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Time for civil disobedience in Illinois

Way back in 2008 I highlighted a then-new law in Victoria, Australia, requiring a doctor to refer patients for abortions if the doctor wouldn't perform the abortion himself. I said that this was a case in which civil disobedience would be justified.

Illinois has recently passed a law (text here), which has been signed by the Republican (!) governor, that is much like Victoria's law. Ironically, the new law is an amendment to a conscience protection act previously passed in Illinois. The current law brazenly guts the original conscience protection act and replaces it with conscience coercion.

Under the new law (yes, I've read it), doctors, crisis pregnancy centers, and pharmacies must do the following:

1) They must inform patients of risks and benefits of all legal procedures relevant to their situation. This would mean that doctors opposed to abortion would have to talk about the alleged benefits of abortion.

2) If they have a conscientious objection to a treatment option the patient wants, they must, upon patient request, either refer the patient, transfer the patient, or provide written information to the patient about other providers whom they "reasonably believe may offer" the service in question. The wording of the legislation isn't clear as to whether the patient gets to choose which of these options the health care provider must follow (refer, transfer, or provide written information).

3) Regardless of which option is selected, the health care provider with the conscientious objection must provide copies of relevant medical records to the other provider (the one who is expected to perform the abortion or other service) "without undue delay." As I've pointed out before, this is a way in which requiring medical transfer isn't the equivalent (at all) of handing a patient the yellow pages or suggesting that he do a Google search. It's a matter of treating the abortionist (say) as a medical colleague.

So this bill requires cooperation of some sort with abortion on the part of conscientious objectors. They are to speak about abortion (or contraception, for that matter) to the patient as though it's just another treatment option, speak of its "benefits," and assist the patient in finding someone who will provide the service.

As the Family Research Council points out, this Illinois law is in direct violation of the Weldon amendment, a bit of federal law that says that states that receive federal funding can't discriminate against doctors for their failure to refer patients for abortions.

But the Weldon Amendment depends upon the federal government for enforcement, and the Obama administration isn't going to do any such thing. Always remember that it takes effort on the part of the government to enforce good laws. The administration must be motivated to do so, and sheer neglect is an effective form of de facto nullification. The Weldon Amendment contains no private cause of action, so doctors and pregnancy centers that are punished or threatened with punishment by the State of Illinois have no effective recourse even though Illinois will be violating the terms of its receipt of federal funding.

The U.S. House of Representatives passed a Conscience Protection Act in July that would have created a private cause of action in such cases. It looks like (as far as I can tell) the Senate has not passed it yet, and of course Obama would veto it if passed.

While we will get the same, tired nonsense from the lefties about how doctors should just get out of the profession if they "refuse to do their job," sane people know better. In fact, even non-Christian sane people know that referring for an abortion isn't some sort of deep, intrinsic part of the "job" of being a doctor. And the fact that an abortion is legal makes not one whit of difference.

It would be bad for the world as a whole if all pro-life doctors left the profession. This law applies to crisis pregnancy centers, too, if they "provide medical care." Pro-life pregnancy centers provide an important service and must not close their doors.

A lawsuit has been filed by (who else?) the ADF. They are filing in state court under provisions of the Illinois State Constitution.

Meanwhile, conscientious doctors and crisis pregnancy counselors should just go on quietly doing their job and not turning patients toward the destructive "choice" of abortion.

Comments (13)

Good thing we have such a savvy and hard-headed GOP candidate running for president who's well-versed in this encroaching tyranny and well-prepared to call it out directly and effectively.

. . .

Meanwhile, conscientious doctors and crisis pregnancy counselors should just go on quietly doing their job and not turning patients toward the destructive "choice" of abortion.

And be prepared for sting operations.

Wait, I thought the baby killers were morally opposed to sting operations...

Julian the Apostate was embarrassed by the example of Christian charity towards believers and non-believers alike. This charity was instrumental in converting people to the faith. Satan, having learned from experience, is inspiring progs to launch a layered assault on this avenue of Christian witness. First, they will run us out of the helping professions and charitable spaces. Then they will paint us as fanatics more interested in "punishing women" then providing healthcare.

I don't mean to be a counsel of despair, but I don't see a way out of this in our current climate. First Amendment freedoms are increasingly giving way to the feelings of the "marginalised group" of the moment. I honestly think things will continue to decline until the current political order gives way to whatever comes next.

