Legislation / Court Cases

ACOG to Review Abortion Policy / HHS Leavitt Urges ABOG to Protedt Right of Conscience (Update 6/08)

CMA Physicians Laud HHS Secretary Leavitt for Protecting Physicians and Patients on Abortion and Conscience Issue Washington

–June 27, 2008–The Christian Medical Association (CMA, www.cmda.org), the nation's largest faith-based organization of physicians, today lauded U.S. Health and Human Services Secretary Michael O. Leavitt for encouraging the American Board of Obstetrics and Gynecology (ABOG) to clearly publish assurances that it will not decertify or otherwise penalize physicians who do not perform or refer for abortions.

CMA CEO David Stevens said, "Secretary Leavitt is serving America's physicians and patients well by prodding ABOG to provide assurances that it will uphold fundamental principles of conscience protections in healthcare. Protecting the right for physicians to abide by longstanding ethical codes such as the Hippocratic Oath is one of the best ways to protect patients—by insuring that their physicians follow time-tested objective standards and not ideological whims or politically motivated pressures."

Secretary Leavitt's letter addresses ABOG's written guidance, published in December, that links its physician certification procedures with the ethics positions of the American College of Obstetricians and Gynecologists (ACOG). Those ACOG positions include a controversial official position issued in November that called upon conscience-objecting obstetricians to refer patients for abortions—an act which many such physicians consider unethical.

Dr. Stevens noted, "As Secretary Leavitt has pointed out, forcing physicians to refer for abortions not only violates ethical standards; it may also violate federal laws such as the Weldon amendment, which prohibits discrimination in certain cases from forcing physicians and institutions to 'provide, pay for, provide coverage of, or refer for abortions.'"

Stevens said, " An informal survey of our membership revealed that over 41 percent have been 'pressured to compromise Biblical or ethical convictions.' Over 46 percent 'know of a colleague in medicine who has experienced' such pressure. We have been working hard to raise awareness of and counter the attack on conscience rights in healthcare—not just to protect our members and their patients, but also to protect physicians and patients of conscience nationwide."

Dr. Gene Rudd, an obstetrician and CMA Senior Vice President, said, "It's one thing for ACOG to allow for differences of opinion on abortion, and quite another to require its members to submit to the ACOG leadership's decidedly partisan position on abortion." Dr. Rudd canceled his ACOG membership as a result of the organization's abortion referral mandate.

Leavitt's letter of June 20 to ABOG notes, "Amending current and future ABOG Bulletins to clarify specifically which ACOG rules and principles the Bulletin refers to would reduce potential future confusion over this issue. So too would amending the Bulletin, or another appropriate ABOG document, to reflect your statement that physicians' refusal to perform or refer for services that violate their ethical or moral standards is not a consideration in certification."

On March 14, Secretary Leavitt sent a letter to the Board that noted, “It appears that the interaction of the [ABOG Bulletin for 2008 Maintenance of Certification] with the ACOG ethics report would force physicians to violate their conscience by referring patients for abortions or taking other objectionable actions, or risk losing their board certification.”  

To schedule an interview, please contact Margie Shealy at (423) 844-1047 or by e-mail: [email protected] The Christian Medical Association is equipped with Ku Band Digital Uplink satellite and ISDN lines.

Links:

Christian Medical Association (CMA) – http://www.cmda.org

ACOG Committee Opinion #385 – http://www.acog.org/from_home/publications/ethics/co385.pdf

