Question 101

Here is the situation: I am in graduate school to become a nurse-midwife. I plan to be an NFP-only practitioner upon graduation. However, I recently explained my position regarding artificial contraception to the director of my midwifery program, and she is insistent that while she will try to place me in NFP-friendly or NFP-only clinical sites, I must still gain the clinical skills of inserting IUDs, counseling for contraceptives, etc. She says that I cannot graduate from this program without doing so, as these skills are within the midwifery scope of practice and thus required for sitting for the boards. 

I can't imagine that they can force me to do these things (or kick me out of the program), but I need some information to go back to her with so that I can maintain my position AND graduate from the program. I would really appreciate any input that you might have on how to appropriately and respectfully fight this issue. In particular, I'd love to find some legal information regarding my rights as a student in the medical field. 

                                                                                                                          Thank you, Perplexed.

Dear Perplexed: This amounts to being forced against one's conscience, as there is no way to licitly agree to participate in providing contraceptive technology or IUD insertion, for contraceptive or sterilizing purposes. That would always involve formal or, at minimum, proximate material cooperation and therefore be unacceptable morally for the Catholic (or anyone). 

Further I don't think this imposition is legal either. It needs to be made clear that this is a non-negotiable issue and that you have a 2-fold responsibility to 1) respect your own religious and conscience-based preferences and beliefs; but just as important, 2) your honest convictions that these types of interventions represent doing harm to patients and therefore are never acceptable from that perspective as well. 

You must explain this calmly but assertively, using the analogy of poisoning of patients, something forbidden not only by our private religious convictions but also by an honest professional-moral sense as well. And you need to make it clear that you intend to vindicate your rights as well. In the end you must unfortunately draw a line somewhere; hopefully it can be amicable and the preceptor can listen to reason. I would love to talk with you about this, and hope you do not end up needing an attorney, but we know some good ones if it comes to that. 

You deserve better than this, and you deserve to be respected. There is nothing unreasonable about this -- it's as if the entire profession condoned cigarette chain smoking. You would still be right to discourage that even if you were the only one doing so. Indeed your counsel would in that instance be all the more needed! Call me because I can provide evidence-based data on contraception and sterilization that can help.