

Good for David Daleidan and the Center for Medical Progress!

 

Mass Shootings and Mental Illness

The rash of recent mass shootings is alarming, especially the most recent mass shooting in San Bernardino following so quickly after the Colorado Planned Parenthood one. Now, people are not only talking about mental illness as in the Planned Parenthood shooting but also the existence of evil as in the apparent terrorist attack in San Bernardino.

Can mental illness and evil be totally separate issues? I confess I don’t know the answer to this.

But I do know that our mental health system needs vast improvement from my own personal experiences.

My first husband and the father of my children was a brilliant, caring psychiatrist whose articles were published in medical journals. When I left bedside nursing to start our family, we had a plan for me to eventually join his private practice to specifically support the families of his patients. We both believed that families were ideally the best support system for people with mental illness and we hoped that such a plan would lead to better outcomes and help keep families together. Communication was key.

However, while our children were still small, my husband started slowly succumbing to severe mental illness himself despite treatment. I was frantic to help but at that time in the 1980s and even without the current HIPPA privacy rules, I was unable to get much information about his condition or how to help him from his psychiatrist even when there were multiple hospitalizations.

As his condition deteriorated, I was told by his psychiatrist that there was nothing I could do or not do to help the situation and that he was handling the situation. Then he told me that I should consider divorce for the sake of our children.

Since I believe in the sanctity of the marriage vows, especially the part about “in sickness and in health”, I soldiered on and got second and even third opinions for my husband. Nothing helped very much and I was still shut out from comprehensive discussion of treatment plans.

My husband finally abandoned our family and I reluctantly had to file for divorce. However, I still wanted to help him.

My now ex-husband eventually went on total disability for mental illness but since mental institutions were closed decades before for “less restrictive” measures, he became homeless and eventually shuffled from one assisted living facility to another until his death in 2014.

When our oldest daughter started using drugs at 14, I ran into many of the same problems with the mental health community. Even though she was a minor, she had the right to  “confidential health services”. This came about because it is thought that minors will be more likely to seek help from a doctor if confidentiality-even from parents- is assured in matters like sex and drugs. Unfortunately, as in my case, that meant that I could be mostly kept in the dark when it came to helping my child. I could pay for rehab but I couldn’t get much information or direction about helping my daughter. I contacted mental health organizations and tried to research support groups on my own with mixed results. My daughter died by suicide using an assisted suicide technique in 2009 when she was 30 years old.

We now have “mental health parity” under Obamacare which was intended to make mental health care better by increasing coverage. However, a recent Washington Post op-ed titled “The problem with Obamacare’s mental-health ‘parity’ measure”  shows how difficult it can still be for family or friends to get help for someone with a mental illness.

Mass shootings get our attention about gun control and terrorism issues but the mental health care crisis goes on. We need to do a better job and I still believe that mental health care must try to include and help the whole family for better long-term outcomes.