I've discussed here the very real possibility that laws will be passed at various jurisdictional levels--one is under consideration in California right now--that would require doctors at least to refer for abortions. If the doctor won't perform an abortion, he has to provide the woman with "access" to abortion by helping her find an abortionist. A law like this is already in place Down Under, in Victoria, Australia.
I have predicted that, faced with such laws, some doctors and/or hospitals will capitulate insofar as they will do the referrals while refusing to (in the case of hospitals) allow abortions on-site or (in the case of doctors) perform abortions themselves.
My guess is that this will be rationalized on the grounds that the referral is purely pro forma, that the woman could have found an abortionist for herself anyway, and that therefore one is not making it materially easier for her to get an abortion by providing her with phone numbers and a referral. And by cooperating with the law, doctors who do not themselves provide abortions, who are personally pro-life, and hospitals that provide important services to the public, can remain open and continue to help people and provide a good influence. So, I conjecture, the reasoning will go.
Why is this reasoning misguided?
In passing, I note that there is already a program for poor people in Boston that bears a family resemblance to these other efforts to involve everyone in abortion. And the requirements of that program stipulate that the Catholic services provider must, if necessary, provide transportation for an abortion-seeking woman. While I won't say for sure that providing transportation will be required by the laws I envisage (the Boston situation is a set of requirements for the Catholic organization to receive a special contract), neither would I put it beyond the realm of possibility. And I hope we can all agree that providing a woman with transportation to an abortion is providing material assistance to her in getting the abortion.
But set aside the transportation question. What about referrals? Here I'm going to draw on my own experience as a patient in the American medical system. What does it mean when a generalist refers you to a specialist, for example? In my experience, one of the things it means is that the office staff at the GP's office offers to call up for you and make an appointment. Sometimes they even make an appointment without your having asked them to, and often you have to change the appointment, because (obviously) the office staff doesn't know what your calendar looks like. Another thing it usually means is a letter. The referring doctor writes a letter telling the specialist about the situation and saying that he recommends that the patient see the other doctor. In all cases, it involves the referring doctor's staff doing some amount of research for you and giving you the information you need to make an appointment, without your having to guess whether the other doctor offers the service in question, will be willing to see you, and so forth. It amounts, too, to a recommendation. Different GP offices have different specialists to which they refer you, and as a patient you take it that the referral means that the specialist has in some sense been "checked out," that he isn't a hack, that he does a good job, and so forth.
It should be absolutely obvious that any of these aspects of referrals, applied to abortion, amount to the normalization of abortion within the medical system. If the pro-life doctor's office staff call up for the patient and make a first appointment with the abortionist, this undeniably communicates that going to an abortionist is just another type of medical appointment, that it is a normal thing, that there is no taboo or problem about it. The pro-life doctor's refusal to perform abortions himself thus is demoted in significance from an actual protest against the abortion regime, a refusal to participate in it, to a mere difference of emphasis in practice, akin to a difference in specialization: "The doctors in our practice don't happen to do that procedure, but we'll refer you to Dr. Jones, who does."
Implicitly, too, Dr. Jones the abortionist now becomes a medical colleague. He just happens to perform a procedure that the patient ostensibly "needs," that the referring doctor doesn't happen to do, but that the pro-life doctor's office is going to guide the patient to obtain. The referral to him implies that he isn't a back-alley butcher, that he can be trusted, and that there is something ordinary and legitimate about what he does.
In short, a referral for an abortion from an erstwhile uncooperative pro-life doctor helps to make abortion socially routine and brings it into the warp and woof of medical practice.
And that's the point. Protestations to the contrary notwithstanding, the pro-aborts are lying if they imply that women are incapable of using the Yellow Pages and finding an abortionist for themselves and that therefore referrals are somehow necessary to "access." This claim is as phony as a three-dollar bill. What the pro-aborts don't like is the silent disapproval conveyed by a woman's meeting a stonewall when she asks her first GP or ob-gyn for an abortion. The message conveyed by, "We don't perform or refer for abortions," full-stop, is that just maybe abortion isn't a medical procedure on a par with having your tonsils out, that it is somehow segregated in the medical world, and that one's own doctor feels distaste about having anything to do with it and refuses to get involved with it in any way. We can't have that. No moral judgements should be conveyed to a woman, however implicitly, against her having an abortion. (This does not apply the other way, of course. The abortionist's staff are free to exercise all sorts of persuasion to get the woman to have an abortion.) So the pro-life witness, even the silent witness, of a doctor's office that refuses to have anything to do with abortion must be broken down. The entire point of the referral requirement is thus a social-approval and rhetorical point, and by cooperating with it, a doctor is cooperating directly with the pro-aborts' social agenda.
It is therefore immoral for a doctor to refer for an abortion.