HHS News Release: HHS Secretary Calls on Certification Group to Protect Conscience Rights – http://www.hhs.gov/news/press/2008pres/03/20080314a.html
~~~~~~~~~~~~~~
Jonathan Imbody
Vice President for Government Relations
Christian Medical Association – Washington Office
21798 Jarvis Square • Ashburn, VA • 20147
Ph/FAX: 703.723.8688 / 6925 • Cell: 703.801.4287
Web: www.cmawashington.org
Alternate Email: [email protected]
NEWS RELEASE
For Immediate Release-June 27, 2008
Contact: Margie Shealy
Telephone: 888-230-2637;
Mobile: 423-341-4254  
E-mail: [email protected]
Website: www.cmda.org
"[O]ur rules can have authority over such natural rights only as we have submitted to them. The rights of conscience we never submitted, we could not submit. We are answerable for them to our God."
–Thomas Jefferson (1743-1826)
[27 June 2008, CMDA News]

 

 

 

 

ACOG TO REVIEW THEIR POLICY THAT OBGYNS SHOULD REFER FOR ABORTIONS. The national organization for OBGYNs will re-examine a policy on Monday saying all doctors, including those who are pro-life, should refer women to abortion centers. When it does, a leading pro-life group for physicians says it should scrap the idea and encourage doctors to follow their consciences.
 
As LifeNews.com has reported, the American College of Obstetrics and Gynecology (ACOG) has been criticized heavily for releasing the statement last year entitled "The Limits of Conscientious Refusal in Reproductive Medicine."
 
The paper targets pro-life physicians, insisting that doctors who object to doing abortions should refer patients to physicians who will do them.
 
ACOG also requests that pro-life doctors move their practices closer to abortion businesses so women can have a shorter drive to get an abortion when these physicians refuse to perform or refer for one.
 
Because of significant protests from members of Congress, physicians and pro-life groups, as well as HHS Director Mike Leavitt, the ACOG ethics committee is reportedly slated on 17March08 to revisit its November 2007 declaration.
 
Another leading medical group, the American Association of ProLife Obstetricians and Gynecologists [AAPLOG], has also called on ACOG to reverse course.
 
"This is a raw power play to cripple, and ultimately eliminate from practice, those doctors who hold a conscience conviction on the sanctity of human life," AAPLOG spokesman Dr. Joe DeCook told LifeNews.com.
 
He said ACOG should be honoring those who "refuse to have a part in doing, or referring for, the elective, deliberate taking of an unborn human life" and called the group's actions "a battering ram, to force pro-life doctors into pro-choice compliance."
 
The ACOG ethics committee should change its course and defend the conscience rights of doctors who refuse to perform or refer for abortions, says CMA vice-president Dr. Gene Rudd: "The right to refuse on moral and ethical grounds to participate in the killing of another human being is … based on long-standing, objective medical ethics and moral principles.
 
"Since ACOG represents the vast majority of obstetrician

s and gynecologists in this country, the organization should be advocating for the decision-making rights of all of its members–not just of those who favor abortions," Rudd added.
 
Rudd says the decision has a monumental effect on doctors, since ACOG ethical positions are formally linked to physician board certification.
 
If ACOG refuses to protect conscience rights, Rudd told LifeNews.com, the group would "threaten the livelihoods of thousands of pro-life obstetricians and gynecologists."
 
"ACOG membership stands to drop dramatically once its pro-life members realize that their organization is actually taking steps to undermine their ability to practice," he explained. "The last thing the women of this country need is for yet more obstetricians to leave the field."
 
Last month, CMA drafted and coordinated a letter signed by leading national pro-life organizations, including LifeNews.com, on ACOG to rescind its November statement.
 
Members of the U.S. Congress, led by obstetrician Rep. Phil Gingrey have also called upon ACOG to explain its controversial statement.
Related: CMA – http://www.cmda.org; American Association of ProLife Obstetricians and Gynecologists – http://www.aaplog.org  [14March08, Ertelt, DC, LifeNews.com]

 

Physician’s Freedom of Conscience Threatened

 An opinion by Felipe E Vizcarrondo, MD

The American College of Obstetricians and Gynecologists (ACOG) Committee on Ethics    published a position paper in November 2007  outlining the limitations of the right of conscience for physicians. The Committee claimed a respect for conscience and recognized its value to the ethical practice of reproductive medicine.

The committee opinion addressed specifically those physicians engaged in the practice of reproductive medicine, but admitted that the conflict of conscience could occur in other medical specialties as well. The Committee on Ethics is of the opinion that a physician’s refusal to a patient’s request for a procedure or treatment that the physician finds morally objectionable is justified only if this decision does not negatively affect the patient’s well being.

