How far should conscience clauses be taken?
More than a dozen states are considering new laws to protect health workers who do not want to provide care that conflicts with their personal beliefs, a surge of legislation that reflects the intensifying tension between asserting individual religious values and defending patients’ rights.
About half of the proposals would shield pharmacists who refuse to fill prescriptions for birth control and “morning-after” pills because they believe the drugs cause abortions. But many are far broader measures that would shelter a doctor, nurse, aide, technician or other employee who objects to any therapy. That might include in-vitro fertilization, physician-assisted suicide, embryonic stem cells and perhaps even providing treatment to gays and lesbians.
This doesn’t seem all that complicated to me. If you aren’t willing to do your job, don’t accept the position. If you don’t want to perform abortions, don’t work in a women’s health clinic; be a neurosurgeon, or a family practitioner, or a pediatrician. If you aren’t willing to fill prescriptions, don’t become a pharmacist. If you’re opposed to in-vitro fertilization, don’t go work at a fertility clinic. If you don’t want to do stem cell research, don’t become a stem cell researcher. Kind of how if you don’t want to look at meat, don’t take a job in a slaughterhouse.
And if you aren’t willing to provide treatment to gays and lesbians, then don’t become a doctor, because your job is to treat people. (And if you aren’t willing to give medical treatment to gays and lesbians, feel free to kick your own ass, because you’re an unbelievable asshat and it’s laughable that you’re pulling the “morals” card).
“This goes to the core of what it means to be an American,” said David Stevens, executive director of the Christian Medical & Dental Associations. “Conscience is the most sacred of all property. Doctors, dentists, nurses and other health care workers should not be forced to violate their consciences.”
I actually agree with this. I don’t think that individual doctors should be required to perform abortions, or assist suicides. That’s fair. But if you take a job, you should be willing to perform the duties required — i.e., don’t take a job as a pharmacist and then act shocked when you have to fill birth control prescriptions, or take a job in an abortion clinic and wonder why people are mad when you refuse abortions.
“We are moving into a brave new world of cloning, cyborgs, sex selection, genetic testing of embryos,” Stevens said. “The list of difficult ethical issues involving nurses, physicians, research scientists, pharmacists and other health care workers is just continuing to increase.”
Don’t you just hate it when you attempt to abort your cyborg clone-baby, and a doctor refuses to help you?
Seriously, what the hell is this guy talking about? The popularity of this “Brave New World” rhetoric from the anti-choice right is getting really old. It’s technology, people. Yes, there are ethical concerns involved, and we should absolutely be talking about the morality of things like stem cell research, cloning, sex selection and other issues. But hyped-up rhetoric about cyborgs and Brave New Worlds doesn’t lend itself to productive debate.
“We live in a culture where more and more people are on opposite sides of these basic issues,” said Manion, who has represented an ambulance driver who was fired after she refused to take a patient to a hospital for an abortion, a health department secretary who was not promoted after she objected to providing abortion information, and a nurse who was transferred after she refused to provide morning-after pills.
Christ. Healthcare workers should not get special treatment in refusing to perform the duties they were hired to do. An ambulance driver won’t take a patient to the hospital because she doesn’t like the reason that the patient is going? Of course she should be fired! Would we argue that a bus driver has the right to refuse rides to overweight passengers, because he thinks that it would be better for their health to walk? Or that an ambulance driver could refuse to take a potential heart attack patient in, because hey, they shouldn’t have eaten so many Twinkies and this could serve as a good lesson?
A health department secretary wasn’t promoted because she objected to providing abortion information, as her job required. Would you promote a waiter who objected to providing customers with a menu because it included meat dishes, and he felt that killing animals for food was morally wrong?
A nurse was transferred after she refused to provide morning-after pills. Sticking with the waiter example, wouldn’t you think it was appropriate to transfer him to your restaurant chain’s vegetarian place?
These people aren’t being persecuted. They’re being told to do their job just like anybody else. Refuse to do it, don’t expect to keep it.
Opponents fear the laws are often so broad that they could be used to withhold health services far beyond those related to abortion and embryos.
“The so-called right-to-life movement in the United States has expanded its agenda way beyond the original focus on abortion,” Uttley said. “Given the political power of religious conservatives, the impact of a whole range of patient services could be in danger.”
Doctors opposed to fetal tissue research, for example, could refuse to notify parents that their child was due for a chicken pox inoculation because the vaccine was originally produced using fetal tissue cell cultures, said R. Alto Charo, a bioethicist at the University of Wisconsin.
“That physician would be immunized from medical malpractice claims and state disciplinary action,” Charo said.
Again, it’s not just about abortion. Consider also the conservatives who oppose an HPV vaccine that could save women from dying of cervical cancer, because they argue that it will encourage women to have sex — and everyone knows that if women have sex, they deserve to die for it.
And I wonder how the right-to-life-we-*heart*-conscience crew would feel if particular doctors began to tell pregnant women that the possibility of psychological issues after childbirth was very high, or that a lot of women experience severe depression after giving their children up for adoption? Or if they involuntarily sterilized “less fit” women, like drug addicts, because those women shouldn’t be having babies? Before you laugh at the impossibility of it all, consider the conservative “anti-drug” program started by a Texas woman which paid addicts a couple hundred bucks to permanently sterilize them, and offered no help for them to actually end their drug use, all in the name of saving crack babies. I mean, if the conscience of healthcare providers dictates it…
Advocates for end-of-life care are alarmed that the laws would allow health care workers and institutions to disregard terminally ill patients’ decisions to refuse resuscitation, feeding tubes and other invasive measures.
“Patients have a right to say no to CPR, to being put on a ventilator, to getting feeding tubes,” said Kathryn Tucker of Compassion and Choice, which advocates better end-of-life care and physician-assisted suicide.
Again, ridiculous. If your patient says, “Don’t give me CPR,” then don’t give them CPR. Part of being a doctor is dealing with death. Now, I don’t think that any doctors should be legally required to partake in assisted suicide; it shouldn’t be mandated that, at a patient’s request, the doctor administers a lethal dose of drugs. But if a patient requests non-action, the doctors and nurses should respect that.
Others worry that health care workers could refuse to provide sex education because they believe in abstinence instead, or deny care to gays and lesbians.
“I already get calls all the time from people who have been turned away by their doctors,” said Jennifer C. Pizer of the Lambda Legal Defense and Education Fund, who is representing a California lesbian whose doctor refused her artificial insemination. “This is a very grave concern.”
This is scary, hateful stuff. And to be clear, it’s not about “life” or “morals.” It’s about bigotry, misogyny and homophobia, plain and simple.