CJ, I don't see what you said as a counsel of despair. I think the current election cycle is the last gasp of an exhausted political order that is no longer serves a good purpose. From Obama's empty slogan to Trump's empty slogan, perhaps it's a capstone on an era.

Even with the "helping professions", I've always thought that Christians were naively operating within a system that offers less real help than is thought. There's plenty of free advice that is worthless and wrong, but still the fact remains that people actually able and prepared to offer help to those in need will do so for free, or at least a part of a charitable effort. And those that do so will frequently be actively opposed by the "professionals" in the field.

As for "healthcare", the very term has been politicized and insofar as it's an industry it is ripe for disruption. People don't care about "healthcare", they care about medical services but that term is all they know. Either a tyrannical state under the failed "blue model" continues to succeed in denying health services to the public and participating with the AMA in limiting the number of doctors and practitioners by corruption, or it fails to do so and loses control of its ability to dictate all details of the doctor-patient relationship.

Satan, having learned from experience, is inspiring progs to launch a layered assault on this avenue of Christian witness. First, they will run us out of the helping professions and charitable spaces. Then they will paint us as fanatics more interested in "punishing women" then providing healthcare.

CJ, I think that is well put.

And I would also note that the regulations in Illinois do apply to places like crisis pregnancy centers that offer their services for free to the needy. So it isn't only the hyper-professionalized who are being driven out.

Same with the Little Sisters of the Poor.

Satan is clever. We know we will win in the long run, but we simply don't know what will happen in the short run.

For us there is only the trying. The rest is not our business. (T.S. Eliot)

Wait, I thought the baby killers were morally opposed to sting operations...

No, they are morally opposed to sting operations that sting them. "Morally opposed" can mean whatever you want it to mean, when "morals" are subjective anyway.

I honestly think things will continue to decline until the current political order gives way to whatever comes next.

This growing more and more probable. The problem is that it is very difficult indeed to prudentially know what is the right thing to do when things are finally breaking down, or have broken down and nothing has yet replaced the old order.

I should have been clear above that the medical profession proper is clearly a valid "helping profession". It's the non-medical professions I meant to refer to, which are now unfortunately all lumped into the category of "healthcare".

But look, I think we have patterned and formulaic understandings of some things, and probably civil disobedience is one of them. The term “Irish Democracy” is a term maybe we should become familiar. Google says it's "the silent, dogged resistance, withdrawal, and truculence of millions of ordinary people."

I think reading the news has corrupted many of us. Whether the military or the medical professions, or any number of others. Just knowing people on the inside makes it clear enough things look very different from the inside. I'm skeptical that Christians will be "driven out" of this or that field. I'd say the clever ones won't be. Hopefully that will be most of them. Look, all Christians have to decide whether the cause of Christ will be helped or hurt more by their absence in the face of formal resistance. I think most who choose to stay in will find allies even among the nonreligious. They'll find that staying in and fighting for the institutions and people those institutions are meant to serve is the right thing to do. Absolutism doesn't work any better for Christians than anyone else.

We forget or don't realize how many times we've seen this in action. Just now while running through my imagination hypotheticals of how the doctor-patient conversation might go in cases where law requires things contrary to conscience, I realized that I've personally seen it in medicine myself in a different state than I'm living now. The doctor said something very close to this: "I'm required by state law to advise you of the availability of these services". Oh that's very comforting isn't it? Ok doc, go ahead and fulfill the obligation of the state you seem clearly not to be advising. "I'm going to leave and a nurse practitioner will advise you of your options in this regard". Ok, thanks doc see you later. She comes in. She may be a true believer or not. The time I personally witnessed she was, or I took her to be. If she hadn't been, she'd have given the same "I'm fulfilling state requirements so there you go" that the doctor did.

In any case though I'm all for fighting this onerous paternalist crap, I have a hard time thinking that most clients will be fooled in naively accepting as valid such government intrusion. Likewise, I have a hard time believing that Christian medical practitioners that have never been blind to the flaws of the medical-industrial complex they worked so hard to become a part of–despite its flaws–are suddenly going to conclude because of more onerous state laws they just can't dirty their hands any more and leave the professions they worked so hard to enter. I think that's very much an outsider's view.

