In November 2007, the American College of Obstetrics and Gynecology (ACOG) Committee on Ethics issued new ethics guidelines on "the limits of conscientious refusal in reproductive medicine." The guidelines state that conscientious refusals -- that is, a provider's denying a patient requested services (such as contraceptives or abortion) because of a personal moral objection -- "should be accommodated only if the primary duty to the patient can be fulfilled." In ACOG's view, refusals that impose the provider's religious or moral beliefs on the patient, negatively affect the patient's health, reinforce negative social or racial stereotypes, or are based on scientifically invalid information "should be limited." Patients are to be provided with advance notice of the provider's views, so as not to be caught unawares in a crisis; and if the provider decides to refuse to provide requested services, he or she is obligated to provide a timely referral to another provider. Finally, providers in areas without such referral availability should either provide the services requested (against their own commitments) or find another place to work.
This week, in a letter to Norman Gant, Executive Director of the American Board of Obstetrics and Gynecology, HHS Secretary Mike Leavitt suggested that the guidelines and any punitive actions ABOG might take are discriminatory and may conflict with existing Federal law. You can also hear the story on NPR's Morning Edition.
Photo credit NIH.gov