Interview with Catholic Family
By Genevieve Pollock
NEW YORK, 24 JULY 2009 (ZENIT)
A doctor who launched a new network for Catholic and pro-life
physicians is affirming that now is the time for a renewal to occur in
Doctor Anne Mielnik, a family physician, is the cofounder and executive
director of the John Paul II Center for Women and Gianna Health Care for
Women, pro-life centers completely committed to following the teachings
of the Catholic Church.
In this interview with ZENIT, she spoke about the importance of a
developing movement of health care workers that includes a network she
Part 2 will appear Sunday.
ZENIT: What has been your experience as a new Catholic doctor, recently
out of medical school and having just completed your residency?
Mielnik: During the past seven years of medical training, I became aware
of a disturbing trend in the education of future physicians in the area
of medical ethics.
The conscience debate that is occurring at the national level in U.S.
politics is only one piece of a much deeper problem.
In my experience, there appears to be a deliberate attempt in medical
education to teach future physicians to ignore, rather than sharpen and
strengthen, the dictates of their consciences.
More emphasis is placed on "facilitating a patient's choices" than on
learning how to think critically through ethical dilemmas and to commit
to always doing what is right.
At my medical school and in what I read in commentaries in some of the
major medical journals today, the "take-home" message seems to be:
"It's fine for you as a physician to believe whatever you want to
believe about medical ethics, but when you go to work, your professional
responsibility is to leave your 'personal beliefs' at home, and
'facilitate the choices of your patient.'"
This is truly terrifying.
Prior to entering medical school, I had studied medical ethics in
college. I was thus familiar with the process of applying ethical
principles in making "real world" decisions about dilemmas.
But at the medical school I went to
and from what I've heard from other medical students, this is occurring
in schools around the country; medical ethics is being reduced to a
distorted understanding of one principle
"respect for patient autonomy."
All of the other ethical principles
non-maleficence, beneficence, justice
are presented as being secondary to and trumped by "respect for
autonomy," and physicians are encouraged to understand this "respect for
patient autonomy" as a mandate to facilitate any "legal" choice a
patient may make.
This is particularly true in the area of reproductive health and at the
end of life.
In subtle ways, I see an entire generation of physicians being taught,
in effect, that their responsibility is to deliberately ignore their
Thus, good people, who know the difference between right and wrong, who
believe in the sanctity of human life and in particular Catholic
physicians, who know what the Church teaches in the areas of
reproductive health and in care at the end of life, are taught from the
earliest years of their medical education that they should ignore the
voice inside of them that tells them what is right, and do whatever
their patient wants.
Ethics is becoming relativism, where no "right answers" exist and
critical reflection is discouraged.
Because the students are not hearing anything else, this is wha t they
and then do in practice.
They believe that what it means to be an ethical physician is being
willing to put aside the dictates of their conscience, rejecting them as
"your own personal beliefs," which have no place in medicine.
They believe that somehow being faithful to doing what is right makes
you a bad doctor.
In response to this message being taught at our medical school, I and
several other students started a pro-life student group at that school.
We then started a citywide medical student pro-life group.
We brought in speakers
older physicians and an ethicist from the National Catholic Bioethics
to testify before the students that what we were being taught was not an
authentic medical ethic and was not the way other physicians practice.
Our goal was just to get the word out there that there is a different
way of looking at medical ethics.
Through the course of working with those pro-life groups, I learned more
about the Church's teaching in the area of reproductive health.
Going into medicine, I knew the Church's basic teachings about Natural
Family Planning, and I was committed to being faithful to them
never planned to prescribe contraception.
But during this time, I really began to learn about the writings of John
Paul II known as the Theology of the Body. As I learned about the
purpose and dignity of the human body and of human sexuality,
understanding this teaching became a passion. I see these teachings as
being the key to a truly authentic approach to medical ethics.
I also began to understand in a deeper way that the natural methods of
family planning are just phenomenal. And thanks to decades of research,
we now have proof that these methods are highly effective. They also
strengthen marriage and the family.
ZENIT: How did you come up with the idea to form this network of
Catholic, pro-life doctors?
Mielnik: That actually just came about to fulfill a need.
Over the past one or two years, as I have travelled around the country
researching models for the centers I am starting in New York City, I've
networked with a lot of different Catholic and pro-life physicians.
