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Moral Refusal Clauses: More Than Just Contraception

Jill

I’ve written quite a bit on so-called “conscience clauses” that allow health care providers with particular beliefs — lately, anti-choice health care providers — to refuse care to certain patients. It’s come up most often with pharmacists refusing to fill prescriptions for birth control and emergency contraception, but has also extended to fertility specialists refusing to work with lesbian patients, pharmacists refusing to fill prescriptions for antibiotics if those antibiotics are being used to treat STDs, and even pharmacists refusing to fill scrips for pre-natal vitamins.

But it’s not stopping there. Pro-choicers have been sounding the alarm about “conscience clauses” for a while now, even while we’re often met with blathering from idiots like William Saletan about how it’s easy for women to just go elsewhere, or the market will control and these pharmacies will go out of business, or it’s a pharmacist’s right to refuse to do his job.

So is it also the right of an EMT or an ambulance driver to transport a woman for an emergency abortion?

22 thoughts on Moral Refusal Clauses: More Than Just Contraception

  1. Uhhhh . . . wouldn’t the fetus die too if she dies?

    Which means, basically, that any such EMT would be essentially saying, “This one’s doomed anyway, but (so) let’s have that one die too.”

    And the concept of such a person in such a profession is possibly the scariest thing I’ve read this year.

  2. Uhhhh . . . wouldn’t the fetus die too if she dies?

    Which means, basically, that any such EMT would be essentially saying, “This one’s doomed anyway, but (so) let’s have that one die too.”

    Good one, Kyra. People’s hypocrisy over the “pro-life” movement just amazes and sickens me.

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  4. Oh, fuck. I couldn’t even read the whole story because I was too sick over the basic premise.

  5. I couldn’t finish the original story, either. Too depressing and aggravating.

    I think that most people, at some point in their lives, are going to experience situations at work that they don’t agree with. In my opinion, you either suck it up and do your job, or you switch companies, or you find a new career. Unless you’re being asked to do something like launder money or commit forgery or something like that. But putting people’s lives at risk because of your own morals? Not acceptable.

  6. This is probably just cluelessness on my part, but why would you need an ambulance to take you to an abortion?

    I agree with Jill completely on conscience clauses, I’m just genuinely confused about this part.

  7. OK, scratch that, just read the part in the Daily Kos article that describes that particular situation.

  8. I am unsure where to draw the line. Is it alright to refuse medical assistance to people of mixed blood or perhaps non-believers. Or for that matter people who might be illegal aliens. Or perhaps a male who has committed self abuse ?

  9. Or for that matter can I refuse to transport to a reactionary pig ? Or for that matter a progressive pig (as a non-practicing Jew I mean)

  10. i just cannot understand going through all the schooling to become a medical anything and then taking the Hippocratic Oath (although i am unsure if EMTs take it, Drs and Nurses and such do) and then STANDING THERE AND LETTING A WOMAN DIE BECAUSE YOU ARE TOO SQUEAMISH TO TAKE HER TO SOMEONE ELSE TO SAVE HER LIFE.

  11. I’m glad I’m not the only one who couldn’t finish reading the original Daily Kos article out of disgust. The person who wrote that post is absolutely right that these people are purposely choosing these professions to alter them from the inside. And, to use the anti-choice logic on them, since they chose to become EMTs or OB/GYNs or pharmacists, shouldn’t they have to deal with the consequences themselves?

    And when people use that logic to explain why abortion should be illegal, I ask them if drug addicts should be prohibited from going to rehab, or if drunk drivers should be left to die instead of taken to the hospital, or if someone at a restaurant who talked with their mouth full and started to choke on their food shouldn’t be given the Heimlich. After all, all of these people brought these situations on themselves. Shouldn’t they be punished for their mistakes or downright stupidity? After reading what I could of the Daily Kos article, I’m almost afraid to ask those questions of anti-choicers anymore, since they’ll probably say, “Sure. Let ’em die” or at least ask, “Depends. Are they sluts?” Pro-life indeed.

  12. I’m delurking for this one because I actually was an EMT back before I let my certs lapse:

    i just cannot understand going through all the schooling to become a medical anything and then taking the Hippocratic Oath (although i am unsure if EMTs take it, Drs and Nurses and such do)

    The Hippocratic Oath is not required of any medical professional. It’s traditional for doctors to recite it upon graduation, but medical personnel are actually regulated by the canons of their professional societies (and of course by law), not by the Hippocratic Oath. (The original in fact contains prohibitions against abortion.)

    That said, an EMT refusing to transport when medically appropriate is a ridiculous, egregious, unforgivable breach of professional ethics, full stop. Stephanie Adamson should be brought before an ethics board of her licensing organization and, if the facts as related in the dKos diary are correct, be severely punished.

    I don’t know how “conscience clauses” interact with the licensing authority of the state EMT boards, but licensed EMTs on duty are not permitted to refuse to emergency treatment for any reason but danger to themselves. If the conscience laws interfere with or weaken that requirement…well, I’m damn near speechless.