The opinion states that a physician with a moral objection to a procedure requested by a patient has the duty to refer the patient to another physician that would perform the procedure; in an emergency situation, where transfer of the patient would impact negatively the physical or mental health of the patient, the physician has the obligation to provide the requested care.

The Committee on Ethics concluded the opinion statement by making the following seven recommendations: 

   1. In the provision of reproductive services, the patient’s well-being must be paramount. Any
       conscientious refusal that conflicts with a patient’s well-being should be accommodated
       only  if the primary duty to the patient can be fulfilled.

Comment:
The Committee considers a refusal to provide a requested service an imposition on the patient of the physician’s views. The Committee refers to the patient’s well-being (as defined by the patient), rather than health. Well-being is defined  as a good and satisfactory condition of existence; a state characterized by health, happiness and prosperity.

Patient autonomy (the right of self-determination) should be balanced with physician beneficence (“I will use my knowledge to help the sick according to my ability and judgment” ); there need not be a conflict between the two.

The physician is not merely to provide the requested treatment without thoughtful consideration of the patient’s best interest. The physician, using his medical knowledge, should refuse requests that are not in the best interest of the patient, such as prescribing antibiotics for a viral infection.

   2. Health care providers must impart accurate and unbiased information so that patients can
       make informed decisions about their health care. They must disclose scientifically accurate
       and professionally accepted characterizations of reproductive health services.

Comment:
Accurate and complete information should be provided the patient. Of note, ACOG has gone to court to protest the requirement for the abortionist to describe the procedure and consequences to the patient and to mention other alternatives such as adoption and the help available to support the woman through the pregnancy. 

Evidence the law suit, ACOG v. Thornburgh, alleging that the Pennsylvania Abortion Control Act of 1982 violated the Federal Constitution. The Act required the woman a) to give her informed consent to the abortion, b) to be informed of the name of the person to perform the abortion, c) to be informed of the particular medical risks of the procedure, d) to be informed of alternatives to the abortion, e) to be informed of medical assistance agencies that support the pregnant woman and assist after the baby is born.

The Act required the physician who performed the abortion to keep a medical record, and to protect the viable unborn child.  The decision was appealed to the Supreme Court, who struck down the statute as unconstitutional.

  3. Where conscience implores physicians to deviate from standard practices, including
      abortion, sterilization, and provision of contraceptives, they must provide potential patients
      with accurate and prior notice of their personal moral commitments. In the process of
      providing prior notice, physicians should not use their professional authority to argue or
      advocate these positions.
Comment:
The physician with moral objection to abortion should notify the patient. If the patient inquires the reason for the refusal to do or recommend an abortion, the pro-life physician ought to be able to give a complete and honest answer.

   4. Physicians and other health care professionals have the duty to refer patients in a timely
       manner to other providers if they do not feel that they can in conscience provide the
       standard reproductive services that their patients request.
Comment:
The pro-life physician must not be forced to send the patient to an abortionist. In doing so, the pro-life physician is forced to participate in the act he or she considers morally objectionable. The pro-life physician would become an accomplice of the action.

   5. In an emergency in which referral is not possible or might negatively affect a patient’s
       physical or mental health, providers have an obligation to provide medically indicated and
       requested care regardless of the providers moral objections.

< span style="font-size: 10pt; font-family: verdana,geneva"> Comment:
ACOG states that it is the pro-life physician’s obligation to provide the requested service in an emergency, regardless of the physician’s moral objections. 

The procedures and treatments specifically addressed are abortion, sterilization and contraception; these interventions are not considered emergency procedures. An improper or poorly conducted transport may deteriorate the patient’s physical condition, however, it is doubtful that the patient’s mental health would be affected by transport to another facility.

 
Is the mental health caveat a convenient ruse to object to transport and force the hand of the pro-life physician?

There may be situations where a lifesaving procedure is indicated in a pregnant woman; the pre-viable child would die as a result of the lifesaving procedure. The surgery will produce two effects, the good effect of saving the mother’s life and the evil effect of ending the baby’s life.

