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| Doctor, Warned to Be Silent on Abortions, Files Civil Rights Complaint | |
| (35 minutes later) | |
| A doctor who performs abortions at a hospital in Washington, D.C., filed a federal civil rights complaint on Monday, charging that the hospital had violated the law by forbidding her, out of concerns for security, to speak publicly in defense of abortion and its role in health care. | A doctor who performs abortions at a hospital in Washington, D.C., filed a federal civil rights complaint on Monday, charging that the hospital had violated the law by forbidding her, out of concerns for security, to speak publicly in defense of abortion and its role in health care. |
| The doctor, Diane J. Horvath-Cosper, 37, an obstetrician and gynecologist, has in recent years emerged as a public advocate, urging abortion providers not to shrink before threats. Last December, her complaint says, officials of the MedStar Washington Hospital Center imposed what she described as a “gag order,” but what the officials termed a sensible precaution against anti-abortion violence. | The doctor, Diane J. Horvath-Cosper, 37, an obstetrician and gynecologist, has in recent years emerged as a public advocate, urging abortion providers not to shrink before threats. Last December, her complaint says, officials of the MedStar Washington Hospital Center imposed what she described as a “gag order,” but what the officials termed a sensible precaution against anti-abortion violence. |
| At odds in the case are sharply conflicting visions of how best to protect abortion providers and patients. The dispute comes at a time when legal restrictions on the procedure are tightening, many clinics are besieged daily by hostile protesters and an extremist fringe has sometimes made murderous attacks. | At odds in the case are sharply conflicting visions of how best to protect abortion providers and patients. The dispute comes at a time when legal restrictions on the procedure are tightening, many clinics are besieged daily by hostile protesters and an extremist fringe has sometimes made murderous attacks. |
| Dr. Horvath-Cosper is part of a national movement of physicians and other medical staff members who argue that silence about their work only feeds the drive to stigmatize and restrict abortion. Similar sentiments among some patients have led to a “Shout Your Abortion” campaign on social media. | Dr. Horvath-Cosper is part of a national movement of physicians and other medical staff members who argue that silence about their work only feeds the drive to stigmatize and restrict abortion. Similar sentiments among some patients have led to a “Shout Your Abortion” campaign on social media. |
| “The dialogue is dominated by those who have demonized this totally normal part of health care,” Dr. Horvath-Cosper said in an interview. | “The dialogue is dominated by those who have demonized this totally normal part of health care,” Dr. Horvath-Cosper said in an interview. |
| “I don’t think the way to deal with bullies is to cower and pull back,” she said. | “I don’t think the way to deal with bullies is to cower and pull back,” she said. |
| Still, some hospitals and clinics providing abortion services, and many physicians, especially in more conservative and rural regions, think it is safer to try to keep a low profile. | Still, some hospitals and clinics providing abortion services, and many physicians, especially in more conservative and rural regions, think it is safer to try to keep a low profile. |
| According to the legal complaint, hospital officials told Dr. Horvath-Cosper that they were worried about security after a self-described anti-abortion “warrior” attacked a Planned Parenthood center in Colorado Springs in November, killing three people and wounding nine. It was the latest of many attacks on abortion clinics over the decades. | According to the legal complaint, hospital officials told Dr. Horvath-Cosper that they were worried about security after a self-described anti-abortion “warrior” attacked a Planned Parenthood center in Colorado Springs in November, killing three people and wounding nine. It was the latest of many attacks on abortion clinics over the decades. |
| In ordering Dr. Horvath-Cosper to end her media appearances and writings, the medical director of the hospital, Dr. Gregory J. Argyros, said he did “not want to put a Kmart blue-light special on the fact that we provide abortions at MedStar,” according to the complaint. | In ordering Dr. Horvath-Cosper to end her media appearances and writings, the medical director of the hospital, Dr. Gregory J. Argyros, said he did “not want to put a Kmart blue-light special on the fact that we provide abortions at MedStar,” according to the complaint. |
| Since then, hospital officials have ordered Dr. Horvath-Cosper to turn down several requests for interviews, speeches or articles or risk losing her job , she said in the complaint, which was filed with the Office for Civil Rights of the Department of Health and Human Services. | Since then, hospital officials have ordered Dr. Horvath-Cosper to turn down several requests for interviews, speeches or articles or risk losing her job , she said in the complaint, which was filed with the Office for Civil Rights of the Department of Health and Human Services. |
| If the civil rights office finds that Dr. Horvath-Cosper’s rights were violated, it can order the hospital to take corrective action or risk losing its federal funding. | If the civil rights office finds that Dr. Horvath-Cosper’s rights were violated, it can order the hospital to take corrective action or risk losing its federal funding. |