    The mere thought of someone calling herself an EMT and refusing treatment makes me vibrate with rage. I can be at least superficially calm about pharmacists refusing to dispense prescriptions–it’s wrong, a breach of ethics, and the thought of someone doing so fills me with contempt–but it doesn’t hit me viscerally the way an EMT refusing treatment does. We’re far too often the only thing between a hurt, scared patient and death. If Stephanie Adamson doesn’t feel the weight of that responsibility in her goddamn bones–and it’s clear she doesn’t–she must never be allowed to treat a patient again.

  13. Oho, I was so filled with rage I missed this on the first readthrough:

    According to Manion, the technician, Stephanie Adamson, said her Christian beliefs prevented her from transporting the woman, who had abdominal pain, for an elective abortion.

    There are two kinds of abortion, medically speaking: “spontaneous” and “elective.” Spontaneous abortions are the ones the body does by itself. We call ’em “miscarriages” if the pregnancy was far enough along, but they’re still perfectly correctly referred to as spontaneous abortions.

    All other abortions are “elective,” even an emergency procedure performed because the mother is bleeding and going to die without intervention. Still, technically, “elective.” There’s been some shift to try to separate this second class of abortions into “therapeutic,” meaning medically necessary, and “elective,” meaning not, but this use isn’t anything close to universal, and may never be.

    I see people who don’t understand this claiming “elective abortion” is synonymous with “non-medically-necessary.” It’s not.

  14. Wait just a fucking minute here. This isnt just about the EMT, its clear the hospital fucked up here too. If this woman had a pregnancy-induced life threatening emergency which required an abortion, then you DO NOT SEND HER to an abortion clinic, you send her to the fucking hospital for an emergency OR suite.

    Abortion clinics arent open at night, and the hospital is partly at fault here for shirking their duty. There’s obvious medical malpractice going on here. If somebody came into the ER with an arm chopped off and they’re bleeding out, you dont tell them to take an ambulance to the nearest plastic surgery practice, you fix them right there on the spot.

  15. Re #14: No, but if you break your leg, they do an x ray, hand you vicodin and an aircast, and say, “Go to the for-profit orthopedic practice on the edge of town and get it set tomorrow.”

    We were irate. Hell, if we’d known they were going to do that….I have my splint left over from my foot surgery, we knew it was broken because he heard it snap when he went down, and we had ice packs and four vicodin to get him through the night and to next morning, without the eight hundred dollar bill and six hour wait for him to get that level of “care”.

    The healthcare system in this country is fractally fucked up, and idiots who refuse care because of their “faith” are not helping it at all.

  16. The healthcare system in this country is fractally fucked up, and idiots who refuse care because of their “faith” are not helping it at all.
    Wow, that really sucks. Did insurance cover the surgery at least?

  17. I see people who don’t understand this claiming “elective abortion” is synonymous with “non-medically-necessary.” It’s not.

    Exactly – I’ve heard anti-abortion activists angrily claim that all late-term abortions are “elective”, to prove that women who get them are just evil, impulsive sluts. Well, of course those abortions are generally elective – doesn’t mean there is no medical reason for them. I don’t know if it’s the intention to muddy the waters, or if it’s just willful ignorance.

  18. Stories like this almost tempt me to go through EMT training just so I can “morally” refuse to treat car accident victims who had those stupid Christian fish on their cars. But, sadly, I actually have a moral sense and wouldn’t be able to bring myself to do that.

  19. Male101: Wait just a fucking minute here. This isnt just about the EMT, its clear the hospital fucked up here too. If this woman had a pregnancy-induced life threatening emergency which required an abortion, then you DO NOT SEND HER to an abortion clinic, you send her to the fucking hospital for an emergency OR suite.

    That assumes that the hospital has the equipment and the trained staff necessary to perform the abortion. Not all of them do, particularly if the hospital is opposed to abortion in the first place.

  20. I understand the medical distinction between “spontaneous” and “elective” abortion, but by that standard, every medical treatment is “elective.” Would this EMT refuse to transport a man to get an “elective” coronary bypass? Somehow, I doubt it.

  21. I understand the medical distinction between “spontaneous” and “elective” abortion, but by that standard, every medical treatment is “elective.” Would this EMT refuse to transport a man to get an “elective” coronary bypass? Somehow, I doubt it.

    Abortions are in a special class, because they so frequently happen without medical intervention. There’s no such thing and a “spontaneous” coronary bypass.

    Not that you’re not right, ethically. But, from a legal standpoint, one would hope that the awful “conscience clauses” do not extend to emergency care. That would be beyond horrific. (I’m probably being too optimistic, though.)

    Ambulances and EMTs are often used for routine transfers for those patients who are considered to be at risk or need medical support during the transfer, but aren’t in immediate danger. Nursing home residents, for instance, or someone with an IV drip. This probably wasn’t a case of Adamson denying emergency care, which demotes her from “absolute monster” to “moralizing power-tripping asshole,” just like the rest of ’em. Still not right, but not as viscerally rage-inducing for me on a professional level.

    I’d still refuse to be her partner, though.

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