Practicing medicine is getting dangerous. Little did I know when I began my medical career 42 years ago that some day the government might force me to provide medical treatment that violates my conscience.

As you might guess, the issue that comes into conflict most often is abortion. Those who believe in abortion are not satisfied that it is legal in this and many other countries. They want every health care provider to participate in this termination of a human life or be punished for their failure to comply.

Never mind that all physicians take an oath before they begin their medical careers that is epitomized by Hippocrates who said, “First, do no harm.” An abortion is fatal to the baby – what could be more harmful than that?

We like to think this kind of treatment is restricted to other countries. There is certainly plenty of evidence of government pressure to perform abortions in European countries like Sweden. Ellinor Grimmark recently experienced the full measure of the Swedish government’s position on this issue.

Grimmark was a 40 year-old mother of two who in 2007 quit her catering job to become a midwife. After years of study to fulfill her dream of bringing life into the world she found herself blacklisted by the Swedish government for her refusal to perform abortions. Now she is the focus of a yearslong legal dispute that may have implications for freedom of conscience laws in Sweden and throughout Europe.

Sohrab Ahmari, writing in The Wall Street Journal, says Sweden faces an acute midwife shortage. Eighty percent of the county councils that run local hospitals reported having trouble recruiting midwives last year. An older cohort is retiring faster than its members can be replaced, and the perception that midwives are overworked dampens enthusiasm for the profession.

Since Sweden has socialized medicine, midwives are employed by local governments that provide them with a monthly stipend while they are in training. In return, they expect them to be compliant with any procedures they determine are needed. Grimmark, a devout Christian, knew that some midwives perform abortions, but she assumed that hospitals would offer conscience carve-outs for practitioners like her who oppose abortion.

In fact, a 2007 study from Umea University found that 35% of Swedish midwives had never been involved with abortions during their careers. But changes in attitudes of Swedish authorities have resulted in determination to root out antiabortion sentiment. To escape the persecution she has received since her antiabortion stance became known, Grimmark travels four hours each way to neighboring Norway where hospitals accommodate abortion objectors, while she pursues litigation to overturn the blacklisting she has experienced in Sweden.

Could this happen in the United States?

The American College of Obstetricians and Gynecologists (ACOG) put out this statement in 2016:

“Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious and moral beliefs on patients. . . . Physicians and other healthcare providers have the duty to refer patients in a timely manner to other providers if they do not feel that they can in conscience provide the standard reproductive services that patients request.”

In other words, ACOG respects rights of conscience unless they are based on religious or moral beliefs. Huh? Do they even understand the meaning of the word?

Wesley J. Smith, writing in The Weekly Standard, responds with these comments:

“If ACOG’s view were ever mandated legally, every obstetrician and gynecologist in America would be required to be complicit in terminating pregnancies. Victoria, Australia, has already imposed a legal duty to abort-or-refer on all of its licensed doctors. Meanwhile, the American Civil Liberties Union (ACLU) has launched a campaign of litigation against Catholic hospitals that adhere to the church’s moral teachings, shopping for that one judge willing to shatter the religious freedom of church-affiliated health care institutions.”

This issue is not limited to providing abortions. It is also relevant to performing doctor-assisted suicide (euthanasia), cosmetic surgery to change gender or other procedures designed to alter the normal bodily function. Surgeons could be forced to mutilate bodies of disturbed individuals such as the radical modifications undertaken by the late “Stalking Cat” who had whiskers implanted to look feline before committing suicide. Female genital mutilation could be demanded by those whose cultural or religious beliefs justify such horrid treatment.

All of this makes me give thanks for the confirmation of Justice Neil Gorsuch to the United States Supreme Court, whose judicial track record on upholding religious freedom is stellar. Only a Supreme Court that will defend the rights of conscience and religious freedom embodied in the Constitution by our founders will prevent us from sliding down the same slippery slope found in Sweden today.

Democrats want to have it both ways. When Betsy DeVos was nominated to be the Secretary of Education, they complained that she didn’t have enough experience. She had never worked as a teacher, they said, so she couldn’t be qualified to lead the Department of Education.

Now they’re complaining that Dr. Scott Gottlieb, nominated to be the commissioner of the Food and Drug Administration, has too much experience working with pharmaceutical companies. They say he has a “conflict of interest” since he knows too much about the industries he’d regulate.

The Wall Street Journal editorial board takes the Democrats to task for their over-reactions to Gottlieb. They note Washington Senator Patty Murray and other Democrats spent an entire morning whining about Gottlieb’s “unprecedented financial entanglements” because he has served as a consultant to various companies and invested in health-care startups. Rhode Island’s Senator Sheldon Whitehouse tried to portray these as “dark money operations” when these financial disclosures are available on the Internet.

Vermont Senator Bernie Sanders used twitter to call it a “disgrace” to have an FDA commissioner who has taken money from drug companies. Yet these same committee Democrats excoriated Betsy DeVos for not having enough experience in public education.

Dr. Gottlieb has disclosed all his work in accordance with government rules and promised to liquidate all his investments. He also agreed to recuse himself for a year on decisions relevant to his past interests. He also promised to follow directives from the Health and Human Services ethics office and to be an “impartial and independent advocate for the public health.”

