New ACOG position on abortion refusal drawing fire

Anti-abortion doctors say it obliges them to become morally complicit, but the position's supporters say personal views should not trump patients' access to care.

By Kevin B. O'Reilly, AMNews staff. Jan. 21, 2008.

A recent American College of Obstetricians and Gynecologists' position statement outlining the limits of conscientious refusal in reproductive medicine is drawing fire from physicians who oppose abortion.

The ACOG Committee on Ethics opinion says doctors whose personal beliefs may require them to "deviate from standard practices" such as providing abortion, sterilization or contraceptives should:

• Give patients prior notice of their moral commitments and provide accurate and unbiased information about reproductive services.
• Refer patients in a timely manner to another doctor who can provide the requested service.
• Provide medically indicated services in an emergency when referral is impossible or might affect a patient's physical or emotional health.
• Practice close to physicians who will provide legal services or ensure that referral processes are in place so that patient access is not impeded.

The opinion, published in November 2007, comes in response to heated debate over some pharmacists' refusal to fill patient prescriptions for Plan B, known as the morning-after pill. The Food and Drug Administration in September 2006 approved Plan B for over-the-counter status, but the debate over the right to refuse certain procedures or medication has not disappeared.

In its opinion, ACOG cites other cases of impeded reproductive access it finds disturbing, such as a California doctor's refusal to provide artificial insemination to a lesbian couple and a Nebraska hospital's refusal to perform an abortion for a 19-year-old with a life-threatening pulmonary embolism.