The intention of the physician is to save the mother’s life and not to kill the baby. The death of the baby is an unintended consequence of the lifesaving surgery. The lifesaving surgery is permissible under the principle of the twofold effect. 
   6. In resource-poor areas, access to safe and legal reproductive services should be
       maintained. Conscientious refusals that undermine access should raise significant caution.
       Providers with moral or religious objections should either practice in proximity to individuals
       who do not share their views or ensure that referral processes are in place so that patients
       have access to the service that the physician does not wish to provide. Rights to withdraw
       from caring for an individual should not be a pretext for interfering with patient’s rights to
       health care services.

Comment:
Forcing a pro-life physician to practice in proximity to an abortion establishment in order to ease referral is to impose a partnership with the abortionist. Controlling the location of the pro-life physician’s practice is a violation of the pro-life physician’s rights and his or her freedom. 
 
  7. Lawmakers should advance policies that balance protection of providers’ consciences with
       the critical goal of ensuring timely, effective, evidence-based, and safe access to all women
       seeking reproductive services.
Comment:
Legislation to enforce these recommendations would render the pro-life physician unable to exercise his right to dissent. If these recommendations were enacted into law, a physician would have to disregard his moral conviction and comply to maintain his license and hospital privileges.

The ACOG is an aggressively pro-abortion organization. Abortion, sterilization and contraception, in their view, are the hallmark of reproductive medicine. The opinion of the Committee on Ethics sets limitations on those that dissent from their views on abortion, sterilization and contraception. The respect ACOG purports to have for freedom of conscience is self-serving.

The physician’s conscience is free provided he or she is in agreement with the organization’s views. The dissenting physician is forbidden to speak his or her opinion, he or she is expected to become an accomplice of the abortionist, and his or her practice is kept under surveillance and control.

The physician becomes a provider/dispenser of services, ceases to be a thinking person who applies moral discernment to his or her decision making.  The committee opinion is attempting to influence thought. A person can be commanded by human law to speak or be silent, to do or not to do, but human law cannot command to believe or disbelief, to feel or not to feel. 

Note: Dr.Vizcarrondo is a retired pediatrician, member of the American College of Pediatricians.
Endnotes:
1  The Limits of Conscientious Refusal in Reproductive Medicine, Committee Opinion, ACOG
  Committee on Ethics, Number 385, November 2007

2  Random House Webster’s College Dictionary, 1992

3  Oath of Hippocrates

4  ACOG v. Thornburgh, 737 F.2d 283, 297-98 (3d Cir.1984)

5  Hayes, E. J. et al, Catholicism and Ethics, C. R. Publications, Inc., MA, 1997, pp.53-60.

6  Budziszewski, J., Written on the Heart, The Case for Natural Law, InterVarsity Press, Downers
  Grove, IL, 1997, p. 77.

         
MT VICTORY FOR PHARMACIST FIRST AMENDMENT CONSCIENCE RIGHTS.  I just got back home last night (Thursday) from my trip to Helena.  As many of you know, I was asked to go before a Montana Board of Pharmacy review panel (on Wed. 3/5) regarding 11 complaints filed with the Board stating that “it is ridiculous” that I, as a pharmacist, would not carry and dispense oral contraceptives and emergency contraceptives and they all asked that I be cited for “Unprofessional Conduct”.   

Although both products can act to prevent ovulation, both products also have post-conceptive effects that would prevent implantation if fertilization were to take place…so that just in and of itself is a moral issue regardless of a person’s faith affiliation.  Many of you have emailed and written me and I apologize to answer in a general fashion but wanted to let you know how things turned out.
 
Much to my relief they turned out very well.  None of the complainants made themselves available either in person or via phone for these proceedings.  The Board was clear in that they only wanted to discuss the complaints in how they relate to current pharmacy regulation. 

The Board thought that I had gone above and beyond in preventing trouble with my decision as I posted in our local paper over 2 months in advance of the policy change, I had written each patient, and the fact that those who want that type of service can still attain it though our county health nurse who administers the government program called Family Planning (not to mention availability via mail). 
 
The Board saw fit to dismiss all of the complaints against me and furthermore logged them as prejudiced.  They went on to say that they do not feel that it is the profession’s best interest to mandate product availability and that they intend to leave the matter of “professional conscience” or product availability (like Plan B) to the MT Legislature. 
 