What are the Democrats afraid of? You might think they believe Gottlieb will somehow be “in the pocket of the drug companies.” Yet it was the Obama administration that made secret deals with Big Pharma in the backroom negotiations before the passage of ObamaCare.

If Gottlieb was expected to be soft on pharmaceutical companies, why is he promoting increasing generic drug competition? That’s certain to be good for consumers at the expense of the drug manufacturers. Reducing regulatory barriers to spur competition is the surest way to avoid the escalation of drug prices we have seen in the Obama years.

Democrats are also accusing Gottlieb of turning a blind eye to the opioid crisis because he has worked with companies that produce these drugs. The WSJ found this particularly unfathomable: “Yup – he wants to take a pay cut and subject himself to bureaucratic hassles so he can peddle pills to addict more Americans. Who writes this stuff?”

In reality, Gottlieb has gone on record saying that opioid abuse is “a public emergency on the order of Ebola and Zika” and suggested an “all of the above strategy” that would include inventing less addictive painkillers and better patient care.

Dr. Gottlieb has been a regular contributor to the discussion on how to improve our healthcare system, especially how to improve ObamaCare. That’s probably when he first earned the disdain of the Democrats. He promises to unleash the FDA to promote innovation without comprising public safety. Sounds like a man whose qualifications for the job are perfect.

Democrats are fighting to preserve ObamaCare. In a recent post (What Americans Really Say About ObamaCare) I discussed their strategy and their claims that most Americans favor keeping this failing healthcare system.

But sooner or later reality will force them to consider changes to sustain the law. It’s only a matter of time until ObamaCare collapses of its own weight, when there are no insurance options on the ObamaCare exchanges in most states. When that happens what can we expect the Democrats to propose?

Karl Rove, writing in The Wall Street Journal, quoted Dr. Ezekiel Emanuel, one of ObamaCare’s original architects, who discussed his recommendations recently in an interview with Salon. Emanuel had three suggestions:

• Renew billions in now-lapsed payments to insurance companies – to hide premium increases.
• Raise penalties for violations of the Individual Mandate – to force more people to purchase insurance they don’t want.
• Increase subsidies on the exchanges – to cushion premium increases for low-income Americans at the expense of middle and high-income families.

Renewing billions in bailouts to insurance companies has always been the Democratic response to ObamaCare’s failures. The Obama White House tried to do the same thing in 2015 but was thwarted by the Senate largely due to the objections of Senator Marco Rubio. The ACA provided these bailouts on a “budget-neutral” basis only, meaning insurance companies could only be bailed out the same amount that they paid in for excessive profits. When the losses greatly exceeded the profits, there was no money left for the bailouts. But the Obama administration tried to provide them anyway.

Bailing out insurance companies for their losses is simply making taxpayers foot the bill for the cost of a system that wastes money on unnecessary coverage mandated by the law and inappropriately priced by the law’s regulations. (We’re already $20 Trillion in debt!) The young and healthy are forced to pay more than the cost of their care while the old and sick pay less than the real price of treatment. This means the insurance pool is made up of far too few young and healthy people and too many old and sick. Throwing more money at the problem is a waste of the taxpayers’ money and doesn’t solve the real problems.

Raising penalties for violations of the Individual Mandate is just more government coercion to force people to purchase a product they don’t want. This was never considered acceptable in the history of our nation until the Affordable Care Act was passed – and even then it only passed muster with The Supreme Court when they considered this a tax rather than a penalty. If government can force us to purchase health insurance, what product will they consider next – solar panels?

Increasing subsidies on the exchanges only widens the gap between the middle class and the poor – and further discourages work. The marginal “tax “ of earning more but losing more subsidy has already been calculated to discourage employment by economists Casey Mulligan at the University of Chicago and Greg Mankiw of Harvard University. Mulligan calculated the marginal costs of working due to the perverse incentives of ObamaCare and concluded that they lower the return from working by 10%. Mankiw says the negative effect on workers results in a loss to the economy on the order of 5% of GDP – or more than $800 Billion a year. More subsidies will make this even worse.

Senate Majority Leader Chuck Schumer was recently asked for his recommendations to fix ObamaCare. In addition to the same suggestions offered by Ezekiel Emanuel, Schumer called for a “Public Option.” This refers to a government-run insurance company that offers insurance plans that would compete in the marketplace with private insurers. This idea was discussed in the original healthcare debate before the passage of the ACA but dropped from the final bill when even Democrats did not fully support it.

The truth is that a “Public Option” is simply a tool to force us into socialized medicine. Any government-run insurance plan will easily undermine private insurance because it can under-cut the price of insurance and eliminate the private competition – then lean on the taxpayers to bail out the government when it loses money. Soon there will be no private insurance market – and no way to get around a government-run healthcare system that chooses your doctor, your treatment and when or if you receive it.

All of the Democratic suggestions have one real purpose. They are just progressive manipulations to achieve their ultimate goal of total government control of healthcare. It has been their goal since the days of Teddy Roosevelt and they have no intention of giving up now when they are closer to that goal than ever before.

(Note: For more on the history of healthcare reform over the last hundred years, read my book The ObamaCare Train Wreck available through a link on this same page. For more on socialized medicine, read the second book, The ObamaCare Reality.)