| The hospital on Monday afternoon did not directly respond to the allegations in the complaint, saying in a brief, emailed statement, “MedStar Washington Hospital Center is committed to providing family planning services for our community, and we do so in a respectful, private and safe environment.” | The hospital on Monday afternoon did not directly respond to the allegations in the complaint, saying in a brief, emailed statement, “MedStar Washington Hospital Center is committed to providing family planning services for our community, and we do so in a respectful, private and safe environment.” |
| “We look forward to cooperating fully with the Office for Civil Rights,” said the statement, which was issued by Donna L. Arbogast, the hospital’s vice president for public affairs and marketing. | “We look forward to cooperating fully with the Office for Civil Rights,” said the statement, which was issued by Donna L. Arbogast, the hospital’s vice president for public affairs and marketing. |
| Dr. Horvath-Cosper’s legal case rests on a little-known aspect of the Church Amendment, which was adopted in 1973 after Roe v. Wade established abortion rights nationwide earlier that year. The bill is best known for offering protections to medical staff members who object to participating in abortions on religious or moral grounds. | Dr. Horvath-Cosper’s legal case rests on a little-known aspect of the Church Amendment, which was adopted in 1973 after Roe v. Wade established abortion rights nationwide earlier that year. The bill is best known for offering protections to medical staff members who object to participating in abortions on religious or moral grounds. |
| But the legislative history and final wording of the amendment show it was intended to be two-sided, said Gretchen Borchelt, the vice president for reproductive rights and health at the National Women’s Law Center and a co-counsel in Dr. Horvath-Cosper’s complaint. | But the legislative history and final wording of the amendment show it was intended to be two-sided, said Gretchen Borchelt, the vice president for reproductive rights and health at the National Women’s Law Center and a co-counsel in Dr. Horvath-Cosper’s complaint. |
| The law states that no entity receiving federal money may discriminate against any doctor “because of his religious beliefs or moral convictions respecting sterilization procedures or abortions.” That means that doctors are protected from punishment for supporting abortion, just as they are protected if they oppose it and refuse to participate, according to the complaint. | The law states that no entity receiving federal money may discriminate against any doctor “because of his religious beliefs or moral convictions respecting sterilization procedures or abortions.” That means that doctors are protected from punishment for supporting abortion, just as they are protected if they oppose it and refuse to participate, according to the complaint. |
| “If she can’t speak out about abortion the way other doctors at the hospital do about what they work on, she is being treated differently and that is discrimination,” Ms. Borchelt said. She said the current complaint is the first she is aware of to rely on this reading of the Church Amendment. | “If she can’t speak out about abortion the way other doctors at the hospital do about what they work on, she is being treated differently and that is discrimination,” Ms. Borchelt said. She said the current complaint is the first she is aware of to rely on this reading of the Church Amendment. |
| Dr. Horvath-Cosper finished her medical residency in obstetrics and gynecology in Minnesota in 2010, and eventually decided, she said in the interview, that she wanted to focus on abortion and contraception, and to train more doctors in this subspecialty. | Dr. Horvath-Cosper finished her medical residency in obstetrics and gynecology in Minnesota in 2010, and eventually decided, she said in the interview, that she wanted to focus on abortion and contraception, and to train more doctors in this subspecialty. |
| “There will always be someone to do C-sections at 3 in the morning,” she said. “But there might not always be someone to perform abortions.” | “There will always be someone to do C-sections at 3 in the morning,” she said. “But there might not always be someone to perform abortions.” |
| She came to MedStar in 2014 on a two-year Family Planning Fellowship, which is offered by a national foundation that subsidizes doctors’ salaries at selected hospitals as they pursue advanced training in reproductive medicine, including the development of teaching and speaking skills. | She came to MedStar in 2014 on a two-year Family Planning Fellowship, which is offered by a national foundation that subsidizes doctors’ salaries at selected hospitals as they pursue advanced training in reproductive medicine, including the development of teaching and speaking skills. |
| MedStar’s decision to halt her media appearances, Dr. Horvath-Cosper said, fosters the stigmatization of abortion care, ultimately endangering both providers and patients. | MedStar’s decision to halt her media appearances, Dr. Horvath-Cosper said, fosters the stigmatization of abortion care, ultimately endangering both providers and patients. |
| “We need to talk publicly and proudly about the good work we do every day,” she said. “We need to make it unacceptable for people to stand outside a clinic and yell at women coming in for care.” | “We need to talk publicly and proudly about the good work we do every day,” she said. “We need to make it unacceptable for people to stand outside a clinic and yell at women coming in for care.” |