In conversation with the MT Board of Pharmacy and the MT Pharmacy Association they fully expect that the legislators will be called to consider the issues of “conscience” and the question of mandating product availability to come up in the 2009 legislative session.  So please keep those topics in mind if you happen to write or contact your

own legislators. 
 
Even though I would have liked to see the Board adopt a protective conscience clause, I was greatly relieved at the hearing results.  Thank you all for your interest, your correspondence and your prayers.  Not only were they a great comfort to me, I can only conclude that they were very fruitful.
John L. RPh [7March2008, Broadus, MT, PharmFacts E-News Update — 10 Mar 2008 AD #3; PFLI, www.pfli.org,  supports pharmacist rights of conscience NOT to be forced to dispense or counsel for chemicals which violate their sincerely held religious, moral or ethical beliefs.  For more info see:
http://www.pfli.org/main.php?pfli=conscienceclausefaq]

 

 

 

Ob/Gyns Oppose Attempt to Shut Down Their Conscience Convictions

The American Association of ProLife Obstetricians and Gynecologists [AAPLOG] Responds to the ACOG Promulgated "Limitations of Conscientious Refusal."

MEDIA ADVISORY, Feb. 20 /CN/ — In Nov 07, the (ACOG) American College of Obstetrics and Gynecology's Ethics Committee issued a formal Opinion titled "The Limits of Conscientious Refusal In Reproductive Medicine."

This Opinion warns Ob/Gyn doctors that their practice pattern can be considered "unethical" by ACOG standards if they do not either do abortions, or refer patients desiring an abortion to an abortion provider.

The Opinion goes so far as to suggest that pro-life doctors should locate their office in proximity to an abortion provider, for the convenience of such patients.

The American Board of Ob/Gyn in January 08, published revised standards for doctors seeking recertification (which maintains their professional reputation in good standing). The revised standards are tied to ACOG Ethics compliance.

This is a raw power play to cripple, and ultimately eliminate from practice, those doctors who hold a conscience conviction on the sanctity of human life, and refuse to have a part in doing, or referring for, the elective, deliberate taking of an unborn human life.

The American Association of ProLife Obstetricians and Gynecologists (AAPLOG) objects strenuously to this attempt, by a professional medical organization (ACOG), using "ethics violations" and "denial of recertification" as a battering ram, to force pro-life doctors into pro-choice compliance.


This country has, since its beginnings, honored the legitimate conscience convictions of its citizens. Pro-life doctors refuse either to electively kill the unborn, or to become an accomplice to such killing by referral to an abortionist. This is a legitimate conscience conviction held by AAPLOG members, and by many other physicians in various specialties.

The Position Statement issued by AAPLOG on Feb 6. 2008, concludes, "… it seems that the (ACOG) Ethics Committee does not understand the strength and depth of a conscience conviction against the elective, deliberate taking of an unborn human life. This is not a negotiable issue for those who hold this conviction. The United States Supreme Court allowed elective abortion to be a legal right. The U.S. Supreme Court is not an infallible moral guide for a person's conscience, as evidenced by a previous similar egregious ruling.7 (This references the infamous 1857 Dred Scott decision, in which the US Supreme court, by a 7-2 majority, concluded that Africans are "beings of an inferior order" than the white race, and slaves are property devoid of all rights of legal redress for grievances. The US Supreme court got it wrong in 1887, and they made the same mistake in 1973 in Roe vs. Wade: Unborn children are fully human, and are entitled to the same right to life as the rest of society.)

The complete AAPLOG Statement may be accessed at www.aaplog.org/responsetoacogethicscommittee385. htm [CN]

Here is the AAPLOG response to the ACOG Ethics Committee's Opinion #385,
(in which ACOG tells you how your conscience must operate to fall within their acceptable ethics guidelines.)
The AAPLOG answer is quite long. AAPLOG is seeking to represent physicians for their right to obey their own consciences in their professional lives.

The Ethics Committee of ACOG will meet again on March 17 and 18.

President Kenneth Noller, MD;
Ralph Hale, M.D. Executive Vice President

The American College of Obstetrics & Gynecologist
409 12th Street, S.W.
Washington, D.C. 20090-6920

AAPLOG RESPONSE TO THE ACOG ETHICS COMMITTEE OPINION #385,TITLED "THE LIMITS OF CONSCIENTIOUS REFUSAL IN REPRODUCTIVE MEDICINE"

The American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), one of the largest Special Interest Groups of the American College of Obstetricians and Gynecologists (ACOG), strongly objects to the November 2007 release of ACOG Committee Opinion, Number 385, titled "The Limits of Conscientious Refusal in Reproductive Medicine."