These rules would actually impose a _substantial_ difference in practice upon crisis pregnancy centers. Their entire raison d'etre is to prevent women from having abortions. For a CPC even to be saying, "As required by state law, I'm informing you of the supposed benefits of abortion" would be a huge compromise. CPCs are not like ordinary doctors. They are not hedged around with gazillions of regulations. They are run in a largely informal way. They are often explicitly religious in terms of the counseling they give. The counselors are explicitly trying to offer women _alternatives_ to abortion ("alternatives" is sometimes in the name of the clinic) and deter abortion.

But beyond that there is the referral requirement. That is very stubborn. No amount of unenthusiastic wording is going to get around that, even for doctors who are used to navigating the bureaucratic junk. It doesn't matter how unenthusiastically or with how much distancing language one goes about _finding_ a woman an abortionist and sends her records to him. That is a practical form of cooperation, no matter what.

I think that demand is just going to have to be refused. I don't see any way to pretend to do it but not really do it, or do it with dragging feet and thus appease one's conscience, or whatever. I think they are going to have to break the law, according to the clear wording and intent of the law.

As Scott W. says, they then risk being caught by sting operations, which the leftists do engage in. But I think they'll have to take that risk.

It also occurs to me: Insofar as any narrow distinction between "giving information" and "a referral" actually makes any *practical* difference to the all-holy goal of access to abortion, it will have to disappear in practice in the application of the law. Suppose, for example, that a woman's insurance requires an actual *referral* from her primary care physician in order to obtain coverage for an abortion. (Not at all an implausible scenario.) If a pro-life PCP says, "I'll choose the option in the law to give you *information* about abortion providers but not a *referral*," then she can't get the abortion covered by insurance, which limits her access. The clear intent of the law is that no pro-life conscientious convictions can have any practical *effect* in making it difficult to any significant extent for someone to obtain an abortion. Hence, I'm going to say that a doctor who tried to draw the line there would, in the scenario I've sketched, be subject to punishment under the law, precisely *because* his drawing that line actually helped to prevent or even delay an abortion.

I agree that crisis pregnancy centers are a special case. But even those are a response to conditions as they've developed.

In 1980 22% of abortions happened in hospitals, whereas in 2005 only 5%. Abortions now virtually depend upon stand alone clinics and the procedure is stigmatized among real doctors. Yet even keeping those open is no picnic. I think that's where state level civil disobedience needs to happen. Planned Parenthood would go into an immediate financial crisis if government funding is removed. The only thing keeping it from being removed is hiding it within other appropriation bills.

Abortion has existed for centuries when death during childbirth was common, but actively taking advantage of the weak and vulnerable on an industrial scale as happened post-Wade and now with government funding is very new.

Any of us can spin out any number of Kafkaesque legal scenarios because that's how self-contained legal scenarios end up. If the medical-industrial complex under the blue-model continues as it has since shortly after WWII then we're all screwed. I'm merely pointing out that civil disobedience is more of a degreed property than an absolute. This probably comes down to a glass half-empty or half-full sort of outlook. Overreach leads to reaction. It's human nature. Trying to manage such things is an unpredictable and unstable mix, and it doesn't always favor the lawmakers.

I am going to predict that some pro-life Catholic, Evengelical, and Mormon doctors will attempt to get around the law as follow: For every new patient, and every patient who comes in for an appointment after the date of the law is effective, he has them sign a Disclosure and Agreement Form. The disclosure is that he is morally opposed to abortion including referring for it or explaining its "benefits". The agreement is the patient agreeing to be a patient with this doctor by not seeking abortion services, information, or referrals, and that any such intent severs the patient-doctor relationship. Oh, and the disclosure part also states that "this form stands as fully supplying mandated information" because it notes "there are complete information resources on abortion as mandated by the state available on the internet."

I doubt it would work very well, but who knows?

I'm in graduate school to become a social worker with hopes working in a school setting, if not going into mental social work. The current assignment I'm working on wants us to write about our cultural upbringing and is masked as a "tell me how you became the way you are" type of way, but it's really about exposing any cultural biases we have and how we have to align our values, or put aside them, for "social work values." There's no doubt that any student who expresses anything not compatible with "social work values" and who refuses to part with conservative thought will be deducted points. It's a clever way to weed out those "not suited" for social work.

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