A common theme keeps recurring, with many physicians saying, "I keep
having this stirring within my prayer life, feeling like God is calling
me to start a Catholic health center in my community, to leave my
practice, or step out and start my own practice offering health care
that is completely faithful to the Church."
Having heard it so many times, it occurred to me that maybe God really
is calling us to build an alternative health care system
or to work to renew and strengthen the Catholic health care system that
Over the past year, some physicians have already begun to look at a
formal way to do this
create an independent network of authentically Catholic health care
centers. I also know that the U.S. bishops, too, are looking seriously
at how to strengthen Catholic health care in the country.
With respect to the listserve, I was having dinner with one such
physician in Omaha, Nebraska, who has a similar sense of feeling called
to step apart and create an independent health care center in his
As we talked about how to bring this about, he said, "It would be so
nice if there was a place where Catholic physicians could network and
just talk about how to actually do this, as well as find support from
other physicians who share our beliefs."
The listserve was thus created to be a place where health care
providers, and physicians in particular, feeling this movement of the
Holy Spirit, could network and support each other.
It is a place for physicians, residents, medical students and other
health care providers to talk about the challenges they face as
Catholics, the challenges in the area of medical ethics and the
challenges they will face in starting independent businesses.
It is also a place to discuss ways we can unite in a public way to
affirm our commitment to pro-life health care, to discuss ways to
address all the issues currently being debated in medicine, particularly
on the issue of physician conscience, and to dialogue about how to deal
with the very real threats coming from our government, as well as the
very real threats coming from within medicine itself.
ZENIT: What kind of effect would an alternative health care system have
on the larger society?
Mielnik: I really believe that abortion
or the so-called war on abortion
is going to be won not by a law that eliminates abortion, but by
creating an alternative approach to women's health care that is so far
superior to it, that only the rarest, most hardened individuals would
even consider abortion to be "health care."
I believe that if abortion is made illegal, people are still going to
have abortions. Doctors are still going to perform abortions, and women
are still going to seek out illegal abortions.
I'm all for a law and believe it is critically necessary to work to pass
laws which protect the sanctity of all human life from the first moment
of conception. I would do everything I could to create and support such
but that is not enough. We have to go further if we want to truly
At this point, some 35 years since Roe v. Wade, so many women have
suffered the consequences of having an abortion that I believe it's only
a matter of a time before it becomes public that women are not happy
about the choices they have made, that their abortion "choice" was
harmful to them.
People are going to begin to see that abortion, far from being an
expression of a woman's free choice, is actually an act of violence
That's what I have seen in my clinic practice, as I have been seeing my
own patients over the last three years.
The other co-founder of the John Paul II Center for Women, Joan Nolan,
has witnessed the same thing in her work with women.
She leads small group studies of John Paul II's teachings on women,
using a program called ENDOW, and the stories women share of what they
have suffered, both because of the birth control pill and because of
abortion are devastating and heart-wrenching.
In light of what Joan and I have heard from women and experienced in
working with them, we truly believe women themselves are ready to stand
up and speak out on these issues.
As women go through this conversion process, recognizing that
contraception and abortion are not good for them, they're looking for an
alternative approach to health care and family planning, one which
respects the integrity o f their body and the dignity of their vocation
This is the alternative we hope to create.
If the alternative exists in a very public way
if there are set apart pro-life health care centers where women and
communities know the doctors are different, are committed to protecting
the sanctity of human life at all of its stages
it draws that proverbial "line in the sand."
Patients will then be free to choose and will actually have to choose,
practically speaking, between the "culture of life" and the "culture of
Patients will have to ask themselves as they make decisions about where
to receive their health care, "Am I going to go to the doctors who
support abortion, which I believe is taking a human life, or am I going
to support the pro-life doctors who are committed to the same principles
that I believe in?"
Further, just as patients are faced with the choice of where to receive
health care based on ethical principles, health care providers will be
faced with the same decision: "Am I going to practice in the health care
system which supports abortion and euthanasia or choose to work for the
alternative system which operates according to principles which I share
and believe in?"
We saw in the Gallup poll that came out a few weeks ago that Americans
are really beginning to identify themselves as solidly pro-life. I think
it was the first time ever that 51% of Americans identified themselves
as pro-life, the first time that the scales had tipped.
This is also what I have seen in medicine
honestly believe the majority of doctors are pro-life, but many are
utterly silent, because they are afraid of the consequences of speaking
out on these issues.
