Health care trends threaten religious freedom

As an Air Force physician working at a clinic in Germany, Dr. Lloyd Pierre realized something was wrong with the way he practiced medicine. Routinely prescribing contraceptives for patients, he saw that the way they often worked – preventing a fertilized egg from being implanted in the uterus – could kill a human being, and he would be complicit.

"I had never considered that before," he said. "I told my wife, ‘I think I need to stop this.’"

Pierre said he was lucky that his superior officer supported his decision to stop prescribing contraceptives.

And he held firm to that conviction when he returned to the United States, first at Offutt Air Force Base in Bellevue, and later at the clinics where he worked after his 2008 discharge from the military.



A member of St. Peter Parish in Omaha, Pierre’s journey of conscience culminated in his 2011 founding of Sancta Familia Medical Apostolate in Omaha, a clinic that respects the teachings of the Catholic Church.

Now, Pierre has the freedom to practice medicine according to his conscience, but recognizes that many health care providers face pressure to violate their beliefs and morals, particularly concerning abortion and contraception.

"Friends of ours have been told that if they don’t learn to perform abortions, they can be kicked out of their OB-GYN residencies, and I’ve seen it happen to a military resident who had to leave the military because he was not going to do that," Pierre said.

The issue is not limited to abortion, said Wesley Smith, senior fellow with the Discovery Institute’s Center on Human Exceptionalism, award-winning author and advocate for human dignity, liberty and equality.

The onset of assisted suicide, euthanasia, gender reassignment, surrogacy, artificial insemination and other practices point toward a growing threat to conscience rights, he said.

"Health care has become a front in the culture war," Smith said. "If we’re going to have comity (mutual recognition of rights), you’re going to have to protect doctors’, nurses’ and pharmacists’ rights to practice according to their conscience and religious beliefs."



Andrew Bath, executive vice president and chief counsel with the Thomas More Society, an Omaha- and Chicago-based nonprofit, special interest law firm that supports life, family and religious freedom, said: "A great concern among Catholic physicians is that some procedures that violate the teaching of the church might be regarded as becoming required by a standard of care," creating pressure to conform.

Pierre said he started Sancta Familia in part because of the direction medicine was going in the United States. "It was not the kind of medicine we were made for – we were not made to contracept. You and I were not made to be sterile, we were made to be life-giving."

"I can’t do a vasectomy and I can’t do a bilateral tubal ligation because sterilization goes against the teaching of the church," he said.

"And pharmacists can lose their jobs if they refuse to dispense birth control pills, but there are certain pharmacists that are trying to fight that," Pierre said.



Hospital consolidations also have contributed to the threat, Bath said.

As the regulatory burden under the Affordable Care Act (ACA) increases, smaller providers have trouble affording the information technology and compliance staff, software and legal advice they need, which has accelerated the trend, he said.

Every time a non-Catholic hospital system is consolidated into a Catholic system, providers of abortion and sterilization might disappear, "so organizations like the ACLU have targeted Catholic medicine and are recruiting plaintiffs and filing lawsuits against Catholic hospitals," Bath said.

ACLU actions have included a 2015 lawsuit against Trinity Health Corp., claiming the Michigan-based health system’s adherence to Catholic teaching on abortion discriminates against and harms women. A federal judge dismissed the case, saying the ACLU failed to show that the plaintiffs actually were harmed.

Pierre said his attorneys have told him he also is at risk for lawsuits.

"Doctors need to educate themselves on the laws," he said. "Getting with lawyers and having them explain in doctor language what this all means to our practice, that’s a start."

Keeping an eye on the shifting landscape includes watching for regulatory changes, Bath said.

For example, a section of the ACA prohibits health care providers denying service based on various factors, including sex, he said. But, last July, "regulations were published interpreting sex discrimination to include discrimination based on termination of pregnancy, sex stereotyping and gender identity," Bath said.



A lawsuit filed against the U.S. Department of Health and Human Services (HHS) by a Catholic hospital system, Catholic and Christian medical groups, and eight states, including Nebraska, claims the regulation forces practitioners to provide gender transition services and perform abortions in violation of their religious beliefs.

A federal district court granted a stay on further court proceedings while the HHS reconsiders the regulation.

"Many people are unaware that these threats are right around the corner," Bath said. "The solution comes through legislation, regulation and litigation."

There is hope for some relief, Bath said.

"We have a new administration that is enacting new regulations that protect religious believers who participate in the healing professions," he said. "We’re waiting to see what the Trump administration is going to do with these regulations."

Citing the U.S. Constitution’s Bill of Rights, Bath said: "Government cannot establish its own religion or prohibit us from practicing ours. But that’s a proposition that seems to be up for grabs in the court of public opinion and the court system today."

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