Some fear a recent American College of Obstetricians and Gynecologists ethics opinion could force them to perform abortions or refer patients to willing doctors - or else risk losing certification through a separate organization. That certification is required by many hospitals and insurance companies.
Michael Leavitt, former Utah governor and current secretary of the U.S. Department of Health and Human Services, in a letter shared his "strong concern," too.
The ACOG says doctors' certification is not at risk, but has agreed to reevaluate the guideline.
State and federal law protects physicians who object to abortion on moral or religious grounds. But an ACOG opinion issued in November called "The Limits of Conscientious Refusal in Reproductive Medicine" recommended doctors who deviate from the "standard practices" of providing abortion, sterilization and contraception refer patients to other providers.
If it's an emergency, doctors have an "obligation" to provide the requested care, the opinion said.
"Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a patient's health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities," the opinion states.
'Mixed interpretation.'
In a letter written in March, Leavitt said ACOG's position could "undermine the conscience and other individual rights of health care providers."
When he was Utah governor, Leavitt supported what would have been the nation's strictest abortion law. A 1991 Utah law prohibited abortions except in cases of rape or incest or grave risk to the mother's life. The law was found unconstitutional.
Kenneth Noller, president of the Washington, D.C.,-based ACOG, said the opinion is meant to be a guide, not a binding document. The American Board of Obstetricians and Gynecologists, which certifies doctors, has also said doctors who don't follow ACOG's ethics opinion won't be decertified, according to American Medical News.
"We want to be clear the opinion does not compel any fellow to perform any procedure which he or she finds to be in conflict with his or her conscience," Noller wrote in a March 28 letter to objecting doctors. He acknowledged the "uncertain and mixed interpretation" of the opinion.
Layton doctor Teresa Durbin said she may resign from the voluntary organization unless the opinion changes. By her reading, it would be unethical for her not to perform an abortion, which she opposes as an evangelical Christian.
She also refuses to make referrals. Comparing abortion to killing toddlers, she explained: "If I told somebody where they could have that child executed would that make me less responsible?"
Durbin, who wrote a letter of complaint to ACOG, said she knows of a handful of other Utah ob-gyns who protested the opinion, too.
William Parker, a Pleasant Grove obstetrician-gynecologist, said he was dismayed by the opinion.
Parker's, whose views are informed by his Mormon religion, said he tries to persuade women who want an abortion to choose adoption instead. In rare cases in which the mother's life is in jeopardy, he has terminated the pregnancies.
Parker also told of a 19-year-old who had been raped and wanted an abortion and had noted that her father, an LDS bishop, agreed. Parker recommended she also seek out the opinion of a third party - her church's stake president.
Earlier in his career, Parker said he refused to tie the fallopian tubes of "someone I thought was making a mistake." He said he performs sterilizations now, though he refuses to help single women get pregnant through artificial insemination.
"I try not to be paternalistic," said Parker. "I am very free with my personal opinion."
Access in Utah
Only a handful of doctors in Utah are willing to provide abortions, according to those doctors who do terminate pregnancies. But they don't consider that an insurmountable barrier.
"A lot of patients know to look in the phone book and called the Planned Parenthood," said Madhuri Shah, medical director of Utah Women's Clinic in Salt Lake City. Planned Parenthood doesn't perform abortions but refers patients to clinics like Shah's.
Kathy Burke, assistant medical director for Planned Parenthood Association of Utah, said she has heard of doctors who won't prescribe contraception to single women and a group of Orem doctors who will not prescribe emergency contraception to patients under 18.
Emergency contraception, which prevents pregnancy, is available over the counter to adults, though some Utah pharmacists have reportedly scolded such consumers.
Doctor William Adams, director of Mountain View Women's Center, which provides abortions in West Jordan, said doctors who won't perform abortions on women whose health is at risk are allowing their religion to interfere with their medical judgment. He terminated a pregnancy of a woman whose leukemia returned upon becoming pregnant. She was referred to Adams by her doctor.
And he said few Utah doctors are willing to tie the tubes of an unmarried young woman.
"The woman's in the best position to determine how many kids she wants or how many she can raise," he said.