When I started the medical student pro-life groups when I was in medical
school, a number of people would come up to me privately and say: "Thank
you for doing this. I completely agree with you, this is how I want to
practice, I just can't tell anyone."
Interview With Catholic Family Physician
By Genevieve Pollock
NEW YORK, 26 JULY 2009 (ZENIT)
A doctor who launched a new network for Catholic and pro-life
physicians is explaining the risks of health care workers today, and is
encouraging collegial public witness in the field.
Doctor Anne Mielnik, a family physician, is the cofounder and
executive director of the John Paul II Center for Women and Gianna
Health Care for Women, pro-life centers committed to following the
teachings of the Catholic Church.
In this interview with ZENIT, she spoke about a developing movement
of health care workers that includes a network she is launching in
response to growing ethical concerns.
Part 1 of this interview was published Friday.
ZENIT: What are the main ethical concerns of pro-life doctors these
Mielnik: The most fundamental problem is this: Both in medical and
government policymaking, there is a move to define what are called
"standards of care."
Groups of supposed experts in a given area of medicine define as "the
standard" what a physician "should do" in a given situation. This
usually refers to defining the appropriate medical or surgical treatment
approach based on research. But it is increasingly being used to define
the "appropriate ethical approach" as well.
Because medical ethics has gone so far down the path of moral
— of framing all ethical decision-making in the context of doing
whatever the patient wants, regardless of whether it is right or wrong,
or even whether it's harmful to the patient
the growing trend in medicine is to define as the "standard of care" ;
actions such as abortion and euthanasia, which are morally and ethically
The definition and widespread acceptance of such standards in medical
ethics puts Catholic physicians and health care systems at risk on
As a physician, or as a health care system or practice, if you
violate a standard of care, you can be held liable for medical
negligence and face the very real threat of a malpractice lawsuit.
Furthermore, a physician can lose his license to practice medicine if
it is considered a gross enough violation of the standard.
At the level of law, which is being modeled on these standards, there
is another very real risk that the government could mandate
participation in things that are unethical.
I don't know that the law would go so far as to make it a criminal
act to refuse to participate in certain actions which we as Catholics
believe are unethical, but I could certainly foresee the loss of one's
medical license and the threat of a lawsuit.
These risks are dramatically increased by the laws being considered
by our government, and are very real things that Catholic and other
pro-life physicians are afraid of when it comes to these ethical issues.
With respect to the passage of laws regulating health care, I believe
the government would have a hard time mandating the provision of
abortion because it is such a divisive issue. But they certainly can
mandate referral for abortion
and that is what all of the major medical societies are pushing for.
That would mean that as a Catholic physician, I would actually have
to take concrete action to guarantee that my patients have access to
abortion. However, as a Catholic physician, that is something I cannot
and will not do.
Even more concerning is the issue of contraception. On abortion, the
nation is deeply divided, so I don't think the government would ever go
so far as to say physicians have to do it.
But contraception absolutely could be mandated as part of what
President Obama recently referred to as a "reasonable conscience
policy." It could then be considered a violation of the "patient's
rights" to not provide contraception or to fail to guarantee patient
access to it, which brings up the dilemma of formal cooperation for the
The same concerns apply to end of life issues, which has so many grey
areas that you need a solid foundation in medical ethics to even begin
to make these decisions.
At the end of life, even before you get to the point of promoting
active euthanasia, there are actions which constitute passive
euthanasia, and which again are becoming the mainstream approach in
medicine, with some pushing to define these actions as the "standard of
Once something becomes widely accepted in medicine, it commonly
becomes the standard, and if as a physician you don't follow that rule
then you're at risk of being accused of negligence or even maleficence.
So euthanasia, abortion, and contraception are probably the biggest
areas of concern for Catholic physicians when it comes to law and
policy. I don't think anyone's going to mandate participation in stem
cell research, but that's something that we, as Catholic physicians,
need oppose as well.
If we don't speak out on this issue, who will?
The other major area where Catholic physicians have reason to be
concerned about defining "standards of care" is in the treatment of
I don't think anybody would mandate the provision of artificial
reproductive technologies, but they certainly could mandate referral and
participation to some degree. We have more effective, ethical
alternatives for the treatment of infertility in an approach called
NaProTechnology, so I hope that our progress in this area will afford us
some protection against this particular threat to conscience.
