The Trampling of Conscience

by Fr. Roger Landry - August 12, 2011

On August 1, Kathleen Sebelius, appointed by President Obama to head the U.S. Department of Health and Human Services (HHS), announced that beginning a year from now all new private insurance plans must provide free "preventive care" for women, which includes not just mammograms, blood pressure checks, breastfeeding support, domestic violence counseling, diabetes and STD testing and counseling, but also free access to sterilization and all contraceptives (including clearly abortifacient ones) approved by the U.S. Food and Drug Administration. The new federal regulations are part of the implementation of the Patient Protection and Affordable Care Act (PPACA) promoted and signed by President Obama, who had previously assured wary religious groups that the Act would protect conscience rights.

As an indication that the Obama administration recognized that they were breaking that promise and compelling employers and employees with religious objections to offering or paying higher premiums to fund others free access to contraception and abortion-causing pills, the HHS offered certain non-profit religious organizations whose purpose is the "inculcation of religious values" and which primarily employs and serves those who share its religious tenets an opportunity to apply for an exemption. But this conscious clause was so narrowly worded that most Catholic institutions — like hospitals, universities, schools, and social service programs — would not qualify because they do not serve exclusively or primarily Catholics but those who are qualified or in need.

There are several grave issues in the new regulations.

The first is that HHS is trying to pretend that surgical sterilization, contraception and chemically-induced abortions are "preventive care" that enhance the health of women. This concept treats pregnancy as a pathological condition and a child in the womb a virus or tumor that should be prevented or eliminated if prevention fails. Some have tried to argue that sterilizations, contraception, and abortifacients (like the FDA approved "Ella" which can abort a baby several weeks after conception) are "preventive" in the sense that they can prevent surgical abortions, but abortion is not a disease condition either, but a totally optional, and tragic, decision made by a woman and a paid abortionist. Rather than preventing a disease, moreover, contraception and abortions in many circumstances actually contribute to causing many of the health complications that the morally unobjectionable parts of the new "preventive" regulations for women seek to combat. To focus just on contraception, multiple recent studies have demonstrated that contraceptive use may increase the risk of heart attacks, blood clots, high blood pressure, strokes and sexually transmitted diseases like Chlamydia and HIV. The "Physicians Desk Reference" warns contraception users of "serious and possibly life-threatening side effects," including chest pain, coughing up blood, blood clots in the lung, leg, and eyes, heart attacks, severe headaches and vomiting, vision and speech problems, breast cancer or fibrocystic disease, liver tumors, depression, jaundice, fever, fatigue, and loss of appetite. One of the reasons why contraception is mostly only by prescription is precisely because of these risks. For this reason, it is simply a scientific contradiction, not to mention a lie, to call contraception, sterilization and abortifacient pills "preventive" medicine.

Even more alarming, the new regulations trample on the freedom of conscience — both the freedom and the conscience — of employers or those in private health plans who have objections to having to provide and pay for others to access this pseudo-preventive counterfeit care. Currently, employers, insurance companies and those who are privately self-insured are totally free under federal law to offer, purchase and negotiate health coverage that excludes things like sterilization and contraception that they find immoral. Up until the Obama administration and the PPACA, the federal government had a longstanding commitment to respect and protect the conscience rights of all citizens and to allow health care institutions, religious employers and enrollees to participate fully in health programs without violating their convictions. The Obama administration is now taking away that freedom — and seeing what the reaction will be.

The conscience clause offered by HHS is a clear admission that the administration anticipated some objections. But the exemption pathway is basically lip service rather than real remedy to the concern. If the administration truly respected the rights of conscience then it would allow any organization or individual with conscientious objections to receive a waiver. To offer just a few people or organizations with moral objections a remedy is, basically, an admission that it is hoping to be able to get a pass on trampling on the moral convictions of most individual citizens while trying to mollify a few larger non-profit objectors. But if that were the plan, it has certainly backfired because the exemption is so narrow that not only does it exclude individual citizens, but most non-profit religious agencies, like the Catholic Church, which have social outreach to those who are not of their particular religion.

As Sr. Mary Ann Walsh, Director of Media Relations for the U.S. Bishops Conference, wrote in a feisty op-ed, "In a tacit acknowledgement that this violates the Constitution's cherished respect for religious liberty, HHS provides an exemption for religious employers — but with a catch. The church agency can only claim exemption if it primarily serves people of its own faith. It also must meet other requirements, such as employing mostly people of its own faith. This means HHS is setting itself up to determine what constitutes church ministry and who Jesus meant when he referred to serving 'the least of my brethren.' Catholic hospitals, charities and educational institutions provide about $30 billion worth of service annually in this country. No one presents a baptismal certificate at the emergency room. The hungry do not recite the Creed to get groceries at the food pantry. Students can pursue learning at The Catholic University of America, Villanova or any other Catholic college without passing a catechism admissions test. The commitment to serve those in need, the sick, the hungry, the uneducated, is intrinsic to Catholicism. No federal rule (except now HHS's) says the church must limit its service to Catholics if it is to be true to its teaching. HHS doesn't get the parable of the Good Samaritan, who helped the stranger simply because he was in need. Look at the numbers. Catholic hospitals admit about 5.6 million people annually. That's one out of every six persons seeking hospital care in the United States. Catholic Charities serves more than 9 million people annually. Catholic colleges and universities teach 850,000 students annually. Among those served are Catholics, Protestants, Jews, Muslims, atheists, agnostics and members of any other religious or irreligious group you can name. For the time being HHS has given itself wiggle room, saying that the public in the next two months can suggest an 'alternative' definition of a 'religious employer.' That's good because health care reform ought to increase access to basic care, not push religious groups to either violate their principles or abandon service to those in need whatever their religious beliefs."

Cardinal Daniel DiNardo of Galveston-Houston, chairman of the USCCB Committee on Pro-Life Activities, is calling the attention of Catholics and all interested citizens to do far more than simply try to get the HHS to change its definition, but to tackle what he calls "a major deficiency in PPACA," namely that "it lacks a conscience clause to prevent the Act itself from being used to suppress the rights and freedoms of those who may have moral or religious objections to specific procedures." He wrote to members of Congress asking them the address this "serious flaw regarding lack of conscience rights" by supporting the Respect for Rights of Conscience Act (H.R. 1179), introduced by Representatives Dan Boren (D-OK) and Jeff Fortenberry (R-NE). "This legislation," he said, "would change no current state or federal mandate for health coverage, but simply prevent any new mandates under PPACA — such as [HHS'] 'preventive services for women' -- from being used to disregard the freedom of conscience that Americans now enjoy."

Readers are urged to call their U.S. Representatives and persuade them to protect our legitimate rights of conscience by supporting this bill. They're also asked to contact Dr. Mary Wakefield, Administrator of the Health Resources and Services Administration (womensguidelines@hrsa.gov or 301.443.2216) and urge the government to eliminate sterilizations, contraception and abortifacient pills from female "preventive care."


Father Roger J. Landry is pastor of St. Anthony of Padua in New Bedford, MA and Executive Editor of The Anchor, the weekly newspaper of the Diocese of Fall River.