We find it unethical and unacceptable that a small committee of ACOG members would pretend to provide the moral compass for 49,000 other members on one of the most ethically controversial issues in our society and within our medical specialty—and that without ever consulting the full membership.

ACOG Committee Opinion #385 is in opposition to 2500 years of accepted Hippocratic ethical medical tradition. Legal elective abortion made a unique arrival in the late 1960s in the United States as part of a legal-societal initiative, rather than as the culmination of a scientific process in biomedicine. The acceptance of elective abortion in American medical practice was contrary to the historic ethical position of Western medicine with regard to abortion.

Therefore it is of great concern that this committee opinion repeatedly describes elective abortion, and other controversial reproductive medical procedures and services as "standard."

The term "standard," as used in the document, is never defined. Ideally, a care "standard" would involve a balanced and thorough consideration of the existing medical literature for the effect on the patient's health and well being, both in the short term and in the long term. There is scant evidence regarding the outcomes of elective abortion, other than its decided effectiveness at ending a pregnancy. In general, the long term safety of abortion, and its "benefit" for women, has been either assumed, or accepted on the basis of inadequate follow-up studies.

On the contrary, there are poor reproductive and other health outcomes associated with elective abortion in methodologically sound scientific studies.

The data from nations with extensive computer based health registries, where linkage with subsequent health outcomes is a practical reality, show that elective abortion has significant adverse association with subsequent preterm birth, depression, suici

de, placenta previa. and breast cancer. ("Although it remains uncertain whether elective abortion increases subsequent breast cancer, it is clear that a decision to abort and delay pregnancy culminates in a loss of protection with the net effect being an increased risk.")4

While there may be conflicting data with regard to these issues, ACOG documents have summarily denied the significance of any literature demonstrating an association. We are aware of no current ACOG educational materials providing balance to this extreme position.

In this regard, we also find the Opinion statement, "Health care providers must impart accurate and unbiased information so that patients can make informed decisions about their health care," to be at odds with the actual practice of informed consent in elective abortion.

The College has allowed the development of a procedure (elective abortion) in its specialty area for which record keeping is inadequate and meaningful tracking of complications is virtually impossible.

There is a relative absence of data collected on abortion and subsequent health status in the United States. ACOG has colluded in this state of affairs by not insisting on adequate record keeping and reporting for this procedure. Since accurate risk and complication rates are unavailable, it is vacuous to make reference to "accurate and unbiased information" for making "informed" decisions.

Further, in most instances, the abortion practitioner is not responsible to care for "complications" of his or her work, and often may not even be aware that a complication has occurred. Rather, the emergency room physician, or the obstetrician/gynecologist on call for the emergency department, inherits untoward fallout of abortion.

Therefore the physician performing the procedure cannot even accurately reference his or her own experience with regard to complications in informed consent conversations. This is the only instance in American medicine where the operating physician is not the primary physician responsible for the initial oversight of complications of their surgical procedure. Perhaps the ACOG Committee on Ethics should address the strange ethics of this "prevailing standard" of reproductive health service.

Dr. Allan Sawyer, who is an AAPLOG member and current Chairman of the ACOG Committee on Coding and Nomenclature, as well as chairman of a hospital ethics committee, has stated in a prior letter to ACOG, "It is a foundational principle of ethics that autonomy must be balanced by the other principles of ethics.

"Any one principle of ethics cannot trump all of the others, otherwise there is distortion of truth and the dominant principle ends up skewing the analysis. The end result often is anything but ethical.

"ACOG's Committee Opinion #385 is an excellent example of the collapse of ethical decision-making when patient autonomy is allowed to dominate over every other principle of ethics. This is not so much an ethics committee opinion as it is a document that promotes the right-to-abortion-on-demand stance of ACOG." Dr. Sawyer's comments accurately reflect AAPLOG's position on this issue.

