Do Religiously-Based Restrictions Contribute to Late-term Abortion?

Analysis–The assassination of Dr. George Tiller has brought some attention to the issue of abortions that take place late in pregnancy, inspiring many to wonder aloud how often these procedures take place and what contributing factors may leave women in this difficult position.  A myriad of physical and psychological crises give rise to this rare occurrence, but one situation possibly arose because a doctor imposed his religious or moral beliefs on his patient.  

One woman ended up having an abortion in her third trimester because a doctor purposefully withheld information from her about her fetus’s terminal medical condition.  As reported in the Washington Post, a woman discovered only a few weeks before her due date that her fetus had developed without a brain, and would never take one breath.  Dr. LeRoy Carhart, who worked with Tiller, said “Her doctor knew the problem all along but just never told her.”

While the article doesn’t give all the details, the facts suggest that the doctor withheld information because of his opposition to abortion.  He apparently believed that she would terminate her pregnancy if she knew her baby couldn’t survive, and then made a decision, based on his personal religious or moral beliefs, to withhold crucial information about her medical condition.  This is exactly the hypothetical situation we described in our paper, When health care providers refuse: The impact on patients of providers’ religious and moral objections to give medical care, information or referrals. In a federal case called Grant v. Fairview Hosp., decided in 2006, an ultrasound technician claimed that he had a religiously based need to “counsel” pregnant patients once he found out they were considering abortion.  Fortunately the court held that his employer had a right to protect patients seeking medical care from the employee’s religious harassment.

This doctor apparently decided that his beliefs trumped the patient’s legally-enforceable right to informed consent, which resulted in the patient having a far more dangerous third-trimester abortion.  Perhaps he would claim that he didn’t want to “participate” in abortion, and therefore had a right to deny her the information she needed to make the medical decision that was best for her.  Under the HHS refusal rule proposed by the Bush administration he may have believed he was justified—which is why we’ve urged the Obama administration to rescind the rule.

We are grateful that Dr. Tiller was there for his patient in her time of need, but it is possible that she would not have been in need of a third-trimester abortion but for her doctor’s refusal to give her important medical information earlier in her pregnancy.  This is why religiously motivated refusals to give information are so harmful.  We know that most patients who are subject to refusals just want to get on with their lives, and ultimately won’t sue the doctors that violate their right to informed consent.  Perhaps if more doctors were taken to court to defend their actions, we’d see more good medicine and less “morality.”

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  • sayna

    Thank you for pointing this out. With refusal to give patients treatment or infomration regarding abortion or birth control doctors and other healthcare professionals are threatening their patients’ health.

    They’re also completely ignoring the patients’ legal right to informed consent and disrespecting them by saying that they’re incapable of making a decision for themselves. And religion should be left out of it entirely. We’re not a theocracy and no one should be able to force another to live by their religious views. Especially when it comes to matters as private as this.

  • invalid-0

    It is incredible to see such things occur in medicine. I mean really, for god sakes its not your choice Doc!!! Not informing your patient of what is going on with her or her baby is beyond irresponsible. In a way I can understand why he did what he did, maybe he has seen so many abortions in his time that he just couldn’t do it anymore. Maybe he thought he was making a difference and taking a stand. But my oh my is this the wrong way to do it. I feel for that patient and for the doctor in a way. I am a healthcare professional as a CNA and never in my wildest dreams would i do something like this.

  • crowepps

    Anencephalic fetuses have no brain, die as soon as they are born, and also do not have whatever it is that ‘triggers’ labor and so in these cases labor must always be induced. The doctor withheld from the patient the fact that her fetus was grossly deformed, and by doing so not only did he delay her abortion until a more dangerous time for her personally but he also left her at risk of that complication of anencephalic fetus.

    In addition, as a woman who has been pregnant and had children, when an ultrasound or other test is done most patients infer that ‘no news is good news’. To leave this patient happily expecting the live birth of a healthy baby when the doctor was well aware that wasn’t going to happen is just grossly WRONG, and in my opinion this man should no longer be a practicing OB/GYN.

    I certainly don’t see any ‘moral superiority’ in continuing the pregnancy an extra 3 or 4 months, straining the woman’s body with the metabolic load of creating and then delivering a large dead fetus at 9 months, when the ‘pre-dead’ condition of the fetus justifies aborting the much smaller fetus at 5 or 6 months.

  • invalid-0

    Observing rules of medical ethics, I lower the description of the patients and their sincere problems, but it is possible to tell one phrase jammed to holes: “Rich too cry…”
    The doctor has not made any professional mistake and has not broken a rule of medical ethics.