'Opt-in' vs 'opt-out': Why abortion training is not 'essential' for medical residents

Since the late 1990s, medical residents with moral objections to participating in abortions have had to actively choose to opt-out of induced abortion training amid pressure to learn how to carry out the procedures — but some are beginning to voice objections about the pressure this places on residents to ignore their consciences out of fear that saying 'no' could negatively impact their careers.

Key Takeaways:

• In the late 1990s, medical residents who did not wish to participate in abortion training were forced to begin to "opt-out" of the training. This put coercive pressure on residents to go along with the expectation of abortion training, even if doing so went against their consciences.

• Training in induced abortion (which directly and intentionally kills a preborn child) is not necessary, as medical residents receive training in ectopic pregnancy care, miscarriage treatment, and emergency care for pregnant women.

• Refusing to participate in abortion training could harm a medical resident's evaluations and career opportunities.

• Senator James Lankford introduced a bill in November to protect medical residents who don't want to participate in abortion training. The bill aims to restore abortion training to an opt-in model, allowing medical students who wish to learn how to commit abortions to do so.

The Backstory:

For years, the American College of Obstetricians and Gynecologists (ACOG) has supported the opt-out format of abortion training, calling abortion "an essential component of comprehensive, evidence-based medical care." It has long claimed that abortion keeps maternal morbidity and mortality lower, an argument easily debunked. Yet, because of its pro-abortion stance and political advocacy work, it claims that knowing how to carry out an abortion is "essential for any health care professional caring for people who could become pregnant." But even ACOG knows there is a difference between intentionally dismembering a living child and removing the remains of an already-miscarried, deceased one.

In addition, the Accreditation Council for Graduate Medical Education has been forcing medical schools to train students on abortion for 30 years or face a loss of accreditation. While individual residents could opt out, programs could not. They had to offer that training.

This opened the door to discrimination against medical residents who did not want to commit abortions, and it may have dissuaded some medical residents from pursuing a career in obstetrics at all — and potentially contributed to the current maternal healthcare desert.

The Details:

In November, Senator James Lankford (R-Okla.) introduced the Conscience Protections for Medical Residents Act to protect medical residents in federally-funded programs from abortion training coercion and any retaliation for refusing to participate. Along with other lawmakers, Lankford penned a letter to the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), urging them to take immediate regulatory action to protect the conscience rights of medical residents.

Opt-out abortion training can lead to discrimination

Making abortion training "opt-out" has developed the false idea that abortion training is necessary and important. Medical residents may fear that choosing to opt-out will affect their evaluations, recommendations, and even career opportunities. This puts immense pressure on medical students who don't want to participate in abortions for ethical reasons, to do so against their conscience and against the Hippocratic Oath. Choosing not to kill innocent preborn children shouldn't be considered a "liability."

“Medical residents should never be pressured to violate their beliefs in order to finish their training or advance in their careers,” said Lankford in a press release. “Many went into medicine to protect life, not take it. No one should have to choose between their conscience and their future in medicine. Our bill makes that clear and ensures medical students and residents can follow their convictions as they care for their patients.”

Opt-in training allows students who want to commit abortions to do so

Standard OB-GYN training includes miscarriage treatment, ectopic pregnancy treatment, and how to handle varying complications in pregnancy, including induced labor and C-section surgery.

Including training on how to intentionally kill a preborn child is unnecessary. Restoring abortion training to opt-in would relieve the pressure on students who don't want to deliberately kill preborn humans while still allowing abortion-interested medical residents to learn how to commit abortions. For them, it would be an additional training to the standard care offered to pregnant women. The bill would protect those who don't want to participate in abortion training from discrimination.

It's for that reason that the bill and its supporters believe abortion training should be opt-in rather than opt-out.

"If this bill is enacted into law, the criteria put forth by the Accreditation Council for Graduate Medical Education (ACGME) for OB/GYN residency programs to maintain their accreditation would have to shift training in induced abortion from opt out back to opt in only – what it was for nearly 30 years prior to 2018," said the American Association of Pro-life OBGYNs (AAPLOG).

Why It Matters:

Induced abortion is not healthcare. It involves deliberately causing a child's death, which is not medically necessary. Coercing doctors to actively kill human beings is morally wrong; however, as abortion workers themselves have admitted, the more abortions they saw and performed, the more desensitized to the procedure they became — and perhaps that is the underlying goal of "opt-out" training.

If a pregnancy must end due to a medical emergency, the child can be delivered, and doctors can work to save both mother and child. If the child is born too young to survive, this is not an abortion because the intent was not to cause the child's death.

"We believe no resident should have to jeopardize their career simply to decline unnecessary training that violates their commitment to life-affirming medicine," AAPLOG explained. "After all, every OB/GYN resident already learns how to manage miscarriages, ectopic pregnancies, and other pregnancy complications as part of standard education."