We Need to Recognize Conscience
In Provision of Reproductive Services

The Obama Administration made a concession to Catholic leaders yesterday, bowing to conscience-based refusals to subsidize contraception coverage. At the same time, a compromise was struck enabling women who work for Catholic nonprofit institutions to use separate insurance plans independent from the church to obtain coverage for contraception at no out-of-pocket cost. The National Health Law Program stated: “Today’s announcement is largely a victory for women who have been fighting alongside health advocates for the past two years while employers threatened to deny women coverage for birth control in the courts and as lawmakers attacked and resisted implementation. No employer should be able to make personal decisions for their employees, including whether or when a woman is able to access birth control.”

However, the conscience-based contraception and abortion refusers are unlikely to let rulings like this stick. They promise to keep pressing for exemptions to providing reproductive services based on conscience.

But the Catholic Church does not have a monopoly on conscience. I neglected to cover an important New England Journal of Medicine Perspectives piece last fall, also overlooked by the mainstream press by Lisa H. Harris, MD, PhD.  Harris drew attention to recognizing conscience in abortion provision.

Harris pointed to “an ongoing false dichotomization of abortion and conscience, making it appear that all abortion opponents support legal protections of conscience and all supporters of abortion rights oppose such protections, with little nuance in either position.” What perpetuating this falsehood has done is permitted laws that fail to protect caregivers who are compelled by conscience to offer care, rather than refuse it, Harris argues.

Like many readers, I cannot believe that we are back to trying preserve the legalization of abortion and access to contraceptive care services. Day after day, roadblocks to reproductive care services are introduced, many claiming moral superiority, we need to underscore, as Harris and many others before her have done, that before the legalization of abortion, providers performed abortions “for reasons of conscience.”

Harris points out that before abortion was legal, many providers rallied to provide safe abortions to prevent women from dying from self-induced abortions and abortions provided by unskilled providers. This was a matter of conscience. Today, Harris explains, “abortion providers working within the law continue to describe their work in moral terms as “right and good and important” and articulate that the failure to offer abortion care generates a crisis of conscience.” It’s a moral imperative that underlies belief in “women’s reproductive autonomy as the linchpin of full personhood and self determination.”

On one hand, I am glad that the compromise yesterday ensures that women who work for religious organizations will be able to gain the same access to contraception as other women. However, I think we must continue to press for equitable access to contraception for all women. If we must work around conscience-based refusals, it is high time that we recognized conscience-based provision of reproductive care services.

This entry was posted in reproductive care and tagged , , , , . Bookmark the permalink.