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10/20/2017

Regarding objections to the change in the contraceptive coverage rule

The Journal of the American Medical Association carries a “Viewpoint” piece that categorically rejects the Trump administration’s reversal of its predecessor’s mandate that employer-based health insurance include payments for contraceptives.  As reported in the general press, the current administration’s new stance was hailed by religious and other political conservatives as a welcome support of conscience rights.

Read the article here.  Briefly, some key points and quick responses:

  1. “The Trump administration has rejected balance [between conscience rights and access to contraceptives] as a worthwhile goal.”  The prior rule was widely understood to be narrow, intending to apply only to religious organizations and not to private employers who held sincere and consistent objections to some or all forms of contraception.
  2. It is argued that religious freedom should not be privileged over “women’s rights” or “the interests of patients.”  However, religious freedom is arguably protected, explicitly, in the US Constitution.
  3. “Ethical obligations to prioritize the interests of patients” are wrongly compromised.  This claim seems to wrongly invoke the obligation of a physician to prioritize the patient’s interest over his own.  This is not the same as claiming that a woman’s right to seek and obtain contraception entails an obligation by anyone and everyone to provide it for free.
  4. “Government should intervene” to ensure all women have access to free contraceptives.  Even if the cost of some contraceptives is prohibitive to some women of limited means, that does not entail the government creating an obligation for private citizens or groups to violate their strong moral convictions by direct or close involvement in providing said contraceptives.  The government could pass legislation and appropriate funds to provide the contraceptives more directly, eliminating employers as middlemen.
  5. The order is claimed to prioritize conscientious objections over “evidence,” in this case evidence that contraceptives are not abortifacients.  This claim, which cites a blog post as evidence and is not further developed, seems to rely on a definition of abortion as occurring only after implantation.  I don’t believe that it has been conclusively proven that at least some contraceptives cannot work after fertilization.

 

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