ACOG Ethics Opinion On Referrals By Physicians Opposed To Abortion, EC

Main Category: Abortion
Also Included In: Primary Care / General Practice
Article Date: 09 Apr 2008 - 8:00 PDT

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The American Medical News reports that the American College of Obstetricians and Gynecologists said last month that it will re-examine a November 2007 opinion that calls on physicians to provide referrals for patients seeking abortions, emergency contraception or other procedures if they are opposed to providing the services themselves. According to the Medical News, the decision to review the opinion comes after criticism from HHS Secretary Mike Leavitt and some antiabortion physicians.

Leavitt in March sent a letter to ACOG and the American Board of Obstetrics and Gynecology to challenge the opinion. In his letter, Leavitt expressed "strong concern" that the ACOG opinion might endanger conscience rights. Leavitt said he is worried that antiabortion ob-gyns could be decertified for refusing to refer patients to other physicians willing to provide the procedure. He added that health care organizations that require American Board of Obstetrics and Gynecology certification could be in jeopardy of violating a federal law known as the Weldon Amendment, which prohibits recipients of federal funds from discriminating against doctors who refuse to perform or refer for abortions.

Leaders from ACOG and the American Board of Obstetrics and Gynecology quickly responded to Leavitt, saying his interpretation of the opinion was incorrect, the Medical News reports. ACOG President Kenneth Noller in a statement said an ob-gyn's board certification is not determined or jeopardized by the physician's adherence to the ethics committee opinion on conscientious refusal. Noller added that because of the "uncertain and mixed interpretation" of the opinion, he ordered ACOG's ethics committee to re-evaluate it as soon as possible. In a letter to Leavitt, American Board of Obstetrics and Gynecology Executive Director Norman Gant said the organization has no policy on providing or referring for abortions. He added that the issue is not a consideration in any of the American Board of Obstetrics and Gynecology's certification requirements or exams. An HHS spokesperson said Leavitt is now "satisfied that the conscience rights of ob-gyn doctors will not be undermined by the board-certification process."

Physician Comments

Some abortion-rights physicians criticized Leavitt's involvement in the matter and said ACOG should not change its original opinion. Lee Shulman -- an oral examiner for the American Board of Obstetrics and Gynecology and immediate past chair of the Association of Reproductive Health Professionals' board of trustees -- said Leavitt's letter was "political mumbo jumbo" and that targeting the American Board of Obstetrics and Gynecology was a "travesty" and "ridiculous."

Some antiabortion physicians said Noller's comments are not enough, the Medical News reports. "The policy as it's stated leaves significant potential for decertification and discrimination," Joe DeCook, vice president of the American Association of Pro Life Obstetricians and Gynecologists, said. He added, "That may not be the intent, but the effect of the language is there, and we need some provision in the language that makes plain that this is not referable to our conscience convictions." Gene Rudd, vice president of the Christian Medical & Dental Associations, said that although he is pleased that the opinion will be re-examined, anything short of retracting it will not be enough. "There is no way they can satisfy many people ... if they want to compromise conscience" (O'Reilly, American Medical News, 4/14).

ACOG's ethics opinion is available online (.pdf).

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