| In the first year of her fellowship, she obtained a master’s degree in public health and began speaking at conferences and writing articles about the need to train a new generation of abortion doctors. | In the first year of her fellowship, she obtained a master’s degree in public health and began speaking at conferences and writing articles about the need to train a new generation of abortion doctors. |
| In her second year — the fellowship ends this June— she has returned to seeing patients as she continued her advocacy efforts. | In her second year — the fellowship ends this June— she has returned to seeing patients as she continued her advocacy efforts. |
| Dr. Horvath-Cosper created a buzz last November when she wrote an article in The Washington Post that described what it was like to live in fear because of her profession. | Dr. Horvath-Cosper created a buzz last November when she wrote an article in The Washington Post that described what it was like to live in fear because of her profession. |
| The Colorado shootings occurred on Nov. 27. On Dec. 4, she was called to meet with Dr. Argyros and other hospital officials who said she should stop her public advocacy and clear any media requests with the public affairs office. | The Colorado shootings occurred on Nov. 27. On Dec. 4, she was called to meet with Dr. Argyros and other hospital officials who said she should stop her public advocacy and clear any media requests with the public affairs office. |
| Since then, Dr. Horvath-Cosper said, she has forwarded several requests to be interviewed or write articles and in each case has been turned down. | Since then, Dr. Horvath-Cosper said, she has forwarded several requests to be interviewed or write articles and in each case has been turned down. |
| Unsure of her rights and fearing dismissal, she said, she hired a lawyer even though she was warned that, as one official put it, this would be seen as “an aggressive move.” | Unsure of her rights and fearing dismissal, she said, she hired a lawyer even though she was warned that, as one official put it, this would be seen as “an aggressive move.” |
| Her private lawyer, Debra S. Katz, of the Washington firm Katz, Marshall & Banks, who is also co-counsel in the complaint, said she tried to negotiate an agreement with the hospital that would allow Dr. Horvath-Cosper to write about abortion without mentioning where she worked. | Her private lawyer, Debra S. Katz, of the Washington firm Katz, Marshall & Banks, who is also co-counsel in the complaint, said she tried to negotiate an agreement with the hospital that would allow Dr. Horvath-Cosper to write about abortion without mentioning where she worked. |
| Hospital officials responded that if she wished to speak about abortion, she should relinquish her fellowship and leave. | Hospital officials responded that if she wished to speak about abortion, she should relinquish her fellowship and leave. |
| Some doctors and other staff members involved with abortions prefer to keep their identities secret, but others do not. Dr. Nancy L. Stanwood, an associate professor of obstetrics and gynecology at the Yale School of Medicine, said she has heard of numerous abortion providers who were warned by their employers, as Dr. Horvath-Cosper was, not to speak out. | Some doctors and other staff members involved with abortions prefer to keep their identities secret, but others do not. Dr. Nancy L. Stanwood, an associate professor of obstetrics and gynecology at the Yale School of Medicine, said she has heard of numerous abortion providers who were warned by their employers, as Dr. Horvath-Cosper was, not to speak out. |
| “Abortion care is so highly stigmatized that providers have felt safer staying in the closet, and many institutions have also wanted their doctors to stay in the closet,” said Dr. Stanwood, who is the chairwoman of Physicians for Reproductive Health, a national advocacy group that includes more than 3,000 doctors and provides media training to those who want to speak out. | “Abortion care is so highly stigmatized that providers have felt safer staying in the closet, and many institutions have also wanted their doctors to stay in the closet,” said Dr. Stanwood, who is the chairwoman of Physicians for Reproductive Health, a national advocacy group that includes more than 3,000 doctors and provides media training to those who want to speak out. |
| “Each individual has to decide how he or she feels about being out of the closet,” she said. “That is a personal decision based on privacy and risk.” | “Each individual has to decide how he or she feels about being out of the closet,” she said. “That is a personal decision based on privacy and risk.” |
| Dr. Horvath-Cosper said that the MedStar center in Washington, while seeking to silence her, had not carried out many of the physical security measures at the clinic that are recommended by professional groups like the National Abortion Federation. | Dr. Horvath-Cosper said that the MedStar center in Washington, while seeking to silence her, had not carried out many of the physical security measures at the clinic that are recommended by professional groups like the National Abortion Federation. |
| “Of course I think about personal safety,” she said, adding that she took precautions but would not describe them. | “Of course I think about personal safety,” she said, adding that she took precautions but would not describe them. |
| “But I also think that the people making these threats have been doing so with impunity,” she said. | “But I also think that the people making these threats have been doing so with impunity,” she said. |