"I am a physician assistant (PA). My employer has asked me to see patients for birth control (combination pills, progesterone only pills, depo provera, nuva ring, ortho-evra). His expectation is that I see the patients, complete their exams, counsel them regarding ALL options of birth control and if they need a prescription I am to give them a script written by one of the other providers in the office. In my opinion, even though it is not my prescription, it is still a violation of my conscience."
Comments:
The Hyde-Weldon Amendment covers all health care professionals. I believe this includes physicians assistants. If there is a dispute over who it covers, let me know and I will try to document it. The law says:
…the term 'health care entity' includes an individual physician or other healthcare professional.
Thus, this should cover you.
I do not know if Hyde-Weldon covers all types of birth control. There is some debate over what is an abortifacient and what is birth control.
If a PA is being required to do all, it would likely be covered. But, if there is only limited involvement, it may be a closer question.
Application of the Hyde-Weldon amendment. At some point there will be court and administrative opinions that will apply it. I believe it should apply to the fact situation you presented to me [pressure to dispense artificial birth control].
Counseling for abortion is usually considered a protected area. As long as the employer is receiving federal funds, it is covered by the law.
The Civil Rights Act of 1964, 42 U.S.C. Section 2000e-2(a), may also apply. It prohibits discrimination based on religious beliefs. Therefore, if a person is against abortion for religious reasons, the employer must respect those rights and try to accommodate them.
The Church Amendment, 42 U.S.C. Section 300A-7, may also apply. It is similar to the above, but more specific on abortion.
clsnet.org – Center for Law and Religious Freedom, a public interest law firm representing health care workers in a number of cases around the country in which medical professionals' rights of conscience are threatened.
Comments for pro-life medical students/residents from a top pro-life OBG:
If you are harassed by your professors for your pro-life views, write a detailed description of the harassment for legal purposes. Federal Civil Rights Laws should protect you.
Being harassed for your pro life views is a given. Expect it now and for the rest of your career. Know your position, and be able to articulate it, be sure it is conscience based. Being penalized is what we need protection from. And we have protection from the Medical Training Nondiscrimination Act of l995, which states: The federal govt and any state that receives federal financial assistance (and that would be all of them!!) may not subject any health care entity to discrimination on the basis that the entity refuses to undergo training in the performance of induced abortions, to provide such training, to perform such abortions, or to provide referrals for such abortions.
So programs may insist that students/residents must do abortions, but if they so insist, they stand to lose all their government money—and no program could stand that. So, every pro-life student/resident should be very conversant with that bill, by name, and be able to quote it in your sleep.
Some suggest writing a statement to have placed in your file. As far as being sure a statement stating you will not do abortions is in your folder, I don't have an opinion on that. Should you put such statement in your file before hand, or wait until the issue comes up? I don't know. It would only be relevant in your ob/gyn training (whether student or resident), and as long as you know the law, you might just wait to see if the issue comes up. Or there may be an appropriate time to declare your stand, going into that section of training. I just don't know. Having it in there from the first would be good if there was a way to do it that didn't look like you were trying to start an issue. Might vary with the circumstance.
As for a lawyer, I would urge you, if challenged, to call Alliance Defense Fund, or American Center for Law and Justice, or Rutherford Institute, all of whom would be willing to help.