The idea that physicians are obligated to provide or refer for elective abortion services simply on the basis of "patient request" is antithetical to the practice of modern medicine. It is to make patient autonomy rule over physician conscience. It is to make the physician the corner vendor.

A more balanced approach would be to accept that where opinions vary, the patient is free to seek a second opinion, but not to impose her will on the
attending physician.

The Ethics Committee directive that those who oppose elective abortion on conscience grounds should locate their practice in proximity to an abortionist for patient convenience is patently absurd.

Quite apart from our conscience convictions, this is a completely unrealistic idea. Conformity with this recommendation would result in large swathes of
the United States being without any obstetric or gynecologic care (the large majority of abortion clinics are located in the inner city).

The Committee Opinion informs us that conscience based refusals should be evaluated on the basis of their potential for discrimination. For years a glaring example of systematic discrimination has been implicitly accepted within the current provision of abortion services nationwide.

Year after year, African-American women have their unborn children aborted at a per capita rate three times that of Caucasian women. There has never been a protest from ACOG against this extreme disproportion in the actual distribution of abortion services. What would the Ethics Committee advise to rectify this inequity? Should the abortion rate be increased for Caucasian women, or should the abortion rate be decreased for African-American women, in order to meet the standards of justice and equitable distribution of reproductive health services?

Finally, it seems that the Ethics Committee does not understand the strength and depth of a conscience conviction against the elective, deliberate taking of an unborn human life. This is not a negotiable issue for those who hold this conviction. The United States Supreme Court allowed elective abortion to be a legal right. The U.S. Supreme Court is not an infallible moral guide for a person's conscience, as evidenced by a previous similar egregious ruling.7

For these reasons, we, the AAPLOG board of directors, find this Committee Opinion to be neither scientifically nor ethically sound.

We strongly urge that Committee Opinion #385 be rescinded at the earliest opportunity.

Sincerely,(signed by aaplog exec committee member, for aaplog)

7 We reference the infamous Dred Scott vs Sanford case of 1857, in which the Supreme Court of the United States found, by a 7-2 majority, that no person of African descent could claim U.S. Citizenship. (Africans, according to the Court, were "beings of an inferior order, and altogether unfit to associate with the white race,… so far inferior that they had no rights which the white man was bound to respect.") Since slaves had no claim to citizenship, they could not bring suit in court. We find the status of the unborn under Roe to be strikingly similar to the plight of the African slaves under Dred Scott: Both are
human beings, but neither had/has basic human rights: neither had/has the legal right to appeal to the courts for justice or protection when they were/are victims of inhumane treatment or purposeful killing.
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We are not fighting this battle alone. A number of organizations are exerting individual and combined influence to see this travesty rescinded (and it is a travesty—telling you and me that to be ethical –and, ultimately credentialed- we have to kill the unborn, or at leas

t refer them to be killed, and certainly locate your practice near someone who does this gristly work, is a travesty.)

Here are excerpts from a recent CMDA release:

……. a letter was sent to ACOG on December 7, 2007 that included the signatures of 29 organizations and individuals. This month Christian Medical & Dental Associations sent ACOG's (Immed. Past) President, Dr. Douglas Laube a letter requesting reconsideration. CMDA member Dr. Bob Orr's critique of the statement was included. It details the flawed assumptions in the statement and comments on the four criteria ACOG used to determine appropriate limits to claims of conscience. I encourage you to read Dr. Orr's critique which can be found on the Conscience Rights section of our website (www.cmda.org)

We distributed a news release on December 11, 2007 that continues to draw attention to this issue. We are doing media interviews and collaborating with other organizations. Additional meetings are scheduled to discuss possible professional, legal, legislative and media strategies. We have also been in touch with the American Board of Obstetrics and Gynecology (ABOG) on whether non-compliance with this ACOG position will affect recertification.

This is not just a bioethical issue. The ACOG position is in direct conflict with the First Amendment of the Bill of Rights. It also runs counter to the positions of many professional organizations, including the American Medical Association, and to state and federal laws.

It seeks to alter 2000+ years of medical ethics. Quite simply, ACOG has embarked on the dangerous path of relinquishing fundamental rights in order to advance a contemporary agenda (abortion access).