|
AN
EXCERPT FROM "Unconscionable Care". The entire
article can be read in our June/July, 2001 issue on
newstands now.
Just six months after the supreme court decided Roe
v. Wade in 1973, Congress enacted the Church Amendment.
Largely unnoticed, the statute exempted individuals
and institutions with religious or moral objections
from performing abortions or sterilizations, even though
they were receiving federal funds. By 1978, nearly every
state had passed its own version of the amendment, in
many cases expanding the scope of the exemptions.
To
the extent that these laws protected individual rights,
they seemed reasonable enough to most pro-choice advocates;
after all, the abortion debate had been waged on the
battlegrounds of conscience and the rights of women
to make their own decisions. It seemed fair to take
into account the personal choice of the providers being
asked to perform abortions. In an era when private doctors
were the norm, this rationale made sense.
But
these laws also covered hospitals and clinics, and so
pitted an abstract notion of institutional conscience
against a woman's individual right to have an abortion.
They also declared that in the shadowy realm of conscience,
the basic medical principle of full disclosure did not
apply to everyone-in most states with these laws, providers
were not required to publicly post their "conscientious
objections."
Fast-forward
to the present; the Church Amendment and its state progeny
have spawned a new generation of exemptions, and they
go even further than the originals. "Noncompliance clauses"
(called "conscience clauses" by the religious right)
began showing up in state legislatures in the early
1990s, not coincidentally at the same time that Bill
Clinton's proposed health care reform bill was being
debated. While they vary in specifics, the clauses allow
religiously affiliated hospitals, employers, insurers,
HMOs, or individual doctors to opt out, not only from
performing abortions and sterilizations, but, in some
cases, even from discussing abortions. They can also
allow providers to refuse to offer, pay for, or talk
about contraception. As with their predecessors, most
of these clauses offer a veil of secrecy: providers
are rarely required to inform anyone of their objections.
By protecting a health care provider's right to refuse
specific services, and giving this right precedence
over a woman's right to make informed decisions about
her health, noncompliance clauses create a parallel
medical universe where professional obligations can
be altered by personal beliefs.
-
Emily Bass is a writer living in Brooklyn, N.Y.
AN
EXCERPT FROM "Unconscionable Care". The entire
article can be read in our June/July, 2001 issue on
newstands now.
|