ZENIT: Is this why it is such a danger to lose the conscience
Mielnik: Exactly. The original conscience laws passed in the decades
since Roe vs. Wade have not been rescinded by the current
administration, and President Obama has said that he does not plan to
reverse these previously existing conscience laws.
The administration does, however, intend to rescind the conscience
law that President Bush passed at the end of his last term, which was
intended to strengthen conscience laws already in place by mandating
documentation of compliance with such laws.
This most recent law was passed in response to testimony from
physicians, residents and medical students who report widespread
discrimination based on their moral and religious beliefs.
I and many of my pro-life classmates personally experienced this
while interviewing at residency programs, being told directly by some of
the programs to which we applied that we would not "fit in" or "be
welcome"; there, despite our qualifications, due to our beliefs on
This is technically illegal, according to existing conscience laws,
but the laws are not enforced and so discrimination is widespread.
Furthermore, current conscience laws could be further weakened by the
government if it does not take the threats to conscience rights
seriously because as I said, even if the government doesn't pass
specific laws limiting provider rights of conscience, these protections
are already being threatened by the definition of "standards of care,"
as I previously described.
One area where this assault on physician conscience is most evident
is in the written opinions of some of the major medical societies which
have, in a very clear, dramatic and political fashion, come out in favor
of penalizing physicians who are not willing to provide services and are
not willing to guarantee patient access to them.
ZENIT: Who is responsible for writing these "standards of care?"
Mielnik: Generally, groups of experts collaborate to define these
standards based on medical evidence and research.
When it comes to ethical issues, however, it is not based on research
but on opinion, and specific agendas are promoted by groups with a
vested interest in them.
For instance, the American College of Obstetricians and
Gynecologists, which is believed by the lay public to represent OB/GYNs
in the United States issued a "committee opinion" on "The Limits of
Conscientious Refusal in Reproductive Medicine" in 2007.
This document essentially argued that physicians have a moral obligation
to facilitate a patient's access to all legally available options,
regardless of their "conscientious objections."
It argued that those who do not provide abortion, contraception or
artificial reproductive technologies either should provide them against
their ethical judgment if it is in the "best interest" of the patient,
such as in the case of contraception, or should be willing to make sure
the patient has access to those services through direct referral, such
as in the case of abortion.
This document even went so far as to state that physicians who are
not willing to provide contraception and abortion should not practice in
areas of the country with few physicians, where patients might not be
able to obtain these from a different physician and further stated that
in such areas, physicians and hospital systems should be mandated to
provide even access to abortion.
This is extremely troubling.
Not all OB/GYNs belong to this college, and their opinion was
strongly opposed by the American Association of Pro-life Obstetricians
and Gynecologists, the Catholic Medical Association, and the Christian
Medical and Dental Association.
But the college is considered the authority on women's health issues,
so formal statements like thes e have a tremendous amount of influence
on medical policymaking.
There is a lot of rhetoric on these controversial issues in the
medical literature, but the more that is written about it and published,
the more the negation of individual physician conscience becomes the
ZENIT: What would you say to Catholics who are hesitant to get into
the health care field, or are leaving it, because of the challenges that
are facing them in keeping true to their values?
Mielnik: It definitely happens. There are many Catholic and pro-life
doctors who don't go into obstetrics and gynecology or other areas of
medicine because of the ethical issues and because of the very real
challenges they will face, just getting through their medical training.
But honestly, I truly feel that in this time, in this culture, when
millions of unborn children are being massacred by our colleagues, it is
we, Catholic physicians, who have to be willing to stand up, to fight
tirelessly to rebuild a culture of life in medicine.
The way the medical field works, no one else can do it. No one else
has the power to transform medicine that physicians have; we have to be
willing to challenge our colleagues, always with love, of course.
I think if we, as Catholic physicians, felt called to go into
medicine, we need to recognize that our vocation calls us to sacrifice.
There is a very real chance that there will be very real losses.
I honestly believe that if it does come to be that physicians take
this public step of creating an alternative pro-life, Catholic health
care system, if we bear witness against the culture of death by
uncompromisingly opposing abortion and euthanasia, there are going to be
consequences for many of us
but it is this very thing that is most needed at this time.
Because I really believe that it is the silence of good doctors that
has let things go this far. As they say, all it takes for evil to thrive
is the sile nce of a few good men.
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For more information about the network, contact Dr. Anne Mielnik at: